WorldWideScience

Sample records for patient-reported height loss

  1. Patient-Reported Measures of Hearing Loss and Tinnitus in Pediatric Cancer and Hematopoietic Stem Cell Transplantation: A Systematic Review

    Science.gov (United States)

    Stark, Daniel; Rosenberg, Abby R.; Johnston, Donna; Knight, Kristin; Caperon, Lizzie; Uleryk, Elizabeth; Frazier, A. Lindsay; Sung, Lillian

    2016-01-01

    Purpose: We identified studies that described use of any patient-reported outcome scale for hearing loss or tinnitus among children and adolescents and young adults (AYAs) with cancer or hematopoietic stem cell transplantation (HSCT) recipients. Method: In this systematic review, we performed electronic searches of OvidSP MEDLINE, EMBASE, and…

  2. Serum osteoprotegerin levels are related to height loss: The Tromsø Study

    International Nuclear Information System (INIS)

    Jørgensen, Lone; Hansen, John-Bjarne; Brox, Jan; Mathiesen, Ellisiv; Vik, Anders; Jacobsen, Bjarne K.

    2011-01-01

    Severe loss of body height is often a consequence of osteoporotic vertebral fractures. Osteoprotegerin (OPG) and receptor activator of nuclear factor-kB ligand (RANKL) are cytokines essential for the regulation of bone resorption. The aim of this study was to assess the relationship between the OPG/RANKL system and height loss. A total of 4,435 inhabitants from the municipality of Tromsø, Norway (2,169 men and 2,266 women) were followed for 6 years. Baseline measurements included height, weight, bone mineral density, OPG, RANKL, serum parathyroid hormone and information about lifestyle, prevalent diseases and use of medication. Height was measured again at follow-up, and the loss of height was categorized into 4 groups: ≤1, 1.1–2, 2.1–3, >3 cm. We found increasing height loss with increasing baseline OPG levels in both men and women (P trend = 0.02 and 0.001, respectively), after adjustments for age and other confounders. However, when the women were stratified according to menopausal status and use of hormone replacement therapy (HRT), a significant relationship was present only among postmenopausal women not using HRT (P trend = 0.02). No relations between OPG and height loss were found in post-menopausal HRT-users and premenopausal women (P trend ≥0.39). We conclude that height loss is positively associated with OPG in men and in postmenopausal women not using HRT. No relationship was found between RANKL and height loss.

  3. Patient-Reported Outcomes in Weight Loss and Body Contouring Surgery

    DEFF Research Database (Denmark)

    Poulsen, Lotte; Klassen, Anne; Rose, Michael

    2017-01-01

    BACKGROUND: Health-related quality of life and satisfaction with appearance are important outcomes in bariatric and body contouring surgery. To investigate these outcomes, scientifically sound and clinically meaningful patient-reported outcome instruments are needed. The authors measured health-r...

  4. Minimum Abutment Height to Eliminate Bone Loss: Influence of Implant Neck Design and Platform Switching.

    Science.gov (United States)

    Spinato, Sergio; Galindo-Moreno, Pablo; Bernardello, Fabio; Zaffe, Davide

    This retrospective study quantitatively analyzed the minimum prosthetic abutment height to eliminate bone loss after 4.7-mm-diameter implant placement in maxillary bone and how grafting techniques can affect the marginal bone loss in implants placed in maxillary areas. Two different implant types with a similar neck design were singularly placed in two groups of patients: the test group, with platform-switched implants, and the control group, with conventional (non-platform-switched) implants. Patients requiring bone augmentation underwent unilateral sinus augmentation using a transcrestal technique with mineralized xenograft. Radiographs were taken immediately after implant placement, after delivery of the prosthetic restoration, and after 12 months of loading. The average mesial and distal marginal bone loss of the control group (25 patients) was significantly more than twice that of the test group (26 patients), while their average abutment height was similar. Linear regression analysis highlighted a statistically significant inverse relationship between marginal bone loss and abutment height in both groups; however, the intercept of the regression line, both mesially and distally, was 50% lower for the test group than for the control group. The marginal bone loss was annulled with an abutment height of 2.5 mm for the test group and 3.0 mm for the control group. No statistically significant differences were found regarding marginal bone loss of implants placed in native maxillary bone compared with those placed in the grafted areas. The results suggest that the shorter the abutment height, the greater the marginal bone loss in cement-retained prostheses. Abutment height showed a greater influence in platform-switched than in non-platform-switched implants on the limitation of marginal bone loss.

  5. Loss of inter-vertebral disc height after anterior cervical discectomy.

    Science.gov (United States)

    Haden, N; Latimer, M; Seeley, H M; Laing, R J

    2005-12-01

    Most surgeons undertaking anterior cervical discectomy (ACD) introduce a bone graft or cage into the disc space when the decompression is complete. This is done to prevent segmental collapse, preserve cervical spine alignment and to promote fusion. We have conducted a prospective observational cohort study to investigate the relationship between loss of disc height, cervical spine alignment and clinical outcome in 140 patients undergoing ACD without inter-body graft or cage. At a minimum of 12 months after operation changes in disc space height and cervical spine alignment were correlated with clinical outcome measured by SF36, Neck Disability Index, and visual analogue neck and arm pain scores. There was no relationship between loss of disc height and outcome. Loss of the overall cervical lordosis was present in 71 patients and segmental kyphosis was found in 69. Analysis of clinical outcome showed no significant differences between patients with preserved and abnormal cervical alignment. Neither loss of disc height nor disturbance of cervical alignment compromised clinical outcome in the first year following ACD.

  6. Radiological assessment of loss of disc height during acute and chronic degenerative lumbar disc alterations

    International Nuclear Information System (INIS)

    Zoellner, J.; Sancaktaroglu, T.; Nafe, B.; Eysel, P.; Loew, R.

    2001-01-01

    Aim of the study: A loss of disc height with increasing segmental mobility is an important reason for low back pain. The measurement of hyaluronic acid content of the nucleus pulposus prolaps shows a difference between acute (group 1) and chronic (group 2) disc degeneration. The purpose of the present investigation was to determine the decreasing of disc height between these two groups and the no-symptomatic segments of these patients. Methods: 20 human lateral preoperative X-ray measurements according to Frobin et al. were taken; group 1 with 7 patients (mean age 41 years) and group 2 with 13 patients (mean age 44 years). Results: There was a significant tendency (p=0.091) to a reduction of disc height in group 2 between symptomatic and asymptomatic discs. Conclusion: The used method is not suitable to answer the present question conclusively. (orig.) [de

  7. Patient-reported outcome measures (PROMs) for assessing perceived listening effort in hearing loss: protocol for a systematic review

    Science.gov (United States)

    Rapport, Frances L; Boisvert, Isabelle; McMahon, Catherine M; Hutchings, Hayley A

    2017-01-01

    Introduction In the UK, it is estimated that a disabling hearing loss (HL) affects 1 in 6 people. HL has functional, economic and social-emotional consequences for affected individuals. Intervention for HL focuses on improving access to the auditory signal using hearing aids or cochlear implants. However, even if sounds are audible and speech is understood, individuals with HL often report increased effort when listening. Listening effort (LE) may be measured using self-reported measures such as patient-reported outcome measures (PROMs). PROMs are validated questionnaires completed by patients to measure their perceptions of their own functional status and well-being. When selecting a PROM for use in research or clinical practice, it is necessary to appraise the evidence of a PROM’s acceptability to patients, validity, responsiveness and reliability. Methods and analysis A systematic review of studies evaluating the measurement properties of PROMs available to measure LE in HL will be undertaken. MEDLINE, EMBASE, CINAHL, PsychINFO and Web of Science will be searched electronically. Reference lists of included studies, key journals and the grey literature will be hand-searched to identify further studies for inclusion. Two reviewers will independently complete title, abstract and full-text screening to determine study eligibility. Data on the characteristics of each study and each PROM will be extracted. Methodological quality of the included studies will be appraised using the COnsensus-based Standards for the selection of health Measurement INstruments, the quality of included PROMs appraised and the credibility of the evidence assessed. A narrative synthesis will summarise extracted data. Ethics and dissemination Ethical permission is not required, as this study uses data from published research. Dissemination will be through publication in peer-reviewed journals, conference presentations and the lead author’s doctoral dissertation. Findings may inform the

  8. Abutment height influences the effect of platform switching on peri-implant marginal bone loss.

    Science.gov (United States)

    Galindo-Moreno, Pablo; León-Cano, Ana; Monje, Alberto; Ortega-Oller, Inmaculada; O'Valle, Francisco; Catena, Andrés

    2016-02-01

    The purpose was to radiographically analyze and compare the marginal bone loss (MBL) between implants with different mismatching distance and to study the influence of the prosthetic abutment height on the MBL in association with the related mismatching distances. This retrospective study included 108 patients in whom 228 implants were placed, 180 with diameter of 4.5 mm and 48 with diameter of 5 mm. All patients received OsseoSpeed™ implants with internal tapered conical connection (Denstply Implants). Different mismatching distances were obtained, given that all implants were loaded with the same uni-abutment type (Lilac; Denstply Implants). Data were gathered on age, gender, bone substratum, smoking habits, previous history of periodontitis, and prosthetic features. MBL was analyzed radiographically at 6 and 18 months post-loading. Mixed linear analysis of mesial and distal MBL values yielded significant effects of abutment, implant diameter, follow-up period, bone substratum, smoking, and abutment × time interaction. MBL was greater at 18 vs. 6 months, for short vs. long abutments, for grafted vs. pristine bone, for a heavier smoking habit, and for implants with a diameter of 5.0 vs. 4.5 mm. Greater mismatching does not minimize the MBL; abutment height, smoking habit, and bone substratum may play a role in the MBL over the short- and medium term. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Height loss with advancing age in a hospitalized population of Polish men and women: magnitude, pattern and associations with mortality

    Directory of Open Access Journals (Sweden)

    Chmielewski Piotr

    2015-06-01

    Full Text Available The connection between the rate of height loss in older people and their general health status has been well documented in the medical literature. Our study was aimed at furthering the characterization of this interrelationship in the context of health indices and mortality in a hospitalized population of Polish adults. Data were collated from a literature review and from a longitudinal study of aging carried out in the Polish population which followed 142 physically healthy inmates, including 68 men and 74 women, for at least 25 years from the age of 45 onwards. Moreover, cross-sectional data were available from 225 inmates, including 113 men and 112 women. These subjects were confined at the same hospital. ANOVA, t-test, and regression analysis were employed. The results indicate that the onset of height loss emerges in the fourth and five decade of life and there is a gradual acceleration of reduction of height at later stages of ontogeny in both sexes. Postmenopausal women experience a more rapid loss of height compared with men. The individuals who had higher rate of loss of height (≥3 cm/decade tend to be at greater risk of cardiovascular events and all-cause mortality. In conclusion, our findings suggest that a systematic assessment of the rate of loss of height can be useful for clinicians caring for elderly people because of its prognostic value in terms of morbidity and mortality.

  10. An efficient approach to characterizing and calculating carrier loss due to heating and barrier height variation in vertical-cavity surface-emitting lasers

    International Nuclear Information System (INIS)

    Jian, Wu; Summers, H. D.

    2010-01-01

    It is important to determine quantitatively the internal carrier loss arising from heating and barrier height variation in a vertical-cavity surface-emitting quantum well laser (VCSEL). However, it is generally difficult to realize this goal using purely theoretical formulas due to difficulty in deriving the parameters relating to the quantum well structure. In this paper, we describe an efficient approach to characterizing and calculating the carrier loss due to the heating and the barrier height change in the VCSEL. In the method, the thermal carrier loss mechanism is combined with gain measurement and calculation. The carrier loss is re-characterized in a calculable form by constructing the threshold current and gain detuning-related loss current using the measured gain data and then substituting them for the quantum well-related parameters in the formula. The result can be expressed as a product of an exponential weight factor linked to the barrier height change and the difference between the threshold current and gain detuning-related loss current. The gain variation at cavity frequency due to thermal carrier loss and gain detuning processes is measured by using an AlInGaAs–AlGaAs VCSEL structure. This work provides a useful approach to analysing threshold and loss properties of the VCSEL, particularly, gain offset design for high temperature operation of VCSELs. (classical areas of phenomenology)

  11. Some studies on the pulse-height loss due to capacitive decay in the detector-circuit of parallel plate ionization chambers

    International Nuclear Information System (INIS)

    Sharma, S.L.; Anil Kumar, G.; Choudhury, R.K.

    2006-01-01

    Pulse-type ionization chambers are invariably operated in the electron-sensitive mode where the capacitive decay in the detector-circuit during the electron collection produces loss in the pulse-height. In order to understand and appreciate the effect of this capacitive decay on the detector response, we have carried out Monte Carlo simulations of the response of two-electrode parallel plate ionization chambers with and without the capacitive decay keeping shaping time so large that the ballistic deficit is negligibly small. These simulations have been carried out incorporating the physical processes, namely, emission of charged particles from a point radioactive source, the generation of charge carriers in the active volume, separation and acceleration of the charge carriers, transport of the charge carriers, induction of charges on the electrodes, pulse processing by preamplifier-amplifier network, etc. These simulations have shown that the concerned capacitive decay produces appreciable loss in the pulse-height, if the detector-circuit time constant is of the order of maximum electron collection time. We have also carried out measurements on the pulse-height loss due to the capacitive decay in the detector-circuit during the electron collection for a two-electrode parallel plate ionization chamber. The experimental data on the pulse-height loss match reasonably well with the theoretical predictions

  12. Relevance of future snowfall level height in the Peruvian Andes for glacier loss in the 21st century under different emission scenarios

    Science.gov (United States)

    Schauwecker, Simone; Kronenberg, Marlene; Rohrer, Mario; Huggel, Christian; Endries, Jason; Montoya, Nilton; Neukom, Raphael; Perry, Baker; Salzmann, Nadine; Schwarb, Manfred; Suarez, Wilson

    2017-04-01

    In many regions of Peru, the competition for limited hydrological resources already represents a large risk for conflicts. In this context, and within the circumstances of climate change, there is a great interest in estimating the future loss of Peruvian glaciers. Solid precipitation on glaciers, which affects the shortwave radiation budget via its effects on albedo, in general reduces ablation. For that reason, the height of the upper level of the transition zone between liquid and solid precipitation (snowfall level height) is considered to play a critical role. This snowfall level height is linked to air temperature. The observed and projected warming of the atmosphere is therefore affecting the glaciers amongst others by changing the snowfall level height. Despite the potential significance of these changes for Peruvian glaciers, the relations between snowfall level heights, glacier extents and climate scenarios have been poorly investigated so far. In our study, we first analyse the snowfall level heights over the Peruvian Cordilleras. Second, we investigate the relationship between the present snowfall level heights and current glacier extents. As a third step, we derive projected changes of snowfall level heights from GCMs for the RCP2.6 and 8.5 emission scenarios and use them to roughly estimate the end of XXI century glaciation for the Peruvian Cordilleras. Our results indicate a large difference in future glacier extent between the high-emission (pessimistic) RCP8.5 and the low-emission (optimistic) RCP2.6. If global emissions can be substantially reduced, a significant part of the glaciated area of Peru can be maintained. On the contrary, if mitigation is unsuccessful, most of the glacier mass in Peru will be lost during the 21st century. In both cases, but even more so for the high-emission scenario, adaptation will play a critical role and should focus on improvements in water resource management which is essential on a local to regional scale. Air

  13. Effects of patient-reported non-severe hypoglycemia on healthcare resource use, work-time loss, and wellbeing in insulin-treated patients with diabetes in seven European countries.

    Science.gov (United States)

    Geelhoed-Duijvestijn, Petronella H; Pedersen-Bjergaard, Ulrik; Weitgasser, Raimund; Lahtela, Jorma; Jensen, Marie Markert; Östenson, Claes-Göran

    2013-12-01

    Hypoglycemia is a frequent side effect induced by insulin treatment of type 1 (T1DM) and type 2 diabetes (T2DM). Limited data exist on the associated healthcare resource use and patient impact of hypoglycemia, particularly at a country-specific level. This study investigated the effects of self-reported non-severe hypoglycemic events (NSHE) on use of healthcare resources and patient wellbeing. Patients with T1DM or insulin-treated T2DM diabetes from seven European countries were invited to complete four weekly questionnaires. Data were collected on patient demographics, NSHE occurrence in the last 7 days, hypoglycemia-related resource use, and patient impact. NSHE were defined as events with hypoglycemia symptoms, with or without blood glucose measurement, or low blood glucose measurement without symptoms, which the patient could manage without third-party assistance. Three thousand, nine hundred and fifty-nine respondents completed at least one wave of the survey, with 57% completing all four questionnaires; 3827 respondents were used for data analyses. Overall, 2.3% and 8.9% of NSHE in patients with T1DM and T2DM, respectively, resulted in healthcare professional contact. Across countries, there was a mean increase in blood glucose test use of 3.0 tests in the week following a NSHE. Among respondents who were employed (48%), loss of work-time after the last hypoglycemic event was reported for 9.7% of NSHE. Overall, 10.2% (daytime) and 8.0% (nocturnal) NSHE led to work-time loss, with a mean loss of 84.3 (daytime) and 169.6 (nocturnal) minutes among patients reporting work-time loss. Additionally, patients reported feeling tired, irritable, and having negative feelings following hypoglycemia. Direct comparisons between studies must be interpreted with caution because of different definitions of hypoglycemia severity, duration of the studies, and methods of data collection. NSHE were associated with use of extra healthcare resources and work-time loss in all

  14. Radiological assessment of loss of disc height during acute and chronic degenerative lumbar disc alterations; Radiologische Beurteilung der segmentalen Hoehenabnahme bei akuten und chronisch degenerativen lumbalen Bandscheibenveraenderungen

    Energy Technology Data Exchange (ETDEWEB)

    Zoellner, J.; Sancaktaroglu, T.; Nafe, B.; Eysel, P. [Orthopaedische Universitaetsklinik Mainz (Germany); Loew, R. [Radiologische Universitaetsklinik Mainz (Germany)

    2001-03-01

    Aim of the study: A loss of disc height with increasing segmental mobility is an important reason for low back pain. The measurement of hyaluronic acid content of the nucleus pulposus prolaps shows a difference between acute (group 1) and chronic (group 2) disc degeneration. The purpose of the present investigation was to determine the decreasing of disc height between these two groups and the no-symptomatic segments of these patients. Methods: 20 human lateral preoperative X-ray measurements according to Frobin et al. were taken; group 1 with 7 patients (mean age 41 years) and group 2 with 13 patients (mean age 44 years). Results: There was a significant tendency (p=0.091) to a reduction of disc height in group 2 between symptomatic and asymptomatic discs. Conclusion: The used method is not suitable to answer the present question conclusively. (orig.) [German] Ziel: Die segmentale Hoehenabnahme der Bandscheibe mit nachfolgender Instabilitaet im Rahmen von degenerativen lumbalen Bandscheibenerkrankungen hat eine wesentliche klinische Bedeutung. In einer vorgeschalteten Untersuchung konnte ueber die Bestimmung des Hyaluronsaeuregehaltes von Nucleus pulposus-Material der Grad der Bandscheibendegeneration beurteilt werden. Die Frage ist, ob hier ein praeoperativ radiologisch nachweisbarer Hoehenunterschied zwischen den akuten (Gruppe 1) und den chronischen (Gruppe 2) Bandscheibenvorfaellen im Vergleich zu den klinisch nicht betroffenen Bandscheibensegmenten der Patienten besteht? Methode: Es wurden 20 konsekutive praeoperative seitliche Roentgenaufnahmen der Lendenwirbelsaeule nach der Methode von Frobin et al. vermessen. Diese bestanden aus einer ersten Gruppe (7 Patienten) mit einem durchschnittlichen Alter von 41 Jahren und einer zweiten Gruppe (13 Patienten) mit einem durchschnittlichen Alter von 44 Jahren. Ergebnisse: Die Ergebnisse der Untersuchung zeigten lediglich in der 2. Gruppe mit einer chronischen Bandscheibendegeneration eine Tendenz zur Abhaengigkeit (p

  15. Wuthering Heights

    NARCIS (Netherlands)

    Bronte, Emily

    2005-01-01

    Wuthering Heights tells the story of a romance between two youngsters: Catherine Earnshaw and an orphan boy, Heathcliff. After she rejects him for a boy from a better background he develops a lust for revenge that takes over his life. In attempting to win her back and destroy those he blames for his

  16. The Shadow of Freudian Core Issues on Wuthering Heights: A Reenactment of Emily Brontë’s Early Mother Loss

    Directory of Open Access Journals (Sweden)

    Moussa Pourya Asl

    2014-04-01

    Full Text Available The study attempts to indicate how the manifest content of a text is in essence the projection of the obsessional thoughts of the neurotic author. The research approach adopted in this study is what is referred to as psychobiography or the Freudian psychoanalytic criticism. Freud's ideas have been employed due to the increasing shift to him in the recent decades, particularly in the discipline of psychobiography. The findings of this research underline that nearly all the characters of the novel are stricken by their mother's death, and they not only undergo the processes of dejection, melancholia, and hysteria, but also suffer from certain core issues—fear of intimacy, fear of abandonment, fear of betrayal, low self-esteem, insecure or unstable sense of self. The main conclusion to be drawn from this article is that Emily Brontë was a neurotic person whose unconscious obsession of psychoanalytic love of mother is projected in Wuthering Heights.

  17. Patient reported outcome measures (PROMs)

    DEFF Research Database (Denmark)

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

    2018-01-01

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

  18. Fear of heights and visual height intolerance.

    Science.gov (United States)

    Brandt, Thomas; Huppert, Doreen

    2014-02-01

    The aim of this review is, first, to cover the different aspects of visual height intolerance such as historical descriptions, definition of terms, phenomenology of the condition, neurophysiological control of gaze, stance and locomotion, and therapy, and, second, to identify warranted epidemiological and experimental studies. Vivid descriptions of fear of heights can be found in ancient texts from the Greek, Roman, and Chinese classics. The life-time prevalence of visual height intolerance is as high as 28% in the general population, and about 50% of those who are susceptible report an impact on quality of life. When exposed to heights, visual exploration by eye and head movements is restricted, and the velocity of locomotion is reduced. Therapy for fear of heights is dominated by the behavioral techniques applied during real or virtual reality exposure. Their efficacy might be facilitated by the administration of D-cycloserine or glucocorticoids. Visual height intolerance has a considerable impact on daily life and interpersonal interactions. It is much more frequent than fear of heights, which is defined as an environmental subtype of a specific phobia. There is certainly a continuum stretching from acrophobia to a less-pronounced visual height intolerance, to which the categorical distinction of a specific phobia does not apply.

  19. Final height in survivors of childhood cancer compared with Height Standard Deviation Scores at diagnosis.

    Science.gov (United States)

    Knijnenburg, S L; Raemaekers, S; van den Berg, H; van Dijk, I W E M; Lieverst, J A; van der Pal, H J; Jaspers, M W M; Caron, H N; Kremer, L C; van Santen, H M

    2013-04-01

    Our study aimed to evaluate final height in a cohort of Dutch childhood cancer survivors (CCS) and assess possible determinants of final height, including height at diagnosis. We calculated standard deviation scores (SDS) for height at initial cancer diagnosis and height in adulthood in a cohort of 573 CCS. Multivariable regression analyses were carried out to estimate the influence of different determinants on height SDS at follow-up. Overall, survivors had a normal height SDS at cancer diagnosis. However, at follow-up in adulthood, 8.9% had a height ≤-2 SDS. Height SDS at diagnosis was an important determinant for adult height SDS. Children treated with (higher doses of) radiotherapy showed significantly reduced final height SDS. Survivors treated with total body irradiation (TBI) and craniospinal radiation had the greatest loss in height (-1.56 and -1.37 SDS, respectively). Younger age at diagnosis contributed negatively to final height. Height at diagnosis was an important determinant for height SDS at follow-up. Survivors treated with TBI, cranial and craniospinal irradiation should be monitored periodically for adequate linear growth, to enable treatment on time if necessary. For correct interpretation of treatment-related late effects studies in CCS, pre-treatment data should always be included.

  20. Fall from heights: does height really matter?

    Science.gov (United States)

    Alizo, G; Sciarretta, J D; Gibson, S; Muertos, K; Romano, A; Davis, J; Pepe, A

    2018-06-01

    Fall from heights is high energy injuries and constitutes a fraction of all fall-related trauma evaluations while bearing an increase in morbidity and mortality. We hypothesize that despite advancements in trauma care, the overall survivability has not improved in this subset of trauma patients. All adult trauma patients treated after sustaining a fall from heights during a 40-month period were retrospectively reviewed. Admission demographics, clinical data, fall height (ft), injury patterns, ISS, GCS, length of stay, and mortality were reviewed. 116 patients sustained a fall from heights, 90.4% accidental. A mean age of 37± 14.7 years, 86% male, and a fall height of 19 ± 10 ft were encountered. Admission GCS was 13 ± 2 with ISS 10 ± 11. Overall LOS was 6.6 ± 14.9 days and an ICU LOS of 2.8 ± 8.9 days. Falls ≥ 25 ft.(16%) had lower GCS 10.4 ± 5.8, increased ISS 22.6 ± 13.8, a fall height 37.9 ± 13.1 ft and associated increased mortality (p < 0.001). Mortality was 5.2%, a mean distance fallen of 39 ± 22 ft. and an ISS of 31.5 ±16.5. Brain injury was the leading cause of death, 50% with open skull fractures. Level of height fallen is a good predictor of overall outcome and survival. Despite advances in trauma care, death rates remain unchanged. Safety awareness and injury prevention programs are needed to reduce the risk of high-level falls.

  1. Lucas Heights technology park

    International Nuclear Information System (INIS)

    1987-01-01

    The proposed Lucas Heights Technology Park will pound together the applied research programs of Government, tertiary and industry sectors, aiming to foster technology transfer particularly to the high-technology manufacturing industry. A description of the site is given along with an outline of the envisaged development, existing facilities and expertise. ills

  2. APTCARE - Lucas Heights

    International Nuclear Information System (INIS)

    1986-05-01

    This plan details command co-ordination and support responses of Commonwealth and State Authorities in the event of an accident with offsite consequences at the Lucas Heights Research Laboratories. The plan has been prepared by the AAEC Local Liaison Working Party, comprising representatives of the Australian Atomic Energy Commission, NSW Police Department, NSW Board of Fire Commissioners, NSW State Emergency Services and Civil Defence Organisation, NSW Department of Health, NSW Department of Environment and Planning and Sutherland Shire Council

  3. Childhood height, adult height, and the risk of prostate cancer

    DEFF Research Database (Denmark)

    Bjerregaard, Lise Geisler; Aarestrup, Julie; Gamborg, Michael

    2016-01-01

    PURPOSE: We previously showed that childhood height is positively associated with prostate cancer risk. It is, however, unknown whether childhood height exerts its effects independently of or through adult height. We investigated whether and to what extent childhood height has a direct effect...... on the risk of prostate cancer apart from adult height. METHODS: We included 5,871 men with height measured at ages 7 and 13 years in the Copenhagen School Health Records Register who also had adult (50-65 years) height measured in the Danish Diet, Cancer and Health study. Prostate cancer status was obtained...... through linkage to the Danish Cancer Registry. Direct and total effects of childhood height on prostate cancer risk were estimated from Cox regressions. RESULTS: From 1996 to 2012, 429 prostate cancers occurred. Child and adult heights were positively and significantly associated with prostate cancer risk...

  4. Accuracy of recumbent height measurement.

    Science.gov (United States)

    Gray, D S; Crider, J B; Kelley, C; Dickinson, L C

    1985-01-01

    Since many patients requiring specialized nutritional support are bedridden, measurement of height for purposes of nutritional assessment or prescription must often be done with the patient in bed. This study examined the accuracy of measuring body height in bed in the supine position. Two measurements were performed on 108 ambulatory inpatients: (1) standing height using a standard height-weight scale, and (2) bed height using a flexible tape. Patients were divided into four groups based on which of two researchers performed each of the two measurements. Each patient was also weighed and self-reported height, weight, sex, and age were recorded. Bed height was significantly longer than standing height by 3.68 cm, but the two measurements were equally precise. It was believed, however, that this 2% difference was probably not clinically significant in most circumstances. Bed height correlated highly with standing height (r = 0.95), and the regression equation was standing height = 13.82 +/- 0.09 bed height. Patients overestimated their heights. Heights recorded by nurses were more accurate when patients were measured than when asked about their heights, but the patients were more often asked than measured.

  5. Memory for target height is scaled to observer height.

    Science.gov (United States)

    Twedt, Elyssa; Crawford, L Elizabeth; Proffitt, Dennis R

    2012-04-01

    According to the embodied approach to visual perception, individuals scale the environment to their bodies. This approach highlights the central role of the body for immediate, situated action. The present experiments addressed whether body scaling--specifically, eye-height scaling--occurs in memory when action is not immediate. Participants viewed standard targets that were either the same height as, taller than, or shorter than themselves. Participants then viewed a comparison target and judged whether the comparison was taller or shorter than the standard target. Participants were most accurate when the standard target height matched their own heights, taking into account postural changes. Participants were biased to underestimate standard target height, in general, and to push standard target height away from their own heights. These results are consistent with the literature on eye-height scaling in visual perception and suggest that body scaling is not only a useful metric for perception and action, but is also preserved in memory.

  6. Development of a patient-reported outcome

    DEFF Research Database (Denmark)

    Juul, Tina; Søgaard, Karen; Roos, Ewa M.

    2015-01-01

    removed from the original 69. A multidimensional questionnaire, divided into five subscales, was developed from the remaining 34 items: mobility; symptoms; sleep disturbance; everyday activity and pain; and participation in everyday life. Exploratory factor analysis supported a 5-subscale structure......OBJECTIVE: To develop a patient-reported outcome evaluating the impact of neck pain. The results of item generation and reduction and subscale structure in support of the content and construct validity of the measure are reported. METHODS: Items were generated from the literature and through focus...

  7. Patient-reported Outcomes in Cystic Fibrosis

    OpenAIRE

    Goss, Christopher H.; Quittner, Alexandra L.

    2007-01-01

    Over the past 20 years, there has been tremendous progress in the area of patient-reported outcomes (PROs). A PRO instrument is defined as any measure of a patient's health status that is elicited directly from the patient and assesses how the patient “feels or functions with respect to his or her health condition.” The advances seen in clinical research regarding PROs has been mirrored in research in cystic fibrosis (CF). A large number of instruments have been used for both therapeutic and ...

  8. Concordant preferences for actual height and facial cues to height

    OpenAIRE

    Re, Daniel Edward; Perrett, David I.

    2012-01-01

    Physical height has a well-documented effect on human mate preferences. In general, both sexes prefer opposite-sex romantic relationships in which the man is taller than the woman, while individual preferences for height are affected by a person’s own height. Research in human mate choice has demonstrated that attraction to facial characteristics, such as facial adiposity, may reflect references for body characteristics. Here, we tested preferences for facial cues to height. In general, incre...

  9. Sexual Orientation, Objective Height, and Self-Reported Height.

    Science.gov (United States)

    Skorska, Malvina N; Bogaert, Anthony F

    2017-01-01

    Studies that have used mostly self-reported height have found that androphilic men and women are shorter than gynephilic men and women, respectively. This study examined whether an objective height difference exists or whether a psychosocial account (e.g., distortion of self-reports) may explain these putative height differences. A total of 863 participants, recruited at a Canadian university, the surrounding region, and through lesbian, gay, bisexual, and transgender (LGBT) events across Canada, self-reported their height and had their height measured. Androphilic men were shorter, on average, than gynephilic men. There was no objective height difference between gynephilic, ambiphilic, and androphilic women. Self-reported height, statistically controlling for objective height, was not related to sexual orientation. These findings are the first to show an objective height difference between androphilic and gynephilic men. Also, the findings suggest that previous studies using self-reported height found part of a true objective height difference between androphilic and gynephilic men. These findings have implications for existing biological theories of men's sexual orientation development.

  10. Sri Lanka, Colored Height

    Science.gov (United States)

    2005-01-01

    The topography of the island nation of Sri Lanka is well shown in this color-coded shaded relief map generated with digital elevation data from the Shuttle Radar Topography Mission (SRTM). Two visualization methods were combined to produce the image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the northwest-southeast direction, so that northwest slopes appear bright and southeast slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow and tan, to white at the highest elevations. For this special view heights below 10 meters (33 feet) above sea level have been colored red. These low coastal elevations extend 5 to 10 km (3.1 to 6.2 mi) inland on Sri Lanka and are especially vulnerable to flooding associated with storm surges, rising sea level, or, as in the aftermath of the earthquake of December 26, 2004, tsunami. These so-called tidal waves have occurred numerous times in history and can be especially destructive, but with the advent of the near-global SRTM elevation data planners can better predict which areas are in the most danger and help develop mitigation plans in the event of particular flood events. Sri Lanka is shaped like a giant teardrop falling from the southern tip of the vast Indian subcontinent. It is separated from India by the 50km (31mi) wide Palk Strait, although there is a series of stepping-stone coral islets known as Adam's Bridge that almost form a land bridge between the two countries. The island is just 350km (217mi) long and only 180km (112mi) wide at its broadest, and is about the same size as Ireland, West Virginia or Tasmania. The southern half of the island is dominated by beautiful and rugged hill country, and includes Mt Pidurutalagala, the islandaE(TM)s highest point at 2524 meters (8281 ft). The entire northern half comprises a large plain extending from the edge of the hill country to the

  11. Height premium for job performance.

    Science.gov (United States)

    Kim, Tae Hyun; Han, Euna

    2017-08-01

    This study assessed the relationship of height with wages, using the 1998 and 2012 Korean Labor and Income Panel Study data. The key independent variable was height measured in centimeters, which was included as a series of dummy indicators of height per 5cm span (wages to assess the heterogeneity in the height-wage relationship, across the conditional distribution of monthly wages. We found a non-linear relationship of height with monthly wages. For men, the magnitude of the height wage premium was overall larger at the upper quantile of the conditional distribution of log monthly wages than at the median to low quantile, particularly in professional and semi-professional occupations. The height-wage premium was also larger at the 90th quantile for self-employed women and salaried men. Our findings add a global dimension to the existing evidence on height-wage premium, demonstrating non-linearity in the association between height and wages and heterogeneous changes in the dispersion and direction of the association between height and wages, by wage level. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. More practical critical height sampling.

    Science.gov (United States)

    Thomas B. Lynch; Jeffrey H. Gove

    2015-01-01

    Critical Height Sampling (CHS) (Kitamura 1964) can be used to predict cubic volumes per acre without using volume tables or equations. The critical height is defined as the height at which the tree stem appears to be in borderline condition using the point-sampling angle gauge (e.g. prism). An estimate of cubic volume per acre can be obtained from multiplication of the...

  13. Degeneration and height of cervical discs classified from MRI compared with precise height measurements from radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Kolstad, Frode [National Centre of Spinal Disorders, Norwegian University of Science and Technology, University Hospital of Trondheim, 7006 Trondheim (Norway)]. E-mail: frode.kolstad@medisin.ntnu.no; Myhr, Gunnar [Department of Radiology, University Hospital of Trondheim, 7006 Trondheim (Norway); Kvistad, Kjell Arne [Department of Radiology, University Hospital of Trondheim, 7006 Trondheim (Norway); Nygaard, Oystein P. [National Centre of Spinal Disorders, Norwegian University of Science and Technology, University Hospital of Trondheim, 7006 Trondheim (Norway); Leivseth, Gunnar [Department of Neuromedicine, Faculty of Medicine, Norwegian University of Science and Technology, University Hospital of Trondheim, 7006 Trondheim (Norway)

    2005-09-01

    Study design: Descriptive study comparing MRI classifications with measurements from radiographs. Objectives: 1.Define the relationship between MRI classified cervical disc degeneration and objectively measured disc height. 2.Assess the level of inter- and intra-observer errors using MRI in defining cervical disc degeneration. Summary of background data: Cervical spine degeneration has been defined radiologically by loss of disc height, decreased disc and bone marrow signal intensity and disc protrusion/herniation on MRI. The intra- and inter-observer error using MRI in defining cervical degeneration influences data interpretation. Few previous studies have addressed this source of error. The relation and time sequence between cervical disc degeneration classified by MRI and cervical disc height decrease measured from radiographs is unclear. Methods: The MRI classification of degeneration was based on nucleus signal, prolaps identification and bone marrow signal. Two neuro-radiologists evaluated the MR-images independently in a blinded fashion. The radiographic disc height measurements were done by a new computer-assisted method compensating for image distortion and permitting comparison with normal level-, age- and gender-appropriate disc height. Results/conclusions: 1.Progressing disc degeneration classified from MRI is on average significantly associated with a decrease of disc height as measured from radiographs. Within each MRI defined category of degeneration measured disc heights, however, scatter in a wide range. 2.The inter-observer agreement between two neuro-radiologists in both defining degeneration and disc height by MRI was only moderate. Studies addressing questions related to cervical disc degeneration should take this into consideration.

  14. Degeneration and height of cervical discs classified from MRI compared with precise height measurements from radiographs

    International Nuclear Information System (INIS)

    Kolstad, Frode; Myhr, Gunnar; Kvistad, Kjell Arne; Nygaard, Oystein P.; Leivseth, Gunnar

    2005-01-01

    Study design: Descriptive study comparing MRI classifications with measurements from radiographs. Objectives: 1.Define the relationship between MRI classified cervical disc degeneration and objectively measured disc height. 2.Assess the level of inter- and intra-observer errors using MRI in defining cervical disc degeneration. Summary of background data: Cervical spine degeneration has been defined radiologically by loss of disc height, decreased disc and bone marrow signal intensity and disc protrusion/herniation on MRI. The intra- and inter-observer error using MRI in defining cervical degeneration influences data interpretation. Few previous studies have addressed this source of error. The relation and time sequence between cervical disc degeneration classified by MRI and cervical disc height decrease measured from radiographs is unclear. Methods: The MRI classification of degeneration was based on nucleus signal, prolaps identification and bone marrow signal. Two neuro-radiologists evaluated the MR-images independently in a blinded fashion. The radiographic disc height measurements were done by a new computer-assisted method compensating for image distortion and permitting comparison with normal level-, age- and gender-appropriate disc height. Results/conclusions: 1.Progressing disc degeneration classified from MRI is on average significantly associated with a decrease of disc height as measured from radiographs. Within each MRI defined category of degeneration measured disc heights, however, scatter in a wide range. 2.The inter-observer agreement between two neuro-radiologists in both defining degeneration and disc height by MRI was only moderate. Studies addressing questions related to cervical disc degeneration should take this into consideration

  15. Height-Deterministic Pushdown Automata

    DEFF Research Database (Denmark)

    Nowotka, Dirk; Srba, Jiri

    2007-01-01

    We define the notion of height-deterministic pushdown automata, a model where for any given input string the stack heights during any (nondeterministic) computation on the input are a priori fixed. Different subclasses of height-deterministic pushdown automata, strictly containing the class...... of regular languages and still closed under boolean language operations, are considered. Several of such language classes have been described in the literature. Here, we suggest a natural and intuitive model that subsumes all the formalisms proposed so far by employing height-deterministic pushdown automata...

  16. Unified height systems after GOCE

    Science.gov (United States)

    Rummel, Reiner; Gruber, Thomas; Sideris, Michael; Rangelova, Elena; Woodworth, Phil; Hughes, Chris; Ihde, Johannes; Liebsch, Gunter; Rülke, Axel; Gerlach, Christian; Haagmans, Roger

    2015-04-01

    The objectives of global height unification are twofold, (1) the realization of accurate geopotential numbers C together with their standard deviation σ(C) at a selected set of stations (datum points of national height systems, geodetic fundamental stations (IERS), primary tide gauges (PSMSL) and primary reference clocks (IERS)) and (2) the determination of height off-sets between all existing regional/national height systems and one global height reference. In the future the primary method of height determination will be GPS-levelling with very stringent requirements concerning the consistency of the positioning and the gravity potential difference part. Consistency is required in terms of the applied standards (ITRF, zero tide system, geodetic reference system). Geopotential differences will be based on a next generation geopotential model combining GOCE and GRACE and a best possible collection of global terrestrial and altimetric gravity and topographic data. Ultimately, the envisaged accuracy of height unification is about 10 cm2/s2 (or 1cm). At the moment, in well surveyed regions, an accuracy of about 40 to 60 cm2/s2 (or 4 to 6cm) is attainable. Objective One can be realized by straight forward computation of geopotential numbers C, i.e. geopotential differences relative to an adopted height reference. No adjustment is required for this. Objective Two, the unification of existing height systems is achieved by employing a least-squares adjustment based on the GBVP-approach. In order to attain a non-singular solution, this requires for each included datum zone at least one geo-referenced station per zone, i.e. its ellipsoidal height h and, in addition, the corresponding physical height H (geopotential number, normal height, orthometric height, etc.). Changes in geopotential numbers of consecutive realizations reflect (1) temporal changes of station heights, (2) improvements or changes of the applied geopotential (or geoid) model and (3) improvements of the

  17. Agreement between measured height, and height predicted from ...

    African Journals Online (AJOL)

    lower limb measurements, such as knee height, as well as upper limb measures ... had with bone injuries/fractures affecting height or ulna length; and n = 1 had a ... and heels, buttocks and upper back in contact with the vertical surface of the .... found striking similarity in linear growth of infants to five-year- olds among all ...

  18. Height and Tilt Geometric Texture

    DEFF Research Database (Denmark)

    Andersen, Vedrana; Desbrun, Mathieu; Bærentzen, Jakob Andreas

    2009-01-01

    compromise between functionality and simplicity: it can efficiently handle and process geometric texture too complex to be represented as a height field, without having recourse to full blown mesh editing algorithms. The height-and-tilt representation proposed here is fully intrinsic to the mesh, making...

  19. Fluctuations in Schottky barrier heights

    International Nuclear Information System (INIS)

    Mahan, G.D.

    1984-01-01

    A double Schottky barrier is often formed at the grain boundary in polycrystalline semiconductors. The barrier height is shown to fluctuate in value due to the random nature of the impurity positions. The magnitude of the fluctuations is 0.1 eV, and the fluctuations cause the barrier height measured by capacitance to differ from the one measured by electrical conductivity

  20. Glaucoma Patient-Reported Concerns and Associated Factors.

    Science.gov (United States)

    Mogil, Rachel S; Tirsi, Andrew; Lee, Jung Min; Tello, Celso; Park, Sung Chul

    2017-06-01

    To assess the character and degree of concerns of glaucoma patients and identify demographic/clinical factors affecting the concerns. Prospective cross-sectional study. A questionnaire that addressed patients' concerns was administered to consecutive glaucoma patients. Severity of concern was scored with a scale of 0-5 in order of increasing severity. Age, sex, intraocular pressure, visual field (VF) mean deviation (MD), number of antiglaucoma medications, history of glaucoma surgery, and employment status were recorded. Questionnaire results of 152 patients (mean VF MD, -8.03 ± 7.86 dB [better eye] and -16.06 ± 10.22 dB [worse eye]; mean age, 69 ± 14 years) were analyzed. Severity of concern was greatest for general eyesight (2.92/5.00) and visual symptoms (2.78/5.00), followed by activities (2.20/5.00) and socioeconomic factors (2.13/5.00), and then ocular symptoms (1.69/5.00) (P factors correlated with VF MD of the better eye (r = -0.245; P = .003) and age (r = -0.260; P = .001). Glaucoma patients reported varied degrees of concern regarding items associated with quality of life. Certain items may be more concerning than others. Severity of some concerns increased with more severe VF loss, prior glaucoma surgery, or younger age. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Mexico Geoid Heights (MEXICO97)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This 2' geoid height grid for Mexico, and North-Central America, is the MEXICO97 geoid model. The computation used about one million terrestrial and marine gravity...

  2. Alaska Geoid Heights (GEOID96)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This 2' x 4' geoid height grid for Alaska is distributed as a GEOID96 model. The computation used 1.1 million terrestrial and marine gravity data held in the...

  3. Clutter Height Variation Effects on Frequency Dependen Path Loss ...

    African Journals Online (AJOL)

    http://dx.doi.org/10.4314/star.v4i4.21 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL · News. OTHER RESOURCES... for Researchers · for Journals · for Authors · for Policy Makers ...

  4. Encounter Probability of Significant Wave Height

    DEFF Research Database (Denmark)

    Liu, Z.; Burcharth, H. F.

    The determination of the design wave height (often given as the significant wave height) is usually based on statistical analysis of long-term extreme wave height measurement or hindcast. The result of such extreme wave height analysis is often given as the design wave height corresponding to a c...

  5. Height and Breast Cancer Risk

    DEFF Research Database (Denmark)

    Zhang, Ben; Shu, Xiao-Ou; Delahanty, Ryan J

    2015-01-01

    BACKGROUND: Epidemiological studies have linked adult height with breast cancer risk in women. However, the magnitude of the association, particularly by subtypes of breast cancer, has not been established. Furthermore, the mechanisms of the association remain unclear. METHODS: We performed a meta......-analysis to investigate associations between height and breast cancer risk using data from 159 prospective cohorts totaling 5216302 women, including 113178 events. In a consortium with individual-level data from 46325 case patients and 42482 control patients, we conducted a Mendelian randomization analysis using...... a genetic score that comprised 168 height-associated variants as an instrument. This association was further evaluated in a second consortium using summary statistics data from 16003 case patients and 41335 control patients. RESULTS: The pooled relative risk of breast cancer was 1.17 (95% confidence...

  6. Patient reported outcomes in hip arthroplasty registries.

    Science.gov (United States)

    Paulsen, Aksel

    2014-05-01

    PROs are used increasingly in orthopedics and in joint registries, but still many aspects of use in this area have not been examined in depth. To be able to introduce PROs in the DHR in a scientific fashion, my studies were warranted; the feasibility of four often used PROs (OHS, HOOS, EQ-5D and SF-12) was examined in a registry context. Having the PROs in the target language is an absolute necessity, so I translated, cross-culturally adapted and validated a Danish language version of an often used PRO (OHS), since this PRO had no properly developed Danish language version. To minimize data loss and to maximize the data quality I validated our data capture procedure, an up to date AFP system, by comparing scannable, paper-based PROs, with manual single-key- and double-key entered data. To help further registry-PRO studies, I calculated the number of patients needed to discriminate between subgroups of age, sex, diagnosis, and prosthesis type for each of four often used PROs (OHS, HOOS, EQ-5D and SF-12), and to simplify the clinical interpretation of PRO scores and PRO change scores in PRO studies, I estimated MCII and PASS for two often used PROs (EQ-5D and HOOS). The feasibility study included 5,747 THA patients registered in the DHR, and I found only minor differences between the disease-specific and the generic PROs regarding ceiling and floor effects as well as discarded items. The HOOS, the OHS, the SF-12, and the EQ-5D are all appropriate PROs for administration in a hip registry. I found that group sizes from 51 to 1,566 were needed for subgroup analysis, depending on descriptive factors and choice of PRO. The AFP study included 200 THA patients (398 PROs, 4,875 items and 21,887 data fields), and gave excellent results provided use of highly structured questionnaires. OMR performed equally as well as manual double-key entering, and better than single-key entering. The PRO translation and validation study included 2,278 patients (and 212 patients for the test

  7. Heritability of adult body height

    DEFF Research Database (Denmark)

    Silventoinen, Karri; Sammalisto, Sampo; Perola, Markus

    2003-01-01

    /unique environment (AE) model. Among women the heritability estimates were generally lower than among men with greater variation between countries, ranging from 0.68 to 0.84 when an additive genes/shared environment/unique environment (ACE) model was used. In four populations where an AE model fit equally well...... countries; body height was least in Italy (177 cm in men and 163 cm in women) and greatest in the Netherlands (184 cm and 171 cm, respectively). In men there was no corresponding variation in heritability of body height, heritability estimates ranging from 0.87 to 0.93 in populations under an additive genes...... or better, heritability ranged from 0.89 to 0.93. This difference between the sexes was mainly due to the effect of the shared environmental component of variance, which appears to be more important among women than among men in our study populations. Our results indicate that, in general, there are only...

  8. Can height categories replace weight categories in striking martial arts competitions? A pilot study.

    Science.gov (United States)

    Dubnov-Raz, Gal; Mashiach-Arazi, Yael; Nouriel, Ariella; Raz, Raanan; Constantini, Naama W

    2015-09-29

    In most combat sports and martial arts, athletes compete within weight categories. Disordered eating behaviors and intentional pre-competition rapid weight loss are commonly seen in this population, attributed to weight categorization. We examined if height categories can be used as an alternative to weight categories for competition, in order to protect the health of athletes. Height and weight of 169 child and adolescent competitive karate athletes were measured. Participants were divided into eleven hypothetical weight categories of 5 kg increments, and eleven hypothetical height categories of 5 cm increments. We calculated the coefficient of variation of height and weight by each division method. We also calculated how many participants fit into corresponding categories of both height and weight, and how many would shift a category if divided by height. There was a high correlation between height and weight (r = 0.91, p<0.001). The mean range of heights seen within current weight categories was reduced by 83% when participants were divided by height. When allocating athletes by height categories, 74% of athletes would shift up or down one weight category at most, compared with the current categorization method. We conclude that dividing young karate athletes by height categories significantly reduced the range of heights of competitors within the category. Such categorization would not cause athletes to compete against much heavier opponents in most cases. Using height categories as a means to reduce eating disorders in combat sports should be further examined.

  9. Patient reported outcomes: looking beyond the label claim

    Directory of Open Access Journals (Sweden)

    Doward Lynda C

    2010-08-01

    Full Text Available Abstract The use of patient reported outcome scales in clinical trials conducted by the pharmaceutical industry has become more widespread in recent years. The use of such outcomes is particularly common for products developed to treat chronic, disabling conditions where the intention is not to cure but to ameliorate symptoms, facilitate functioning or, ultimately, to improve quality of life. In such cases, patient reported evidence is increasingly viewed as an essential complement to traditional clinical evidence for establishing a product's competitive advantage in the marketplace. In a commercial setting, the value of patient reported outcomes is viewed largely in terms of their potential for securing a labelling claim in the USA or inclusion in the summary of product characteristics in Europe. Although, the publication of the recent US Food and Drug Administration guidance makes it difficult for companies to make claims in the USA beyond symptom improvements, the value of these outcomes goes beyond satisfying requirements for a label claim. The European regulatory authorities, payers both in the US and Europe, clinicians and patients all play a part in determining both the availability and the pricing of medicinal products and all have an interest in patient-reported data that go beyond just symptoms. The purpose of the current paper is to highlight the potential added value of patient reported outcome data currently collected and held by the industry for these groups.

  10. On the Extreme Wave Height Analysis

    DEFF Research Database (Denmark)

    Burcharth, H. F.; Liu, Zhou

    1994-01-01

    The determination of the design wave height is usually based on the statistical analysis of long-term extreme wave height measurements. After an introduction to the procedure of the extreme wave height analysis, the paper presents new development concerning various aspects of the extreme wave...... height analysis. Finally, the paper gives a practical example based on a data set of the hindcasted wave heights for a deep water location in the Mediterranean Sea....

  11. Encounter Probability of Individual Wave Height

    DEFF Research Database (Denmark)

    Liu, Z.; Burcharth, H. F.

    1998-01-01

    wave height corresponding to a certain exceedence probability within a structure lifetime (encounter probability), based on the statistical analysis of long-term extreme significant wave height. Then the design individual wave height is calculated as the expected maximum individual wave height...... associated with the design significant wave height, with the assumption that the individual wave heights follow the Rayleigh distribution. However, the exceedence probability of such a design individual wave height within the structure lifetime is unknown. The paper presents a method for the determination...... of the design individual wave height corresponding to an exceedence probability within the structure lifetime, given the long-term extreme significant wave height. The method can also be applied for estimation of the number of relatively large waves for fatigue analysis of constructions....

  12. Final height in survivors of childhood cancer compared with Height Standard Deviation Scores at diagnosis

    NARCIS (Netherlands)

    Knijnenburg, S. L.; Raemaekers, S.; van den Berg, H.; van Dijk, I. W. E. M.; Lieverst, J. A.; van der Pal, H. J.; Jaspers, M. W. M.; Caron, H. N.; Kremer, L. C.; van Santen, H. M.

    2013-01-01

    Our study aimed to evaluate final height in a cohort of Dutch childhood cancer survivors (CCS) and assess possible determinants of final height, including height at diagnosis. We calculated standard deviation scores (SDS) for height at initial cancer diagnosis and height in adulthood in a cohort of

  13. Patient-Reported Safety Information: A Renaissance of Pharmacovigilance?

    Science.gov (United States)

    Härmark, Linda; Raine, June; Leufkens, Hubert; Edwards, I Ralph; Moretti, Ugo; Sarinic, Viola Macolic; Kant, Agnes

    2016-10-01

    The role of patients as key contributors in pharmacovigilance was acknowledged in the new EU pharmacovigilance legislation. This contains several efforts to increase the involvement of the general public, including making patient adverse drug reaction (ADR) reporting systems mandatory. Three years have passed since the legislation was introduced and the key question is: does pharmacovigilance yet make optimal use of patient-reported safety information? Independent research has shown beyond doubt that patients make an important contribution to pharmacovigilance signal detection. Patient reports provide first-hand information about the suspected ADR and the circumstances under which it occurred, including medication errors, quality failures, and 'near misses'. Patient-reported safety information leads to a better understanding of the patient's experiences of the ADR. Patients are better at explaining the nature, personal significance and consequences of ADRs than healthcare professionals' reports on similar associations and they give more detailed information regarding quality of life including psychological effects and effects on everyday tasks. Current methods used in pharmacovigilance need to optimise use of the information reported from patients. To make the most of information from patients, the systems we use for collecting, coding and recording patient-reported information and the methodologies applied for signal detection and assessment need to be further developed, such as a patient-specific form, development of a severity grading and evolution of the database structure and the signal detection methods applied. It is time for a renaissance of pharmacovigilance.

  14. Hearing loss

    Science.gov (United States)

    Decreased hearing; Deafness; Loss of hearing; Conductive hearing loss; Sensorineural hearing loss; Presbycusis ... Symptoms of hearing loss may include: Certain sounds seeming too loud Difficulty following conversations when two or more people are talking ...

  15. Proceedings of Patient Reported Outcome Measure’s (PROMs) Conference Oxford 2017: Advances in Patient Reported Outcomes Research

    NARCIS (Netherlands)

    Velikova, Galina; Valderas, Jose M.; Potter, Caroline; Batchelder, Laurie; A’Court, Christine; Baker, Matthew; Bostock, Jennifer; Coulter, Angela; Fitzpatrick, Ray; Forder, Julien; Fox, Diane; Geneen, Louise; Gibbons, Elizabeth; Jenkinson, Crispin; Jones, Karen; Kelly, Laura; Peters, Michele; Mulhern, Brendan; Labeit, Alexander; Rowen, Donna; Meadows, Keith; Elliott, Jackie; Brazier, John E.; Knowles, Emma; Keetharuth, Anju; Brazier, John E.; Connell, Janice; Carlton, Jill; Buck, Lizzie Taylor; Ricketts, Thomas; Barkham, Michael; Goswami, Pushpendra; Salek, Sam; Ionova, Tatyana; Oliva, Esther; Fielding, Adele K.; Karakantza, Marina; Al-Ismail, Saad; Collins, Graham P.; McConnell, Stewart; Langton, Catherine; Jennings, Daniel M.; Else, Roger; Kell, Jonathan; Ward, Helen; Day, Sophie; Lumley, Elizabeth; Phillips, Patrick; Duncan, Rosie; Buckley-Woods, Helen; Aber, Ahmed; Jones, Gerogina; Michaels, Jonathan; Porter, Ian; Gangannagaripalli, Jaheeda; Davey, Antoinette; Ricci-Cabello, Ignacio; Haywood, Kirstie; Hansen, Stine Thestrup; Valderas, Jose; Roberts, Deb; Gumber, Anil; Podmore, Bélène; Hutchings, Andrew; van der Meulen, Jan; Aggarwal, Ajay; Konan, Sujith; Price, Andrew; Jackson, William; Bottomley, Nick; Philiips, Michael; Knightley-Day, Toby; Beard, David; Gibbons, Elizabeth; Fitzpatrick, Ray; Greenhalgh, Joanne; Gooding, Kate; Gibbons, Elizabeth; Valderas, Chema; Wright, Judy; Dalkin, Sonia; Meads, David; Black, Nick; Fawkes, Carol; Froud, Robert; Carnes, Dawn; Price, Andrew; Cook, Jonathan; Dakin, Helen; Smith, James; Kang, Sujin; Beard, David; Griffiths, Catrin; Guest, Ella; Harcourt, Diana; Murphy, Mairead; Hollinghurst, Sandra; Salisbury, Chris; Carlton, Jill; Elliott, Jackie; Rowen, Donna; Gao, Anqi; Price, Andrew; Beard, David; Lemanska, Agnieszka; Chen, Tao; Dearnaley, David P.; Jena, Rajesh; Sydes, Matthew; Faithfull, Sara; Ades, A. E.; Kounali, Daphne; Lu, Guobing; Rombach, Ines; Gray, Alastair; Jenkinson, Crispin; Rivero-Arias, Oliver; Holch, Patricia; Holmes, Marie; Rodgers, Zoe; Dickinson, Sarah; Clayton, Beverly; Davidson, Susan; Routledge, Jacqui; Glennon, Julia; Henry, Ann M.; Franks, Kevin; Velikova, Galina; Maguire, Roma; McCann, Lisa; Young, Teresa; Armes, Jo; Harris, Jenny; Miaskowski, Christine; Kotronoulas, Grigorios; Miller, Morven; Ream, Emma; Patiraki, Elizabeth; Geiger, Alexander; Berg, Geir V.; Flowerday, Adrian; Donnan, Peter; McCrone, Paul; Apostolidis, Kathi; Fox, Patricia; Furlong, Eileen; Kearney, Nora; Gibbons, Chris; Fischer, Felix; Gibbons, Chris; Coste, Joel; Martinez, Jose Valderas; Rose, Matthias; Leplege, Alain; Shingler, Sarah; Aldhouse, Natalie; Al-Zubeidi, Tamara; Trigg, Andrew; Kitchen, Helen; Davey, Antoinette; Porter, Ian; Green, Colin; Valderas, Jose M.; Coast, Joanna; Smith, Sarah; Hendriks, Jolijn; Black, Nick; Shah, Koonal; Rivero-Arias, Oliver; Ramos-Goni, Juan-Manuel; Kreimeier, Simone; Herdman, Mike; Devlin, Nancy; Finch, Aureliano Paolo; Brazier, John E.; Mukuria, Clara; Zamora, Bernarda; Parkin, David; Feng, Yan; Bateman, Andrew; Herdman, Mike; Devlin, Nancy; Patton, Thomas; Gutacker, Nils; Shah, Koonal

    2017-01-01

    The proceedings contain 36 papers. The topics discussed include: using patient reported outcome measures (PROMs) in cancer care; validation of the long-term conditions questionnaire (LTCQ) in a diverse sample of health and social care users in England; the national institutes of health

  16. Maternal Height and Child Growth Patterns

    OpenAIRE

    Addo, O. Yaw; Stein, Aryeh D.; Fall, Caroline H.; Gigante, Denise P.; Guntupalli, Aravinda M.; Horta, Bernardo L.; Kuzawa, Christopher W.; Lee, Nanette; Norris, Shane A.; Prabhakaran, Poornima; Richter, Linda M.; Sachdev, Harshpal S.; Martorell, Reynaldo

    2013-01-01

    OBJECTIVE:\\ud To examine associations between maternal height and child growth during 4 developmental periods: intrauterine, birth to age 2 years, age 2 years to mid-childhood (MC), and MC to adulthood.\\ud \\ud STUDY DESIGN:\\ud Pooled analysis of maternal height and offspring growth using 7630 mother-child pairs from 5 birth cohorts (Brazil, Guatemala, India, the Philippines, and South Africa). We used conditional height measures that control for collinearity in height across periods. We estim...

  17. The taking of Lucas Heights

    International Nuclear Information System (INIS)

    Sandilands, B.

    1993-01-01

    Plans for a new research reactor at Lucas Heights have sparked a 'civil war' in New South Wales. The author considers the arguments. The leading antagonists are the local government body - The Sutherland Shire Council, Greenpeace, and the Sutherland Shire Environment Centre. Many of the economic benefits claimed for the existing and proposed replacement reactor have been tagged with question marks. However, ANSTO is confident of refuting claims that the money could be better spent on alternative methods of producing medical isotopes and neutron streams for industry or research, such as particle accelerators. If ANSTO's critics have their way, non-reactor-dependent work like the laser enrichment project could continue without the alleged hazards of sustained nuclear fission. If ANSTO wins the day, a far more efficient reactor will be built which is capable of keeping pace with the emerging nuclear industries of Asia. ills

  18. Genetically Determined Height and Coronary Artery Disease

    NARCIS (Netherlands)

    Nelson, Christopher P.; Hamby, Stephen E.; Saleheen, Danish; Hopewell, Jenna C.; Zeng, Lingyao; Assimes, Themistocles L.; Kanoni, Stavroula; Willenborg, Christina; Burgess, Stephen; Amouyel, Phillipe; Anand, Sonia; Blankenberg, Stefan; Boehm, Bernhard O.; Clarke, Robert J.; Collins, Rory; Dedoussis, George; Farrall, Martin; Franks, Paul W.; Groop, Leif; Hall, Alistair S.; Hamsten, Anders; Hengstenberg, Christian; Hovingh, G. Kees; Ingelsson, Erik; Kathiresan, Sekar; Kee, Frank; König, Inke R.; Kooner, Jaspal; Lehtimäki, Terho; März, Winifred; McPherson, Ruth; Metspalu, Andres; Nieminen, Markku S.; O'Donnell, Christopher J.; Palmer, Colin N. A.; Peters, Annette; Perola, Markus; Reilly, Muredach P.; Ripatti, Samuli; Roberts, Robert; Salomaa, Veikko; Shah, Svati H.; Schreiber, Stefan; Siegbahn, Agneta; Thorsteinsdottir, Unnur; Veronesi, Giovani; Wareham, Nicholas; Willer, Cristen J.; Zalloua, Pierre A.; Erdmann, Jeanette

    2015-01-01

    BACKGROUND The nature and underlying mechanisms of an inverse association between adult height and the risk of coronary artery disease (CAD) are unclear. METHODS We used a genetic approach to investigate the association between height and CAD, using 180 height-associated genetic variants. We tested

  19. In defense of the classical height system

    Science.gov (United States)

    Foroughi, Ismael; Vaníček, Petr; Sheng, Michael; Kingdon, Robert William; Santos, Marcelo C.

    2017-11-01

    In many European countries, normal heights referred to the quasi-geoid as introduced by Molodenskij in the mid-20th century are preferred to the classical height system that consists of orthometric heights and the geoid as a reference surface for these heights. The rationale for this choice is supposed to be that in the classical height system, neither the geoid, nor the orthometric height can be ever known with centimetre level accuracy because one would need to know the topographical mass density to a level that can never be achieved. The aim of this paper is to question the validity of this rationale. The common way of assessing the congruency of a local geoid model and the orthometric heights is to compare the geoid heights with the difference between orthometric heights provided by leveling and geodetic heights provided by GNSS. On the other hand, testing the congruency of a quasi-geoidal model with normal height a similar procedure is used, except that instead of orthometric heights, normal heights are employed. For the area of Auvergne, France, which is now a more or less standard choice for precise geoid or quasi-geoid testing, only the normal heights are supplied by the Institute Geographic National, the provider of the data. This is clearly the consequence of the European preference for the Molodenskij system. The quality of the height system is to be judged by the congruency of the difference of the geoid/quasi-geoid heights subtracted from the geodetic heights and orthometric/normal heights. To assess the congruency of the classical height system, the Helmert approximation of orthometric heights is typically used as the transformation between normal and Helmert's heights is easily done. However, the evaluation of the differences between Helmert's and the rigorous orthometric heights is somewhat more involved as will be seen from the review in this paper. For the area of interest, the differences between normal and Helmert's heights at the control

  20. Obesity-Related Adipokines Predict Patient-Reported Shoulder Pain

    Directory of Open Access Journals (Sweden)

    Rajiv Gandhi

    2013-12-01

    Full Text Available Background/Aims: Increasingly, an inflammatory modulating effect of adipokines within synovial joints is being recognized. To date, there has been no work examining a potential association between the presence of adipokines in the shoulder and patient-reported outcomes. This study undertakes an investigation assessing these potential links. Methods: 50 osteoarthritis patients scheduled for shoulder surgery completed a pre-surgery questionnaire capturing demographic information including validated, patient-reported function (Disabilities of the Arm, Shoulder, and Hand questionnaire and pain (Short Form McGill Pain Questionnaire measures. Synovial fluid (SF samples were analyzed for leptin, adiponectin, and resistin levels using Milliplex MAP assays. Linear regression modeling was used to assess the association between adipokine levels and patient-reported outcomes, adjusted for age, sex, BMI, and disease severity. Results: 54% of the cohort was female (n = 27. The mean age (SD of the sample was 62.9 (9.9 years and the mean BMI (SD was 28.1 (5.4 kg/m2. From regression analyses, greater SF leptin and adiponectin levels, but not regarding resistin, were found to be associated with greater pain (p Conclusions: The identified association between shoulder-derived SF leptin and adiponectin and shoulder pain is likely explained by the pro-inflammatory characteristics of the adipokines and represents potentially important therapeutic targets.

  1. Obesity-related adipokines predict patient-reported shoulder pain.

    Science.gov (United States)

    Gandhi, Rajiv; Perruccio, Anthony V; Rizek, Randy; Dessouki, Omar; Evans, Heather M K; Mahomed, Nizar N

    2013-01-01

    Increasingly, an inflammatory modulating effect of adipokines within synovial joints is being recognized. To date, there has been no work examining a potential association between the presence of adipokines in the shoulder and patient-reported outcomes. This study undertakes an investigation assessing these potential links. 50 osteoarthritis patients scheduled for shoulder surgery completed a pre-surgery questionnaire capturing demographic information including validated, patient-reported function (Disabilities of the Arm, Shoulder, and Hand questionnaire) and pain (Short Form McGill Pain Questionnaire) measures. Synovial fluid (SF) samples were analyzed for leptin, adiponectin, and resistin levels using Milliplex MAP assays. Linear regression modeling was used to assess the association between adipokine levels and patient-reported outcomes, adjusted for age, sex, BMI, and disease severity. 54% of the cohort was female (n = 27). The mean age (SD) of the sample was 62.9 (9.9) years and the mean BMI (SD) was 28.1 (5.4) kg/m(2). From regression analyses, greater SF leptin and adiponectin levels, but not regarding resistin, were found to be associated with greater pain (p < 0.05). Adipokine levels were not associated with functional outcome scores. The identified association between shoulder-derived SF leptin and adiponectin and shoulder pain is likely explained by the pro-inflammatory characteristics of the adipokines and represents potentially important therapeutic targets. © 2013 S. Karger GmbH, Freiburg.

  2. Using Patient-Reported Information to Improve Clinical Practice.

    Science.gov (United States)

    Schlesinger, Mark; Grob, Rachel; Shaller, Dale

    2015-12-01

    To assess what is known about the relationship between patient experience measures and incentives designed to improve care, and to identify how public policy and medical practices can promote patient-valued outcomes in health systems with strong financial incentives. Existing literature (gray and peer-reviewed) on measuring patient experience and patient-reported outcomes, identified from Medline and Cochrane databases; evaluations of pay-for-performance programs in the United States, Europe, and the Commonwealth countries. We analyzed (1) studies of pay-for-performance, to identify those including metrics for patient experience, and (2) studies of patient experience and of patient-reported outcomes to identify evidence of influence on clinical practice, whether through public reporting or private reporting to clinicians. First, we identify four forms of "patient-reported information" (PRI), each with distinctive roles shaping clinical practice: (1) patient-reported outcomes measuring self-assessed physical and mental well-being, (2) surveys of patient experience with clinicians and staff, (3) narrative accounts describing encounters with clinicians in patients' own words, and (4) complaints/grievances signaling patients' distress when treatment or outcomes fall short of expectations. Because these forms vary in crucial ways, each must be distinctively measured, deployed, and linked with financial incentives. Second, although the literature linking incentives to patients experience is limited, implementing pay-for-performance systems appears to threaten certain patient-valued aspects of health care. But incentives can be made compatible with the outcomes patients value if: (a) a sufficient portion of incentives is tied to patient-reported outcomes and experiences, (b) incentivized forms of PRI are complemented by other forms of patient feedback, and (c) health care organizations assist clinicians to interpret and respond to PRI. Finally, we identify roles for the

  3. The timeliness of patients reporting the side effects of chemotherapy.

    Science.gov (United States)

    Olver, Ian; Carey, Mariko; Boyes, Allison; Hall, Alix; Noble, Natasha; Bryant, Jamie; Walsh, Justin; Sanson-Fisher, Rob

    2018-05-03

    To explore the actions cancer patients reported they would take in response to a range of common side effects of chemotherapy and whether these were considered appropriate based on current guidelines and evidence; and to explore the sociodemographic and cancer-related variables associated with patients selecting the appropriate action (immediate medical attention or reporting) for two potentially life-threatening side effects: fever, and unusual bleeding and bruising. Four hundred thirty-six medical oncology and haematology patients receiving chemotherapy completed two surveys to provide demographic, disease and treatment characteristics, and details on how they would respond if they experienced a range of specified side effects of chemotherapy (for example, nausea and vomiting, fatigue, and skin rash or nail changes). The proportion of patients reporting the appropriate action for each side effect was calculated. Multiple logistic regressions examined the patient demographic and cancer characteristics associated with selecting the appropriate action (seeking immediate medical attention) for two potentially life-threatening side effects of chemotherapy: high fever of 38 °C or more, and unusual bleeding or bruising. Two thirds of patients indicated that they would seek immediate medical attention for high fever (67%), but only 41% would seek immediate attention for bleeding or bruising. Cancer type and time since diagnosis were significantly associated with patients indicating that they would seek immediate medical attention for high fever; while time since diagnosis was the only variable significantly associated with patients reporting that they would seek immediate medical attention for unusual bleeding or bruising. For chronic side effects, like skin rash or nail changes, and tingling or numbness, which usually do not require urgent reporting, only between 12 and 16% would report them immediately. A significant proportion of patients reported that they would

  4. Patient-reported outcomes, patient-reported information: from randomized controlled trials to the social web and beyond.

    Science.gov (United States)

    Baldwin, Mike; Spong, Andrew; Doward, Lynda; Gnanasakthy, Ari

    2011-01-01

    Internet communication is developing. Social networking sites enable patients to publish and receive communications very easily. Many stakeholders, including patients, are using these media to find new ways to make sense of diseases, to find and discuss treatments, and to give support to patients and their caregivers. We argue for a new definition of patient-reported information (PRI), which differs from the usual patient-reported outcomes (PRO). These new emergent data from the social web have important implications for decision making, at both an individual and a population level. We discuss new emergent technologies that will help aggregate this information and discuss how this will be assessed alongside the use of PROs in randomized controlled trials and how these new emergent data will be one facet of changing the relationship between the various stakeholders in achieving better co-created health.

  5. Physiological pattern of lumbar disc height

    International Nuclear Information System (INIS)

    Biggemann, M.; Frobin, W.; Brinckmann, P.

    1997-01-01

    Purpose of this study is to present a new method of quantifying objectively the height of all discs in lateral radiographs of the lumbar spine and of analysing the normal craniocaudal sequence pattern of lumbar disc heights. Methods: The new parameter is the ventrally measured disc height corrected for the dependence on the angle of lordosis by normalisation to mean angles observed in the erect posture of healthy persons. To eliminate radiographic magnification, the corrected ventral height is related to the mean depth of the cranially adjoining vertebra. In this manner lumbar disc heights were objectively measured in young, mature and healthy persons (146 males and 65 females). The craniocaudal sequence pattern was analysed by mean values from all persons and by height differences of adjoining discs in each individual lumbar spine. Results: Mean normative values demonstrated an increase in disc height between L1/L2 and L4/L5 and a constant or decreasing disc height between L4/L5 and L5/S1. However, this 'physiological sequence of disc height in the statistical mean' was observed in only 36% of normal males and 55% of normal females. Conclusion: The radiological pattern of the 'physiological sequence of lumbar disc height' leads to a relevant portion of false positive pathological results especially at L4/L5. An increase of disc height from L4/L5 to L5/S1 may be normal. The recognition of decreased disc height should be based on an abrupt change in the heights of adjoining discs and not on a deviation from a craniocaudal sequence pattern. (orig.) [de

  6. Pregnancy Loss

    Science.gov (United States)

    ... To receive Pregnancy email updates Enter email Submit Pregnancy loss Pregnancy loss is a harsh reality faced ... have successful pregnancies. Expand all | Collapse all Why pregnancy loss happens As many as 10 to 15 ...

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

    Directory of Open Access Journals (Sweden)

    Tim Croudace

    2016-10-01

    Full Text Available Table of contents S1 Using computerized adaptive testing Tim Croudace S2 Well-being: what is it, how does it compare to health and what are the implications of using it to inform health policy John Brazier O1 “Am I going to get better?”—Using PROMs to inform patients about the likely benefit of surgery Nils Gutacker, Andrew Street O2 Identifying Patient Reported Outcome Measures for an electronic Personal Health Record Dan Robotham, Samantha Waterman, Diana Rose, Safarina Satkunanathan, Til Wykes O3 Examining the change process over time qualitatively: transformative learning and response shift Nasrin Nasr, Pamela Enderby O4 Developing a PROM to evaluate self-management in diabetes (HASMID: giving patients a voice Jill Carlton, Donna Rowen, Jackie Elliott, John Brazier, Katherine Stevens, Hasan Basarir, Alex Labeit O5 Development of the Primary Care Outcomes Questionnaire (PCOQ Mairead Murphy, Sandra Hollinghurst, Chris Salisbury O6 Developing the PKEX score- a multimodal assessment tool for patients with shoulder problems Dominic Marley, James Wilson, Amy Barrat, Bibhas Roy O7 Applying multiple imputation to multi-item patient reported outcome measures: advantages and disadvantages of imputing at the item, sub-scale or score level Ines Rombach, Órlaith Burke, Crispin Jenkinson, Alastair Gray, Oliver Rivero-Arias O8 Integrating Patient Reported Outcome Measures (PROMs into routine primary care for patients with multimorbidity: a feasibility study Ian Porter, Jaheeda Gangannagaripalli, Charlotte Bramwell, Jose M. Valderas O9 eRAPID: electronic self-report and management of adverse-events for pelvic radiotherapy (RT patients Patricia Holch, Susan Davidson, Jacki Routledge, Ann Henry, Kevin Franks, Alex Gilbert, Kate Absolom & Galina Velikova O10 Patient reported outcomes (PROMs based recommendation in clinical guidance for the management of chronic conditions in the United Kingdom Ian Porter, Jose M.Valderas O11 Cross-sectional and

  8. Imagery and fear influence height perception.

    Science.gov (United States)

    Clerkin, Elise M; Cody, Meghan W; Stefanucci, Jeanine K; Proffitt, Dennis R; Teachman, Bethany A

    2009-04-01

    The current study tested whether height overestimation is related to height fear and influenced by images of falling. To assess perceptual biases, participants high (n=65) versus low (n=64) in height fear estimated the vertical extents of two balconies using a visual matching task. On one of the balconies, participants engaged in an imagery exercise designed to enhance the subjective sense that they were acting in a dangerous environment by picturing themselves falling. As expected, we found that individuals overestimated the balcony's height more after they imagined themselves falling, particularly if they were already afraid of heights. These findings suggest that height fear may serve as a vulnerability factor that leads to perceptual biases when triggered by a stressor (in this case, images of falling).

  9. Kyphoplasty increases vertebral height, decreases both pain score and opiate requirements while improving functional status.

    Science.gov (United States)

    Tolba, Reda; Bolash, Robert B; Shroll, Joshua; Costandi, Shrif; Dalton, Jarrod E; Sanghvi, Chirag; Mekhail, Nagy

    2014-03-01

    Vertebral compression fractures can result from advanced osteoporosis, or less commonly from metastatic or traumatic insults to the vertebral column, and result in disabling pain and decreased functional capacity. Various vertebral augmentation options including kyphoplasty aim at preventing the sequelae of pain and immobility that can develop as the result of the vertebral fractures. The mechanism for pain relief following kyphoplasty is not entirely understood, and the restoration of a portion of the lost vertebral height is a subject of debate. We retrospectively reviewed radiographic imaging, pain relief, analgesic intake and functional outcomes in 67 consecutive patients who underwent single- or multilevel kyphoplasty with the primary goal of quantifying the restoration of lost vertebral height. We observed a mean of 45% of the lost vertebral height restored postprocedurally. Secondarily, kyphoplasty was associated with significant decreases in pain scores, daily morphine consumption and improvement in patient-reported functional measures. © 2013 World Institute of Pain.

  10. Patient-reported outcomes (PROs) in chronic urticaria

    DEFF Research Database (Denmark)

    Moestrup, Kristian; Ghazanfar, Misbah N.; Thomsen, Simon F.

    2017-01-01

    Chronic urticaria is an itching skin disease which persists for more than 6 weeks. Chronic urticaria has great impact on the daily life of the patient, and the fluctuating nature of the symptoms complicates the monitoring and treatment of the disease. Currently, there are no reliable biomarkers...... to identify and measure disease activity in chronic spontaneous urticaria. Consequently, use of patient-reported outcomes (PROs) is crucial when evaluating and monitoring different aspects of chronic urticaria such as disease activity/severity, disease control, and quality of life. We present an overview...... of seven different PROs used in chronic urticaria and highlight their strengths, limitations, and use in clinical practice and research....

  11. Recognition of patient-reported impairment in oral aesthetics

    DEFF Research Database (Denmark)

    Dannemand Jensen, Katrine; Øzhayat, Esben Boeskov

    2014-01-01

    Scale (OES). Background variables were: gender, age, work-situation, education-level, marital status, number and location of teeth, wearing a removable dental prosthesis (RDP), and smile line. Results: A significant correlation was found between the overall professional evaluation and the OHIP-Aes score...... of prosthodontic replacements. The oral esthetics was professionally evaluated using the Prosthetic Esthetic Index (PEI), compiling 13 different esthetic aspects and an overall evaluation. The patient-reported impairment was evaluated using the Oral Health Impact Profile Aesthetic (OHIP-Aes) and the Oral Esthetic...

  12. Adult height, nutrition, and population health

    Science.gov (United States)

    Perkins, Jessica M.; Subramanian, S.V.; Davey Smith, George

    2016-01-01

    In this review, the potential causes and consequences of adult height, a measure of cumulative net nutrition, in modern populations are summarized. The mechanisms linking adult height and health are examined, with a focus on the role of potential confounders. Evidence across studies indicates that short adult height (reflecting growth retardation) in low- and middle-income countries is driven by environmental conditions, especially net nutrition during early years. Some of the associations of height with health and social outcomes potentially reflect the association between these environmental factors and such outcomes. These conditions are manifested in the substantial differences in adult height that exist between and within countries and over time. This review suggests that adult height is a useful marker of variation in cumulative net nutrition, biological deprivation, and standard of living between and within populations and should be routinely measured. Linkages between adult height and health, within and across generations, suggest that adult height may be a potential tool for monitoring health conditions and that programs focused on offspring outcomes may consider maternal height as a potentially important influence. PMID:26928678

  13. Mass loss from S stars

    International Nuclear Information System (INIS)

    Jura, M.

    1988-01-01

    The mass-loss process in S stars is studied using 65 S stars from the listing of Wing and Yorka (1977). The role of pulsations in the mass-loss process is examined. It is detected that stars with larger mass-loss rates have a greater amplitude of pulsations. The dust-to-gas ratio for the S stars is estimated as 0.002 and the average mass-loss rate is about 6 x 10 to the -8th solar masses/yr. Some of the properties of the S stars, such as scale height, surface density, and lifetime, are measured. It is determined that scale height is 200 pc; the total duration of the S star phase is greater than or equal to 30,000 yr; and the stars inject 3 x 10 to the -6th solar masses/sq kpc yr into the interstellar medium. 46 references

  14. Patients' reports of barriers to expressing concerns during cancer consultations.

    Science.gov (United States)

    Brandes, Kim; Linn, Annemiek J; Smit, Edith G; van Weert, Julia C M

    2015-03-01

    To identify cancer patients' most influential barriers to expressing concerns during cancer consultations in a new manner by examining patients' reports of perceived barriers and perceived occurrence of barriers in consultations. Two online focus groups (N=16) and an online survey (N=236) were conducted among cancer patients and cancer survivors. The online focus groups and survey were used to examine two elements of patients' barriers, i.e., patients' reports of perceived barriers and perceived occurrence of barriers in consultations. Composite scores of these two elements were calculated to determine influential barriers. Results showed that the most influential barriers were related to providers' behavior (e.g., providers do not explicitly invite patients to express concerns) and the environment where the consultation takes place (e.g., perceived lack of time). The results of this study indicate that influential barriers to expressing concerns are barriers that patients cannot overcome themselves (i.e., they are related to providers' behavior or the environment of the consultation). A collaborative approach between researchers, providers and policy makers is needed to overcome these barriers. The results of this study can be used to develop strategies to overcome barriers to patients expressing concerns. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

    OpenAIRE

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

    2016-01-01

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

  16. The Effect of NPP's Stack Height to Radiation Dose

    International Nuclear Information System (INIS)

    Pandi, Liliana Yetta; Rohman, Budi

    2003-01-01

    The purpose of dose calculation for accidents is to analyze the capability of NPP to maintain the safety of public and workers in case an accident occurs on the Plant in a site. This paper calculates the Loss of Coolant Accident in PWR plant. The calculation results shows that no risks of serious radiation exposure are given to the neighboring public even if such a large accident occurred, and the effect of stack height can be predicted by analysis of the calculation results. The whole dose is calculated for some location (100 m, 300 m, 500 m, 700 m, 900 m, 1500 m, and 2000 m) with three difference stack height i.e. 0 m, 40 m and 100 m. The result of the whole dose calculation is under permitted criteria for whole dose : 0.25 Sv and thyroid dose : 3.0 Sv. The calculation of radiation dose in this paper use EEDCDQ code

  17. Evolutionary perspectives on human height variation

    NARCIS (Netherlands)

    Stulp, Gert; Barrett, Louise

    Human height is a highly variable trait, both within and between populations, has a high heritability, and influences the manner in which people behave and are treated in society. Although we know much about human height, this information has rarely been brought together in a comprehensive,

  18. Final height and intrauterine growth retardation.

    Science.gov (United States)

    Tauber, Maïthé

    2017-06-01

    Approximately 10% of small for gestational age (SGA) children maintain a small body size throughout childhood and often into adult life with a decreased pubertal spurt. Growth hormone (GH) therapy increases short-term growth in a dose-dependent manner and adult height had now been well documented. Shorter children might benefit from a higher dose at start (50μg/kg/day). The response to GH treatment was similar for both preterm and term short SGA groups and the effect of GH treatment on adult height showed a wide variation in growth response. As a whole, mean adult height is higher than -2 SDS in 60% of patients and 70% reached an adult height in their target height with better results with higher doses and combined GnRH analog therapy in those who were short at onset of puberty. Copyright © 2017. Published by Elsevier Masson SAS.

  19. Observing Crop-Height Dynamics Using a UAV

    Science.gov (United States)

    Ziliani, M. G.; Parkes, S. D.; McCabe, M.

    2017-12-01

    Retrieval of vegetation height during a growing season is a key indicator for monitoring crop status, offering insight to the forecast yield relative to previous planting cycles. Improvement in Unmanned Aerial Vehicle (UAV) technologies, supported by advances in computer vision and photogrammetry software, has enabled retrieval of crop heights with much higher spatial resolution and coverage. These methodologies retrieve a Digital Surface Map (DSM), which combine terrain and crop elements to obtain a Crop Surface Map (CSM). Here we describe an automated method for deriving high resolution CSMs from a DSM, using RGB imagery from a UAV platform. Importantly, the approach does not require the need for a digital terrain map (DTM). The method involves distinguishing between vegetation and bare-ground cover pixels, using vegetation index maps from the RGB orthomosaic derived from the same flight as the DSM. We show that the absolute crop height can be extracted to within several centimeters, exploiting the data captured from a single UAV flight. In addition, the method is applied across five surveys during a maize growing cycle and compared against a terrain map constructed from a baseline UAV survey undertaken prior to crop growth. Results show that the approach is able to reproduce the observed spatial variability of the crop height within the maize field throughout the duration of the growing season. This is particularly valuable since it may be employed to detect intra-field problems (i.e. fertilizer variability, inefficiency in the irrigation system, salinity etc.) at different stages of the season, from which remedial action can be initiated to mitigate against yield loss. The method also demonstrates that UAV imagery combined with commercial photogrammetry software can determine a CSM from a single flight without the requirement of a prior DTM. This, together with the dynamic crop height estimation, provide useful information with which to inform precision

  20. The Cost of Ankylosing Spondylitis in the UK Using Linked Routine and Patient-Reported Survey Data.

    Directory of Open Access Journals (Sweden)

    Roxanne Cooksey

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory arthritis which typically begins in early adulthood and impacts on healthcare resource utilisation and the ability to work. Previous studies examining the cost of AS have relied on patient-reported questionnaires based on recall. This study uses a combination of patient-reported and linked-routine data to examine the cost of AS in Wales, UK.Participants in an existing AS cohort study (n = 570 completed questionnaires regarding work status, out-of-pocket expenses, visits to health professionals and disease severity. Participants gave consent for their data to be linked to routine primary and secondary care clinical datasets. Health resource costs were calculated using a bottom-up micro-costing approach. Human capital costs methods were used to estimate work productivity loss costs, particularly relating to work and early retirement. Regression analyses were used to account for age, gender, disease activity.The total cost of AS in the UK is estimated at £19016 per patient per year, calculated to include GP attendance, administration costs and hospital costs derived from routine data records, plus patient-reported non-NHS costs, out-of-pocket AS-related expenses, early retirement, absenteeism, presenteeism and unpaid assistance costs. The majority of the cost (>80% was as a result of work-related costs.The major cost of AS is as a result of loss of working hours, early retirement and unpaid carer's time. Therefore, much of AS costs are hidden and not easy to quantify. Functional impairment is the main factor associated with increased cost of AS. Interventions which keep people in work to retirement age and reduce functional impairment would have the greatest impact on reducing costs of AS. The combination of patient-reported and linked routine data significantly enhanced the health economic analysis and this methodology that can be applied to other chronic conditions.

  1. The Cost of Ankylosing Spondylitis in the UK Using Linked Routine and Patient-Reported Survey Data.

    Science.gov (United States)

    Cooksey, Roxanne; Husain, Muhammad J; Brophy, Sinead; Davies, Helen; Rahman, Muhammad A; Atkinson, Mark D; Phillips, Ceri J; Siebert, Stefan

    2015-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory arthritis which typically begins in early adulthood and impacts on healthcare resource utilisation and the ability to work. Previous studies examining the cost of AS have relied on patient-reported questionnaires based on recall. This study uses a combination of patient-reported and linked-routine data to examine the cost of AS in Wales, UK. Participants in an existing AS cohort study (n = 570) completed questionnaires regarding work status, out-of-pocket expenses, visits to health professionals and disease severity. Participants gave consent for their data to be linked to routine primary and secondary care clinical datasets. Health resource costs were calculated using a bottom-up micro-costing approach. Human capital costs methods were used to estimate work productivity loss costs, particularly relating to work and early retirement. Regression analyses were used to account for age, gender, disease activity. The total cost of AS in the UK is estimated at £19016 per patient per year, calculated to include GP attendance, administration costs and hospital costs derived from routine data records, plus patient-reported non-NHS costs, out-of-pocket AS-related expenses, early retirement, absenteeism, presenteeism and unpaid assistance costs. The majority of the cost (>80%) was as a result of work-related costs. The major cost of AS is as a result of loss of working hours, early retirement and unpaid carer's time. Therefore, much of AS costs are hidden and not easy to quantify. Functional impairment is the main factor associated with increased cost of AS. Interventions which keep people in work to retirement age and reduce functional impairment would have the greatest impact on reducing costs of AS. The combination of patient-reported and linked routine data significantly enhanced the health economic analysis and this methodology that can be applied to other chronic conditions.

  2. Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome

    DEFF Research Database (Denmark)

    Storgaard, Filip Holst; Pedersen, Christina Gravgaard; Jensen, Majbritt Lykke

    Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome.......Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome....

  3. Collecting Patient Reported Outcomes in the Wild: Opportunities and Challenges.

    Science.gov (United States)

    Cabitza, Federico; Dui, Linda Greta

    2018-01-01

    Collecting Patient Reported Outcomes (PROs) is generally seen as an effective way to assess the efficacy and appropriateness of medical interventions, from the patients' perspective. In 2016 the Galeazzi Orthopaedic Institute established a digitized program of PROs collection from spine, hip and knee surgery patients. In this work, we re-port the findings from the data analysis of the responses collected so far about the complementarity of PROs with respect to the data reported by the clinicians, and about the main biases that can undermine their validity and reliability. Although PROs collection is recognized as being far more complex than just asking the patients "how they feel" on a regular basis and it entails costs and devoted electronic platforms, we advocate their further diffusion for the assessment of health technology and clinical procedures.

  4. Using Patient Reported Outcomes Measures to Promote Integrated Care

    Directory of Open Access Journals (Sweden)

    Marcel G. M. Olde Rikkert

    2018-04-01

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

  5. Patient-reported outcomes in borderline personality disorder

    Science.gov (United States)

    Hasler, Gregor; Hopwood, Christopher J.; Jacob, Gitta A.; Brändle, Laura S.; Schulte-Vels, Thomas

    2014-01-01

    Patient-reported outcome (PRO) refers to measures that emphasize the subjective view of patients about their health-related conditions and behaviors. Typically, PROs include self-report questionnaires and clinical interviews. Defining PROs for borderline personality disorder (BPD) is particularly challenging given the disorder's high symptomatic heterogeneity, high comorbidity with other psychiatric conditions, highly fluctuating symptoms, weak correlations between symptoms and functional outcomes, and lack of valid and reliable experimental measures to complement self-report data. Here, we provide an overview of currently used BPD outcome measures and discuss them from clinical, psychometric, experimental, and patient perspectives. In addition, we review the most promising leads to improve BPD PROs, including the DSM-5 Section III, the Recovery Approach, Ecological Momentary Assessments, and novel experimental measures of social functioning that are associated with functional and social outcomes. PMID:25152662

  6. Patient-reported outcome measures in arthroplasty registries

    DEFF Research Database (Denmark)

    Rolfson, Ola; Bohm, Eric; Franklin, Patricia

    2016-01-01

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

  7. Assessment of patient-reported symptoms of anxiety

    Science.gov (United States)

    Rose, Matthias; Devine, Janine

    2014-01-01

    Patient self-reported symptoms are of crucial importance to identify anxiety disorders, as well as to monitor their treatment in clinical practice and research. Thus, for evidence-based medicine, a precise, reliable, and valid (ie, “objective”) assessment of the patient's reported “subjective” symptoms is warranted. There is a plethora of instruments available, which can provide psychometrically sound assessments of anxiety, but there are several limitations of current tools that need to be carefully considered for their successful use. Nevertheless, the empirical assessment of mental health status is not as accepted in medicine as is the assessment of biomarkers. One reason for this may be that different instruments assessing the same psychological construct use different scales. In this paper we present some new developments that promise to provide one common metric for the assessment of anxiety, to facilitate the general acceptance of mental health assessments in the future. PMID:25152658

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

    Science.gov (United States)

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

    2018-01-29

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

  9. Height perception influenced by texture gradient.

    Science.gov (United States)

    Tozawa, Junko

    2012-01-01

    Three experiments were carried out to examine whether a texture gradient influences perception of relative object height. Previous research implicated texture cues in judgments of object width, but similar influences have not been demonstrated for relative height. In this study, I evaluate a hypothesis that the projective ratio of the number of texture elements covered by the objects combined with the ratio of the retinal object heights determines percepts of relative object height. Density of texture background was varied: four density conditions ranged from no-texture to very dense texture. In experiments 1 and 2, participants judged the height of comparison bar compared to the standard bar positioned on no-texture or textured backgrounds. Results showed relative height judgments differed with texture manipulations, consistent with predictions from a hypothesised combination of the number of texture elements with retinal height (experiment 1), or partially consistent with this hypothesis (experiment 2). In experiment 2, variations in the position of a comparison object showed that comparisons located far from the horizon were judged more poorly than in other positions. In experiment 3 I examined distance perception; relative distance judgments were found to be also affected by textured backgrounds. Results are discussed in terms of Gibson's relational theory and distance calibration theory.

  10. Global effects of income and income inequality on adult height and sexual dimorphism in height.

    Science.gov (United States)

    Bogin, Barry; Scheffler, Christiane; Hermanussen, Michael

    2017-03-01

    Average adult height of a population is considered a biomarker of the quality of the health environment and economic conditions. The causal relationships between height and income inequality are not well understood. We analyze data from 169 countries for national average heights of men and women and national-level economic factors to test two hypotheses: (1) income inequality has a greater association with average adult height than does absolute income; and (2) neither income nor income inequality has an effect on sexual dimorphism in height. Average height data come from the NCD-RisC health risk factor collaboration. Economic indicators are derived from the World Bank data archive and include gross domestic product (GDP), Gross National Income per capita adjusted for personal purchasing power (GNI_PPP), and income equality assessed by the Gini coefficient calculated by the Wagstaff method. Hypothesis 1 is supported. Greater income equality is most predictive of average height for both sexes. GNI_PPP explains a significant, but smaller, amount of the variation. National GDP has no association with height. Hypothesis 2 is rejected. With greater average adult height there is greater sexual dimorphism. Findings support a growing literature on the pernicious effects of inequality on growth in height and, by extension, on health. Gradients in height reflect gradients in social disadvantage. Inequality should be considered a pollutant that disempowers people from the resources needed for their own healthy growth and development and for the health and good growth of their children. © 2017 Wiley Periodicals, Inc.

  11. Forensic Physics 101: Falls from a height

    Science.gov (United States)

    Cross, Rod

    2008-09-01

    The physics of falling from a height, a topic that could be included in a course on forensic physics or in an undergraduate class as an example of Newton's laws, is applied to a common forensic problem.

  12. Estimating Mixing Heights Using Microwave Temperature Profiler

    Science.gov (United States)

    Nielson-Gammon, John; Powell, Christina; Mahoney, Michael; Angevine, Wayne

    2008-01-01

    A paper describes the Microwave Temperature Profiler (MTP) for making measurements of the planetary boundary layer thermal structure data necessary for air quality forecasting as the Mixing Layer (ML) height determines the volume in which daytime pollution is primarily concentrated. This is the first time that an airborne temperature profiler has been used to measure the mixing layer height. Normally, this is done using a radar wind profiler, which is both noisy and large. The MTP was deployed during the Texas 2000 Air Quality Study (TexAQS-2000). An objective technique was developed and tested for estimating the ML height from the MTP vertical temperature profiles. In order to calibrate the technique and evaluate the usefulness of this approach, estimates from a variety of measurements during the TexAQS-2000 were compared. Estimates of ML height were used from radiosondes, radar wind profilers, an aerosol backscatter lidar, and in-situ aircraft measurements in addition to those from the MTP.

  13. Soft computing methods for geoidal height transformation

    Science.gov (United States)

    Akyilmaz, O.; Özlüdemir, M. T.; Ayan, T.; Çelik, R. N.

    2009-07-01

    Soft computing techniques, such as fuzzy logic and artificial neural network (ANN) approaches, have enabled researchers to create precise models for use in many scientific and engineering applications. Applications that can be employed in geodetic studies include the estimation of earth rotation parameters and the determination of mean sea level changes. Another important field of geodesy in which these computing techniques can be applied is geoidal height transformation. We report here our use of a conventional polynomial model, the Adaptive Network-based Fuzzy (or in some publications, Adaptive Neuro-Fuzzy) Inference System (ANFIS), an ANN and a modified ANN approach to approximate geoid heights. These approximation models have been tested on a number of test points. The results obtained through the transformation processes from ellipsoidal heights into local levelling heights have also been compared.

  14. U.S. Geoid Heights (GEOID96)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This 2' geoid height grid for the conterminous United States is the GEOID96 model. The computation used about 1.8 million terrestrial and marine gravity data held in...

  15. PR/VI Geoid Heights (GEOID96)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This 2' geoid height grid for Puerto Rico and the Virgin Islands is distributed as a GEOID96 model. The computation used 26,000 terrestrial and marine gravity data...

  16. Principal Hawaiian Islands Geoid Heights (GEOID96)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This 2' geoid height grid for the Principal Hawaiian Islands is distributed as a GEOID96 model. The computation used 61,000 terrestrial and marine gravity data held...

  17. Challenges in Defining Tsunami Wave Height

    Science.gov (United States)

    Stroker, K. J.; Dunbar, P. K.; Mungov, G.; Sweeney, A.; Arcos, N. P.

    2017-12-01

    The NOAA National Centers for Environmental Information (NCEI) and co-located World Data Service for Geophysics maintain the global tsunami archive consisting of the historical tsunami database, imagery, and raw and processed water level data. The historical tsunami database incorporates, where available, maximum wave heights for each coastal tide gauge and deep-ocean buoy that recorded a tsunami signal. These data are important because they are used for tsunami hazard assessment, model calibration, validation, and forecast and warning. There have been ongoing discussions in the tsunami community about the correct way to measure and report these wave heights. It is important to understand how these measurements might vary depending on how the data were processed and the definition of maximum wave height. On September 16, 2015, an 8.3 Mw earthquake located 48 km west of Illapel, Chile generated a tsunami that was observed all over the Pacific region. We processed the time-series water level data for 57 tide gauges that recorded this tsunami and compared the maximum wave heights determined from different definitions. We also compared the maximum wave heights from the NCEI-processed data with the heights reported by the NOAA Tsunami Warning Centers. We found that in the near field different methods of determining the maximum tsunami wave heights could result in large differences due to possible instrumental clipping. We also found that the maximum peak is usually larger than the maximum amplitude (½ peak-to-trough), but the differences for the majority of the stations were Warning Centers. Since there is currently only one field in the NCEI historical tsunami database to store the maximum tsunami wave height, NCEI will consider adding an additional field for the maximum peak measurement.

  18. Ion transition heights from topside electron density profiles

    International Nuclear Information System (INIS)

    Titheridge, J.E.

    1976-01-01

    Theoretical electron density profiles are calculated for the topside ionosphere to determine the major factors controlling the profile shape. Only the mean temperature, the vertical temperature gradient and the O + /H + ion transition height are important. Vertical proton fluxes alter the ion transition height but have no other effect on the profile shape. Diffusive equilibrium profiles including only these three effects fit observed profiles, at all latitudes, to within experimental accuracy. Values of plasma temperature, temperature gradient and ion transition height hsub(T) were determined by fitting theoretical models to 60,000 experimental profiles obtained from Alouette 1 ionograms, at latitudes of 75 0 S to 85 0 N near solar minimum. Inside the plasmasphere hsub(T) varies from about 500 km on winter nights to 850 km on summer days. Diurnal variations are caused primarily by the production and loss of O + in the ionosphere. The approximately constant winter night value of hsub(T) is close to the level for chemical equilibrium. In summer hsub(T) is always above the equilibrium level, giving a continual production of protons which travel along lines of force to aid in maintaining the conjugate winter night ionosphere. Outside the plasmasphere hsub(T) is 300 to 600 km above the equilibrium level at all times. This implies a continual near-limiting upwards flux of protons which persists down to latitudes of about 60 0 at night and 50 0 during the day. (author)

  19. Love and fear of heights: the pathophysiology and psychology of height imbalance.

    Science.gov (United States)

    Salassa, John R; Zapala, David A

    2009-01-01

    Individual psychological responses to heights vary on a continuum from acrophobia to height intolerance, height tolerance, and height enjoyment. This paper reviews the English literature and summarizes the physiologic and psychological factors that generate different responses to heights while standing still in a static or motionless environment. Perceptual cues to height arise from vision. Normal postural sway of 2 cm for peripheral objects within 3 m increases as eye-object distance increases. Postural sway >10 cm can result in a fall. A minimum of 20 minutes of peripheral retinal arc is required to detect motion. Trigonometry dictates that a 20-minute peripheral retinal arch can no longer be achieved in a standing position at an eye-object distance of >20 m. At this distance, visual cues conflict with somatosensory and vestibular inputs, resulting in variable degrees of imbalance. Co-occurring deficits in the visual, vestibular, and somatosensory systems can significantly increase height imbalance. An individual's psychological makeup, influenced by learned and genetic factors, can influence reactions to height imbalance. Enhancing peripheral vision and vestibular, proprioceptive, and haptic functions may improve height imbalance. Psychotherapy may improve the troubling subjective sensations to heights.

  20. Social inequalities in height: persisting differences today depend upon height of the parents.

    Directory of Open Access Journals (Sweden)

    Bruna Galobardes

    Full Text Available Substantial increases in height have occurred concurrently with economic development in most populations during the last century. In high-income countries, environmental exposures that can limit genetic growth potential appear to have lessened, and variation in height by socioeconomic position may have diminished. The objective of this study is to investigate inequalities in height in a cohort of children born in the early 1990s in England, and to evaluate which factors might explain any identified inequalities.12,830 children from The Avon Longitudinal Study of Parents and Children (ALSPAC, a population based cohort from birth to about 11.5 years of age, were used in this analysis. Gender- and age-specific z-scores of height at different ages were used as outcome variables. Multilevel models were used to take into account the repeated measures of height and to analyze gender- and age-specific relative changes in height from birth to 11.5 years. Maternal education was the main exposure variable used to examine socioeconomic inequalities. The roles of parental and family characteristics in explaining any observed differences between maternal education and child height were investigated. Children whose mothers had the highest education compared to those with none or a basic level of education, were 0.39 cm longer at birth (95% CI: 0.30 to 0.48. These differences persisted and at 11.5 years the height difference was 1.4 cm (95% CI: 1.07 to 1.74. Several other factors were related to offspring height, but few changed the relationship with maternal education. The one exception was mid-parental height, which fully accounted for the maternal educational differences in offspring height.In a cohort of children born in the 1990s, mothers with higher education gave birth to taller boys and girls. Although height differences were small they persisted throughout childhood. Maternal and paternal height fully explained these differences.

  1. The Effects of Microgravity on Seated Height (Spinal Elongation)

    Science.gov (United States)

    Young, K. S.; Rajulu, S.

    2011-01-01

    ABSTRACT Many physiological factors, such as spinal elongation, fluid shifts, bone atrophy, and muscle loss, occur during an exposure to a microgravity environment. Spinal elongation is just one of the factors that can also affect the safety and performance of a crewmember while in space. Spinal elongation occurs due to the lack of gravity/compression on the spinal column. This allows for the straightening of the natural spinal curve. There is a possible fluid shift in the inter-vertebral disks that may also result in changes in height. This study aims at collecting the overall change in seated height for crewmembers exposed to a microgravity environment. During previous Programs, Apollo-Soyuz Test Project (ASTP) and Skylab, spinal elongation data was collected from a small number of subjects in a standing posture but were limited in scope. Data from these studies indicated a quick increase in stature during the first few days of weightlessness, after which stature growth reached a plateau resulting in up to a 3% increase of the original measurement [1-5]. However, this data was collected only for crewmembers in standing posture and not in a seated posture. Seated height may have a different effect than standing height due to a change in posture as well as due to a compounded effect of wearing restraints and a potential compression of the gluteal area. Seated height was deemed as a critical measurement in the design of the Constellation Program s (CxP) Crew Exploration Vehicle (CEV), called Orion which is now the point-of-departure vehicle for the Multi-Purpose Crew Vehicle (MPCV) Program; therefore a better understanding of the effects of microgravity on seated height is necessary. Potential changes in seated height that may not have impacted crew accommodation in previous Programs will have significant effects on crew accommodation due to the layout of seats in the Orion.. The current and existing configuration is such that the four crewmembers are stacked two by

  2. Patient reported outcome measures in male incontinence surgery.

    Science.gov (United States)

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

    2014-10-01

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

  3. Clinical and patient reported outcomes of bleaching effectiveness.

    Science.gov (United States)

    Klaric Sever, Eva; Budimir, Zrinka; Cerovac, Matea; Stambuk, Mario; Par, Matej; Negovetic Vranic, Dubravka; Tarle, Zrinka

    2018-01-01

    The objective of this study is to evaluate clinical and patient reported outcomes of different bleaching products. Thirty participants were randomly divided into three bleaching groups (n = 10). Bleaching was performed with high concentrations of hydrogen peroxide (HP) - Boost (40%) and Dash (30%), and with prefabricated splints Bite&White (6% HP). Tooth colour was measured before, immediately after, and 1 and 6 months after the bleaching by using classical shade guide and spectrophotometer. Tooth hypersensitivity was self-rated by patients on the Wong-Baker's face scale. Patient satisfaction was evaluated on a 7-point Likert-type scales that measured perceived performance and importance of different characteristics of bleaching treatment. All products were effective in teeth colour change (ΔE > 3.3), which was significantly higher for Boost (p = .016) and Dash (p = .024) than Bite&White treatment. Perception of hypersensitivity was the highest in Boost group, followed by Dash and Bite&White treatment. Most of the patients were satisfied with final tooth colour, length and comfort during treatment, but were dissatisfied with the stability of bleached tooth colour. Materials with the higher concentrations of bleaching agent demonstrated greater bleaching effectiveness than at-home bleaching product, but also a greater hypersensitivity. Lengthening the treatment process, but achieving a more stable tooth colour may improve the perceived value of a bleaching service.

  4. Does CPAP Affect Patient-Reported Voice Outcomes?

    Science.gov (United States)

    Hartke, Vance; Gillespie, Amanda; Smith, Libby J; Soose, Ryan J

    2018-04-01

    Upper aerodigestive tract symptoms are common in patients with obstructive sleep apnea (OSA). It remains unclear whether continuous positive airway pressure (CPAP) improves or worsens these otolaryngology symptoms. As therapy-related side effects limit CPAP adherence, this study aimed to determine if CPAP negatively affects voice, sinonasal, and reflux symptoms of the upper airway. Case series with planned data collection was performed at an academic otolaryngology sleep center. Newly diagnosed patients with OSA were evaluated before and 6 months after initiating CPAP therapy. Data collected included CPAP data download, Reflux Symptom Index (RSI), Epworth Sleepiness Scale (ESS), Voice Handicap Index 10 (VHI-10), Sino-Nasal Questionnaire (SNQ), and oral dryness visual analog scale (VAS). For the 11 CPAP-adherent participants, the RSI significantly improved with CPAP (mean RSI, 22.0-9.5; P = .002); however, the VAS, VHI-10, and SNQ did not change after 6 months of CPAP therapy. In a small sample size, patient-reported voice outcomes (VHI-10) and other upper aerodigestive tract symptoms did not worsen with CPAP; rather, CPAP therapy was associated with a reduction in reflux symptoms.

  5. Experiencing Loss

    DEFF Research Database (Denmark)

    Kristiansen, Maria; Younis, Tarek; Hassani, Amani

    2015-01-01

    In this article, we explore how Islam, minority status and refugee experiencesintersect in shaping meaning-making processes following bereavement. We do this througha phenomenological analysis of a biographical account of personal loss told by Aisha, a Muslim Palestinian refugee living in Denmark......, who narrates her experience of losing herhusband to lung cancer. By drawing on a religious framework, Aisha creates meaning fromher loss, which enables her to incorporate this loss into her life history and sustain agency.Her narrative invites wider audiences to witness her tale of overcoming loss...

  6. Birth order progressively affects childhood height.

    Science.gov (United States)

    Savage, Tim; Derraik, José G B; Miles, Harriet L; Mouat, Fran; Cutfield, Wayne S; Hofman, Paul L

    2013-09-01

    There is evidence suggesting that first-born children and adults are anthropometrically different to later-borns. Thus, we aimed to assess whether birth order was associated with changes in growth and metabolism in childhood. We studied 312 healthy prepubertal children: 157 first-borns and 155 later-borns. Children were aged 3-10 years, born 37-41 weeks gestation, and of birth weight appropriate-for-gestational-age. Clinical assessments included measurement of children's height, weight, fasting lipid and hormonal profiles and DEXA-derived body composition. First-borns were taller than later-borns (P < 0·0001), even when adjusted for parents' heights (0·31 vs 0·03 SDS; P = 0·001). There was an incremental height decrease with increasing birth order, so that first-borns were taller than second-borns (P < 0·001), who were in turn taller than third-borns (P = 0·007). Further, among sibling pairs both height SDS (P = 0·009) and adjusted height SDS (P < 0·0001) were lower in second- vs first-born children. Consistent with differences in stature, first- (P = 0·043) and second-borns (P = 0·003) had higher IGF-I concentrations than third-borns. Both first- (P < 0·001) and second-borns (P = 0·004) also had reduced abdominal adiposity (lower android fat to gynoid fat ratio) when compared with third-borns. Other parameters of adiposity and blood lipids were unaffected by birth order. First-borns were taller than later-born children, with an incremental height reduction from first to third birth order. These differences were present after correction for genetic height, and associated to some extent with alterations in plasma IGF-I. Our findings strengthen the evidence that birth order is associated with phenotypic changes in childhood. © 2013 John Wiley & Sons Ltd.

  7. A systematic review and development of a classification framework for factors associated with missing patient-reported outcome data.

    Science.gov (United States)

    Palmer, Michael J; Mercieca-Bebber, Rebecca; King, Madeleine; Calvert, Melanie; Richardson, Harriet; Brundage, Michael

    2018-02-01

    Missing patient-reported outcome data can lead to biased results, to loss of power to detect between-treatment differences, and to research waste. Awareness of factors may help researchers reduce missing patient-reported outcome data through study design and trial processes. The aim was to construct a Classification Framework of factors associated with missing patient-reported outcome data in the context of comparative studies. The first step in this process was informed by a systematic review. Two databases (MEDLINE and CINAHL) were searched from inception to March 2015 for English articles. Inclusion criteria were (a) relevant to patient-reported outcomes, (b) discussed missing data or compliance in prospective medical studies, and (c) examined predictors or causes of missing data, including reasons identified in actual trial datasets and reported on cover sheets. Two reviewers independently screened titles and abstracts. Discrepancies were discussed with the research team prior to finalizing the list of eligible papers. In completing the systematic review, four particular challenges to synthesizing the extracted information were identified. To address these challenges, operational principles were established by consensus to guide the development of the Classification Framework. A total of 6027 records were screened. In all, 100 papers were eligible and included in the review. Of these, 57% focused on cancer, 23% did not specify disease, and 20% reported for patients with a variety of non-cancer conditions. In total, 40% of the papers offered a descriptive analysis of possible factors associated with missing data, but some papers used other methods. In total, 663 excerpts of text (units), each describing a factor associated with missing patient-reported outcome data, were extracted verbatim. Redundant units were identified and sequestered. Similar units were grouped, and an iterative process of consensus among the investigators was used to reduce these units to a

  8. Memory loss

    Science.gov (United States)

    ... barbiturates or ( hypnotics ) ECT (electroconvulsive therapy) (most often short-term memory loss) Epilepsy that is not well controlled Illness that ... appointment. Medical history questions may include: Type of memory loss, such as short-term or long-term Time pattern, such as how ...

  9. Oncology patient-reported claims: maximising the chance for success.

    Science.gov (United States)

    Kitchen, H; Rofail, D; Caron, M; Emery, M-P

    2011-01-01

    To review Patient Reported Outcome (PRO) labelling claims achieved in oncology in Europe and in the United States and consider the benefits, and challenges faced. PROLabels database was searched to identify oncology products with PRO labelling approved in Europe since 1995 or in the United States since 1998. The US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) websites and guidance documents were reviewed. PUBMED was searched for articles on PRO claims in oncology. Among all oncology products approved, 22 were identified with PRO claims; 10 in the United States, 7 in Europe, and 5 in both. The language used in the labelling was limited to benefit (e.g. "…resulted in symptom benefits by significantly prolonging time to deterioration in cough, dyspnoea, and pain, versus placebo") and equivalence (e.g. "no statistical differences were observed between treatment groups for global QoL"). Seven products used a validated HRQoL tool; two used symptom tools; two used both; seven used single-item symptom measures (one was unknown). The following emerged as likely reasons for success: ensuring systematic PRO data collection; clear rationale for pre-specified endpoints; adequately powered trials to detect differences and clinically significant changes; adjusting for multiplicity; developing an a priori statistical analysis plan including primary and subgroup analyses, dealing with missing data, pooling multiple-site data; establishing clinical versus statistical significance; interpreting failure to detect change. End-stage patient drop-out rates and cessation of trials due to exceptional therapeutic benefit pose significant challenges to demonstrating treatment PRO improvement. PRO labelling claims demonstrate treatment impact and the trade-off between efficacy and side effects ultimately facilitating product differentiation. Reliable and valid instruments specific to the desired language, claim, and target population are required. Practical

  10. Patient Compliance With Electronic Patient Reported Outcomes Following Shoulder Arthroscopy.

    Science.gov (United States)

    Makhni, Eric C; Higgins, John D; Hamamoto, Jason T; Cole, Brian J; Romeo, Anthony A; Verma, Nikhil N

    2017-11-01

    To determine the patient compliance in completing electronically administered patient-reported outcome (PRO) scores following shoulder arthroscopy, and to determine if dedicated research assistants improve patient compliance. Patients undergoing arthroscopic shoulder surgery from January 1, 2014, to December 31, 2014, were prospectively enrolled into an electronic data collection system with retrospective review of compliance data. A total of 143 patients were included in this study; 406 patients were excluded (for any or all of the following reasons, such as incomplete follow-up, inaccessibility to the order sets, and inability to complete the order sets). All patients were assigned an order set of PROs through an electronic reporting system, with order sets to be completed prior to surgery, as well as 6 and 12 months postoperatively. Compliance rates of form completion were documented. Patients who underwent arthroscopic anterior and/or posterior stabilization were excluded. The average age of the patients was 53.1 years, ranging from 20 to 83. Compliance of form completion was highest preoperatively (76%), and then dropped subsequently at 6 months postoperatively (57%) and 12 months postoperatively (45%). Use of research assistants improved compliance by approximately 20% at each time point. No differences were found according to patient gender and age group. Of those completing forms, a majority completed forms at home or elsewhere prior to returning to the office for the clinic visit. Electronic administration of PRO may decrease the amount of time required in the office setting for PRO completion by patients. This may be mutually beneficial to providers and patients. It is unclear if an electronic system improves patient compliance in voluntary completion PRO. Compliance rates at final follow-up remain a concern if data are to be used for establishing quality or outcome metrics. Level IV, case series. Copyright © 2017 Arthroscopy Association of North

  11. Cognitive reserve and patient-reported outcomes in multiple sclerosis.

    Science.gov (United States)

    Schwartz, Carolyn E; Snook, Erin; Quaranto, Brian; Benedict, Ralph H B; Vollmer, Timothy

    2013-01-01

    Adaptation and compensation in the face of changing pathology may be better understood by considering the concept of cognitive reserve, which may protect against disability in multiple sclerosis (MS). The present work investigates the relationship between cognitive reserve and demographic characteristics, health behaviors, and patient-reported outcomes (PROs). Cross-sectional data (n=1142) were drawn from the North American Research Committee on MS (NARCOMS) Registry, from whom additional survey data were collected. Cognitive reserve was measured using the Stern and Sole-Padulles measures, the O*NET occupational classification system, and the Godin Leisure-Time Exercise Questionnaire. PROs were assessed using generic (SF -12v2, Perceived Deficits Questionnaire, Ryff Psychological Well-Being, Diener Satisfaction with Life Scale) and disease-specific (Patient-Determined Disease Steps, Performance Scales) measures. Psychometric analysis created unidimensional cognitive reserve subscales. Regression models examined relationships between cognitive reserve, demographic characteristics, and PROs. The cognitive reserve measures assessed distinct but related constructs. Individuals with high cognitive reserve were more likely to report lower levels of perceived disability and perceived cognitive deficits, and higher levels of physical health, mental health, and well-being. Both active and passive reserve are associated with better outcomes, independent of demographic factors, and these associations apply to both generic and disease-specific outcomes. This expanded measurement of cognitive reserve captures both the passive and active aspects of the construct, and there is a consistent and substantial relationship with PROs. Individuals with high passive and/or active reserve are healthier and experience higher levels of well-being.

  12. The height of watermelons with wall

    International Nuclear Information System (INIS)

    Feierl, Thomas

    2012-01-01

    We derive asymptotics for the moments as well as the weak limit of the height distribution of watermelons with p branches with wall. This generalizes a famous result of de Bruijn et al (1972 Graph Theory and Computing (New York: Academic) pp 15–22) on the average height of planted plane trees, and results by Fulmek (2007 Electron. J. Combin. 14 R64) and Katori et al (2008 J. Stat. Phys. 131 1067–83) on the expected value and higher moments, respectively, of the height distribution of watermelons with two branches. The asymptotics for the moments depend on the analytic behaviour of certain multidimensional Dirichlet series. In order to obtain this information, we prove a reciprocity relation satisfied by the derivatives of one of Jacobi’s theta functions, which generalizes the well-known reciprocity law for Jacobi’s theta functions. (paper)

  13. Experiences of ZAMG on mixing height determination

    Energy Technology Data Exchange (ETDEWEB)

    Piringer, M. [Zentralanstalt fuer Meteorologie und Geodynamik, ZAMG, Vienna (Austria)

    1997-10-01

    Temperature inversions in the boundary layer occur quite often, esp. in mountainous terrain by which Austria is covered to a large extent, and can lead to enhanced pollution at the surface because the air volume available for dilution is then vertically limited. The Department of Environmental Meteorology of ZAMG therefore set up several field programs in the past to study such conditions at a variety of sites in Austria, using tethersondes and Sodars. Early investigations aimed at comparing Sodar echo profiles to the tethersonde temperature profiles to derive mixing heights from the Sodar echo structure. More recently, evolving from KONGEX, the `convective boundary layer experiment`, mixing heights calculated for Vienna by the OML model were compared to those derived from radiosonde and tethersonde potential temperature profiles. Results of these investigations will be presented, focussing on the problems when using the different methods. New efforts to derive mixing heights from data were also undertaken and are discussed separately. (au)

  14. Height, Relationship Satisfaction, Jealousy, and Mate Retention

    Directory of Open Access Journals (Sweden)

    Gayle Brewer

    2009-07-01

    Full Text Available Male height is associated with high mate value. In particular, tall men are perceived as more attractive, dominant and of a higher status than shorter rivals, resulting in a greater lifetime reproductive success. Female infidelity and relationship dissolution may therefore present a greater risk to short men. It was predicted that tall men would report greater relationship satisfaction and lower jealousy and mate retention behavior than short men. Ninety eight heterosexual men in a current romantic relationship completed a questionnaire. Both linear and quadratic relationships were found between male height and relationship satisfaction, cognitive and behavioral jealousy. Tall men reported greater relationship satisfaction and lower levels of cognitive or behavioral jealousy than short men. In addition, linear and quadratic relationships were found between male height and a number of mate retention behaviors. Tall and short men engaged in different mate retention behaviors. These findings are consistent with previous research conducted in this area detailing the greater attractiveness of tall men.

  15. Evidence of inbreeding depression on human height.

    Directory of Open Access Journals (Sweden)

    Ruth McQuillan

    Full Text Available Stature is a classical and highly heritable complex trait, with 80%-90% of variation explained by genetic factors. In recent years, genome-wide association studies (GWAS have successfully identified many common additive variants influencing human height; however, little attention has been given to the potential role of recessive genetic effects. Here, we investigated genome-wide recessive effects by an analysis of inbreeding depression on adult height in over 35,000 people from 21 different population samples. We found a highly significant inverse association between height and genome-wide homozygosity, equivalent to a height reduction of up to 3 cm in the offspring of first cousins compared with the offspring of unrelated individuals, an effect which remained after controlling for the effects of socio-economic status, an important confounder (χ(2 = 83.89, df = 1; p = 5.2 × 10(-20. There was, however, a high degree of heterogeneity among populations: whereas the direction of the effect was consistent across most population samples, the effect size differed significantly among populations. It is likely that this reflects true biological heterogeneity: whether or not an effect can be observed will depend on both the variance in homozygosity in the population and the chance inheritance of individual recessive genotypes. These results predict that multiple, rare, recessive variants influence human height. Although this exploratory work focuses on height alone, the methodology developed is generally applicable to heritable quantitative traits (QT, paving the way for an investigation into inbreeding effects, and therefore genetic architecture, on a range of QT of biomedical importance.

  16. Adult height, dietary patterns, and healthy aging.

    Science.gov (United States)

    Ma, Wenjie; Hagan, Kaitlin A; Heianza, Yoriko; Sun, Qi; Rimm, Eric B; Qi, Lu

    2017-08-01

    Background: Adult height has shown directionally diverse associations with several age-related disorders, including cardiovascular disease, cancer, decline in cognitive function, and mortality. Objective: We investigated the associations of adult height with healthy aging measured by a full spectrum of health outcomes, including incidence of chronic diseases, memory, physical functioning, and mental health, among populations who have survived to older age, and whether lifestyle factors modified such relations. Design: We included 52,135 women (mean age: 44.2 y) from the Nurses' Health Study without chronic diseases in 1980 and whose health status was available in 2012. Healthy aging was defined as being free of 11 major chronic diseases and having no reported impairment of subjective memory, physical impairment, or mental health limitations. Results: Of all eligible study participants, 6877 (13.2%) were classified as healthy agers. After adjustment for demographic and lifestyle factors, we observed an 8% (95% CI: 6%, 11%) decrease in the odds of healthy aging per SD (0.062 m) increase in height. Compared with the lowest category of height (≤1.57 m), the OR of achieving healthy aging in the highest category (≥1.70 m) was 0.80 (95% CI: 0.73, 0.87; P -trend healthy aging ( P -interaction = 0.005), and among the individual dietary factors characterizing the prudent dietary pattern, fruit and vegetable intake showed the strongest effect modification ( P -interaction = 0.01). The association of greater height with reduced odds of healthy aging appeared to be more evident among women with higher adherence to the prudent dietary pattern rich in vegetable and fruit intake. Conclusions: Greater height was associated with a modest decrease in the likelihood of healthy aging. A prudent diet rich in fruit and vegetables might modify the relation. © 2017 American Society for Nutrition.

  17. Weight Loss

    Science.gov (United States)

    ... Rights Employment Discrimination Health Care Professionals Law Enforcement Driver's License For Lawyers Food & Fitness Home Food MyFoodAdvisor ... Fit Types of Activity Weight Loss Assess Your Lifestyle Getting Started Food Choices In My Community Home ...

  18. Tree height and tropical forest biomass estimation

    Science.gov (United States)

    M.O. Hunter; M. Keller; D. Vitoria; D.C. Morton

    2013-01-01

    Tropical forests account for approximately half of above-ground carbon stored in global vegetation. However, uncertainties in tropical forest carbon stocks remain high because it is costly and laborious to quantify standing carbon stocks. Carbon stocks of tropical forests are determined using allometric relations between tree stem diameter and height and biomass....

  19. Falls from height: A retrospective analysis.

    Science.gov (United States)

    Turgut, Kasim; Sarihan, Mehmet Ediz; Colak, Cemil; Güven, Taner; Gür, Ali; Gürbüz, Sükrü

    2018-01-01

    Emergency services manage trauma patients frequently and falls from height comprise the main cause of emergency service admissions. In this study, we aimed to analyse the demographic characteristics of falls from height and their relationship to the mortality. A total of 460 patients, who admitted to the Emergency Department of Inonu University between November 2011 and November 2014 with a history of fall from height, were examined retrospectively. Demographic parameters, fall characteristics and their effect to mortality were evaluated statistically. The study comprised of 292 (63.5%) men and 168 (36.5%) women patients. The mean age of all patients was 27±24.99 years. Twenty-six (5.6%) patients died and the majority of them were in ≥62 years old group. The highest percentage of falls was at 0-5 years age group (28.3%). People fell mainly from 1.1-4 metres(m) level (46.1%). The causes of falls were ordered as unintentional (92.2%), workplace (8.1%) and suicidal (1.7%). Skin and soft tissue injuries (37.4%) were the main traumatic lesions. Age, fall height, fall place, lineer skull fracture, subarachnoidal hemorrhage, cervical fracture, thoracic vertebra fracture and trauma scores had statistically significant effect on mortality. The casualties died because of subarachnoid hemorrhage mostly.

  20. Optimizing height presentation for aircraft cockpit displays

    Science.gov (United States)

    Jordan, Chris S.; Croft, D.; Selcon, Stephen J.; Markin, H.; Jackson, M.

    1997-02-01

    This paper describes an experiment conducted to investigate the type of display symbology that most effectively conveys height information to users of head-down plan-view radar displays. The experiment also investigated the use of multiple information sources (redundancy) in the design of such displays. Subjects were presented with eight different height display formats. These formats were constructed from a control, and/or one, two, or three sources of redundant information. The three formats were letter coding, analogue scaling, and toggling (spatially switching the position of the height information from above to below the aircraft symbol). Subjects were required to indicate altitude awareness via a four-key, forced-choice keyboard response. Error scores and response times were taken as performance measures. There were three main findings. First, there was a significant performance advantage when the altitude information was presented above and below the symbol to aid the representation of height information. Second, the analogue scale, a line whose length indicated altitude, proved significantly detrimental to performance. Finally, no relationship was found between the number of redundant information sources employed and performance. The implications for future aircraft and displays are discussed in relation to current aircraft tactical displays and in the context of perceptual psychological theory.

  1. Pulse height model for deuterated scintillation detectors

    International Nuclear Information System (INIS)

    Wang, Haitang; Enqvist, Andreas

    2015-01-01

    An analytical model of light pulse height distribution for finite deuterated scintillation detectors is created using the impulse approximation. Particularly, the energy distribution of a scattered neutron is calculated based on an existing collision probability scheme for general cylindrical shaped detectors considering double differential cross-sections. The light pulse height distribution is analytically and numerically calculated by convoluting collision sequences with the light output function for an EJ-315 detector from our measurements completed at Ohio University. The model provides a good description of collision histories capturing transferred neutron energy in deuterium-based scintillation materials. The resulting light pulse height distribution details pulse compositions and their corresponding contributions. It shows that probabilities of neutron collision with carbon and deuterium nuclei are comparable, however the light pulse amplitude due to collisions with carbon nuclei is small and mainly located at the lower region of the light pulse distribution axis. The model can explore those neutron interaction events that generate pulses near or below a threshold that would be imposed in measurements. A comparison is made between the light pulse height distributions given by the analytical model and measurements. It reveals a significant probability of a neutron generating a small light pulse due to collisions with carbon nuclei when compared to larger light pulse generated by collisions involving deuterium nuclei. This model is beneficial to understand responses of scintillation materials and pulse compositions, as well as nuclei information extraction from recorded pulses.

  2. Aircraft height estimation using 2-D radar

    CSIR Research Space (South Africa)

    Hakl, H

    2010-01-01

    Full Text Available A method to infer height information from an aircraft tracked with a single 2-D search radar is presented. The method assumes level flight in the target aircraft and a good estimate of the speed of the aircraft. The method yields good results...

  3. Evidence of inbreeding depression on human height

    NARCIS (Netherlands)

    R. McQuillan (Ruth); N. Eklund (Niina); N. Pirastu (Nicola); M. Kuningas (Maris); B.P. McEvoy (Brian); T. Esko (Tõnu); T. Corre (Tanguy); G. Davies (Gail); M. Kaakinen (Marika); L.-P. Lyytikäinen (Leo-Pekka); K. Kristiansson (Kati); A.S. Havulinna (Aki); M. Gögele (Martin); V. Vitart (Veronique); A. Tenesa (Albert); Y.S. Aulchenko (Yurii); C. Hayward (Caroline); A. Johansson (Åsa); M. Boban (Mladen); S. Ulivi (Shelia); A. Robino (Antonietta); V. Boraska (Vesna); W. Igl (Wilmar); S.H. Wild (Sarah); L. Zgaga (Lina); N. Amin (Najaf); E. Theodoratou (Evropi); O. Polasek (Ozren); S. Girotto; L.M. Lopez (Lorna); C. Sala (Cinzia); J. Lahti (Jari); T. Laatikainen (Tiina); I. Prokopenko (Inga); M. Kals (Mart); J. Viikari (Jorma); J. Yang (Joanna); A. Pouta (Anneli); K. Estrada Gil (Karol); A. Hofman (Albert); N.B. Freimer (Nelson); N.G. Martin (Nicholas); M. Kähönen (Mika); L. Milani (Lili); M. Heliovaara (Markku); E. Vartiainen (Erkki); K. Räikkönen (Katri); C. Masciullo (Corrado); J.M. Starr (John); A.A. Hicks (Andrew); L. Esposito (Laura); I. Kolcic (Ivana); S.M. Farrington (Susan); B.A. Oostra (Ben); T. Zemunik (Tatijana); H. Campbell (Harry); M. Kirin (Mirna); M. Pehlic (Marina); F. Faletra (Flavio); D.J. Porteous (David J.); G. Pistis (Giorgio); E. Widen (Elisabeth); V. Salomaa (Veikko); S. Koskinen (Seppo); K. Fischer (Krista); T. Lehtimäki (Terho); A.C. Heath (Andrew); M.I. McCarthy (Mark); F. Rivadeneira Ramirez (Fernando); G.W. Montgomery (Grant); H.W. Tiemeier (Henning); A.L. Hartikainen; P.A.F. Madden (Pamela); P. d' Adamo (Pio); N. Hastie (Nick); U. Gyllensten (Ulf); A.F. Wright (Alan); C.M. van Duijn (Cornelia); M.G. Dunlop (Malcolm); I. Rudan (Igor); P. Gasparini (Paolo); P.P. Pramstaller (Peter Paul); I.J. Deary (Ian); D. Toniolo (Daniela); K. Hagen (Knut); A. Jula (Antti); O. Raitakari (Olli); A. Metspalu (Andres); M. Perola (Markus); M.-R. Jarvelin (Marjo-Riitta); A.G. Uitterlinden (André); P.M. Visscher (Peter); J.F. Wilson (James)

    2012-01-01

    textabstractStature is a classical and highly heritable complex trait, with 80%-90% of variation explained by genetic factors. In recent years, genome-wide association studies (GWAS) have successfully identified many common additive variants influencing human height; however, little attention has

  4. Predicting vertical jump height from bar velocity.

    Science.gov (United States)

    García-Ramos, Amador; Štirn, Igor; Padial, Paulino; Argüelles-Cienfuegos, Javier; De la Fuente, Blanca; Strojnik, Vojko; Feriche, Belén

    2015-06-01

    The objective of the study was to assess the use of maximum (Vmax) and final propulsive phase (FPV) bar velocity to predict jump height in the weighted jump squat. FPV was defined as the velocity reached just before bar acceleration was lower than gravity (-9.81 m·s(-2)). Vertical jump height was calculated from the take-off velocity (Vtake-off) provided by a force platform. Thirty swimmers belonging to the National Slovenian swimming team performed a jump squat incremental loading test, lifting 25%, 50%, 75% and 100% of body weight in a Smith machine. Jump performance was simultaneously monitored using an AMTI portable force platform and a linear velocity transducer attached to the barbell. Simple linear regression was used to estimate jump height from the Vmax and FPV recorded by the linear velocity transducer. Vmax (y = 16.577x - 16.384) was able to explain 93% of jump height variance with a standard error of the estimate of 1.47 cm. FPV (y = 12.828x - 6.504) was able to explain 91% of jump height variance with a standard error of the estimate of 1.66 cm. Despite that both variables resulted to be good predictors, heteroscedasticity in the differences between FPV and Vtake-off was observed (r(2) = 0.307), while the differences between Vmax and Vtake-off were homogenously distributed (r(2) = 0.071). These results suggest that Vmax is a valid tool for estimating vertical jump height in a loaded jump squat test performed in a Smith machine. Key pointsVertical jump height in the loaded jump squat can be estimated with acceptable precision from the maximum bar velocity recorded by a linear velocity transducer.The relationship between the point at which bar acceleration is less than -9.81 m·s(-2) and the real take-off is affected by the velocity of movement.Mean propulsive velocity recorded by a linear velocity transducer does not appear to be optimal to monitor ballistic exercise performance.

  5. A GEOMETRICAL HEIGHT SCALE FOR SUNSPOT PENUMBRAE

    International Nuclear Information System (INIS)

    Puschmann, K. G.; Ruiz Cobo, B.; MartInez Pillet, V.

    2010-01-01

    Inversions of spectropolarimetric observations of penumbral filaments deliver the stratification of different physical quantities in an optical depth scale. However, without establishing a geometrical height scale, their three-dimensional geometrical structure cannot be derived. This is crucial in understanding the correct spatial variation of physical properties in the penumbral atmosphere and to provide insights into the mechanism capable of explaining the observed penumbral brightness. The aim of this work is to determine a global geometrical height scale in the penumbra by minimizing the divergence of the magnetic field vector and the deviations from static equilibrium as imposed by a force balance equation that includes pressure gradients, gravity, and the Lorentz force. Optical depth models are derived from the inversion of spectropolarimetric data of an active region observed with the Solar Optical Telescope on board the Hinode satellite. We use a genetic algorithm to determine the boundary condition for the inference of geometrical heights. The retrieved geometrical height scale permits the evaluation of the Wilson depression at each pixel and the correlation of physical quantities at each height. Our results fit into the uncombed penumbral scenario, i.e., a penumbra composed of flux tubes with channeled mass flow and with a weaker and more horizontal magnetic field as compared with the background field. The ascending material is hotter and denser than their surroundings. We do not find evidence of overturning convection or field-free regions in the inner penumbral area analyzed. The penumbral brightness can be explained by the energy transfer of the ascending mass carried by the Evershed flow, if the physical quantities below z = -75 km are extrapolated from the results of the inversion.

  6. Atmosphere Impact Losses

    Science.gov (United States)

    Schlichting, Hilke E.; Mukhopadhyay, Sujoy

    2018-02-01

    } ρ0 (π h R)^{3/2}, r_{cap}˜25 km for the current Earth), that are able to eject all the atmosphere above the tangent plane of the impact site, where h, R and ρ0 are the atmospheric scale height, radius of the target, and its atmospheric density at the ground. 3) Small impactors (m_{min}>4 πρ0 h3, r_{min}˜ 1 km for the current Earth), that are only able to eject a fraction of the atmospheric mass above the tangent plane. We demonstrate that per unit impactor mass, small impactors with r_{min} < r < r_{cap} are the most efficient impactors in eroding the atmosphere. In fact for the current atmospheric mass of the Earth, they are more than five orders of magnitude more efficient (per unit impactor mass) than giant impacts, implying that atmospheric mass loss must have been common. The enormous atmospheric mass loss efficiency of small impactors is due to the fact that most of their impact energy and momentum is directly available for local mass loss, where as in the giant impact regime a lot of energy and momentum is 'wasted' by having to create a strong shock that can transverse the entirety of the planet such that global atmospheric loss can be achieved. In the absence of any volatile delivery and outgassing, we show that the population of late impactors inferred from the lunar cratering record containing 0.1% M_{\\oplus } is able to erode the entire current Earth's atmosphere implying that an interplay of erosion, outgassing and volatile delivery is likely responsible for determining the atmospheric mass and composition of the early Earth. Combining geochemical observations with impact models suggest an interesting synergy between small and big impacts, where giant impacts create large magma oceans and small and larger impacts drive the atmospheric loss.

  7. Hidden loss

    DEFF Research Database (Denmark)

    Kieffer-Kristensen, Rikke; Johansen, Karen Lise Gaardsvig

    2013-01-01

    to participate. RESULTS: All children were affected by their parents' ABI and the altered family situation. The children's expressions led the authors to identify six themes, including fear of losing the parent, distress and estrangement, chores and responsibilities, hidden loss, coping and support. The main......PRIMARY OBJECTIVE: The purpose of this study was to listen to and learn from children showing high levels of post-traumatic stress symptoms after parental acquired brain injury (ABI), in order to achieve an in-depth understanding of the difficulties the children face in their everyday lives...... finding indicates that the children experienced numerous losses, many of which were often suppressed or neglected by the children to protect the ill parents. CONCLUSIONS: The findings indicated that the children seemed to make a special effort to hide their feelings of loss and grief in order to protect...

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

    Science.gov (United States)

    Powell, J; Powell, S; Robson, A

    2018-01-01

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

  9. BOREAS AFM-6 Boundary Layer Height Data

    Science.gov (United States)

    Wilczak, James; Hall, Forrest G. (Editor); Newcomer, Jeffrey A. (Editor); Smith, David E. (Technical Monitor)

    2000-01-01

    The Boreal Ecosystem-Atmosphere Study (BOREAS) Airborne Fluxes and Meteorology (AFM)-6 team from National Oceanic and Atmospheric Adminsitration/Environment Technology Laboratory (NOAA/ETL) operated a 915-MHz wind/Radio Acoustic Sounding System (RASS) profiler system in the Southern Study Area (SSA) near the Old Jack Pine (OJP) site. This data set provides boundary layer height information over the site. The data were collected from 21 May 1994 to 20 Sep 1994 and are stored in tabular ASCII files. The boundary layer height data are available from the Earth Observing System Data and Information System (EOSDIS) Oak Ridge National Laboratory (ORNL) Distributed Active Archive Center (DAAC). The data files are available on a CD-ROM (see document number 20010000884).

  10. Towards worldwide height unification using ocean information

    Directory of Open Access Journals (Sweden)

    P. L. Woodworth

    2015-03-01

    Full Text Available This paper describes how we are contributing to worldwide height system unification (WHSU by using ocean models together with sea level (tide gauge and altimeter information, geodetic (GPS and levelling data, and new geoid models based on information from the GRACE and GOCE gravity missions, to understand how mean sea level (MSL varies from place to place along the coast. For the last two centuries, MSL has been used to define datums for national levelling systems. However, there are many problems with this. One consequence of WHSU will be the substitution of conventional datums as a reference for heights with the use of geoid, as the only true "level" or datum. This work is within a number of GOCE-related activities funded by the European Space Agency. The study is focused on the coastlines of North America and Europe where the various datasets are most copious.

  11. Bringing satellite winds to hub-height

    DEFF Research Database (Denmark)

    Badger, Merete; Pena Diaz, Alfredo; Bredesen, Rolv Erlend

    2012-01-01

    Satellite observations of the ocean surface can provide detailed information about the spatial wind variability over large areas. This is very valuable for the mapping of wind resources offshore where other measurements are costly and sparse. Satellite sensors operating at microwave frequencies...... measure the amount of radar backscatter from the sea surface, which is a function of the instant wind speed, wind direction, and satellite viewing geometry. A major limitation related to wind retrievals from satellite observations is that existing empirical model functions relate the radar backscatter...... to wind speed at the height 10 m only. The extrapolation of satellite wind fields to higher heights, which are more relevant for wind energy, remains a challenge which cannot be addressed by means of satellite data alone. As part of the EU-NORSEWInD project (2008-12), a hybrid method has been developed...

  12. Height predicts jealousy differently for men and women

    NARCIS (Netherlands)

    Buunk, Abraham P.; Park, Justin H.; Zurriaga, Rosario; Klavina, Liga; Massar, Karlijn

    Because male height is associated with attractiveness, dominance, and reproductive success, taller men may be less jealous. And because female height has a curvilinear relationship with health and reproductive success (with average-height females having the advantages), female height may have a

  13. Lucas Heights buffer zone: plan of management

    International Nuclear Information System (INIS)

    1986-01-01

    This plan is being used by the Commission as a guide for its management of the Lucas Heights buffer zone, which is essentially a circular area having a 1-6 km radius around the HIFAR reactor. Aspects covered by this plan include past uses, current use, objectives for buffer zone land management, emergency evacuation, resource conservation, archaeology, fire, access, rehabilitation of disturbed areas, resource management and plan implementation

  14. Weight and height prediction of immobilized patients

    OpenAIRE

    Rabito,Estela Iraci; Vannucchi,Gabriela Bergamini; Suen,Vivian Marques Miguel; Castilho Neto,Laércio Lopes; Marchini,Júlio Sérgio

    2006-01-01

    OBJECTIVE: To confirm the adequacy of the formula suggested in the literature and/or to develop appropriate equations for the Brazilian population of immobilized patients based on simple anthropometric measurements. METHODS: Hospitalized patients were submitted to anthropometry and methods to estimate weight and height of bedridden patients were developed by multiple linear regression. RESULTS: Three hundred sixty eight persons were evaluated at two hospital centers and five weight-predicting...

  15. Gravity and Height Variations at Medicina, Italy

    Science.gov (United States)

    Bruni, Sara; Zerbini, Susanna; Errico, Maddalena; Santi, Efisio; Wziontek, Hartmut

    2017-04-01

    Since 1996, at the Medicina station, height and gravity variations are monitored continuously by means of GPS, VLBI and superconducting gravimeter (SG) data. Additionally, absolute gravity observations are performed twice a year and environmental parameters, among others water table levels, are regularly acquired. Levelling between the different monuments at the site area is also carried out repeatedly to constrain local ties in the vertical position. Two GPS systems are located very close to each other, and both are in close proximity to the VLBI antenna. Twenty years of data are now available, which allow investigating both long- and short-period height and gravity signals together with their relevant correlations. Natural land subsidence, which is well known to occur in the area, is a major component of the observed long-term behavior; however, non-linear long-period signatures are also present in the time series. On a shorter time scale, fingerprints of the water table seasonal oscillations can be recognized in the data. The Medicina site is characterized by clayey soil subjected to consolidation effects when the water table lowers during summer periods. The pillar on which the SG is installed is especially affected because of its shallow foundation, causing height decreases in the order of 2.5-3 cm for water table lowering of 2 m. This study presents a comparative analysis of the different data sets with the aim of separating mass and deformation contributions in the SG gravity record.

  16. A global boundary-layer height climatology

    Energy Technology Data Exchange (ETDEWEB)

    Dop, H. van; Krol, M.; Holtslag, B. [Inst. for Marine and Atmospheric Research Utrecht, IMAU, Utrecht (Netherlands)

    1997-10-01

    In principle the ABL (atmospheric boundary layer) height can be retrieved from atmospheric global circulation models since they contain algorithms which determine the intensity of the turbulence as a function of height. However, these data are not routinely available, or on a (vertical) resolution which is too crude in view of the application. This justifies the development of a separate algorithm in order to define the ABL. The algorithm should include the generation of turbulence by both shear and buoyancy and should be based on readily available atmospheric parameters. There is obviously a wide application for boundary heights in off-line global and regional chemistry and transport modelling. It is also a much used parameter in air pollution meteorology. In this article we shall present a theory which is based on current insights in ABL dynamics. The theory is applicable over land and sea surfaces in all seasons. The theory is (for various reasons) not valid in mountainous areas. In areas where boundary-layer clouds or deep cumulus convection are present the theory does not apply. However, the same global atmospheric circulation models contain parameterizations for shallow and deep convection from which separate estimates can be obtained for the extent of vertical mixing. (au)

  17. Phase height measurements on the ionosphere

    International Nuclear Information System (INIS)

    Joyner, K.H.

    1974-01-01

    Phase height measurements have been taken on 2.5 MHz E-region reflection over two paths during the day. The two paths have equivalent vertical frequencies of 2.4 MHz and 1.8 MHz. Vertical pulse measurements on 2.4 MHz have also been recorded. Results and discussion on comparisons between these measurements are presented. Phase and amplitude measurements using 4.5 MHz O and E rays have also been taken at night, F-region reflection. In particular, spectral analysis of these results is discussed. (author)

  18. Boundary layer heights derived from velocity spectra

    Energy Technology Data Exchange (ETDEWEB)

    Hoejstrup, J.; Barthelmie, R.J. [Risoe National Lab., Roskilde (Denmark); Kaellstrand, B. [Univ. of Uppsala, Uppsala (Sweden)

    1997-10-01

    It is a well-known fact that the height of the mixed layer determines the size of the largest and most energetic eddies that can be observed in the unstable boundary layer, and consequently a peak can be observed in the power spectra of the along-wind velocity component at scales comparable to the mixed layer depth. We will now show how the mixed layer depth can be derived from the u-specta and the results will be compared with direct measurements using pibal and tethersonde measurements. (au)

  19. Patella height changes post high tibial osteotomy

    Directory of Open Access Journals (Sweden)

    Siew Ghim Gooi

    2017-01-01

    Full Text Available Background: Medial opening wedge high tibial osteotomy (HTO is a well-described treatment in early medial compartmental osteoarthritis of the knee. However, two undesirable sequelae may follow –patella baja and changes in the posterior tibial slope (TS. Materials and Methods: We conducted a retrospective study in patients who underwent HTO in our center between September 2009 and February 2017. Preoperative and 6-week postoperative long-leg weight bearing films and lateral knee radiographs were assessed. Pre- and postoperative radiological measurements include the Caton-Deschamps Index (CDI, the mechanical axis deviation (MAD, and the posterior TS. Independant t-test and Pearson correlation test were performed. Results: A total of 106 knees were recruited. The mean age was 48.8 ± 10.8 years. 66 (62.3% and 40 (37.7% knees were from males and females, respectively. The mean pre- and postoperative measurements was (−9.70° ± 3.67° to 0.08° ± 2.80° (−varus; +valgus for the MAD, (7.14° ± 1.78° to 8.72° ± 3.11° for posterior TS, and (0.93° ± 0.084° to 0.82° ± 0.13° for CDI (P ≤ 0.001 for all. The association between patella height change and the level of osteotomy (supra-tubercle vs. infra-tubercle was statistically significant (P < 0.001. A supra-tubercle osteotomy cut significantly lowering patella height (P = 0.011. There was otherwise no statistically significant correlations between patella height changes and the correction angle (P = 0.187 or posterior TS change (P = 0.744. Conclusions: A medial opening wedge HTO above the tibial tubercle was significantly associated with lowering patella height or reducing CDI postoperatively. Based on our results, we would recommend the use of an infra-tubercle osteotomy during the corrective surgery to prevent the complication of patella baja.

  20. Development of a pulse height analizer

    International Nuclear Information System (INIS)

    Moreira, E.S.

    1984-01-01

    The development of a Pulse Height Analizer is described. This equipment is essential to analize data coming from detectors producing information codified in pulse amplitudes. The system developed consist of a Signal Input Module connected to a Controller Module based on a 8085A microprocessor capable to memorize pulses up to 1 uS in 256 channels with a resolution better than 20 mV. A Communication Module with a serial interface is used for data transfer to a host computer using RS232c protocol. The Monitoring and Operation Module consist of a hexadecimal Keybord, a 6 digit 7-segment display and a XY analog output enabling real time visualization of data on a XY monitor. The hardware and the software designed for this low cost system were optimized to obtain a typical dead time of approximately 100 uS. As application, this device was used to adquire curves at the Small Angle X-ray Scattering Laboratory in this Department. The apparatus performance was tested by comparing its data with a Northern Pulse Height Analizer model NS633 output, with favorable results. (Author) [pt

  1. A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials

    DEFF Research Database (Denmark)

    Juhl, Carsten Bogh; Lund, Hans; Guyatt, GH

    2010-01-01

    Title A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals Objective To develop a prioritized list for extracting patient-reported outcomes (PROs) measuring pain and disability for meta-analyses ......Title A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals Objective To develop a prioritized list for extracting patient-reported outcomes (PROs) measuring pain and disability for meta...... composite disability scores. Conclusions As choosing the most favorable PROs from individual trials can overestimate the effect compared to a systematic approach, using a prioritized list as presented in this study is recommended to reduce reviewer's likelihood of biased selection of PROs in meta-analyses....

  2. Psychometric properties of patient-reported outcome measures for hip arthroscopic surgery

    DEFF Research Database (Denmark)

    Kemp, Joanne L; Collins, Natalie J; Roos, Ewa M.

    2013-01-01

    Patient-reported outcomes (PROs) are considered the gold standard when evaluating outcomes in a surgical population. While the psychometric properties of some PROs have been tested, the properties of newer PROs in patients undergoing hip arthroscopic surgery remain somewhat unknown.......Patient-reported outcomes (PROs) are considered the gold standard when evaluating outcomes in a surgical population. While the psychometric properties of some PROs have been tested, the properties of newer PROs in patients undergoing hip arthroscopic surgery remain somewhat unknown....

  3. Active numerical model of human body for reconstruction of falls from height.

    Science.gov (United States)

    Milanowicz, Marcin; Kędzior, Krzysztof

    2017-01-01

    Falls from height constitute the largest group of incidents out of approximately 90,000 occupational accidents occurring each year in Poland. Reconstruction of the exact course of a fall from height is generally difficult due to lack of sufficient information from the accident scene. This usually results in several contradictory versions of an incident and impedes, for example, determination of the liability in a judicial process. In similar situations, in many areas of human activity, researchers apply numerical simulation. They use it to model physical phenomena to reconstruct their real course over time; e.g. numerical human body models are frequently used for investigation and reconstruction of road accidents. However, they are validated in terms of specific road traffic accidents and are considerably limited when applied to the reconstruction of other types of accidents. The objective of the study was to develop an active numerical human body model to be used for reconstruction of accidents associated with falling from height. Development of the model involved extension and adaptation of the existing Pedestrian human body model (available in the MADYMO package database) for the purposes of reconstruction of falls from height by taking into account the human reaction to the loss of balance. The model was developed by using the results of experimental tests of the initial phase of the fall from height. The active numerical human body model covering 28 sets of initial conditions related to various human reactions to the loss of balance was developed. The application of the model was illustrated by using it to reconstruct a real fall from height. From among the 28 sets of initial conditions, those whose application made it possible to reconstruct the most probable version of the incident was selected. The selection was based on comparison of the results of the reconstruction with information contained in the accident report. Results in the form of estimated

  4. Adaptive Layer Height During DLP Materials Processing

    DEFF Research Database (Denmark)

    Pedersen, David Bue; Zhang, Yang; Nielsen, Jakob Skov

    2016-01-01

    for considerable process speedup during the Additive Manufacture of components that contain areas of low cross-section variability, at no loss of surface quality. The adaptive slicing strategy was tested with a purpose built vat polymerisation system and numerical engine designed and constructed to serve as a Next......-Gen technology platform. By means of assessing hemispherical manufactured test specimen and through 3D surface mapping with variable-focus microscopy and confocal microscopy, a balance between minimal loss of surface quality with a maximal increase of manufacturing rate has been identified as a simple angle...

  5. On the Flame Height Definition for Upward Flame Spread

    OpenAIRE

    Consalvi, Jean L; Pizzo, Yannick; Porterie, Bernard; Torero, Jose L

    2007-01-01

    Flame height is defined by the experimentalists as the average position of the luminous flame and, consequently is not directly linked with a quantitative value of a physical parameter. To determine flame heights from both numerical and theoretical results, a more quantifiable criterion is needed to define flame heights and must be in agreement with the experiments to allow comparisons. For wall flames, steady wall flame experiments revealed that flame height may be define...

  6. On the Predictability of Hub Height Winds

    DEFF Research Database (Denmark)

    Draxl, Caroline

    Wind energy is a major source of power in over 70 countries across the world, and the worldwide share of wind energy in electricity consumption is growing. The introduction of signicant amounts of wind energy into power systems makes accurate wind forecasting a crucial element of modern electrical...... grids. These systems require forecasts with temporal scales of tens of minutes to a few days in advance at wind farm locations. Traditionally these forecasts predict the wind at turbine hub heights; this information is then converted by transmission system operators and energy companies into predictions...... of power output at wind farms. Since the power available in the wind is proportional to the wind speed cubed, even small wind forecast errors result in large power prediction errors. Accurate wind forecasts are worth billions of dollars annually; forecast improvements will result in reduced costs...

  7. Dominant height-based height-diameter equations for trees in southern Indiana

    Science.gov (United States)

    John A., Jr. Kershaw; Robert C. Morrissey; Douglass F. Jacobs; John R. Seifert; James B. McCarter

    2008-01-01

    Height-diameter equations are developed based on dominant tree data collected in 1986 in 8- to 17-year-old clearcuts and the phase 2 Forest Inventory and Analysis plots on the Hoosier National Forest in south central Indiana. Two equation forms are explored: the basic, three-parameter Chapman-Richards function, and a modification of the three-parameter equation...

  8. Long-term statistics of extreme tsunami height at Crescent City

    Science.gov (United States)

    Dong, Sheng; Zhai, Jinjin; Tao, Shanshan

    2017-06-01

    Historically, Crescent City is one of the most vulnerable communities impacted by tsunamis along the west coast of the United States, largely attributed to its offshore geography. Trans-ocean tsunamis usually produce large wave runup at Crescent Harbor resulting in catastrophic damages, property loss and human death. How to determine the return values of tsunami height using relatively short-term observation data is of great significance to assess the tsunami hazards and improve engineering design along the coast of Crescent City. In the present study, the extreme tsunami heights observed along the coast of Crescent City from 1938 to 2015 are fitted using six different probabilistic distributions, namely, the Gumbel distribution, the Weibull distribution, the maximum entropy distribution, the lognormal distribution, the generalized extreme value distribution and the generalized Pareto distribution. The maximum likelihood method is applied to estimate the parameters of all above distributions. Both Kolmogorov-Smirnov test and root mean square error method are utilized for goodness-of-fit test and the better fitting distribution is selected. Assuming that the occurrence frequency of tsunami in each year follows the Poisson distribution, the Poisson compound extreme value distribution can be used to fit the annual maximum tsunami amplitude, and then the point and interval estimations of return tsunami heights are calculated for structural design. The results show that the Poisson compound extreme value distribution fits tsunami heights very well and is suitable to determine the return tsunami heights for coastal disaster prevention.

  9. Agreement between estimated and measured heights and weights ...

    African Journals Online (AJOL)

    index (BMI = kg/m2) and require accurate recording of a patient's height and weight.1. In reality, however, patients often cannot stand up straight for accurate height measurement, or are unable to step on a scale. In such cases, height and weight values are often obtained from the patient or their relatives, who either do not ...

  10. Anterior Face Height Values in a Nigerian Population | Folaranmi ...

    African Journals Online (AJOL)

    ... Anterior Upper Face Height 47.7 (4) mm, Anterior Total Face Height (ATFH) 108.5 (5) mm, ratio of ALFH to ATFH ALFH: ATFH 56 (4)%. Conclusion: This study provides anterior face height measurements, which will be of great significance in evaluating facial proportions andesthetics in orthodontics, orthognathic surgery, ...

  11. Relationships between diameter and height of trees in natural ...

    African Journals Online (AJOL)

    Relationships between diameter and height of trees in natural tropical forest in Tanzania. Wilson A Mugasha, Ole M Bollandsås, Tron Eid. Abstract. The relationship between tree height (h) and tree diameter at breast height (dbh) is an important element describing forest stands. In addition, h often is a required variable in ...

  12. Estimation of Total Tree Height from Renewable Resources Evaluation Data

    Science.gov (United States)

    Charles E. Thomas

    1981-01-01

    Many ecological, biological, and genetic studies use the measurement of total tree height. Until recently, the Southern Forest Experiment Station's inventory procedures through Renewable Resources Evaluation (RRE) have not included total height measurements. This note provides equations to estimate total height based on other RRE measurements.

  13. The Sine Method: An Alternative Height Measurement Technique

    Science.gov (United States)

    Don C. Bragg; Lee E. Frelich; Robert T. Leverett; Will Blozan; Dale J. Luthringer

    2011-01-01

    Height is one of the most important dimensions of trees, but few observers are fully aware of the consequences of the misapplication of conventional height measurement techniques. A new approach, the sine method, can improve height measurement by being less sensitive to the requirements of conventional techniques (similar triangles and the tangent method). We studied...

  14. Practical application of the geometric geoid for heighting over ...

    African Journals Online (AJOL)

    This is because a geoid model is required to convert ellipsoidal heights to orthometric heights that are used in practice. A local geometric geoid ... The geoid height is expressed as a function of the local plane coordinates through a biquadratic surface polynomial, using 14 GPS/levelling points. Five points have been used ...

  15. 14 CFR 27.87 - Height-speed envelope.

    Science.gov (United States)

    2010-01-01

    ... applicable power failure condition in paragraph (b) of this section, a limiting height-speed envelope must be... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Height-speed envelope. 27.87 Section 27.87... STANDARDS: NORMAL CATEGORY ROTORCRAFT Flight Performance § 27.87 Height-speed envelope. (a) If there is any...

  16. 14 CFR 29.1517 - Limiting height-speed envelope.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Limiting height-speed envelope. 29.1517... Operating Limitations § 29.1517 Limiting height-speed envelope. For Category A rotorcraft, if a range of... following power failure, the range of heights and its variation with forward speed must be established...

  17. 14 CFR 29.87 - Height-velocity envelope.

    Science.gov (United States)

    2010-01-01

    ... Category A engine isolation requirements, the height-velocity envelope for complete power failure must be... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Height-velocity envelope. 29.87 Section 29... AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Flight Performance § 29.87 Height-velocity envelope. (a...

  18. The value of patient reporting to the pharmacovigilance system: a systematic review.

    Science.gov (United States)

    Inácio, Pedro; Cavaco, Afonso; Airaksinen, Marja

    2017-02-01

    Current trends in pharmacovigilance systems are veering towards patient involvement in spontaneous reporting of adverse drug reactions (ADRs). The aim of the current systematic review was to identify what is known and what remains unknown with respect to patient reporting to pharmacovigilance systems. A systematic literature search was conducted in PubMed, CINAHL, Journals@Ovid and the Cochrane Library. Studies were included if they contained: (i) reviews about patient reporting; (ii) evaluation of patient reports to national or supranational pharmacovigilance authorities; (iii) a comparison between patient and healthcare professional (HCP) reports submitted to pharmacovigilance authorities; and (iv) surveys of patient experiences, opinions and awareness about reporting ADRs. The methodological quality of the studies was assessed according to principles of Grading of Recommendations, Assessment, Development and Evaluations (GRADE). A total of thirty four studies were included. Five of the studies were reviews (two of which systematic reviews), fourteen retrospective observational studies, nine surveys and six applied mixed research methods. Patient reporting has the advantages of bringing novel information about ADRs. It provides a more detailed description of ADRs, and reports about different drugs and system organ classes when compared with HCP reporting. In addition, patients describe the severity and impact of ADRs on daily life, complementing information derived from HCPs. Patient reporting is relatively rare in most countries. Patient reporting adds new information, and perspective about ADRs in a way otherwise unavailable. This can contribute to better decision-making processes in regulatory activities. The present review identified gaps in knowledge that should be addressed to improve our understanding of the full potential and drawbacks of patient reporting. © 2016 The British Pharmacological Society.

  19. An antithetic variate to facilitate upper-stem height measurements for critical height sampling with importance sampling

    Science.gov (United States)

    Thomas B. Lynch; Jeffrey H. Gove

    2013-01-01

    Critical height sampling (CHS) estimates cubic volume per unit area by multiplying the sum of critical heights measured on trees tallied in a horizontal point sample (HPS) by the HPS basal area factor. One of the barriers to practical application of CHS is the fact that trees near the field location of the point-sampling sample point have critical heights that occur...

  20. Conversion of ADC pulse heights into MIP units (NUMASS test data, September 1991)

    International Nuclear Information System (INIS)

    Zhang, Q.P.

    1993-04-01

    ADC calibration is an important part of the data analysis in particle physics. Data analysis of ADC pulse heights is based on a physical unit which is called MIP (most probable energy loss of Minimum Ionization Particles). This paper describes the ADC calibration work for the September 1991 NUMASS test data, which were produced at CERN at the SPS facility. The Vavilov function is used to fit the energy loss distributions of minimum ionizing particles traversing the time of flight scintillators embedded in the uranium scintillator calorimeter. It is assumed that the energy loss distribution is the same for identical scintillators and the value at the peak of these distributions is used, i.e., the most probable energy loss, as a physical unit to derive the gains of the individual readout channels

  1. Integrating patient reported outcomes with clinical cancer registry data: a feasibility study of the electronic Patient-Reported Outcomes From Cancer Survivors (ePOCS) system.

    Science.gov (United States)

    Ashley, Laura; Jones, Helen; Thomas, James; Newsham, Alex; Downing, Amy; Morris, Eva; Brown, Julia; Velikova, Galina; Forman, David; Wright, Penny

    2013-10-25

    Routine measurement of Patient Reported Outcomes (PROs) linked with clinical data across the patient pathway is increasingly important for informing future care planning. The innovative electronic Patient-reported Outcomes from Cancer Survivors (ePOCS) system was developed to integrate PROs, collected online at specified post-diagnostic time-points, with clinical and treatment data in cancer registries. This study tested the technical and clinical feasibility of ePOCS by running the system with a sample of potentially curable breast, colorectal, and prostate cancer patients in their first 15 months post diagnosis. Patients completed questionnaires comprising multiple Patient Reported Outcome Measures (PROMs) via ePOCS within 6 months (T1), and at 9 (T2) and 15 (T3) months, post diagnosis. Feasibility outcomes included system informatics performance, patient recruitment, retention, representativeness and questionnaire completion (response rate), patient feedback, and administration burden involved in running the system. ePOCS ran efficiently with few technical problems. Patient participation was 55.21% (636/1152) overall, although varied by approach mode, and was considerably higher among patients approached face-to-face (61.4%, 490/798) than by telephone (48.8%, 21/43) or letter (41.0%, 125/305). Older and less affluent patients were less likely to join (both Pplanning and for targeting service provision.

  2. Pulse-height loss in the signal readout circuit of compound semiconductor detectors

    Science.gov (United States)

    Nakhostin, M.; Hitomi, K.

    2018-06-01

    Compound semiconductor detectors such as CdTe, CdZnTe, HgI2 and TlBr are known to exhibit large variations in their charge collection times. This paper considers the effect of such variations on the measurement of induced charge pulses by using resistive feedback charge-sensitive preamplifiers. It is shown that, due to the finite decay-time constant of the preamplifiers, the capacitive decay during the signal readout leads to a variable deficit in the measurement of ballistic signals and a digital pulse processing method is employed to correct for it. The method is experimentally examined by using sampled pulses from a TlBr detector coupled to a charge-sensitive preamplifier with 150 μs of decay-time constant and 20 % improvement in the energy resolution of the detector at 662 keV is achieved. The implications of the capacitive decay on the correction of charge-trapping effect by using depth-sensing technique are also considered.

  3. The determination of the mixing height. Current progress and problems

    Energy Technology Data Exchange (ETDEWEB)

    Gryning, S.E.; Beyrich, F.; Batchvarova, E. [eds.

    1997-10-01

    This report contains extended abstracts of presentations given at a EURASAP Workshop on The Determination of the Mixing Height - Current Progress and Problems. The Workshop, initiated from discussions with Peter Builtjes, was held at Risoe National Laboratory 1-3 October 1997 within the framework of EURASAP (European Association for the Sciences of Air Pollution). The specific topics and chairpersons of the Workshop were: Theoretical Considerations (Sven-Erik Gryning), Mixing Height Estimation from Turbulence Measurements and In-Situ Soundings (Douw Steyn), Mixing Height Determination from NWP-Models (Han van Dop), Climatology and Global Aspects (Werner Klug), Mixing Height Determination from Remote Systems (Werner Klug), Verification of Mixing Height Parameterizations and Models (Frank Beyrich), Mixing Height over Complex Terrain (Ekaterina Batchvarova), Internal Boundary Layers: Mixing Height in Coastal Areas and Over Cities (Allen White). The discussion at the end of the Workshop was chaired by Robert Bornstein. (au)

  4. Bali, Shaded Relief and Colored Height

    Science.gov (United States)

    2004-01-01

    The volcanic nature of the island of Bali is evident in this shaded relief image generated with data from the Shuttle Radar Topography Mission (SRTM).Bali, along with several smaller islands, make up one of the 27 Provinces of Indonesia. It lies over a major subduction zone where the Indo-Australian tectonic plate collides with the Sunda plate, creating one of the most volcanically active regions on the planet.The most significant feature on Bali is Gunung Agung, the symmetric, conical mountain at the right-center of the image. This 'stratovolcano,' 3,148 meters (10,308 feet) high, is held sacred in Balinese culture, and last erupted in 1963 after being dormant and thought inactive for 120 years. This violent event resulted in over 1,000 deaths, and coincided with a purification ceremony called Eka Dasa Rudra, meant to restore the balance between nature and man. This most important Balinese rite is held only once per century, and the almost exact correspondence between the beginning of the ceremony and the eruption is though to have great religious significance.Two visualization methods were combined to produce the image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the northwest-southeast direction, so that northwest slopes appear bright and southeast slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow and tan, to white at the highest elevations.Elevation data used in this image were acquired by the Shuttle Radar Topography Mission aboard the Space Shuttle Endeavour, launched on Feb. 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. SRTM was designed to collect 3-D measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter (approximately 200-foot

  5. Colored Height and Shaded Relief, Central America

    Science.gov (United States)

    2002-01-01

    Panama, Costa Rica, Nicaragua, El Salvador, Honduras, Guatemala, Belize, southern Mexico and parts of Cuba and Jamaica are all seen in this image from NASA's Shuttle Radar Topography Mission. The dominant feature of the northern part of Central America is the Sierra Madre Range, spreading east from Mexico between the narrow Pacific coastal plain and the limestone lowland of the Yucatan Peninsula. Parallel hill ranges sweep across Honduras and extend south, past the Caribbean Mosquito Coast to lakes Managua and Nicaragua. The Cordillera Central rises to the south, gradually descending to Lake Gatun and the Isthmus of Panama. A highly active volcanic belt runs along the Pacific seaboard from Mexico to Costa Rica.High-quality satellite imagery of Central America has, until now, been difficult to obtain due to persistent cloud cover in this region of the world. The ability of SRTM to penetrate clouds and make three-dimensional measurements has allowed the generation of the first complete high-resolution topographic map of the entire region. This map was used to generate the image.Two visualization methods were combined to produce the image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the north-south direction. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow, red, and magenta, to white at the highest elevations.For an annotated version of this image, please select Figure 1, below: [figure removed for brevity, see original site] (Large image: 9 mB jpeg)Elevation data used in this image were acquired by the Shuttle Radar Topography Mission aboard the Space Shuttle Endeavour, launched on February 11, 2000. The mission used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar that flew twice on the Space Shuttle Endeavour in 1994. The Shuttle Radar Topography Mission was designed to collect

  6. World Globes, Shaded Relief and Colored Height

    Science.gov (United States)

    2003-01-01

    These images of the world were generated with data from the Shuttle Radar Topography Mission (SRTM). The SRTM Project has recently released a new global data set called SRTM30, where the original one arcsecond of latitude and longitude resolution (about 30 meters, or 98 feet, at the equator) was reduced to 30 arcseconds (about 928 meters, or 1496 feet.) These images were created from that data set and show the Earth as it would be viewed from a point in space centered over the Americas, Africa and the western Pacific.Two visualization methods were combined to produce the image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the northwest-southeast direction, so that northwest slopes appear bright and southeast slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow and tan, to white at the highest elevations.Elevation data used in this image were acquired by the Shuttle Radar Topography Mission aboard the Space Shuttle Endeavour, launched on Feb. 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. SRTM was designed to collect 3-D measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter (approximately 200-foot) mast, installed additional C-band and X-band antennas, and improved tracking and navigation devices. The mission is a cooperative project between NASA, the National Imagery and Mapping Agency (NIMA) of the U.S. Department of Defense and the German and Italian space agencies. It is managed by NASA's Jet Propulsion Laboratory, Pasadena, Calif., for NASA's Earth Science Enterprise,Washington, D.C.Orientation: North toward the top Image Data: shaded and colored SRTM elevation model Original Data Resolution: SRTM 1 arcsecond (about 30 meters or 98 feet

  7. Colored Height and Shaded Relief, Kamchatka Peninsula

    Science.gov (United States)

    2002-01-01

    Russia's Kamchatka Peninsula, lying between the Sea of Okhotsk to the west and the Bering Sea and Pacific Ocean to the east, is one of the most active volcanic regions along the Pacific Ring of Fire. It covers an area about the size of Colorado but contains more than 100 volcanoes stretching across the 1000-kilometer-long (620-mile-long) land mass. A dozen or more of these have active vents, with the youngest located along the eastern half of the peninsula. This color-coded shaded relief image, generated with data from the Shuttle Radar Topography Mission (SRTM), shows Kamchatka's volcanic nature to dramatic effect.Kliuchevskoi, one of the most active and renowned volcanoes in the world, dominates the main cluster of volcanoes called the Kliuchi group, visible as a circular feature in the center-right of the image. The two other main volcanic ranges lie along northeast-southwest lines, with the older, less active range occupying the center and western half of Kamchatka. The younger, more active belt begins at the southernmost point of the peninsula and continues upward along the Pacific coastline.Two visualization methods were combined to produce this image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the north-south direction, so northern slopes appear bright and southern slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow and brown to white at the highest elevations.The Shuttle Radar Topography Mission flew aboard the Space Shuttle Endeavour, launched on February 11, 2000. The mission used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar that flew twice on the Space Shuttle Endeavour in 1994. The Shuttle Radar Topography Mission was designed to collect three-dimensional measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter (200

  8. Sinai Peninsula, Shaded Relief and Colored Height

    Science.gov (United States)

    2004-01-01

    The Sinai Peninsula, located between Africa and Asia, is a result of those two continents pulling apart from each other. Earth's crust is cracking, stretching, and lowering along the two northern branches of the Red Sea, namely the Gulf of Suez, seen here on the west (left), and the Gulf of Aqaba, seen to the east (right). This color-coded shaded relief image shows the triangular nature of the peninsula, with the coast of the Mediterranean Sea forming the northern side of the triangle. The Suez Canal can be seen as the narrow vertical blue line in the upper left connecting the Red Sea to the Mediterranean. The peninsula is divided into three distinct parts; the northern region consisting chiefly of sandstone, plains and hills, the central area dominated by the Tih Plateau, and the mountainous southern region where towering peaks abound. Much of the Sinai is deeply dissected by river valleys, or wadis, that eroded during an earlier geologic period and break the surface of the plateau into a series of detached massifs with a few scattered oases. Two visualization methods were combined to produce the image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the northwest-southeast direction, so that northwest slopes appear bright and southeast slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow and tan, to white at the highest elevations. Elevation data used in this image were acquired by the Shuttle Radar Topography Mission aboard the Space Shuttle Endeavour, launched on Feb. 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. SRTM was designed to collect 3-D measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter (approximately 200-foot) mast, installed

  9. Ireland, Shaded Relief and Colored Height

    Science.gov (United States)

    2005-01-01

    The island of Ireland comprises a large central lowland of limestone with a relief of hills surrounded by a discontinuous border of coastal mountains which vary greatly in geological structure. The mountain ridges of the south are composed of old red sandstone separated by limestone river valleys. Granite predominates in the mountains of Galway, Mayo and Donegal in the west and north-west and in Counties Down and Wicklow on the east coast, while a basalt plateau covers much of the north-east of the country. The central plain, which is broken in places by low hills, is extensively covered with glacial deposits of clay and sand. It has considerable areas of bog and numerous lakes. The island has seen at least two general glaciations and everywhere ice-smoothed rock, mountain lakes, glacial valleys and deposits of glacial sand, gravel and clay mark the passage of the ice. Two visualization methods were combined to produce this image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the northwest-southeast direction, so that northwest slopes appear bright and southeast slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow and tan, to white at the highest elevations. Elevation data used in this image were acquired by the Shuttle Radar Topography Mission aboard the Space Shuttle Endeavour, launched on Feb. 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. SRTM was designed to collect 3-D measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter (approximately 200-foot) mast, installed additional C-band and X-band antennas, and improved tracking and navigation devices. The mission is a cooperative project between NASA, the National Geospatial-Intelligence Agency

  10. Yoga & Cancer Interventions: A Review of the Clinical Significance of Patient Reported Outcomes for Cancer Survivors

    Directory of Open Access Journals (Sweden)

    S. Nicole Culos-Reed

    2012-01-01

    Full Text Available Limited research suggests yoga may be a viable gentle physical activity option with a variety of health-related quality of life, psychosocial and symptom management benefits. The purpose of this review was to determine the clinical significance of patient-reported outcomes from yoga interventions conducted with cancer survivors. A total of 25 published yoga intervention studies for cancer survivors from 2004–2011 had patient-reported outcomes, including quality of life, psychosocial or symptom measures. Thirteen of these studies met the necessary criteria to assess clinical significance. Clinical significance for each of the outcomes of interest was examined based on 1 standard error of the measurement, 0.5 standard deviation, and relative comparative effect sizes and their respective confidence intervals. This review describes in detail these patient-reported outcomes, how they were obtained, their relative clinical significance and implications for both clinical and research settings. Overall, clinically significant changes in patient-reported outcomes suggest that yoga interventions hold promise for improving cancer survivors' well-being. This research overview provides new directions for examining how clinical significance can provide a unique context for describing changes in patient-reported outcomes from yoga interventions. Researchers are encouraged to employ indices of clinical significance in the interpretation and discussion of results from yoga studies.

  11. Hilar height ratio in normal Korea

    International Nuclear Information System (INIS)

    Yoo, Kyung Ho; Lee, Nam Joon; Seol, Hae Young; Chung, Kyoo Byung

    1979-01-01

    Hilar displacement is one of the significant sign of pulmonary volume change. The hilar height ratio (HHR) is a value that express the normal position of hilum in its hemithorax, and it is calculated by dividing the distance from the hilum to the lung apex by the distance from the hilum to the diaphragm. Displacement of one hilum is usually easy to detect but both are displaced in the same direction especially, recognition is more difficult. Knowledge of normal HHR allows evaluation of hilar positional change even when the relative hilar position are not altered. Normal chest PA views of 275 cases taken at Korea University Hospital during the period of April 1978 to Jun 1979 were analyzed. The right hilum is positioned in lower half of the right hemithorax, while the left hilum is situated in the upper half of left hemithorax. The difference of hilar ratio according to age group is slight, but there is significant difference between right-HHR and left-HHR. The value of right-HHR is 1.28 ± 0.14, the value of left-HHR is 0.88 ± 0.09.

  12. [Is olfactory function impaired in moderate height?].

    Science.gov (United States)

    Kühn, M; Welsch, H; Zahnert, T; Hummel, Thomas

    2009-09-01

    The human sense of smell seems to be influenced by the surrounding barometric pressure. These factors appear to be especially important during flights, for example, in order to recognize the smell of fire etc. Thus, questions are whether pilots or passengers exhibit an impaired smell sensitivity when tested at moderate heights, or, whether changes in humidity would affect the sense of smell. Using climate chambers, odor discrimination and butanol odor thresholds were tested in 77 healthy normosmic volunteers (5 female, 72 male; aged 25+/-8 years from 18 up to 53 years) under hypobaric (2 700+/-20 m, 20 degrees C+/-1 K, rh=50+/-5%) and hyperbaric, (10+/-0.5 m (2 bar)) and different humidity conditions (30 vs. 80%, 20 degrees C+/-1 K, normobaric). During all conditions cognitive performance was tested. Among other effects, olfactory sensitivity was impaired at threshold, but not suprathreshold level, in a hypobaric compared to a hyperbaric milieu, and thresholds were lower in humid, compared to relatively dry conditions. In conclusion, environmental conditions modulate the sense of smell, and may, consecutively, influence results from olfactory tests. During flight hypobaric conditions, mild hypoxia and dry air may cause impaired sensitivity of smell. Georg Thieme Verlag KG Stuttgart * New York.

  13. Subexponential estimates in Shirshov's theorem on height

    International Nuclear Information System (INIS)

    Belov, Aleksei Ya; Kharitonov, Mikhail I

    2012-01-01

    Suppose that F 2,m is a free 2-generated associative ring with the identity x m =0. In 1993 Zelmanov put the following question: is it true that the nilpotency degree of F 2,m has exponential growth? We give the definitive answer to Zelmanov's question by showing that the nilpotency class of an l-generated associative algebra with the identity x d =0 is smaller than Ψ(d,d,l), where Ψ(n,d,l)=2 18 l(nd) 3log 3 (nd)+13 d 2 . This result is a consequence of the following fact based on combinatorics of words. Let l, n and d≥n be positive integers. Then all words over an alphabet of cardinality l whose length is not less than Ψ(n,d,l) are either n-divisible or contain x d ; a word W is n-divisible if it can be represented in the form W=W 0 W 1 …W n so that W 1 ,...,W n are placed in lexicographically decreasing order. Our proof uses Dilworth's theorem (according to V.N. Latyshev's idea). We show that the set of not n-divisible words over an alphabet of cardinality l has height h 87 l·n 12log 3 n+48 . Bibliography: 40 titles.

  14. Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty.

    Science.gov (United States)

    Tanner, J M; Whitehouse, R H

    1976-01-01

    New charts for height, weight, height velocity, and weight velocity are presented for clinical (as opposed to population survey) use. They are based on longitudinal-type growth curves, using the same data as in the British 1965 growth standards. In the velocity standards centiles are given for children who are early- and late-maturing as well as for those who mature at the average age (thus extending the use of the previous charts). Limits of normality for the age of occurrence of the adolescent growth spurt are given and also for the successive stages of penis, testes, and pubic hair development in boys, and for stages of breast and pubic hair development in girls. PMID:952550

  15. Response to growth hormone treatment and final height after cranial or craniospinal irradiation

    International Nuclear Information System (INIS)

    Sulmont, V.; Brauner, R.; Fontoura, M.; Rappaport, R.

    1990-01-01

    Growth hormone (GH) deficiency (GHD) induced by cranial irradiation has become a frequent indication of hGH substitutive therapy. This study analyses the growth response to hGH therapy and the factors involved in the decrease in growth velocity observed after cranial irradiation. One hundred children given cranial radiation for pathology distant from the hypothalamo-pituitary area were studied. Fifty-six of them received hGH therapy for GHD resulting in decreased growth velocity. The initial annual height gain in the cranial-irradiated group was comparable to that of patients treated for idiopathic GHD; additional spinal irradiation significantly reduced the growth response. Twenty-eight hGH-treated patients reached final heights which were compared to those of 2 untreated irradiated groups, one with GHD (n=27) and the other with normal GH secretion (n=17). The height SD score changes observed in hGH therapy were +0.3 in the cranial (n=10) and -1.2 SD in the craniospinal (n=18) groups. GH deficiency had contributed to a mean height loss of 1 SD and spinal irradiation to a loss of 1.4SD. The small effect of hGH therapy on final height is probably linked to the small bone age retardation at onset of hGH therapy and to the fact that irradiated children entered puberty at a younger age in terms of chronological age and bone age than the idiopathic GHD patients. These data suggest that the results of gGH therapy in irradiated children might be improved with higher and more fractionated hGH doses and, in some patients, by delaying puberty using luteinizing hormone releasing hormone analogs

  16. Response to growth hormone treatment and final height after cranial or craniospinal irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Sulmont, V.; Brauner, R.; Fontoura, M.; Rappaport, R. (Hospital des Enfants Malades, Paris (France). Pediatric Endocrinology Unit and INSERM U30)

    1990-01-01

    Growth hormone (GH) deficiency (GHD) induced by cranial irradiation has become a frequent indication of hGH substitutive therapy. This study analyses the growth response to hGH therapy and the factors involved in the decrease in growth velocity observed after cranial irradiation. One hundred children given cranial radiation for pathology distant from the hypothalamo-pituitary area were studied. Fifty-six of them received hGH therapy for GHD resulting in decreased growth velocity. The initial annual height gain in the cranial-irradiated group was comparable to that of patients treated for idiopathic GHD; additional spinal irradiation significantly reduced the growth response. Twenty-eight hGH-treated patients reached final heights which were compared to those of 2 untreated irradiated groups, one with GHD (n=27) and the other with normal GH secretion (n=17). The height SD score changes observed in hGH therapy were +0.3 in the cranial (n=10) and -1.2 SD in the craniospinal (n=18) groups. GH deficiency had contributed to a mean height loss of 1 SD and spinal irradiation to a loss of 1.4SD. The small effect of hGH therapy on final height is probably linked to the small bone age retardation at onset of hGH therapy and to the fact that irradiated children entered puberty at a younger age in terms of chronological age and bone age than the idiopathic GHD patients. These data suggest that the results of gGH therapy in irradiated children might be improved with higher and more fractionated hGH doses and, in some patients, by delaying puberty using luteinizing hormone releasing hormone analogs.

  17. mHealth and big data will bring meaning and value to patient-reported outcomes.

    Science.gov (United States)

    Weiler, Anne

    2016-01-01

    The intersection of widespread mobile adoption, cloud computing and healthcare will enable patient-reported outcomes to be used to personalize care, draw insights and shorten the cycle from research to clinical implementation. Today, patient-reported outcomes are largely collected as part of a regulatory shift to value-based or bundled care. When patients are able to record their experiences in real-time and combine them with passive data collection from sensors and mobile devices, this information can inform better care for each patient and contribute to the growing body of health data that can be used to draw insights for all patients. This paper explores the current limitations of patient reported outcomes and how mobile health and big data analysis unlocks their potential as a valuable tool to deliver care.

  18. [Final height in symptomatic boys with late-onset adrenal hyperplasia (LOCAH), treated with glucocorticoids. Clinical cases].

    Science.gov (United States)

    Pasqualini, Titania; Alonso, Guillermo; Fernández, Cecilia; Buzzalino, Noemí; Dain, Liliana

    2013-04-01

    Although corticoid replacement is recommended for those late-onset adrenal hyperplasia with clinical manifestations, asymptomatic patients do not need treatment. We describe clinical features at diagnosis, treatment, and growth till adult- height, in 4 boys. At diagnosis, age ranged from 9.2-11.6 years. The initial symptoms/signs were: precocious pubarche (n = 2), accelerated bone age (n = 1) and precocious puberty (n = 1). All of them presented elevated 17 hydroxyprogesterone levels and were compound heterozygotes carrying p.V281L mutation. Since, at diagnosis, bone age was significantly advanced for chronological age (13.1 ± 0.5 vs. 10.2 ± 1.1 p = 0.008), hydrocortisone therapy was initiated. During follow-up, mean height Z score decreased 1.4 ± 0.4 SDS (p = 0.007), though adult mean height was not different from target height (-0.39 ± 0.7 vs. -0.04 ± 0.5 SDS, p = 0.054). In conclusion, in 4 symptomatic patients, accurate treatment of late-onset adrenal hyperplasia led to an adult mean height not different from target height. Advanced bone age at diagnosis and the loss of height during pubertal development suggest the need of therapy.

  19. Can patients report patient safety incidents in a hospital setting? A systematic review.

    Science.gov (United States)

    Ward, Jane K; Armitage, Gerry

    2012-08-01

    Patients are increasingly being thought of as central to patient safety. A small but growing body of work suggests that patients may have a role in reporting patient safety problems within a hospital setting. This review considers this disparate body of work, aiming to establish a collective view on hospital-based patient reporting. This review asks: (a) What can patients report? (b) In what settings can they report? (c) At what times have patients been asked to report? (d) How have patients been asked to report? 5 databases (MEDLINE, EMBASE, CINAHL, (Kings Fund) HMIC and PsycINFO) were searched for published literature on patient reporting of patient safety 'problems' (a number of search terms were utilised) within a hospital setting. In addition, reference lists of all included papers were checked for relevant literature. 13 papers were included within this review. All included papers were quality assessed using a framework for comparing both qualitative and quantitative designs, and reviewed in line with the study objectives. Patients are clearly in a position to report on patient safety, but included papers varied considerably in focus, design and analysis, with all papers lacking a theoretical underpinning. In all papers, reports were actively solicited from patients, with no evidence currently supporting spontaneous reporting. The impact of timing upon accuracy of information has yet to be established, and many vulnerable patients are not currently being included in patient reporting studies, potentially introducing bias and underestimating the scale of patient reporting. The future of patient reporting may well be as part of an 'error detection jigsaw' used alongside other methods as part of a quality improvement toolkit.

  20. Patient-reported access to primary care in Ontario: effect of organizational characteristics.

    Science.gov (United States)

    Muggah, Elizabeth; Hogg, William; Dahrouge, Simone; Russell, Grant; Kristjansson, Elizabeth; Muldoon, Laura; Devlin, Rose Anne

    2014-01-01

    To describe patient-reported access to primary health care across 4 organizational models of primary care in Ontario, and to explore how access is associated with patient, provider, and practice characteristics. Cross-sectional survey. One hundred thirty-seven randomly selected primary care practices in Ontario using 1 of 4 delivery models (fee for service, established capitation, reformed capitation, and community health centres). Patients included were at least 18 years of age, were not severely ill or cognitively impaired, were not known to the survey administrator, had consenting providers at 1 of the participating primary care practices, and were able to communicate in English or French either directly or through a translator. Patient-reported access was measured by a 4-item scale derived from the previously validated adult version of the Primary Care Assessment Tool. Questions were asked about physician availability during and outside of regular office hours and access to health information via telephone. Responses to the scale were normalized, with higher scores reflecting greater patient-reported access. Linear regressions were used to identify characteristics independently associated with access to care. Established capitation model practices had the highest patient-reported access, although the difference in scores between models was small. Our multilevel regression model identified several patient factors that were significantly (P = .05) associated with higher patient-reported access, including older age, female sex, good-to-excellent self-reported health, less mental health disability, and not working. Provider experience (measured as years since graduation) was the only provider or practice characteristic independently associated with improved patient-reported access. This study adds to what is known about access to primary care. The study found that established capitation models outperformed all the other organizational models, including reformed

  1. Heel-Rise Height Deficit 1 Year After Achilles Tendon Rupture Relates to Changes in Ankle Biomechanics 6 Years After Injury.

    Science.gov (United States)

    Brorsson, Annelie; Willy, Richard W; Tranberg, Roy; Grävare Silbernagel, Karin

    2017-11-01

    It is unknown whether the height of a heel-rise performed in the single-leg standing heel-rise test 1 year after an Achilles tendon rupture (ATR) correlates with ankle biomechanics during walking, jogging, and jumping in the long-term. To explore the differences in ankle biomechanics, tendon length, calf muscle recovery, and patient-reported outcomes at a mean of 6 years after ATR between 2 groups that, at 1-year follow-up, had less than 15% versus greater than 30% differences in heel-rise height. Cohort study; Level of evidence, 3. Seventeen patients with less than 15% (30% group) side-to-side difference in heel-rise height at 1 year after ATR were evaluated at a mean (SD) 6.1 (2.0) years after their ATR. Ankle kinematics and kinetics were sampled via standard motion capture procedures during walking, jogging, and jumping. Patient-reported outcome was evaluated with Achilles tendon Total Rupture Score (ATRS), Physical Activity Scale (PAS), and Foot and Ankle Outcome Score (FAOS). Tendon length was evaluated by ultrasonography. The Limb Symmetry Index (LSI = [Injured Side ÷ Healthy Side] × 100) was calculated for side differences. The >30% group had significantly more deficits in ankle kinetics during all activities compared with patients in the 30% group, compared with the biomechanics. Minimizing tendon elongation and regaining heel-rise height may be important for the long-term recovery of ankle biomechanics, particularly during more demanding activities such as jumping.

  2. Early patient-reported outcomes versus objective function after total hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Luna, I E; Kehlet, H; Peterson, B

    2017-01-01

    AIMS: The purpose of this study was to assess early physical function after total hip or knee arthroplasty (THA/TKA), and the correlation between patient-reported outcome measures, physical performance and actual physical activity (measured by actigraphy). PATIENTS AND METHODS: A total of 80...... patients aged 55 to 80 years undergoing THA or TKA for osteoarthritis were included in this prospective cohort study. The main outcome measure was change in patient reported hip or knee injury and osteoarthritis outcome score (HOOS/KOOS) from pre-operatively until post-operative day 13 (THA) or 20 (TKA...

  3. Living with vision loss

    Science.gov (United States)

    Diabetes - vision loss; Retinopathy - vision loss; Low vision; Blindness - vision loss ... of visual aids. Some options include: Magnifiers High power reading glasses Devices that make it easier to ...

  4. Australia, Shaded Relief and Colored Height

    Science.gov (United States)

    2004-01-01

    topographic height. The shade image was derived by computing topographic slope in the northwest-southeast direction, so that northwest slopes appear bright and southeast slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow and tan, to white at the highest elevations. Elevation data used in this image were acquired by the Shuttle Radar Topography Mission aboard the Space Shuttle Endeavour, launched on Feb. 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. SRTM was designed to collect 3-D measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter (approximately 200-foot) mast, installed additional C-band and X-band antennas, and improved tracking and navigation devices. The mission is a cooperative project between NASA, the National Geospatial-Intelligence Agency (NGA) of the U.S. Department of Defense and the German and Italian space agencies. It is managed by NASA's Jet Propulsion Laboratory, Pasadena, Calif., for NASA's Earth Science Enterprise, Washington, D.C. Location: 45 to 10 degrees South latitude, 112 to 155 degrees East longitude Orientation: North toward the top, Mercator projection Image Data: shaded and colored SRTM elevation model Date Acquired: February 2000

  5. Guiana Highlands, Shaded Relief and Colored Height

    Science.gov (United States)

    2003-01-01

    Doyle's 1912 best-seller 'The Lost World.'Two visualization methods were combined to produce the image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the northwest-southeast direction, so that northwest slopes appear bright and southeast slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow and tan, to white at the highest elevations.Elevation data used in this image were acquired by the Shuttle Radar Topography Mission aboard the Space Shuttle Endeavour, launched on Feb. 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. SRTM was designed to collect 3-D measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter (approximately 200-foot) mast, installed additional C-band and X-band antennas, and improved tracking and navigation devices. The mission is a cooperative project between NASA, the National Imagery and Mapping Agency (NIMA) of the U.S. Department of Defense and the German and Italian space agencies. It is managed by NASA's Jet Propulsion Laboratory, Pasadena, Calif., for NASA's Earth Science Enterprise,Washington, D.C.Location: 0.2 South to 8.7 degrees North latitude, 60 to 67.9 degrees West longitude Orientation: North toward the top Image Data: shaded and colored SRTM30 and GTOPO30 elevation models Data Resolution: SRTM 30 arcsecond (about 928 meters or 1496 feet) Date Acquired: February 2000 for SRTM

  6. Olduvai Gorge, Shaded Relief and Colored Height

    Science.gov (United States)

    2004-01-01

    topographic height. The shade image was derived by computing topographic slope in the northwest-southeast direction, so that northwest slopes appear bright and southeast slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow and tan, to white at the highest elevations. Elevation data used in this image were acquired by the Shuttle Radar Topography Mission aboard the Space Shuttle Endeavour, launched on Feb. 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. SRTM was designed to collect 3-D measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter (approximately 200-foot) mast, installed additional C-band and X-band antennas, and improved tracking and navigation devices. The mission is a cooperative project between NASA, the National Geospatial-Intelligence Agency (NGA) of the U.S. Department of Defense and the German and Italian space agencies. It is managed by NASA's Jet Propulsion Laboratory, Pasadena, Calif., for NASA's Earth Science Enterprise, Washington, D.C. Location: 3 degrees south latitude, 35 degrees east longitude Orientation: North toward the top, Mercator projection Size: 223 by 223 kilometers (138 by 138 miles) Image Data: shaded and colored SRTM elevation model Date Acquired: February 2000

  7. France, Shaded Relief and Colored Height

    Science.gov (United States)

    2003-01-01

    This image of France was generated with data from the Shuttle Radar Topography Mission (SRTM). For this broad view the resolution of the data was reduced to 6 arcseconds (about 185 meters north-south and 127 meters east-west), resampled to a Mercator projection, and the French border outlined. Even at this decreased resolution the variety of landforms comprising the country is readily apparent.The upper central part of this scene is dominated by the Paris Basin, which consists of a layered sequence of sedimentary rocks. Fertile soils over much of the area make good agricultural land. The Normandie coast to the upper left is characterized by high, chalk cliffs, while the Brittany coast (the peninsula to the left) is highly indented where deep valleys were drowned by the sea, and the Biscay coast to the southwest is marked by flat, sandy beaches.To the south, the Pyrenees form a natural border between France and Spain, and the south-central part of the country is dominated by the ancient Massif Central. Subject to volcanism that has only subsided in the last 10,000 years, these central mountains are separated from the Alps by the north-south trending Rhone River Basin.Two visualization methods were combined to produce the image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the northwest-southeast direction, so that northwest slopes appear bright and southeast slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow and tan, to white at the highest elevations.Elevation data used in this image were acquired by the Shuttle Radar Topography Mission aboard the Space Shuttle Endeavour, launched on Feb. 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. SRTM was designed to collect 3-D

  8. Combined Treatment with Gonadotropin-releasing Hormone Analog and Anabolic Steroid Hormone Increased Pubertal Height Gain and Adult Height in Boys with Early Puberty for Height.

    Science.gov (United States)

    Tanaka, Toshiaki; Naiki, Yasuhiro; Horikawa, Reiko

    2012-04-01

    Twenty-one boys with a height of 135 cm or less at onset of puberty were treated with a combination of GnRH analog and anabolic steroid hormone, and their pubertal height gain and adult height were compared with those of untreated 29 boys who enter puberty below 135 cm. The mean age at the start of treatment with a GnRH analog, leuprorelin acetate depot (Leuplin(®)) was 12.3 yr, a mean of 1.3 yr after the onset of puberty, and GnRH analog was administered every 3 to 5 wk thereafter for a mean duration of 4.1 yr. The anabolic steroid hormone was started approximately 1 yr after initiation of treatment with the GnRH analog. The mean pubertal height gain from onset of puberty till adult height was significantly greater in the combination treatment group (33.9 cm) than in the untreated group (26.4 cm) (ppenis and pubic hair is promoted by the anabolic steroid hormone, no psychosocial problems arose because of delayed puberty. No clinically significant adverse events appeared. Combined treatment with GnRH analog and anabolic steroid hormone significantly increased height gain during puberty and adult height in boys who entered puberty with a short stature, since the period until epiphyseal closure was extended due to deceleration of the bone age maturation by administration of the GnRH analog and the growth rate at this time was maintained by the anabolic steroid hormone.

  9. Mts. Agung and Batur, Bali, Shaded Relief and Colored Height

    Science.gov (United States)

    2004-01-01

    This perspective view shows the major volcanic group of Bali, one 13,000 islands comprising the nation of Indonesia. The conical mountain to the left is Gunung Agung, at 3,148 meters (10,308 feet) the highest point on Bali and an object of great significance in Balinese religion and culture. Agung underwent a major eruption in 1963 after more than 100 years of dormancy, resulting in the loss of over 1,000 lives.In the center is the complex structure of Batur volcano, showing a caldera (volcanic crater) left over from a massive catastrophic eruption about 30,000 years ago. Judging from the total volume of the outer crater and the volcano, that once lay above it, approximately 140 cubic kilometers(33.4 cubic miles) of material must have been produced by this eruption, making it one of the largest known volcanic events on Earth. Batur is still active and has erupted at least 22 times since the 1800's.Two visualization methods were combined to produce the image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the northwest-southeast direction, so that northwest slopes appear bright and southeast slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow and tan, to white at the highest elevations.Elevation data used in this image were acquired by the Shuttle Radar Topography Mission aboard the Space Shuttle Endeavour, launched on Feb. 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. SRTM was designed to collect 3-D measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter (approximately 200-foot) mast, installed additional C-band and X-band antennas, and improved tracking and navigation devices. The mission is a cooperative project between NASA, the National

  10. Combined Treatment with Gonadotropin-releasing Hormone Analog and Anabolic Steroid Hormone Increased Pubertal Height Gain and Adult Height in Boys with Early Puberty for Height

    OpenAIRE

    Tanaka, Toshiaki; Naiki, Yasuhiro; Horikawa, Reiko

    2012-01-01

    Twenty-one boys with a height of 135 cm or less at onset of puberty were treated with a combination of GnRH analog and anabolic steroid hormone, and their pubertal height gain and adult height were compared with those of untreated 29 boys who enter puberty below 135 cm. The mean age at the start of treatment with a GnRH analog, leuprorelin acetate depot (Leuplin?) was 12.3 yr, a mean of 1.3 yr after the onset of puberty, and GnRH analog was administered every 3 to 5 wk thereafter for a mean d...

  11. Simulation of ICESat-2 canopy height retrievals for different ecosystems

    Science.gov (United States)

    Neuenschwander, A. L.

    2016-12-01

    Slated for launch in late 2017 (or early 2018), the ICESat-2 satellite will provide a global distribution of geodetic measurements from a space-based laser altimeter of both the terrain surface and relative canopy heights which will provide a significant benefit to society through a variety of applications ranging from improved global digital terrain models to producing distribution of above ground vegetation structure. The ATLAS instrument designed for ICESat-2, will utilize a different technology than what is found on most laser mapping systems. The photon counting technology of the ATLAS instrument onboard ICESat-2 will record the arrival time associated with a single photon detection. That detection can occur anywhere within the vertical distribution of the reflected signal, that is, anywhere within the vertical distribution of the canopy. This uncertainty of where the photon will be returned from within the vegetation layer is referred to as the vertical sampling error. Preliminary simulation studies to estimate vertical sampling error have been conducted for several ecosystems including woodland savanna, montane conifers, temperate hardwoods, tropical forest, and boreal forest. The results from these simulations indicate that the canopy heights reported on the ATL08 data product will underestimate the top canopy height in the range of 1 - 4 m. Although simulation results indicate the ICESat-2 will underestimate top canopy height, there is, however, a strong correlation between ICESat-2 heights and relative canopy height metrics (e.g. RH75, RH90). In tropical forest, simulation results indicate the ICESat-2 height correlates strongly with RH90. Similarly, in temperate broadleaf forest, the simulated ICESat-2 heights were also strongly correlated with RH90. In boreal forest, the simulated ICESat-2 heights are strongly correlated with RH75 heights. It is hypothesized that the correlations between simulated ICESat-2 heights and canopy height metrics are a

  12. Hair Loss (Alopecia)

    Science.gov (United States)

    ... care Kids’ zone Video library Find a dermatologist Hair loss Overview Hereditary hair loss: Millions of men ... of hair loss can often be successfully treated. Hair loss: Overview Also called alopecia (al-o-PEE- ...

  13. Body height and weight of patients with childhood onset and adult onset thyrotoxicosis.

    Science.gov (United States)

    Takamatsu, J; Kobe, N; Ito, M; Ohsawa, N

    1999-03-01

    The present study has compared body height and weight of thyrotoxic female patients of childhood onset and adult onset. The body height of 141 out of 143 (99%) adult-onset thyrotoxic patients was within the range of mean +/- 2SD for the age-matched general Japanese female population. On the other hand, in 42 patients with childhood-onset thyrotoxicosis, 6 (14%) had their height being greater than the mean + 2SD of general population, and 34 (81%) were taller than the mean value. In 86 patients with siblings, 42 (49%) were at least 2 cm taller than their sisters, and 26 (30%) were more than 2 cm shorter than their sisters. The body weight of 27 out of 42 (68%) patients younger than 20 years was not decreased but was even greater than the mean value for the age-matched general population. The results indicate that excessive thyroid hormone in vivo enhances body height in humans. The increased body weight in some young patients suggests that enhanced dietary intake due to increased appetite in hyperthyroidism has overcome the energy loss with increased metabolism.

  14. Measuring the height-to-height correlation function of corrugation in suspended graphene

    International Nuclear Information System (INIS)

    Kirilenko, D.A.; Brunkov, P.N.

    2016-01-01

    Nanocorrugation of 2D crystals is an important phenomenon since it affects their electronic and mechanical properties. The corrugation may have various sources; one of them is flexural phonons that, in particular, are responsible for the thermal conductivity of graphene. A study of corrugation of just the suspended graphene can reveal much of valuable information on the physics of this complicated phenomenon. At the same time, the suspended crystal nanorelief can hardly be measured directly because of high flexibility of the 2D crystal. Moreover, the relief portion related to rapid out-of-plane oscillations (flexural phonons) is also inaccessible by such measurements. Here we present a technique for measuring the Fourier components of the height–height correlation function H(q) of suspended graphene which includes the effect of flexural phonons. The technique is based on the analysis of electron diffraction patterns. The H(q) is measured in the range of wavevectors q≈0.4–4.5 nm"−"1. At the upper limit of this range H(q) does follow the T/κq"4 law. So, we measured the value of suspended graphene bending rigidity κ=1.2±0.4 eV at ambient temperature T≈300 K. At intermediate wave vectors, H(q) follows a slightly weaker exponent than theoretically predicted q"−"3"."1"5 but is closer to the results of the molecular dynamics simulation. At low wave vectors, the dependence becomes even weaker, which may be a sign of influence of charge carriers on the dynamics of undulations longer than 10 nm. The technique presented can be used for studying physics of flexural phonons in other 2D materials. - Highlights: • A technique for measuring free-standing 2D crystal corrugation is proposed. • The height-to-height correlation function of the suspended graphene corrugation is measured. • Various parameters of the intrinsic graphene properties are experimentally determined.

  15. A hierarchy of patient-reported outcomes for meta-analysis of knee osteoarthritis trials

    DEFF Research Database (Denmark)

    Juhl, Carsten; Lund, Hans; Roos, Ewa M

    2012-01-01

    Objectives. To develop a prioritised list based on responsiveness for extracting patient-reported outcomes (PROs) measuring pain and disability for performing meta-analyses in knee osteoarthritis (OA). Methods. A systematic search was conducted in 20 highest impact factor general and rheumatology...

  16. Patient reported outcomes in pediatric oncology practice: suggestions for future usage by parents and pediatric oncologists

    NARCIS (Netherlands)

    Schepers, S. A.; Engelen, V. E.; Haverman, L.; Caron, H. N.; Hoogerbrugge, P. M.; Kaspers, G. J. L.; Egeler, R. M.; Grootenhuis, M. A.

    2014-01-01

    Several studies in adults have shown patient reported outcomes (PROs) to be effective in enhancing patient-physician communication and discussion of Health Related Quality of Life outcomes. Although less studied, positive results have been demonstrated in children. A PRO-intervention needs to be

  17. Development and Initial Validation of a Patient-Reported Adverse Drug Event Questionnaire

    NARCIS (Netherlands)

    de Vries, Sieta T.; Mol, Peter G. M.; de Zeeuw, Dick; Haaijer-Ruskamp, Flora M.; Denig, Petra

    2013-01-01

    Background Direct patient reporting of adverse drug events (ADEs) is relevant for the evaluation of drug safety. To collect such data in clinical trials and postmarketing studies, a valid questionnaire is needed that can measure all possible ADEs experienced by patients. Objective Our aim was to

  18. Relationship of patient-reported outcomes with MRI measures in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Baker, Joshua F; Conaghan, Philip G.; Emery, Paul

    2017-01-01

    PURPOSE: We assessed whether MRI measures of synovitis, osteitis and bone erosion were associated with patient-reported outcomes (PROs) in a longitudinal clinical trial setting among patients with rheumatoid arthritis (RA). METHODS: This longitudinal cohort of 291 patients with RA was derived from...

  19. The validity of a patient-reported adverse drug event questionnaire using different recall periods

    NARCIS (Netherlands)

    de Vries, Sieta T; Haaijer-Ruskamp, Flora M; de Zeeuw, Dick; Denig, Petra

    2014-01-01

    PURPOSE: To assess the validity of a patient-reported adverse drug events (ADEs) questionnaire with a 3-month or 4-week recall period. METHODS: Patients receiving at least one oral glucose-lowering drug were asked to report potential ADEs they experienced related to any drug in a daily diary for a

  20. Overcoming barriers to implementing patient-reported outcomes in an electronic health record: a case report.

    Science.gov (United States)

    Harle, Christopher A; Listhaus, Alyson; Covarrubias, Constanza M; Schmidt, Siegfried Of; Mackey, Sean; Carek, Peter J; Fillingim, Roger B; Hurley, Robert W

    2016-01-01

    In this case report, the authors describe the implementation of a system for collecting patient-reported outcomes and integrating results in an electronic health record. The objective was to identify lessons learned in overcoming barriers to collecting and integrating patient-reported outcomes in an electronic health record. The authors analyzed qualitative data in 42 documents collected from system development meetings, written feedback from users, and clinical observations with practice staff, providers, and patients. Guided by the Unified Theory on the Adoption and Use of Information Technology, 5 emergent themes were identified. Two barriers emerged: (i) uncertain clinical benefit and (ii) time, work flow, and effort constraints. Three facilitators emerged: (iii) process automation, (iv) usable system interfaces, and (v) collecting patient-reported outcomes for the right patient at the right time. For electronic health record-integrated patient-reported outcomes to succeed as useful clinical tools, system designers must ensure the clinical relevance of the information being collected while minimizing provider, staff, and patient burden. © 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.

  1. Patient reported outcomes in chronic skin diseases: eHealth applications for clinical practice

    NARCIS (Netherlands)

    van Cranenburgh, O.D.

    2016-01-01

    The overall aim of this thesis was to examine and integrate patient reported outcomes (PROs) in dermatological care. In part I, we specifically examined health-related quality of life (HRQoL), treatment satisfaction, and experiences with care in patients with chronic skin diseases. Our results

  2. Patient-reported depression measures in cancer: a meta-review

    NARCIS (Netherlands)

    Wakefield, C.E.; Butow, P.N.; Aaronson, N.K.; Hack, T.F.; Hulbert-Williams, N.J.; Jacobsen, P.B.

    2015-01-01

    The patient-reported depression measures that perform best in oncology settings have not yet been identified. We did a meta-review to integrate the findings of reviews of more than 50 depression measures used in adults with, or recovering from, any type of cancer. We searched Medline, PsycINFO,

  3. An introduction to patient-reported outcome measures (PROMs) in physiotherapy

    NARCIS (Netherlands)

    Kyte, D.G.; Calvert, M.; Wees, P.J. van der; Hove, R. Ten; Tolan, S.; Hill, J.C.

    2015-01-01

    The use of patient-reported outcome measures (PROMs) is set to rise in physiotherapy. PROMs provide additional 'patient-centred' data which is unique in capturing the patient's own opinion on the impact of their disease or disorder, and its treatment, on their life. Thus, PROMs are increasingly used

  4. Improving a newly developed patient-reported outcome for thyroid patients, using cognitive interviewing

    DEFF Research Database (Denmark)

    Watt, Torquil; Rasmussen, Ase Krogh; Groenvold, Mogens

    2008-01-01

    Objective To improve a newly developed patient-reported outcome measure for thyroid patients using cognitive interviewing. Methods Thirty-one interviews using immediate retrospective and expansive probing were conducted among patients with non-toxic goiter (n = 4), nodular toxic goiter (n = 5) Gr...

  5. Creating guidance for the use of patient reported outcome measures (PROMS) in clinical palliatieve care.

    NARCIS (Netherlands)

    Vliet, L.M. van; Harding, R.; Bausewein, C.; Payne, S.; Higginson, I.J.

    2014-01-01

    Introduction: Routine use of Patient Reported Outcome Measures (PROMs) in clinical practice can influence care but is not always achieved. One reason for this seems to be a lack of guidance on how to use PROMs in palliative care practice. This project aimed to provide such guidance. Aim(s) and

  6. Training clinicians in how to use patient-reported outcome measures in routine clinical practice

    NARCIS (Netherlands)

    Santana, Maria J.; Haverman, Lotte; Absolom, Kate; Takeuchi, Elena; Feeny, David; Grootenhuis, Martha; Velikova, Galina

    2015-01-01

    Patient-reported outcome measures (PROs) were originally developed for comparing groups of people in clinical trials and population studies, and the results were used to support treatment recommendations or inform health policy, but there was not direct benefit for the participants providing PROs

  7. The case for an international patient-reported outcomes measurement information system (PROMIS®) initiative

    NARCIS (Netherlands)

    Alonso, J.; Bartlett, S.J.; Rose, M.; Aaronson, N.K.; Chaplin, J.; Efficace, F.; Leplège, A.; Aiping, L.U.; Tulsky, D.S.; Raat, H.; Ravens-Sieberer, U.; Revicki, D.; Terwee, C.B.; Valderas, J.M.; Cella, D.; Forrest, C.B.

    2013-01-01

    Patient-reported outcomes (PROs) play an increasingly important role in clinical practice and research. Modern psychometric methods such as item response theory (IRT) enable the creation of item banks that support fixed-length forms as well as computerized adaptive testing (CAT), often resulting in

  8. The case for an international patient-reported outcomes measurement information system (PROMIS®) initiative

    NARCIS (Netherlands)

    J. Alonso (Jordi); S.J. Bartlett (Susan); M. Rose (Matthias); N.K. Aaronson (Neil); J.E. Chaplin (John); F. Efficace (Fabio); A. Leplège (Alain); A. LU (Aiping); D.S. Tulsky (David); H. Raat (Hein); U. Ravens-Sieberer (Ulrike); D. Revicki (Dennis); C.B. Terwee (Caroline); J.M. Valderas (Jose); D. Cella (David); C.B. Forrest (Christopher)

    2013-01-01

    textabstractPatient-reported outcomes (PROs) play an increasingly important role in clinical practice and research. Modern psychometric methods such as item response theory (IRT) enable the creation of item banks that support fixed-length forms as well as computerized adaptive testing (CAT), often

  9. Analysing data from patient-reported outcome and quality of life endpoints for cancer clinical trials

    DEFF Research Database (Denmark)

    Bottomley, Andrew; Pe, Madeline; Sloan, Jeff

    2016-01-01

    Measures of health-related quality of life (HRQOL) and other patient-reported outcomes generate important data in cancer randomised trials to assist in assessing the risks and benefits of cancer therapies and fostering patient-centred cancer care. However, the various ways these measures are anal......Measures of health-related quality of life (HRQOL) and other patient-reported outcomes generate important data in cancer randomised trials to assist in assessing the risks and benefits of cancer therapies and fostering patient-centred cancer care. However, the various ways these measures...... are analysed and interpreted make it difficult to compare results across trials, and hinders the application of research findings to inform publications, product labelling, clinical guidelines, and health policy. To address these problems, the Setting International Standards in Analyzing Patient......-Reported Outcomes and Quality of Life Endpoints Data (SISAQOL) initiative has been established. This consortium, directed by the European Organisation for Research and Treatment of Cancer (EORTC), was convened to provide recommendations on how to standardise the analysis of HRQOL and other patient-reported outcomes...

  10. Patient-Reported Disability Measures Do Not Correlate with Electrodiagnostic Severity in Carpal Tunnel Syndrome

    Directory of Open Access Journals (Sweden)

    Jacob E. Tulipan, MD

    2017-08-01

    Conclusions:. Electrodiagnostic severity grades do not correlate with patient-reported disability, including the DASH and MCS–12 surveys. There is a counterintuitive correlation between more-severe electrodiagnostic findings and decreased physical disability. These findings indicate that disability may not correlate with electrodiagnostic severity of median neuropathy in CTS.

  11. Combining Clinical Information and Patient Reported Outcome Measures in Orthopaedic Surgery and Sports Medicine

    NARCIS (Netherlands)

    Kampen, D.A. van

    2013-01-01

    In this thesis we investigated the use of clinical information and Patient Reported Outcome Measures (PROMs) for patient evaluation in orthopaedic surgery and sports medicine. In the first part, we showed that the Dutch version of the Simple Shoulder Test (SST) is a valid and reliable

  12. Height, weight, weight change and risk of breast cancer in Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Anelise Bezerra de Vasconcelos

    Full Text Available CONTEXT: The relationship between body size and breast cancer still remains controversial in considering menopausal status. OBJECTIVE: To evaluate the association of height, weight and weight changes with breast cancer in the city of Rio de Janeiro, Brazil. DESIGN: Case-control study. SETTING: National Cancer Institute (INCA, Rio de Janeiro, Brazil, and State University of Rio de Janeiro (UERJ. SAMPLE: 177 incident cases of invasive breast cancer admitted to the main hospital of INCA between May 1995 and February 1996, and 377 controls recruited from among female visitors to the same hospital. MAIN MEASUREMENTS: Height and weight were measured and information on maximum weight, weight at ages 18 and 30 years, and potential risk factors were ascertained by interview at the hospital. RESULTS: Height was not related to risk of breast cancer among both pre and postmenopausal women. Nevertheless, women in this study were shorter than in studies that have found a positive association. Premenopausal women in the upper quartile of recent body mass index (BMI and maximum BMI showed a reduced risk of breast cancer (P for trend <= 0.03. Weight loss between ages 18 and 30 years and from 18 years to present was also associated with breast cancer among premenopausal women. CONCLUSIONS: These findings may merely indicate the known association between leanness and breast cancer. Further studies should explore the role of weight loss on breast cancer risk.

  13. Dry Eye Symptoms, Patient-Reported Visual Functioning, and Health Anxiety Influencing Patient Satisfaction After Cataract Surgery.

    Science.gov (United States)

    Szakáts, Ildikó; Sebestyén, Margit; Tóth, Éva; Purebl, György

    2017-06-01

    To evaluate how patient satisfaction after cataract surgery is associated with postoperative visual acuity, visual functioning, dry eye signs and symptoms, health anxiety, and depressive symptoms. Fifty-four patients (mean age: 68.02 years) were assessed 2 months after uneventful phacoemulsification; 27 were unsatisfied with their postoperative results and 27 were satisfied. They completed the following questionnaires: Visual Function Index-14 (VF-14), Ocular Surface Disease Index (OSDI), Shortened Health Anxiety Inventory (SHAI), and Shortened Beck Depression Inventory. Testing included logarithm of the Minimum Angle of Resolution (logMAR) uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), dry eye tests (tear meniscus height and depth measured by spectral optical coherence tomography, tear film break-up time (TBUT), ocular surface staining, Schirmer 1 test, and meibomian gland dysfunction grading). Postoperative UCVA, BCVA, and the dry eye parameters - except TBUT - showed no statistically significant difference between the two groups (p > 0.130). However, the VF-14 scores, the OSDI scores, and the SHAI scores were significantly worse in the unsatisfied patient group (p 0.05). However, the VF-14 scores correlated with the OSDI scores (r = -0.436, p dry eye symptoms (odds ratio = 1.46, 95% CI = 1.02-2.09, p = 0.038) and visual functioning (odds ratio = 0.78, 95% CI = 0.60-1.0, p = 0.048). Our results suggest that patient-reported visual functioning, dry eye symptoms, and health anxiety are more closely associated with patients' postoperative satisfaction than with the objective clinical measures of visual acuity or the signs of dry eye.

  14. South America, Shaded Relief and Colored Height

    Science.gov (United States)

    2003-01-01

    occurrence of simple erosional processes acting upon fairly uniform bedrock. Very smooth plateaus here are remnants of landforms most likely developed under geologic and environmental conditions much different than those present today. Fractures paralleling the coast are likely related to the opening of the Atlantic Ocean as South America drifted away from Africa, starting about 130 million years ago.To the southwest, broad lowlands host the Gran Chaco and Pampas regions. The depositional Gran Chaco drainages run almost exclusively from west to east from the Andes Mountains to the western edge of the Brazilian Highlands as a result of the much greater sediment supply from the Andes. Geologic processes on the Pampas are much more diverse, with stream erosion, stream deposition, subsidence, and wind processes all evident, even at the one-kilometer resolution shown here.Further south, Patagonia also displays these geologic processes plus more prominent volcanic features, including bumpy mesas, which are lava plateaus with small (and some large) volcanic cones. At its southern tip South America breaks into islands that include Tierra del Fuego and the Straits of Magellan.Two visualization methods were combined to produce the image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the northwest-southeast direction, so that northwest slopes appear bright and southeast slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow and tan, to white at the highest elevations.Elevation data used in this image were acquired by the Shuttle Radar Topography Mission aboard the Space Shuttle Endeavour, launched on Feb. 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. SRTM was designed to collect 3-D measurements of

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

    Science.gov (United States)

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

    2017-01-01

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

  16. Patient-Reported Disease Activity and Adverse Pregnancy Outcomes in Systemic Lupus Erythematosus and Rheumatoid Arthritis.

    Science.gov (United States)

    Harris, Nathaniel; Eudy, Amanda; Clowse, Megan

    2018-06-15

    While increased rheumatic disease activity during pregnancy has been associated with adverse pregnancy outcomes, this activity is typically assessed by the physician. Little is known, however, about the association between patient-reported measures of disease activity and pregnancy outcomes. Univariate and multivariable regression models were used to assess the relationship between patient and physician-reported measures of disease activity and adverse pregnancy outcomes in 225 patients with lupus or rheumatoid arthritis (RA) enrolled in a prospective registry at a single academic center from 2008-2016. In women with RA, patient-reported disease activity is associated with preterm birth (OR 5.9 (1.5-23.9)), and gestational age (beta -1.5 weeks (-2.6, -0.4 weeks)). The physician assessment of disease activity also predicted preterm (OR 2.1 (1.2-3.5)), small for gestational age births (OR 1.8 (1.03-3.1), and gestational age in weeks (beta -0.6 weeks (-0.9, -0.02 weeks)). On the other hand, SLE patient-reported disease activity measures, including the HAQ, pain or global health measures, are not associated with adverse pregnancy outcomes. However, physician measures of SLE disease activity are associated with preterm birth (OR 2.9 (1.-6.3)), cesarean delivery (OR 2.3 (1.0-5.3)), and preeclampsia (OR 2.8 (1.3-6.3)). The results do not appear to be driven by lupus nephritis or antiphospholipid syndrome. For women with RA, patient-reported measures of disease activity may be useful adjuncts to physician-reported measures in identifying pregnancies at greater risk. In contrast, in SLE, no patient-reported measures were associated with adverse outcomes while physician measures of disease activity helped predict several adverse pregnancy outcomes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  17. Effect of firing conditions & release height on terminal performance of submunitions and conditions for optimum height of release

    Directory of Open Access Journals (Sweden)

    L.K. Gite

    2017-06-01

    Full Text Available Submunitions should exhibit optimum terminal performance at target end when released from certain pre-determined height. Selection of an optimum height of release of the submunitions depends on the terminal parameters like forward throw, remaining velocity, impact angle and flight time. In this paper, the effects of initial firing conditions and height of release on terminal performance of submunitions discussed in detail. For different height of release, the relation between range and forward throw is also established & validated for a number of firing altitude and rocket configurations.

  18. An attempt to link the Brazilian Height System to a World Height System

    Directory of Open Access Journals (Sweden)

    V. G. Ferreira

    Full Text Available This paper deals with the geopotential approach to investigate the present Brazilian Height System (BHS. Geopotential numbers are derived from Global Positioning System (GPS satellite surveying and disturbing potential on selected benchmarks. A model for the disturbing potential can be obtained by an existing set of spherical harmonic coefficients such as the Earth Gravity Model 2008 (EGM08. The approach provides absolute evaluation of local normal geopotential numbers (aka spheropotential numbers related to a so-called World Height System (WHS. To test the validity of the proposed methodology, a numerical experiment was carried out related to a test region in Southern Brazil. The accuracy of the derived geopotential numbers was tested versus local normal geopotential numbers based on 262 GPS/leveling points. The root mean square error (RMSE value for metric offset of BHS derived from geopotential numbers and the disturbing potential modeling in the test area was estimated to be near 0.224 meters in the absolute view. Therefore, since these spheropotential numbers are referred to a local datum, these results of comparisons may be an indicator of the mean bias of local network due to the effect of local Sea Surface Topography (SSTop and possible offset between the unknown reference for the BHS and the quasigeoid model in the region.

  19. Instrument modifications that produced reduced plate heights supercritical fluid chromatography.

    Science.gov (United States)

    Berger, Terry A

    2016-04-29

    The concept of peak fidelity was shown to be helpful in modeling tubing and detector cell dimensions. Connection tubing and flow cell variances were modeled to determine appropriate internal ID's, lengths, and volumes. A low dispersion plumbing configuration, based on these calculations, was assembled to replace the standard plumbing and produced the reported results. The modifications made were straightforward using commercially available parts. The full theoretical efficiency of a 3×100 mm column packed with 1.8 μm totally porous particles was achieved for the first time in supercritical fluid chromatography (SFC). Peak fidelity of >0.95 was maintained to below k=2. A reduced plate height as low as 1.87 was measured. Thus, true "ultra high performance" SFC was achieved, with the results a major improvement from all previous SFC reports. Since there were no efficiency losses, none could be attributed to thermal gradients caused by the expansion of the fluid over large pressure drops, under the conditions used. Similarly, changes in diffusion coefficients caused by significant decreases in density during expansion are apparently balanced by the increase in linear velocity, keeping the ratio between the diffusion coefficient and the linear velocity a constant. Changing modifier concentration to change retention was shown to not be a significant problem. All these issues have been a concern in the past. Diffusion coefficients, and viscosity data needs to be collected at high pressures before the actual limits of SFC can be discovered. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Measuring perceived ceiling height in a visual comparison task.

    Science.gov (United States)

    von Castell, Christoph; Hecht, Heiko; Oberfeld, Daniel

    2017-03-01

    When judging interior space, a dark ceiling is judged to be lower than a light ceiling. The method of metric judgments (e.g., on a centimetre scale) that has typically been used in such tasks may reflect a genuine perceptual effect or it may reflect a cognitively mediated impression. We employed a height-matching method in which perceived ceiling height had to be matched with an adjustable pillar, thus obtaining psychometric functions that allowed for an estimation of the point of subjective equality (PSE) and the difference limen (DL). The height-matching method developed in this paper allows for a direct visual match and does not require metric judgment. It has the added advantage of providing superior precision. Experiment 1 used ceiling heights between 2.90 m and 3.00 m. The PSE proved sensitive to slight changes in perceived ceiling height. The DL was about 3% of the physical ceiling height. Experiment 2 found similar results for lower (2.30 m to 2.50 m) and higher (3.30 m to 3.50 m) ceilings. In Experiment 3, we additionally varied ceiling lightness (light grey vs. dark grey). The height matches showed that the light ceiling appeared significantly higher than the darker ceiling. We therefore attribute the influence of ceiling lightness on perceived ceiling height to a direct perceptual rather than a cognitive effect.

  1. Oxygen–induced barrier height changes in aluminium – amorphous ...

    African Journals Online (AJOL)

    The results show that the application of voltage causes charge exchange between the surface states and the semiconductor leading to a change in the height of the potential barrier for electrons passing from aluminium into the a-Se films. The empirically determined values of barrier height of Al/a-Se diodes with thin and ...

  2. Diagnosis of childhood hypertension: is blood pressure height ratio ...

    African Journals Online (AJOL)

    Blood pressure was also recorded according to the standard method. Systolic and diastolic blood pressure to height ratio were then calculated. Receiver operating curves was used to assess the ability of systolic blood and diastolic blood pressure height ratio to discriminate childhood prehypertension and hypertension.

  3. 17 Years of Cloud Heights from Terra, and Beyond

    Science.gov (United States)

    Davies, R.

    2017-12-01

    The effective cloud height, H, is the integral of observed cloud-top heights, weighted by their frequency of occurrence. Here we look at changes in the effective cloud height, H', as measured by the Multiangle Imaging Spectroradiometer (MISR) on the first Earth Observing System platform, Terra. Terra was launched in December 1999, and now has over 17 years of consistently measured climate records. Globally, HG' has an important influence on Earth's climate, whereas regionally, HR' is a useful measure of low frequency changes in circulation patterns. MISR has a sampling error in the annual mean HG' of ≈11 m, allowing fairly small interannual variations to be detected. This paper extends the previous 15-year summary that showed significant differences in the long term mean hemispheric cloud height changes. Also of interest are the correlations in tropical cloud height changes and related teleconnections. The largest ephemeral values in the annual HR' [over 1.5 km] are noted over the Central Pacific and the Maritime Continent. These changes are strongly anticorrelated with each other, being directly related to changes in ENSO. They are also correlated with the largest ephemeral changes in HG'. Around the equator, we find at least four distinct centres of similar fluctuations in cloud height. This paper examines the relative time dependence of these regional height changes, separately for La Niña and El Niño events, and stresses the value of extending the time series of uniformly measured cloud heights from space beyond EOS-Terra.

  4. Developmental decline in height growth in Douglas-fir.

    Science.gov (United States)

    Barbara J. Bond; Nicole M. Czarnomski; Clifton Cooper; Michael E. Day; Michael S. Greenwood

    2007-01-01

    The characteristic decline in height growth that occurs over a tree's lifespan is often called "age-related decline." But is the reduction in height growth in aging trees a function of age or of size? We grafted shoot tips across different ages and sizes of Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco) trees to determine whether...

  5. Stereoscopic Roadside Curb Height Measurement using V-Disparity

    DEFF Research Database (Denmark)

    Matu, Florin-Octavian; Vlaykov, Iskren; Thøgersen, Mikkel

    2014-01-01

    Managing road assets, such as roadside curbs, is one of the interests of municipalities. As an interesting application of computer vision, this paper proposes a system for automated measurement of the height of the roadside curbs. The developed system uses the spatial information available...... results show that the system can measure the height of the roadside curb with good accuracy and precision....

  6. A century of trends in adult human height

    DEFF Research Database (Denmark)

    Damsgaard, Camilla Trab; Michaelsen, Kim F.; Molbo, Drude

    2016-01-01

    the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8-144.8). The height differential between the tallest...

  7. human pelvis height is associated with other pelvis measurements

    African Journals Online (AJOL)

    guyton2

    no study seeking to relate pelvis height to the other pelvis measurements of obstetric importance in Ugandans. In this paper we set out to answer the research question what are the associations between the various pelvis anthropometric measurements of obstetric importance with pelvis height in a sample of bones from the ...

  8. Generalized height-diameter models for Populus tremula L. stands

    African Journals Online (AJOL)

    USER

    2010-07-12

    Jul 12, 2010 ... and stand density) into the base height-diameter models increased the accuracy of prediction for P. tremula. .... parameter estimates compared with those obtained with ... using coefficient of determination for non-linear regression (. 2. R ), ..... stochastic height-diameter model for maritime pine ecoregions in.

  9. Height among Women is Curvilinearly Related to Life History Strategy

    Directory of Open Access Journals (Sweden)

    Abraham P. Buunk

    2009-10-01

    Full Text Available It was hypothesized that women of medium height would show a more secure, long-term mating pattern characterized by less jealousy, less intrasexual competition and a “slower” life history strategy. In three samples of female undergraduate students clear support was found for these hypotheses. In Study 1, among 120 participants, height was curvilinearly related to well-established measures of possessive and reactive jealousy, with women of medium height being less jealous than tall as well as short women. In Study 2, among 40 participants, height was curvilinearly related to intrasexual competition, with women of medium height being less competitive towards other women than tall as well as short women. In Study 3, among 299 participants, height was curvilinearly related to the Mini-K, a well-validated measure of “slower” life history strategy, with women of medium height having a slower life history strategy than tall as well as short women. The results suggest that women of medium height tend to follow a different mating strategy than either tall or short women. Various explanations and implications of these results are discussed.

  10. A century of trends in adult human height

    NARCIS (Netherlands)

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(Carlos P.); Bongard, V. (Vanina); P. Bovet (Pascal); Braeckman, L. (Lutgart); Bragt, M.C.E. (Marjolijn C. E.); Brajkovich, I. (Imperia); Branca, F. (Francesco); Breckenkamp, J. (Juergen); H. Brenner (Hermann); L.M. Brewster (Lizzy); Brian, G.R. (Garry R.); Bruno, G. (Graziella); Bueno-de-Mesquita, H.B. (H. Bas); Bugge, A. (Anna); Burns, C. (Con); De León, A.C. (Antonio Cabrera); Cacciottolo, J. (Joseph); Cama, T. (Tilema); Cameron, C. (Christine); Camolas, J. (José); G. Can (Günay); Cândido, A.P.C. (Ana Paula C.); Capuano, V. (Vincenzo); Cardoso, V.C. (Viviane C.); Carlsson, A.C. (Axel C.); Carvalho, M.J. (Maria J.); Casanueva, F.F. (Felipe F.); J.P. Casas (Juan Pablo); Caserta, C.A. (Carmelo A.); Chamukuttan, S. (Snehalatha); A.W.M. Chan (Angelique); Chan, Q. (Queenie); Chaturvedi, H.K. (Himanshu K.); Chaturvedi, N. (Nishi); Chen, C.-J. (Chien-Jen); Chen, F. (Fangfang); Chen, H. (Huashuai); Chen, S. (Shuohua); Chen, Z. (Zhengming); Cheng, C.-Y. (Ching-Yu); A. Chetrit (Angela); Chiolero, A. (Arnaud); Chiou, S.-T. (Shu-Ti); Chirita-Emandi, A. (Adela); Cho, B. (Belong); Cho, Y. (Yumi); Christensen, K. (Kaare); Chudek, J. (Jerzy); R. Cifkova (Renata); F. Claessens; E. Clays (Els); Concin, H. (Hans); C. Cooper (Charles); Cooper, R. (Rachel); Coppinger, T.C. (Tara C.); Costanzo, S. (Simona); D. Cottel (Dominique); Cowell, C. (Chris); Craig, C.L. (Cora L.); Crujeiras, A.B. (Ana B.); D’Arrigo, G. (Graziella); d’Orsi, E. (Eleonora); J. Dallongeville; Damasceno, A. (Albertino); Damsgaard, C.T. (Camilla T.); Dankner, R. (Rachel); Dauchet, L. (Luc); G. De Backer (Guy); D. De Bacquer (Dirk); de Gaetano, G. (Giovanni); De Henauw, S. (Stefaan); D. De Smedt (Delphine); Deepa, M. (Mohan); Deev, A.D. (Alexander D.); A. Dehghan (Abbas); Delisle, H. (Hélène); Delpeuch, F. (Francis); Deschamps, V. (Valérie); K. Dhana (Klodian); Di Castelnuovo, A.F. (Augusto F.); Dias-da-Costa, J.S. (Juvenal Soares); Diaz, A. (Alejandro); Djalalinia, S. (Shirin); Do, H.T.P. (Ha T. P.); Dobson, A.J. (Annette J.); C. Donfrancesco (Chiara); Donoso, S.P. (Silvana P.); A. Döring (Angela); Doua, K. (Kouamelan); Drygas, W. (Wojciech); Dzerve, V. (Vilnis); Egbagbe, E.E. (Eruke E.); Eggertsen, R. (Robert); U. Ekelund (Ulf); El Ati, J. (Jalila); P. Elliott (Paul); Engle-Stone, R. (Reina); Erasmus, R.T. (Rajiv T.); Erem, C. (Cihangir); Eriksen, L. (Louise); Escobedo-de la Peña, J. (Jorge); A. Evans (Alun); Faeh, D. (David); Fall, C.H. (Caroline H.); F. Farzadfar (Farshad); Felix-Redondo, F.J. (Francisco J.); Ferguson, T.S. (Trevor S.); Fernández-Bergés, D. (Daniel); Ferrante, D. (Daniel); Ferrari, M. (Marika); Ferreccio, C. (Catterina); J. Ferrieres (Jean); Finn, J.D. (Joseph D.); K. Fischer (Krista); Flores, E.M. (Eric Monterubio); Föger, B. (Bernhard); Foo, L.H. (Leng Huat); Forslund, A.-S. (Ann-Sofie); Forsner, M. (Maria); S.P. Fortmann (Stephen); Fouad, H.M. (Heba M.); Francis, D.K. (Damian K.); Do Carmo Franco, M. (Maria); O.H. Franco (Oscar); Frontera, G. (Guillermo); Fuchs, F.D. (Flavio D.); Fuchs, S.C. (Sandra C.); Fujita, Y. (Yuki); Furusawa, T. (Takuro); Gaciong, Z. (Zbigniew); Gafencu, M. (Mihai); Gareta, D. (Dickman); Garnett, S.P. (Sarah P.); J.-M. Gaspoz (Jean-Michel); Gasull, M. (Magda); Gates, L. (Louise); J.M. Geleijnse (Marianne); Ghasemian, A. (Anoosheh); S. Giampaoli (Simona); F. Gianfagna (Francesco); Giovannelli, J. (Jonathan); A. Giwercman (Aleksander); Goldsmith, R.A. (Rebecca A.); Gonçalves, H. (Helen); M. Gross; González Rivas, J.P. (Juan P.); Gorbea, M.B. (Mariano Bonet); Gottrand, F. (Frederic); Graff-Iversen, S. (Sidsel); Grafnetter, D. (Dušan); Grajda, A. (Aneta); Grammatikopoulou, M.G. (Maria G.); Gregor, R.D. (Ronald D.); T. Grodzicki (Tomasz); Grøntved, A. (Anders); Gruden, G. (Grabriella); Grujic, V. (Vera); Gu, D. (Dongfeng); Gualdi-Russo, E. (Emanuela); Guan, O.P. (Ong Peng); V. Gudnason (Vilmundur); Guerrero, R. (Ramiro); I. Guessous (Idris); Guimaraes, A.L. (Andre L.); Gulliford, M.C. (Martin C.); Gunnlaugsdottir, J. (Johanna); Gunter, M. (Marc); Guo, X. (Xiuhua); Guo, Y. (Yin); Gupta, P.C. (Prakash C.); Gureje, O. (Oye); Gurzkowska, B. (Beata); Gutierrez, L. (Laura); Gutzwiller, F. (Felix); J. Halkjær; Hambleton, I.R. (Ian R.); R. Hardy; Kumar, R.H. (Rachakulla Hari); Hata, J. (Jun); Hayes, A.J. (Alison J.); He, J. (Jiang); M.E. Hendriks (Marleen); Cadena, L.H. (Leticia Hernandez); Herrala, S. (Sauli); Heshmat, R. (Ramin); Hihtaniemi, I.T. (Ilpo Tapani); Ho, S.Y. (Sai Yin); Ho, S.C. (Suzanne C.); Hobbs, M. (Michael); Hofman, A. (Albert); Hormiga, C.M. (Claudia M.); Horta, B.L. (Bernardo L.); Houti, L. (Leila); Howitt, C. (Christina); Htay, T.T. (Thein Thein); Htet, A.S. (Aung Soe); Htike, M.M.T. (Maung Maung Than); Hu, Y. (Yonghua); A. Husseini (Abdullatif); Huu, C.N. (Chinh Nguyen); Huybrechts, I. (Inge); Hwalla, N. (Nahla); L. Iacoviello (Licia); Iannone, A.G. (Anna G.); Ibrahim, M.M. (Mohsen M.); Ikeda, N. (Nayu); M.A. Ikram (Arfan); V. Irazola (Vilma); M. Islam (Muhammad); Ivkovic, V. (Vanja); Iwasaki, M. (Masanori); Jackson, R.T. (Rod T.); Jacobs, J.M. (Jeremy M.); T.H. Jafar (Tazeen); Jamil, K.M. (Kazi M.); K. Jamrozik; Janszky, I. (Imre); Jasienska, G. (Grazyna); Jelakovic, B. (Bojan); Jiang, C.Q. (Chao Qiang); Joffres, M. (Michel); M. Johansson (Mattias); J.B. Jonas (Jost B.); T. Jorgensen (Torben); Joshi, P. (Pradeep); Juolevi, A. (Anne); Jurak, G. (Gregor); Jureša, V. (Vesna); R. Kaaks (Rudolf); Kafatos, A. (Anthony); Kalter-Leibovici, O. (Ofra); Kapantais, E. (Efthymios); Kasaeian, A. (Amir); Katz, J. (Joanne); Kaur, P. (Prabhdeep); M. Kavousi (Maryam); M. Keil (Mark); Boker, L.K. (Lital Keinan); S. Keinanen-Kiukaanniemi (Sirkka); Kelishadi, R. (Roya); H.C.G. Kemper; A.P. Kengne (Andre Pascal); Kersting, M. (Mathilde); T. Key (Tim); Y.S. Khader (Yousef Saleh); D. Khalili (Davood); Khang, Y.-H. (Young-Ho); K.-T. Khaw (Kay-Tee); Khouw, I.M.S.L. (Ilse M. S. L.); S. Kiechl (Stefan); Killewo, J. (Japhet); Kim, J. (Jeongseon); Klimont, J. (Jeannette); J. Klumbiene (Jurate); Koirala, B. (Bhawesh); Kolle, E. (Elin); P. Kolsteren (Patrick); Korrovits, P. (Paul); S. Koskinen (Seppo); Kouda, K. (Katsuyasu); Koziel, S. (Slawomir); W. Kratzer (Wolfgang); Krokstad, S. (Steinar); Kromhout, D. (Daan); Kruger, H.S. (Herculina S.); R. Kubinova; U.M. Kujala (Urho); Kula, K. (Krzysztof); Kulaga, Z. (Zbigniew); Krishna Kumar, R.; Kurjata, P. (Pawel); Kusuma, Y.S. (Yadlapalli S.); K. Kuulasmaa (Kari); Kyobutungi, C. (Catherine); Laamiri, F.Z. (Fatima Zahra); T. Laatikainen (Tiina); C. Lachat (Carl); Laid, Y. (Youcef); Lam, T.H. (Tai Hing); Landrove, O. (Orlando); Lanska, V. (Vera); Lappas, G. (Georg); Larijani, B. (Bagher); L.E. Laugsand (Lars E.); Bao, K.L.N. (Khanh Le Nguyen); Le, T.D. (Tuyen D.); Leclercq, C. (Catherine); J.J.M. Lee (Jeannette); Lee, J. (Jeonghee); T. Lehtimäki (Terho); Lekhraj, R. (Rampal); León-Muñoz, L.M. (Luz M.); Y. Li (Yanping); Lilly, C.L. (Christa L.); W.-Y. 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(Abla M.); Silva, A.M. (Antonio M.); Silva, D.A.S. (Diego Augusto Santos); Simon, M. (Mary); J. Simons (Judith); L.A. Simons (Leon); Sjostrom, M. (Michael); J. Slowikowska-Hilczer (Jolanta); Slusarczyk, P. (Przemyslaw); L. Smeeth (Liam); Smith, M.C. (Margaret C.); M.B. Snijder (Marieke); So, H.-K. (Hung-Kwan); Sobngwi, E. (Eugène); S. Söderberg (Stefan); Soekatri, M.Y.E. (Moesijanti Y. E.); Solfrizzi, V. (Vincenzo); E. Sonestedt (Emily); Song, Y. (Yi); T.I.A. Sørensen (Thorkild); Soric, M. (Maroje); Jérome, C.S. (Charles Sossa); Soumare, A. (Aicha); J.A. Staessen (Jan); Starc, G. (Gregor); Stathopoulou, M.G. (Maria G.); Staub, K. (Kaspar); Stavreski, B. (Bill); Steene-Johannessen, J. (Jostein); Stehle, P. (Peter); Stein, A.D. (Aryeh D.); Stergiou, G.S. (George S.); Stessman, J. (Jochanan); Stieber, J. (Jutta); D. Stöckl (Doris); Stocks, T. (Tanja); Stokwiszewski, J. (Jakub); Stratton, G. (Gareth); K. Stronks (Karien); Strufaldi, M.W. (Maria Wany); Sun, C.-A. (Chien-An); Sundström, J. (Johan); Sung, Y.-T. (Yn-Tz); J. Sunyer (Jordi); Suriyawongpaisal, P. (Paibul); Swinburn, B.A. (Boyd A.); Sy, R.G. (Rody G.); Szponar, L. (Lucjan); E. Shyong Tai; M.L. Tammesoo; A. Tamosiunas (Abdonas); Tang, L. (Line); Tang, X. (Xun); F. Tanser (Frank); Tao, Y. (Yong); Tarawneh, M.R. (Mohammed Rasoul); Tarp, J. (Jakob); Tarqui-Mamani, C.B. (Carolina B.); Taylor, A. (Anne); Tchibindat, F. (Félicité); Theobald, H. (Holger); L. Thijs (Lutgarde); L. Thuesen (Leif); A. Tjønneland (Anne); Tolonen, H.K. (Hanna K.); Tolstrup, J.S. (Janne S.); Topbas, M. (Murat); Topór-Madry, R. (Roman); M. Torrent (Maties); Toselli, S. (Stefania); Traissac, P. (Pierre); A. Trichopoulou (Antonia); Trichopoulos, D. (Dimitrios); Trinh, O.T.H. (Oanh T. H.); Trivedi, A. (Atul); Tshepo, L. (Lechaba); Tulloch-Reid, M.K. (Marshall K.); Tuomainen, T.-P. (Tomi-Pekka); J. Tuomilehto (Jaakko); Turley, M.L. (Maria L.); Tynelius, P. (Per); Tzotzas, T. (Themistoklis); C. Tzourio (Christophe); Ueda, P. (Peter); Ukoli, F.A.M. (Flora A. M.); Ulmer, H. (Hanno); Unal, B. (Belgin); Uusitalo, H.M.T. (Hannu M. T.); Valdivia, G. (Gonzalo); Vale, S. (Susana); D. Valvi (Damaskini); Y.T. van der Schouw (Yvonne); Van Herck, K. (Koen); Van Minh, H. (Hoang); L. van Rossem (Lenie); I. van Valkengoed (Irene); D. Vanderschueren (Dirk); D. Vanuzzo (Diego); L. Vatten (Lars); Vega, T. (Tomas); Velasquez-Melendez, G. (Gustavo); G. Veronesi (Giovanni); Monique Verschuren, W.M.; Verstraeten, R. (Roosmarijn); Victora, C.G. (Cesar G.); G. Viegi; L. Viet (Lucie); E. Viikari-Juntura (Eira); P. Vineis (Paolo); J. Vioque (Jesus); Virtanen, J.K. (Jyrki K.); S. Visvikis-Siest (Sophie); B. Viswanathan (Bharathi); P. Vollenweider (Peter); Voutilainen, S. (Sari); Vrdoljak, A. (Ana); M. Vrijheid (Martine); Wade, A.N. (Alisha N.); Wagner, A. (Aline); Walton, J. (Janette); Mohamud, W.N.W. (Wan Nazaimoon Wan); Wang, M.-D. (Ming-Dong); Wang, Q. (Qian); Y. Wang (Ying); Goya Wannamethee, S.; N.J. Wareham (Nick); Weerasekera, D. (Deepa); P.H. Whincup (Peter); Widhalm, K. (Kurt); Widyahening, I.S. (Indah S.); Wiecek, A. (Andrzej); A.H. Wijga (Alet); Wilks, R.J. (Rainford J.); J. Willeit (Johann); T. Wilsgaard (Tom); B. Wojtyniak (Bogdan); Wong, J.E. (Jyh Eiin); Wong, T.Y. (Tien Yin); Woo, J. (Jean); M. Woodward (Mark); F.C.W. Wu (Frederick C.); Wu, J. (Jianfeng); Wu, S.L. (Shou Ling); Xu, H. (Haiquan); Xu, L. (Liang); Yamborisut, U. (Uruwan); Yan, W. (Weili); Yang, X. (Xiaoguang); Yardim, N. (Nazan); X. Ye (Xingwang); P.K. Yiallouros (P.); Yoshihara, A. (Akihiro); You, Q.S. (Qi Sheng); Younger-Coleman, N.O. (Novie O.); Yusoff, A.F. (Ahmad F.); Zainuddin, A.A. (Ahmad A.); Zambon, S. (Sabina); T. Zdrojewski (T.); Zeng, Y. (Yi); Zhao, D. (Dong); Zhao, W. (Wenhua); Y. Zheng (Yingfeng); M. Zhou (Ming); Zhu, D. (Dan); E. Zimmermann; Cisneros, J.Z. (Julio Zuñiga)

    2016-01-01

    textabstractBeing taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The

  11. Variability of the Mixed-Layer Height Over Mexico City

    Science.gov (United States)

    García-Franco, J. L.; Stremme, W.; Bezanilla, A.; Ruiz-Angulo, A.; Grutter, M.

    2018-02-01

    The diurnal and seasonal variability of the mixed-layer height in urban areas has implications for ground-level air pollution and the meteorological conditions. Measurements of the backscatter of light pulses with a commercial lidar system were performed for a continuous period of almost six years between 2011 and 2016 in the southern part of Mexico City. The profiles were temporally and vertically smoothed, clouds were filtered out, and the mixed-layer height was determined with an ad hoc treatment of both the filtered and unfiltered profiles. The results are in agreement when compared with values of mixed-layer height reconstructed from, (i) radiosonde data, and (ii) surface and vertical column densities of a trace gas. The daily maxima of the mean mixed-layer height reach values > 3 km above ground level in the months of March-April, and are clearly lower (pollution episodes and the height of the mixed layer. The growth rate of the convective mixed-layer height has a seasonal behaviour, which is characterized together with the mixed-layer-height anomalies. A clear residual layer is evident from the backscattered signals recorded in days with specific atmospheric conditions, but also from the cloud-filtered mean diurnal profiles. The occasional presence of a residual layer results in an overestimation of the reported mixed-layer height during the night and early morning hours.

  12. A century of trends in adult human height

    NARCIS (Netherlands)

    Bentham, James; Di Cesare, Mariachiara; Stevens, Gretchen A.; Zhou, Bin; Bixby, Honor; Cowan, Melanie; Fortunato, Léa; Bennett, James E.; Danaei, Goodarz; Hajifathalian, Kaveh; Lu, Yuan; Riley, Leanne M.; Laxmaiah, Avula; Kontis, Vasilis; Paciorek, Christopher J.; Riboli, Elio; Ezzati, Majid; Abdeen, Ziad A.; Hamid, Zargar Abdul; Abu-Rmeileh, Niveen M.; Acosta-Cazares, Benjamin; Adams, Robert; Aekplakorn, Wichai; Aguilar-Salinas, Carlos A.; Agyemang, Charles; Ahmadvand, Alireza; Ahrens, Wolfgang; Al-Hazzaa, Hazzaa M.; Al-Othman, Amani Rashed; Raddadi, Rajaa Al; Ali, Mohamed M.; Alkerwi, Ala'a; Alvarez-Pedrerol, Mar; Aly, Eman; Amouyel, Philippe; Amuzu, Antoinette; Andersen, Lars Bo; Anderssen, Sigmund A.; Anjana, Ranjit Mohan; Aounallah-Skhiri, Hajer; Ariansen, Inger; Aris, Tahir; Arlappa, Nimmathota; Brewster, Lizzy M.; Hendriks, Marleen Elisabeth; Wit, Tobias F. Rinke de; Schultsz, Constance; Snijder, Marieke B.; Stronks, Karien; Valkengoed, Irene Gm van

    2016-01-01

    Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in

  13. Height estimations based on eye measurements throughout a gait cycle

    DEFF Research Database (Denmark)

    Yang, Sylvia X M; Larsen, Peter K; Alkjær, Tine

    2014-01-01

    (EH) measurement, on the other hand, is less prone to concealment. The purpose of the present study was to investigate: (1) how the eye height varies during the gait cycle, and (2) how the eye height changes with head position. The eyes were plotted manually in APAS for 16 test subjects during...

  14. Mixing height measurements from UHF wind profiling radar

    Energy Technology Data Exchange (ETDEWEB)

    Angevine, W.M.; Grimsdell, A.W. [CIRES, Univ. of Colorado, and NOAA Aeronomy Lab., Boulder, Colorado (United States)

    1997-10-01

    Mixing height in convective boundary layers can be detected by wind profiling radars (profilers) operating at or near 915 MHZ. We have made such measurements in a variety of settings including Alabama in 1992; Nova Scotia, Canada, during the North Atlantic Regional Experiment (NARE) 1993; Tennessee during the Southern Oxidant Study (SOS) 1994; near a 450 m tower in Wisconsin in 1995; and extensively in Illinois during the Flatland95, `96, and `97 experiments, as well as continuous operations at the Flatland Atmospheric Observatory. Profiler mixing height measurements, like all measurements, are subject to some limitations. The most important of these are due to rainfall, minimum height, and height resolution. Profilers are very sensitive to rain, which dominates the reflectivity and prevents the mixing height from being detected. Because the best height resolution is currently 60 m and the minimum height is 120-150 m AGL, the profiler is not suited for detecting mixing height in stable or nocturnal boundary layers. Problems may also arise in very dry or cold environments. (au) 12 refs.

  15. Accurate tool height control by bearing gap adjustment

    NARCIS (Netherlands)

    Wielen, van der A.M.; Schellekens, P.H.J.; Jaartsveld, F.T.M.

    2002-01-01

    Face turning of optical surfaces on precision lathes needs high precision tool height adjustment, which may be a difficult and time-consuming task. In this paper we present a new tool adjustment mechanism based on varying the bearing gap height of the hydrostatic bearings present in precision lathe

  16. Definition of Physical Height Systems for Telluric Planets and Moons

    Science.gov (United States)

    Tenzer, Robert; Foroughi, Ismael; Sjöberg, Lars E.; Bagherbandi, Mohammad; Hirt, Christian; Pitoňák, Martin

    2018-01-01

    In planetary sciences, the geodetic (geometric) heights defined with respect to the reference surface (the sphere or the ellipsoid) or with respect to the center of the planet/moon are typically used for mapping topographic surface, compilation of global topographic models, detailed mapping of potential landing sites, and other space science and engineering purposes. Nevertheless, certain applications, such as studies of gravity-driven mass movements, require the physical heights to be defined with respect to the equipotential surface. Taking the analogy with terrestrial height systems, the realization of height systems for telluric planets and moons could be done by means of defining the orthometric and geoidal heights. In this case, however, the definition of the orthometric heights in principle differs. Whereas the terrestrial geoid is described as an equipotential surface that best approximates the mean sea level, such a definition for planets/moons is irrelevant in the absence of (liquid) global oceans. A more natural choice for planets and moons is to adopt the geoidal equipotential surface that closely approximates the geometric reference surface (the sphere or the ellipsoid). In this study, we address these aspects by proposing a more accurate approach for defining the orthometric heights for telluric planets and moons from available topographic and gravity models, while adopting the average crustal density in the absence of reliable crustal density models. In particular, we discuss a proper treatment of topographic masses in the context of gravimetric geoid determination. In numerical studies, we investigate differences between the geodetic and orthometric heights, represented by the geoidal heights, on Mercury, Venus, Mars, and Moon. Our results reveal that these differences are significant. The geoidal heights on Mercury vary from - 132 to 166 m. On Venus, the geoidal heights are between - 51 and 137 m with maxima on this planet at Atla Regio and Beta

  17. Imaging height fluctuations in free-standing graphene membranes

    Science.gov (United States)

    Dorsey, Kyle; Miskin, Marc; Barnard, Arthur; Rose, Peter; Cohen, Itai; McEuen, Paul

    We present a technique based on multi-wavelength interference microscopy to measure the heights of observed ripples in free-standing graphene membranes. Graphene membranes released from a transparent substrate produce interference fringes when viewed in the reflection mode of an inverted microscope(Blees et. al. Nature 524 (7564): 204-207 (2015)). The fringes correspond to corrugation of the membrane as it floats near an interface. A single set of fringes is insufficient to uniquely determine the height profile, as a given fringe spacing can correspond to an increase or decrease in height by λ / 2 . Imaging at multiple wavelengths resolves the ambiguities in phase, and enables unique determination of the height profile of the membrane (Schilling et. al.Phys. Rev. E, 69:021901, 2004). We utilize this technique to map out the height fluctuations in free-standing graphene membranes to answer questions about fundamental mechanical properties of two-dimensional materials.

  18. Height, selected genetic markers and prostate cancer risk

    DEFF Research Database (Denmark)

    Lophatananon, Artitaya; Stewart-Brown, Sarah; Kote-Jarai, Zsofia

    2017-01-01

    Background:Evidence on height and prostate cancer risk is mixed, however, recent studies with large data sets support a possible role for its association with the risk of aggressive prostate cancer.Methods:We analysed data from the PRACTICAL consortium consisting of 6207 prostate cancer cases...... and 6016 controls and a subset of high grade cases (2480 cases). We explored height, polymorphisms in genes related to growth processes as main effects and their possible interactions.Results:The results suggest that height is associated with high-grade prostate cancer risk. Men with height >180 cm...... are at a 22% increased risk as compared to men with height prostate cancer risk. The aggregate scores of the selected variants identified a significantly increased risk of overall prostate cancer...

  19. Footprint parameters as a measure of arch height.

    Science.gov (United States)

    Hawes, M R; Nachbauer, W; Sovak, D; Nigg, B M

    1992-01-01

    The human foot has frequently been categorized into arch height groups based upon analysis of footprint parameters. This study investigates the relationship between directly measured arch height and many of the footprint parameters that have been assumed to represent arch height. A total of 115 male subjects were measured and footprint parameters were calculated from digitized outlines. Correlation and regression analyses were used to determine the relationship between footprint measures and arch height. It may be concluded from the results that footprint parameters proposed in the literature (arch angle, footprint index, and arch index) and two further parameters suggested in this study (arch length index and truncated arch index) are invalid as a basis for prediction or categorization of arch height. The categorization of the human foot according to the footprint measures evaluated in this paper represent no more than indices and angles of the plantar surface of the foot itself.

  20. Education attainment is associated with patient-reported outcomes: findings from the Swedish Hip Arthroplasty Register.

    Science.gov (United States)

    Greene, Meridith E; Rolfson, Ola; Nemes, Szilard; Gordon, Max; Malchau, Henrik; Garellick, Göran

    2014-06-01

    Age, sex, and medical comorbidities may be associated with differences in patient-reported outcome scores after THA. Highest level of education may be a surrogate for socioeconomic status, but the degree to which this is associated with patient-reported outcomes after THA is not known. We investigated the national Swedish Hip Arthroplasty Register for the association of education attainment on patient-reported outcomes 1 year after THA; specifically, we evaluated level of education attainment against health-related quality of life (HRQoL), pain reduction, and satisfaction with treatment 1 year after THA. All THAs for osteoarthritis performed from 2005 through 2007 with complete patient-reported outcome measures (representing 49% of the THAs performed for this diagnosis) were selected from the Swedish Hip Arthroplasty Register. These cases were merged with national databases containing education attainment, marital status, and comorbidities (n = 11,464; mean age of patients, 64 years). The patient-reported outcome measure protocol included the HRQoL measure EuroQol five-dimension scale (EQ-5D), a VAS for pain, the Charnley classification survey, and a VAS addressing THA satisfaction. Linear regression analyses determined the association of preoperative patient factors with patient-reported outcomes. High education attainment was associated with higher HRQoL (EQ-5D index ß(high) = 0.03 ± 0.01; EQ VAS ß(high) = 2.6 ± 0.5) after THA, whereas those with low and medium education were at risk for lower HRQoL. High education was associated with less pain after treatment (ß(high) = -3.3 ± 0.05). Individuals with low or medium education were at risk for less satisfaction with THA (p education to a greater extent. Identification of patients who will benefit most from THA and educating those at risk for poorer outcomes, like patients with low and medium education, ultimately may improve patient satisfaction, HRQoL, pain, and the cost utility of THA. Level III

  1. Postoperative weight bearing and patient reported outcomes at one year following tibial plateau fractures.

    Science.gov (United States)

    Thewlis, Dominic; Fraysse, Francois; Callary, Stuart A; Verghese, Viju Daniel; Jones, Claire F; Findlay, David M; Atkins, Gerald J; Rickman, Mark; Solomon, Lucian B

    2017-07-01

    Tibial plateau fractures are complex and the current evidence for postoperative rehabilitation is weak, especially related to the recommended postoperative weight bearing. The primary aim of this study was to investigate if loading in the first 12 weeks of recovery is associated with patient reported outcome measures at 26 and 52 weeks postoperative. We hypothesized that there would be no association between loading and patient reported outcome measures. Seventeen patients, with a minimum of 52-week follow-up following fragment-specific open reduction and internal fixation for tibial plateau fracture, were selected for this retrospective analysis. Postoperatively, patients were advised to load their limb to a maximum of 20kg during the first 6 weeks. Loading data were collected during walking using force platforms. A ratio of limb loading (affected to unaffected) was calculated at 2, 6 and 12 weeks postoperative. Knee Injury and Osteoarthritis Scores were collected at 6, 12, 26 and 52 weeks postoperative. The association between loading ratios and patient reported outcomes were investigated. Compliance with weight bearing recommendations and changes in the patient reported outcome measures are described. Fracture reduction and migration were assessed on plain radiographs. No fractures demonstrated any measurable postoperative migration at 52 weeks. Significant improvements were seen in all patient reported outcome measures over the first 52 weeks, despite poor adherence to postoperative weight bearing restrictions. There were no associations between weight bearing ratio and patient reported outcomes at 52 weeks postoperative. Significant associations were identified between the loading ratio at 2 weeks and knee-related quality of life at six months (R 2 =0.392), and between the loading ratio at 6 weeks combined with injury severity and knee-related quality of life at 26 weeks (R 2 =0.441). In summary, weight bearing as tolerated does not negatively affect the

  2. Sensitivity of the urban airshed model to mixing height profiles

    Energy Technology Data Exchange (ETDEWEB)

    Rao, S.T.; Sistla, G.; Ku, J.Y.; Zhou, N.; Hao, W. [New York State Dept. of Environmental Conservation, Albany, NY (United States)

    1994-12-31

    The United States Environmental Protection Agency (USEPA) has recommended the use of the Urban Airshed Model (UAM), a grid-based photochemical model, for regulatory applications. One of the important parameters in applications of the UAM is the height of the mixed layer or the diffusion break. In this study, we examine the sensitivity of the UAM-predicted ozone concentrations to (a) a spatially invariant diurnal mixing height profile, and (b) a spatially varying diurnal mixing height profile for a high ozone episode of July 1988 for the New York Airshed. The 1985/88 emissions inventory used in the EPA`s Regional Oxidant Modeling simulations has been regridded for this study. Preliminary results suggest that the spatially varying case yields a higher peak ozone concentrations compared to the spatially invariant mixing height simulation, with differences in the peak ozone ranging from a few ppb to about 40 ppb for the days simulated. These differences are attributed to the differences in the shape of the mixing height profiles and its rate of growth during the morning hours when peak emissions are injected into the atmosphere. Examination of the impact of emissions reductions associated with these two mixing height profiles indicates that NO{sub x}-focussed controls provide a greater change in the predicted ozone peak under spatially invariant mixing heights than under the spatially varying mixing height profile. On the other hand, VOC-focussed controls provide a greater change in the predicted peak ozone levels under spatially varying mixing heights than under the spatially invariant mixing height profile.

  3. Evolution of Human Body Height and Its Implications in Ergonomics

    Directory of Open Access Journals (Sweden)

    İzzet DUYAR

    2009-06-01

    Full Text Available Body height is an crucial variable in the design and production of all physical spaces, primarily in the manifacturing of clothes and means of transportation. Having such an ergonomic significance, the height of the human being has constantly changed during the course of history. There exist strong data suggesting that this change is still continue. To find out stages of evolution of human height throughout the ages up to the present will help us to illuminate the human-environment relations, and to predict the possible changes that the human height might be subjected to in the future. In view of these reasons, the changes that has occured in human height from the period at which hominids appeared until humans’ transition into settled life have been closely examined. The study was carried out on the basis of the data obtained from the earlier studies in literature. These data, when considered as a whole, reveal that the human height did not continuously increase in a linear fashion in its evolutionary path but recorded some increases and decreases at different stages. The difference between males and females (sexual dimorphism has not shown a steady decrease either; instead, it has exhibited an oscillating pattern. The modern humans as a species is not unique in terms of their height; as a matter of fact, two million years ago hominids had existed at approximately the same height as the Homo sapiens. Although the average height had shown some decrease in Homo erectus, its distribution pattern was not much different than the one observed in the modern human societies. In the findings dated to the early stages of the Upper Paleolithic Age, height showed a tendency to increase again

  4. Numerical and Experimental Study of Friction Loss in Hydrostatic Motor

    DEFF Research Database (Denmark)

    Sørensen, Rasmus Mørk; Hansen, Michael R.; Mouritsen, Ole Ø.

    2012-01-01

    This paper presents a numerical and experimental study of the losses in a hydrostatic motor principle. The motor is designed so that the structural de ections and lubricating regimes between moving surfaces and, subsequently, the leakage and friction losses, can be controlled during operation....... This is done by means of additional pressure volumes that in uence the stator de ection. These pressures are referred to as compensation pressures and the main emphasis is on friction or torque loss modeling of the motor as a function of the compensation pressures and the high and low pressures related...... to the load torque. The torque loss modeling is identied as a Stribeck curve which depends on gap height. The asperity friction is decreasing exponentially with an increase in gap height. The parameters of the torque loss model are based on prototype measurements that include the structural de ections...

  5. SRTM Data Release for Africa, Colored Height

    Science.gov (United States)

    2004-01-01

    Africa is dominated by the Great Rift Valley, extending from Lake Nyasa to the Red Sea, and splitting into two arms to enclose an interior plateau and the nearly circular Lake Victoria, visible in the right center of the image. To the west lies the Congo Basin, a vast, shallow depression which rises to form an almost circular rim of highlands. Most of the southern part of the continent rests on a concave plateau comprising the Kalahari basin and a mountainous fringe, skirted by a coastal plain which widens out in Mozambique in the southeast. Many of these regions were previously very poorly mapped due to persistent cloud cover or the inaccessibility of the terrain. Digital elevation data, such as provided by SRTM, are particularly in high demand by scientists studying earthquakes, volcanism, and erosion patterns for use in mapping and modeling hazards to human habitation. But the shape of Earth's surface affects nearly every natural process and human endeavor that occurs there, so elevation data are used in a wide range of applications. In this index map color-coding is directly related to topographic height, with brown and yellow at the lower elevations, rising through green, to white at the highest elevations. Blue areas on the map represent water within the mapped tiles, each of which includes shorelines or islands. Elevation data used in this image were acquired by the Shuttle Radar Topography Mission (SRTM) aboard the Space Shuttle Endeavour, launched on February 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. SRTM was designed to collect three-dimensional measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter-long (200-foot) mast, installed additional C-band and X-band antennas, and improved tracking and navigation devices. The mission is a cooperative project between the National

  6. [Influence of disc height on outcome of posterolateral fusion].

    Science.gov (United States)

    Drain, O; Lenoir, T; Dauzac, C; Rillardon, L; Guigui, P

    2008-09-01

    Experimentally, posterolateral fusion only provides incomplete control of flexion-extension, rotation and lateral inclination forces. The stability deficit increases with increasing height of the anterior intervertebral space, which for some warrants the adjunction of an intersomatic arthrodesis in addition to the posterolateral graft. Few studies have been devoted to the impact of disc height on the outcome of posterolateral fusion. The purpose of this work was to investigate the spinal segment immobilized by the posterolateral fusion: height of the anterior intervertebral space, the clinical and radiographic impact of changes in disc height, and the short- and long-term impact of disc height measured preoperatively on clinical and radiographic outcome. In order to obtain a homogeneous group of patients, the series was limited to patients undergoing posterolateral arthrodesis for degenerative spondylolisthesis, in combination with radicular release. This was a retrospective analysis of a consecutive series of 66 patients with mean 52 months follow-up (range 3-63 months). A dedicated self-administered questionnaire was used to collect data on pre- and postoperative function, the SF-36 quality of life score, and patient satisfaction. Pre- and postoperative (early, one year, last follow-up) radiographic data were recorded: olisthesic level, disc height, intervertebral angle, intervertebral mobility (angular, anteroposterior), and global measures of sagittal balance (thoracic kyphosis, lumbar lordosis, T9 sagittal tilt, pelvic version, pelvic incidence, sacral slope). SpineView was used for all measures. Univariate analysis searched for correlations between variation in disc height and early postoperative function and quality of fusion at last follow-up. Multivariate analysis was applied to the following preoperative parameters: intervertebral angle, disc height, intervertebral mobility, sagittal balance parameters, use of osteosynthesis or not. At the olisthesic

  7. Standardizing Scale Height Computation of Maven Ngims Neutral Data and Variations Between Exobase and Homeopause Scale Heights

    Science.gov (United States)

    Elrod, M. K.; Slipski, M.; Curry, S.; Williamson, H. N.; Benna, M.; Mahaffy, P. R.

    2017-12-01

    The MAVEN NGIMS team produces a level 3 product which includes the computation of Ar scale height an atmospheric temperatures at 200 km. In the latest version (v05_r01) this has been revised to include scale height fits for CO2, N2 O and CO. Members of the MAVEN team have used various methods to compute scale heights leading to significant variations in scale height values depending on fits and techniques within a few orbits even, occasionally, the same pass. Additionally fitting scale heights in a very stable atmosphere like the day side vs night side can have different results based on boundary conditions. Currently, most methods only compute Ar scale heights as it is most stable and reacts least with the instrument. The NGIMS team has chosen to expand these fitting techniques to include fitted scale heights for CO2, N2, CO, and O. Having compared multiple techniques, the method found to be most reliable for most conditions was determined to be a simple fit method. We have focused this to a fitting method that determines the exobase altidude of the CO2 atmosphere as a maximum altitude for the highest point for fitting, and uses the periapsis as the lowest point and then fits the altitude versus log(density). The slope of altitude vs log(density) is -1/H where H is the scale height of the atmosphere for each species. Since this is between the homeopause and the exobase, each species will have a different scale height by this point. This is being released as a new standardization for the level 3 product, with the understanding that scientists and team members will continue to compute more precise scale heights and temperatures as needed based on science and model demands. This is being released in the PDS NGIMS level 3 v05 files for August 2017. Additionally, we are examining these scale heights for variations seasonally, diurnally, and above and below the exobase. The atmosphere is significantly more stable on the dayside than on the nightside. We have also found

  8. Trajectories of Patient-Reported Health Status in Patients With an Implantable Cardioverter Defibrillator

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H; Denollet, Johan; Versteeg, Henneke

    2015-01-01

    , no use of ACE inhibitors, psychotropic medication, negative affectivity, and type D personality were identified as independent determinants of poorer mental health status. In conclusion, the population with an ICD seems to be heterogeneous in terms of patient-reported physical and mental health status......To date, no study has assessed the course of patient-reported health status in patients with an implantable cardioverter defibrillator (ICD). Studying health status trajectories and their baseline determinants would permit the identification of patients at risk for poor health outcomes after ICD...... implantation. A combined cohort of 1,222 patients with an ICD (79% men; age = 61.4 [11.2] years) completed the 12-Item Short-Form Health Survey at baseline and 2 to 3 months and 12 to 14 months after implantation. Latent class analyses were used to identify trajectories and predictors of health status over...

  9. Rationale for Using Social Media to Collect Patient-Reported Outcomes in Patients with Celiac Disease.

    Science.gov (United States)

    Park, Kt; Harris, Merissa; Khavari, Nasim; Khosla, Chaitan

    2014-02-01

    Patients with celiac disease (CD) are increasingly interconnected through social media, exchanging patient experiences and health-tracking information between individuals through various web-based platforms. Social media represents potentially unique communication interface between gastroenterologists and active social media users - especially young adults and adolescents with celiac disease-regarding adherence to the strict gluten-free diet, gastrointestinal symptoms, and meaningful discussion about disease management. Yet, various social media platforms may be underutilized for research purposes to collect patient-reported outcomes data. In this commentary, we summarize the scientific rationale and potential for future growth of social media in patient-reported outcomes research, focusing on college freshmen with celiac disease as a case study and provide overview of the methodological approach. Finally, we discuss how social media may impact patient care in the future through increasing mobile technology use.

  10. Perspectives of patients and professionals on the use of patient reported outcome measures in primary care

    DEFF Research Database (Denmark)

    Porter, Ian; Gangannagaripalli, Jaheeda; Davey, Antoinette

    2017-01-01

    /or healthcare professional’s perspectives on the clinical utility of using PROMs in clinical practice. Results: 19 studies met the inclusion criteria (4 after 2012), 11 of which were conducted in the UK, reporting on the views of professionals (8), patients (5), and both (7). The majority of studies (12...... communication it was also noted that they undermined the human element of consultations, along with professional intuition and judgement. Burden on GP time was also noted. Conclusions: Patients and professionals highlighted a number of benefits of using PROMs in clinical practice, particularly in terms......A71 Perspectives of patients and professionals on the use of patient-reported outcome measures in primary care: a systematic review of qualitative studies Background: Although the use of patient-reported outcome measures (PROMs) in healthcare settings has increased substantially over recent years...

  11. An analysis of the relationship between bodily injury severity and fall height in victims of fatal falls from height

    Directory of Open Access Journals (Sweden)

    Grzegorz Teresiński

    2017-03-01

    Full Text Available Aim of the study : One of the basic issues discussed in forensic literature regarding falls from a height is determination of fall heights and differentiation between suicidal and accidental falls. The aim of the study was to verify the usefulness of the available methods for the purposes of forensic expertises. Material and methods : The study encompassed fatalities of falls from a height whose autopsies were performed in the Department of Forensic Medicine in Lublin. Results : Similarly to other authors, the severity of injuries was assessed using the Abbreviated Injury Scale (AIS and injury severity score (ISS. The study findings demonstrated a statistically significant correlation between the fall height and the severity of injuries according to ISS and a statistically significant difference in fall heights between the groups of accidents and suicides.

  12. Patient-reported outcomes in adult survivors with single-ventricle physiology

    DEFF Research Database (Denmark)

    Overgaard, Dorthe; Schrader, Anne-Marie; Lisby, Karen H

    2011-01-01

    Objectives: Data on patient-reported outcomes (PROs) in patients with single-ventricle physiology (SVP) are scarce. We sought (1) to describe the perceived health status, quality of life, symptoms of anxiety and depression, and sense of coherence in adult survivors with SVP, (2) to compare PROs a...... of perceived health and quality of life. For patients in Ability Index class II and III, PROs were poorer. Conclusions: PROs in patients with SVP are generally good....

  13. Development of a patient-reported outcome instrument for patients with lumbar radicular pain

    OpenAIRE

    Ibsen, Charlotte; Schiøttz-Christensen, Berit; Handberg, Charlotte; Nielsen, Claus Vinther; Hørder, Mogens; Maribo, Thomas

    2017-01-01

    Background Low back pain (LBP) is the leading cause to years lived with disability. 10–20% of patients with LBP experience radicular pain (lumbar radiculopathy). Patient-reported outcomes (PROs) play an important role in advancing patient-centered health care. Although patient involvement is essential to develop valid patient-centred PRO instruments patients are not always involved. The International Classification of Functioning, Disability and Health (ICF) are proposed to facilitate consist...

  14. Challenges and Opportunities in Using Patient-Reported Outcomes in Quality Measurement in Rheumatology

    OpenAIRE

    Wahl, Elizabeth; Yazdany, Jinoos

    2016-01-01

    Use of Patient-reported outcome measures (PROs) in rheumatology research is widespread, but use of PRO data to evaluate the quality of rheumatologic care delivered is less well established. This article reviews the use of PROs in assessing healthcare quality, and highlights challenges and opportunities specific to their use in rheumatology quality measurement. We first explore other countries’ experiences collecting and evaluating national PRO data to assess quality of care. We describe the c...

  15. Water tables constrain height recovery of willow on Yellowstone's northern range.

    Science.gov (United States)

    Bilyeu, Danielle M; Cooper, David J; Hobbs, N Thompson

    2008-01-01

    Excessive levels of herbivory may disturb ecosystems in ways that persist even when herbivory is moderated. These persistent changes may complicate efforts to restore ecosystems affected by herbivores. Willow (Salix spp.) communities within the northern range in Yellowstone National Park have been eliminated or degraded in many riparian areas by excessive elk (Cervus elaphus L.) browsing. Elk browsing of riparian willows appears to have diminished following the reintroduction of wolves (Canis lupis L.), but it remains uncertain whether reduced herbivory will restore willow communities. The direct effects of elk browsing on willows have been accompanied by indirect effects from the loss of beaver (Castor canadensis Kuhl) activity, including incision of stream channels, erosion of fine sediments, and lower water tables near streams historically dammed by beaver. In areas where these changes have occurred, lowered water tables may suppress willow height even in the absence of elk browsing. We conducted a factorial field experiment to understand willow responses to browsing and to height of water tables. After four years of protection from elk browsing, willows with ambient water tables averaged only 106 cm in height, with negligible height gain in two of three study species during the last year of the experiment. Willows that were protected from browsing and had artificially elevated water tables averaged 147 cm in height and gained 19 cm in the last year of the experiment. In browsed plots, elevated water tables doubled height gain during a period of slightly reduced browsing pressure. We conclude that water availability mediates the rate of willow height gain and may determine whether willows grow tall enough to escape the browse zone of elk and gain resistance to future elk browsing. Consequently, in areas where long-term beaver absence has resulted in incised stream channels and low water tables, a reduction in elk browsing alone may not be sufficient for recovery

  16. A STUDY OF EPIDEMIOLOGY OF SPINE INJURY IN FALL FROM HEIGHT

    Directory of Open Access Journals (Sweden)

    Amel Antony

    2016-09-01

    cases showed thoracic spine injury, three cases showed sacral spine injury and one case showed cervical spine injury. CONCLUSION As noted in our study fall from height is commonly seen in the males of productive age and the resultant spinal injuries usually result in loss of earning for the family and may result in life - long disabilities

  17. Brain structure mediates the association between height and cognitive ability.

    Science.gov (United States)

    Vuoksimaa, Eero; Panizzon, Matthew S; Franz, Carol E; Fennema-Notestine, Christine; Hagler, Donald J; Lyons, Michael J; Dale, Anders M; Kremen, William S

    2018-05-11

    Height and general cognitive ability are positively associated, but the underlying mechanisms of this relationship are not well understood. Both height and general cognitive ability are positively associated with brain size. Still, the neural substrate of the height-cognitive ability association is unclear. We used a sample of 515 middle-aged male twins with structural magnetic resonance imaging data to investigate whether the association between height and cognitive ability is mediated by cortical size. In addition to cortical volume, we used genetically, ontogenetically and phylogenetically distinct cortical metrics of total cortical surface area and mean cortical thickness. Height was positively associated with general cognitive ability and total cortical volume and cortical surface area, but not with mean cortical thickness. Mediation models indicated that the well-replicated height-general cognitive ability association is accounted for by individual differences in total cortical volume and cortical surface area (highly heritable metrics related to global brain size), and that the genetic association between cortical surface area and general cognitive ability underlies the phenotypic height-general cognitive ability relationship.

  18. The Visual Analog Scale as a Comprehensible Patient-Reported Outcome Measure (PROM) in Septorhinoplasty.

    Science.gov (United States)

    Spiekermann, Christoph; Amler, Susanne; Rudack, Claudia; Stenner, Markus

    2018-06-01

    The patient's satisfaction with the esthetic result is a major criterion of success in septorhinoplasty. However, the idea of esthetic perfection varies greatly and primarily depends on subjective perception. Hence, patient-reported instruments are important and necessary to assess the outcome in septorhinoplasty. To analyze the potential of the visual analog scale (VAS) as a patient-reported outcome measure in septorhinoplasty, the perception of the nasal appearance was assessed by a VAS pre- and postoperatively in 213 patients undergoing septorhinoplasty. Furthermore, in this prospective study, the patients' satisfaction concerning the procedure's result was analyzed using a five-point Likert scale. Females had lower preoperative VAS scores but a higher increase compared to males. Patients with lower initial VAS scores showed a higher improvement in the VAS score postoperatively compared to patients with higher initial VAS scores. Satisfaction with the result depends on the increase in the VAS score value. The VAS scale is a short and comprehensible tool to assess patients' perception of nasal appearance preoperatively and represents an appropriate instrument to assess the esthetic patient-reported outcome in septorhinoplasty.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  19. Patient-reported outcome measures in burning mouth syndrome - a review of the literature.

    Science.gov (United States)

    Ni Riordain, R; McCreary, C

    2013-04-01

    Oral Diseases (2013) 19, 230-235 This review aims to investigate the patient-reported outcomes currently used in the burning mouth syndrome literature and to explore whether any standardisation of such measures has taken place. Electronic databases were searched for all types of burning mouth syndrome studies using patient-reported outcome measures. Studies were selected by predefined inclusion criteria. Copies of the papers obtained were thoroughly reviewed. A study-specific data extraction form was used, allowing papers to be reviewed in a standardised manner. The initial literature search yielded a total of 173 citations, 43 of which were deemed suitable for inclusion in this study. Symptom severity and symptomatic relief were reported as a patient-reported outcome measure in 40 of the studies and quantified most commonly using a visual analogue scale. Quality of life was reported in 13 studies included in this review. Depression and/or anxiety was reported in 14 of the studies. As is evident from the variety of questionnaires and instruments used in the evaluation of the impact of burning mouth syndrome on patients' lives, no standardisation of patient outcomes has yet been achieved. © 2012 John Wiley & Sons A/S.

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

    Science.gov (United States)

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

    2014-12-01

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

  1. The association between adult attained height and sitting height with mortality in the European prospective investigation into cancer and nutrition (EPIC)

    NARCIS (Netherlands)

    Sawada, Norie; Wark, Petra A.; Merritt, Melissa A.; Tsugane, Shoichiro; Ward, Heather A.; Rinaldi, Sabina; Weiderpass, Elisabete; Dartois, Laureen; His, Mathilde; Boutron-Ruault, Marie Christine; Turzanski-Fortner, Renée; Kaaks, Rudolf; Overvad, Kim; Redondo, María Luisa; Travier, Noemie; Molina-Portillo, Elena; Dorronsoro, Miren; Cirera, Lluis; Ardanaz, Eva; Perez-Cornago, Aurora; Trichopoulou, Antonia; Lagiou, Pagona; Valanou, Elissavet; Masala, Giovanna; Pala, Valeria; Peeters, Petra H M; Van Der Schouw, Yvonne T.; Melander, Olle; Manjer, Jonas; Silva, Marisa Da; Skeie, Guri; Tjønneland, Anne; Olsen, Anja; Gunter, Marc J.; Riboli, Elio; Cross, Amanda J.

    2017-01-01

    Adult height and sitting height may reflect genetic and environmental factors, including early life nutrition, physical and social environments. Previous studies have reported divergent associations for height and chronic disease mortality, with positive associations observed for cancer mortality

  2. Global Distribution of Planetary Boundary Layer Height Derived from CALIPSO

    Science.gov (United States)

    Huang, J.

    2015-12-01

    The global distribution of planetary boundary layer (PBL) height, which was estimated from the attenuated back-scatter observations of Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO), is presented. In general, the PBL is capped by a temperature inversion that tends to trap moisture and aerosols. The gradient of back-scatter observed by lidar is almost always associated with this temperature inversion and the simultaneous decrease of moisture content. Thus, the PBL top is defined as the location of the maximum aerosol scattering gradient, which is analogous to the more conventional thermodynamic definition. The maximum standard deviation method, developed by Jordan et al. (2010), is modified and used to derive the global PBL heights. The derived PBL heights are not only consistent with the results of McGrath-Spangler and Denning (2012) but also agree well with the ground-based lidar measurements. It is found that the correlation between CALIPSO and the ground-based lidar was 0.73. The seasonal mean patterns from 4-year mid-day PBL heights over global are demonstrated. Also it is found that the largest PBL heights occur over the Tibetan Plateau and the coastal areas. The smallest PBL heights appear in the Tarim Basin and the northeast of China during the local winter. The comparison of PBL heights from CALIPSO and ECMWF under different land-cover conditions showed that, over ocean and forest surface, the PBL height estimated from the CALIPSO back-scatter climatology is larger than the ones estimated from ECMWF data. However, the PBL heights from ECMWF, over grass land and bare land surface in spring and summer are larger than the ones from CALIPSO.

  3. Understanding Grief and Loss

    Science.gov (United States)

    ... the process of adapting to life after a loss. It is influenced by each person’s society, culture, and religion. Bereavement is the state of having experienced a loss. Common grief reactions Reactions to loss are called ...

  4. Media attention and the influence on the reporting odds ratio in disproportionality analysis : an example of patient reporting of statins

    NARCIS (Netherlands)

    van Hunsel, Florence; van Puijenbroek, Eugene; van den Berg, Lolkje de Jong; van Grootheest, Kees

    Aim To study the influence of media attention about statins and ADRs on the level of disproportionality, expressed as the reporting odds ratio (ROR) for statins in the Lareb database, based on patients' reports. Methods Patient reports about statins, before and after the broadcast of a consumer

  5. A systematic review of patient-reported measures of burden of treatment in three chronic diseases

    Directory of Open Access Journals (Sweden)

    Eton DT

    2013-06-01

    Full Text Available David T Eton,1 Tarig A Elraiyah,2 Kathleen J Yost,3 Jennifer L Ridgeway,1 Anna Johnson,2 Jason S Egginton,1 Rebecca J Mullan,4 Mohammad Hassan Murad,2 Patricia J Erwin,2 Victor M Montori1,2 1Division of Heath Care Policy and Research, Department of Health Sciences Research, 2Knowledge and Evaluation Research Unit, 3Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; 4University of Minnesota Medical School, Minneapolis, MN, USA Background: Burden of treatment refers to the workload of health care and its impact on patient functioning and well-being. There are a number of patient-reported measures that assess burden of treatment in single diseases or in specific treatment contexts. A review of such measures could help identify content for a general measure of treatment burden that could be used with patients dealing with multiple chronic conditions. We reviewed the content and psychometric properties of patient-reported measures that assess aspects of treatment burden in three chronic diseases, ie, diabetes, chronic kidney disease, and heart failure. Methods: We searched Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, and EBSCO CINAHL through November 2011. Abstracts were independently reviewed by two people, with disagreements adjudicated by a third person. Retrieved articles were reviewed to confirm relevance, with patient-reported measures scrutinized to determine consistency with the definition of burden of treatment. Descriptive information and psychometric properties were extracted. Results: A total of 5686 abstracts were identified from the database searches. After abstract review, 359 full-text articles were retrieved, of which 76 met our inclusion criteria. An additional 22 articles were identified from the references of included articles. From the 98 studies, 57 patient-reported measures of treatment burden (full measures or components within measures were identified. Most were multi-item scales

  6. Clinical assessment and patient-reported outcome measures in low-back pain - a survey among primary health care physiotherapists.

    Science.gov (United States)

    Östhols, Sara; Boström, Carina; Rasmussen-Barr, Eva

    2018-05-09

    We aimed to map the physiotherapy practice in Sweden of clinical tests and patient-reported outcome measures in low-back pain (LBP), and to study advantages and barriers in using patient-reported outcome measures. An online survey was mailed to 4934 physiotherapists in primary health care in Sweden. Multiple choice questions investigated the use of clinical tests and patient-reported outcome measures in assessing patients with LBP. Open questions investigating the advantages and barriers to the use of patient-reported outcome measures were analyzed with content analysis. The response rate was 25% (n = 1217). Clinical tests were used "always/often" by >60% of the participants, while most patient-reported outcome measures were used by measures were: the clinical reasoning process, to increase the quality of assessment, to get the patient's voice, education and motivation of patients, and communication with health professionals. Barriers were lack of time and knowledge, administrative aspects, the interaction between physiotherapist and patient and, the applicability and validity of the patient-reported outcome measures. Our findings show that physiotherapists working in primary health care use clinical testing in LBP to a great extent, while various patient-reported outcome measures are used to a low-to-very-low extent. Several barriers to the use of patient-reported outcome measures were reported such as time, knowledge, and administrative issues, while important findings on advantages were to enhance the clinical reasoning process and to educate and motivate the patient. Barriers might be changed through education or organizational change-work. To enhance the use of patient-reported outcome measures and thus person-centered care in low-back pain, recommendation, and education on various patient-reported outcome measures need to be advocated. Implications for rehabilitation To increase the effects of rehabilitation in low-back pain, yellow flags, and other

  7. Progressive Decline in Height Standard Deviation Scores in the First 5 Years of Life Distinguished Idiopathic Growth Hormone Deficiency from Familial Short Stature and Constitutional Delay of Growth.

    Science.gov (United States)

    Rothermel, Juliane; Lass, Nina; Toschke, Christina; Reinehr, Thomas

    2016-01-01

    Familial short stature (FSS) and constitutional delay of growth (CDG) are the most frequent norm variants in children presenting with short stature. Knowing the growth patterns of these entities in the first years of life might be helpful to distinguish them from growth hormone deficiency (GHD) or other chronic diseases. We studied the height in the first 5 years of life in 26 children with FSS, in 38 children with CDG and in 14 children with idiopathic GHD. Height standard deviation scores (SDS) did not change between birth and 6 months of life, while height SDS decreased significantly afterwards in GHD, FSS, and CDG. The loss of height SDS was higher in the first 2 years of life than between 2 and 5 years of life in children with CDG (-0.92 vs. -0.11; p = 0.003) or FSS (-0.79 vs. -0.01; p = 0.002). In idiopathic GHD, the loss of height SDS did not differ between the first 2 years of life and the next 3 years (-0.78 vs. -0.77; p = 0.821). Children with FSS and CDG showed a decline in height SDS mainly in the first 2 years of life, whereas the height SDS of children with idiopathic GHD decreased almost continuously over the first 5 years of life. © 2016 S. Karger AG, Basel.

  8. Economic Loan Loss Provision and Expected Loss

    Directory of Open Access Journals (Sweden)

    Stefan Hlawatsch

    2010-10-01

    Full Text Available The intention of a loan loss provision is the anticipation of the loan's expected losses by adjusting the book value of the loan. Furthermore, this loan loss provision has to be compared to the expected loss according to Basel II and, in the case of a difference, liable equity has to be adjusted. This however assumes that the loan loss provision and the expected loss are based on a similar economic rationale, which is only valid conditionally in current loan loss provisioning methods according to IFRS. Therefore, differences between loan loss provisions and expected losses should only result from different approaches regarding the parameter estimation within each model and not due to different assumptions regarding the outcome of the model. The provisioning and accounting model developed in this paper overcomes the before-mentioned shortcomings and is consistent with an economic rationale of expected losses. Additionally, this model is based on a close-to-market valuation of the loan that is in favor of the basic idea of IFRS. Suggestions for changes in current accounting and capital requirement rules are provided.

  9. Evaluation of the Correlation of Ramus Height, Gonial Angle, and ...

    African Journals Online (AJOL)

    molar infraocclusion, ramus height, and vertical face type.[1]. Deep bite has been found to ... different facial forms. Subjects and Methods: A total of 51 subjects in all facial form ... to improve the effectiveness of any prosthesis and maintain the.

  10. MLS/Aura L2 Geopotential Height V003

    Data.gov (United States)

    National Aeronautics and Space Administration — ML2GPH is the EOS Aura Microwave Limb Sounder (MLS) standard product for geopotential height derived from radiances measured by the 118 and 240 GHz radiometers. The...

  11. MLS/Aura L2 Geopotential Height V002

    Data.gov (United States)

    National Aeronautics and Space Administration — ML2GPH is the EOS Aura Microwave Limb Sounder (MLS) standard product for geopotential height derived from radiances measured by the 118 and 240 GHz radiometers. The...

  12. Multiresolution wavelet-ANN model for significant wave height forecasting.

    Digital Repository Service at National Institute of Oceanography (India)

    Deka, P.C.; Mandal, S.; Prahlada, R.

    Hybrid wavelet artificial neural network (WLNN) has been applied in the present study to forecast significant wave heights (Hs). Here Discrete Wavelet Transformation is used to preprocess the time series data (Hs) prior to Artificial Neural Network...

  13. OW AVISO Sea-Surface Height & Niiler Climatology

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The dataset contains satellite-derived sea-surface height measurements collected by means of the TOPEX/Poseidon/ERS, JASON-1/Envisat, and Jason-2/Envisat satellite...

  14. Childhood height increases the risk of prostate cancer mortality

    DEFF Research Database (Denmark)

    Aarestrup, J; Gamborg, M; Cook, M B

    2015-01-01

    cancers. Cox proportional hazards regressions were performed. RESULTS: 630 men had prostate cancer recorded as the underlying cause of death. Childhood height at age 13years was positively associated with prostate cancer-specific mortality (hazard ratio [HR]per z-score=1.2, 95% confidence interval [CI]: 1.1-1.3......). Associations were significant at all other childhood ages. Growth analyses showed that height at age 13years had a stronger association with prostate cancer-specific mortality than height at age 7, suggesting the association at age 7 is largely mediated through later childhood height. The tallest boys at age...... 13years had a significantly worse survival, but only when restricted to a diagnosis at years of age (HRz-score of 1=1.7, 95% CI: 1.3-2.4). These associations were significant at all other childhood ages. Childhood BMI was not associated with prostate cancer mortality or survival. CONCLUSION...

  15. A century of trends in adult human height

    DEFF Research Database (Denmark)

    Damsgaard, Camilla Trab; Michaelsen, Kim F.; Molbo, Drude

    2016-01-01

    in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5-22.7) and 16.5 cm (13.3-19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over...... the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8-144.8). The height differential between the tallest...... and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries....

  16. A Mathematical Model for the Height of a Satellite.

    Science.gov (United States)

    Thoemke, Sharon S.; And Others

    1993-01-01

    Emphasizes a real-world-problem situation using sine law and cosine law. Angles of elevation from two tracking stations located in the plane of the equator determine height of a satellite. Calculators or computers can be used. (LDR)

  17. Height, zinc and soil-transmitted helminth infections in schoolchildren

    DEFF Research Database (Denmark)

    de Gier, Brechje; Mpabanzi, Liliane; Vereecken, Kim

    2015-01-01

    Soil-transmitted helminth (STH) infections and zinc deficiency are often found in low- and middle-income countries and are both known to affect child growth. However, studies combining data on zinc and STH are lacking. In two studies in schoolchildren in Cuba and Cambodia, we collected data...... on height, STH infection and zinc concentration in either plasma (Cambodia) or hair (Cuba). We analyzed whether STH and/or zinc were associated with height for age z-scores and whether STH and zinc were associated. In Cuba, STH prevalence was 8.4%; these were mainly Ascaris lumbricoides and Trichuris...... trichiura infections. In Cambodia, STH prevalence was 16.8%, mostly caused by hookworm. In Cuban children, STH infection had a strong association with height for age (aB-0.438, p = 0.001), while hair zinc was significantly associated with height for age only in STH uninfected children. In Cambodian children...

  18. U.S. Geoid Heights, Scientific Model (G96SSS)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This 2' geoid height grid for the conterminous United States is the G96SSS model. The computation used about 1.8 million terrestrial and marine gravity data held in...

  19. Definition of Physical Height Systems for Telluric Planets and Moons

    OpenAIRE

    Tenzer, R.; Foroughi, I.; Sjöberg, L.E.; Bagherbandi, M.; Hirt, C.; Pitoňák, M.

    2018-01-01

    In planetary sciences, the geodetic (geometric) heights defined with respect to the reference surface (the sphere or the ellipsoid) or with respect to the center of the planet/moon are typically used for mapping topographic surface, compilation of global topographic models, detailed mapping of potential landing sites, and other space science and engineering purposes. Nevertheless, certain applications, such as studies of gravity-driven mass movements, require the physical heights to be define...

  20. Stature estimation using the knee height measurement amongst Brazilian elderly

    OpenAIRE

    Siqueira Fogal, Aline; Franceschini, Sylvia do Carmo Castro; Eloiza Priore, Silvia; Cotta, Rosângela Minardi M.; Queiroz Ribeiro, Andreia

    2015-01-01

    Introduction: Stature is an important variable in several indices of nutritional status that are applicable to elderly persons. However, stature is difficult or impossible to measure in elderly because they are often unable to maintain the standing position. A alternative is the use of estimated height from measurements of knee height measure. Aims: This study aimed to evaluate the accuracy of the formula proposed by Chumlea et al. (1985) based on the knee of a Caucasian population to estimat...

  1. Effect of cutting height and frequency on Leucaena leucocephala ...

    African Journals Online (AJOL)

    Leucaena leucocephala is a fast-growing tree that can provide both high quality forage and firewood. The objective of this trial was to determine the optimum height and frequency of cutting for both wood and forage production. Cutting heights at 0.3m, 0.6m and 1.0 m were superimposed on 3-month and 6-month cutting ...

  2. Flow field optimization for proton exchange membrane fuel cells with varying channel heights and widths

    International Nuclear Information System (INIS)

    Wang Xiaodong; Huang Yuxian; Cheng, C.-H.; Jang, J.-Y.; Lee, D.-J.; Yan, W.-M.; Su Ay

    2009-01-01

    The optimal cathode flow field design of a single serpentine proton exchange membrane fuel cell is obtained by adopting a combined optimization procedure including a simplified conjugate-gradient method (SCGM) and a completely three-dimensional, two-phase, non-isothermal fuel cell model. The cell output power density P cell is the objective function to be maximized with channel heights, H 1 -H 5 , and channel widths, W 2 -W 5 as search variables. The optimal design has tapered channels 1, 3 and 4, and diverging channels 2 and 5, producing 22.51% increment compared with the basic design with all heights and widths setting as 1 mm. Reduced channel heights of channels 2-4 significantly enhance sub-rib convection to effectively transport oxygen to and liquid water out of diffusion layer. The final diverging channel prevents significant leakage of fuel to outlet via sub-rib convection from channel 4. Near-optimal design without huge loss in cell performance but is easily manufactured is discussed.

  3. Application and Limitations of GPS Radio Occultation (GPS-RO) Data for Atmospheric Boundary Layer Height Detection over the Arctic.

    Science.gov (United States)

    Ganeshan, M.; Wu, D. L.

    2014-12-01

    Due to recent changes in the Arctic environment, it is important to monitor the atmospheric boundary layer (ABL) properties over the Arctic Ocean, especially to explore the variability in ABL clouds (such as sensitivity and feedback to sea ice loss). For example, radiosonde and satellite observations of the Arctic ABL height (and low-cloud cover) have recently suggested a positive response to sea ice loss during October that may not occur during the melt season (June-September). Owing to its high vertical and spatiotemporal resolution, an independent ABL height detection algorithm using GPS Radio Occultation (GPS-RO) refractivity in the Arctic is explored. Similar GPS-RO algorithms developed previously typically define the level of the most negative moisture gradient as the ABL height. This definition is favorable for subtropical oceans where a stratocumulus-topped ABL is often capped by a layer of sharp moisture lapse rate (coincident with the temperature inversion). The Arctic Ocean is also characterized by stratocumulus cloud cover, however, the specific humidity does not frequently decrease in the ABL capping inversion. The use of GPS-RO refractivity for ABL height retrieval therefore becomes more complex. During winter months (December-February), when the total precipitable water in the troposphere is a minimum, a fairly straightforward algorithm for ABL height retrieval is developed. The applicability and limitations of this method for other seasons (Spring, Summer, Fall) is determined. The seasonal, interannual and spatial variability in the GPS-derived ABL height over the Arctic Ocean, as well as its relation to the underlying surface (ice vs. water), is investigated. The GPS-RO profiles are also explored for the evidence of low-level moisture transport in the cold Arctic environment.

  4. Comparison of Epidrum, Epi‑jet, and Loss of Resistance Syringe ...

    African Journals Online (AJOL)

    2017-09-14

    Sep 14, 2017 ... Pressure of the epidural space in pregnancy is higher than that in nonpregnant woman. Loss of resistance .... abdominal and uterine muscles.[10] These .... related with patients such as posture, anatomy, height and weight of ...

  5. Variability of the Mixed-Layer Height Over Mexico City

    Science.gov (United States)

    García-Franco, J. L.; Stremme, W.; Bezanilla, A.; Ruiz-Angulo, A.; Grutter, M.

    2018-06-01

    The diurnal and seasonal variability of the mixed-layer height in urban areas has implications for ground-level air pollution and the meteorological conditions. Measurements of the backscatter of light pulses with a commercial lidar system were performed for a continuous period of almost six years between 2011 and 2016 in the southern part of Mexico City. The profiles were temporally and vertically smoothed, clouds were filtered out, and the mixed-layer height was determined with an ad hoc treatment of both the filtered and unfiltered profiles. The results are in agreement when compared with values of mixed-layer height reconstructed from, (i) radiosonde data, and (ii) surface and vertical column densities of a trace gas. The daily maxima of the mean mixed-layer height reach values > 3 km above ground level in the months of March-April, and are clearly lower (behaviour, which is characterized together with the mixed-layer-height anomalies. A clear residual layer is evident from the backscattered signals recorded in days with specific atmospheric conditions, but also from the cloud-filtered mean diurnal profiles. The occasional presence of a residual layer results in an overestimation of the reported mixed-layer height during the night and early morning hours.

  6. Modelling foot height and foot shape-related dimensions.

    Science.gov (United States)

    Xiong, Shuping; Goonetilleke, Ravindra S; Witana, Channa P; Lee Au, Emily Yim

    2008-08-01

    The application of foot anthropometry to design good-fitting footwear has been difficult due to the lack of generalised models. This study seeks to model foot dimensions so that the characteristic shapes of feet, especially in the midfoot region, can be understood. Fifty Hong Kong Chinese adults (26 males and 24 females) participated in this study. Their foot lengths, foot widths, ball girths and foot heights were measured and then evaluated using mathematical models. The results showed that there were no significant allometry (p > 0.05) effects of foot length on ball girth and foot width. Foot height showed no direct relationship with foot length. However, a normalisation with respect to foot length and foot height resulted in a significant relationship for both males and females with R(2) greater than 0.97. Due to the lack of a direct relationship between foot height and foot length, the current practice of grading shoes with a constant increase in height or proportionate scaling in response to foot length is less than ideal. The results when validated with other populations can be a significant way forward in the design of footwear that has an improved fit in the height dimension.

  7. Weighting of field heights for sharpness and noisiness

    Science.gov (United States)

    Keelan, Brian W.; Jin, Elaine W.

    2009-01-01

    Weighting of field heights is important in cases when a single numerical value needs to be calculated that characterizes an attribute's overall impact on perceived image quality. In this paper we report an observer study to derive the weighting of field heights for sharpness and noisiness. One-hundred-forty images were selected to represent a typical consumer photo space distribution. Fifty-three sample points were sampled per image, representing field heights of 0, 14, 32, 42, 51, 58, 71, 76, 86% and 100%. Six observers participated in this study. The field weights derived in this report include both: the effect of area versus field height (which is a purely objective, geometric factor); and the effect of the spatial distribution of image content that draws attention to or masks each of these image structure attributes. The results show that relative to the geometrical area weights, sharpness weights were skewed to lower field heights, because sharpness-critical subject matter was often positioned relatively near the center of an image. Conversely, because noise can be masked by signal, noisiness-critical content (such as blue skies, skin tones, walls, etc.) tended to occur farther from the center of an image, causing the weights to be skewed to higher field heights.

  8. Maternal and Paternal Height and the Risk of Preeclampsia.

    Science.gov (United States)

    Lee, Yunsung; Magnus, Per

    2018-04-01

    The etiology of preeclampsia is unknown. Tall women have been found to have lower incidence of preeclampsia. This points to a possible biological causal effect but may be because of socioeconomic confounding. We used paternal height as an unexposed control to examine confounding. The MoBa (Norwegian Mother and Child Cohort Study) was used to extract data on parental heights, maternal prepregnancy weight, other background factors, and pregnancy outcomes for 99 968 singleton births. Multiple logistic regression was used to estimate odds ratios for preeclampsia according to parental height. The adjusted odds ratio for preeclampsia was 0.74 (95% CI, 0.66-0.82) for women >172 cm as compared with women 186 cm was 1.03 (95% CI, 0.93-1.15) compared with men <178 cm. The association between maternal height and preeclampsia is unlikely to be because of confounding by familial, socioeconomic factors or by fetal genes related to height. The observed association between maternal height and preeclampsia merits further investigation. © 2018 American Heart Association, Inc.

  9. Montreal Accord on Patient-Reported Outcomes (PROs) use series - Paper 9: anonymization and ethics considerations for capturing and sharing patient reported outcomes.

    Science.gov (United States)

    Arbuckle, Luk; Moher, Ester; Bartlett, Susan J; Ahmed, Sara; El Emam, Khaled

    2017-09-01

    Patient-reported outcomes (PROs) are collected with consent for care; however, using the data for any other purpose requires consent for that additional purpose, or the anonymization of the data. Collecting explicit consent to use this data for secondary purposes, before the patient completes a PRO, can also bias the responses. We consider the ethical and security issues related to the collection of data at the point of care or in the population and the aggregation and integration of PRO data with administrative databases to facilitate decision making and comparative effectiveness research. In this article, we describe risk-based anonymization, taking the context of the data release into account, so that we may consider the degree by which the release is considered anonymized. We also consider the ethical use of anonymized data, the anonymization of free-form text, and the secure linking data sets without sharing any personal information. Many good standards and best practices exist for the sharing of health data and could be used as a baseline in the development of a national PRO initiative. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Montreal Accord on Patient-Reported Outcomes (PROs) use series - Paper 8: patient-reported outcomes in electronic health records can inform clinical and policy decisions.

    Science.gov (United States)

    Ahmed, Sara; Ware, Patrick; Gardner, William; Witter, James; Bingham, Clifton O; Kairy, Dahlia; Bartlett, Susan J

    2017-09-01

    Given that the goal of health care systems is to improve and maintain the health of the populations they serve, the indicators of performance must include outcomes that are meaningful to patients. The growth of health technologies provides an unprecedented opportunity to integrate the patient voice into clinical care by linking electronic health records (EHRs) to patient-reported outcome (PRO) data collection. However, PRO data must be relevant, meaningful, and actionable for those who will have to invest the time and effort to collect it. In this study, we highlight opportunities to integrate PRO data collection into EHRs. We consider how stakeholder perspectives should influence the selection of PROs and ways to enhance engagement in and commitment to PRO implementation. We propose a research and policy agenda to address unanswered questions and facilitate the widespread adoption of PRO data collection into EHRs. Building a learning health care system that gathers PRO data in ways that can inform individual patient care, quality improvement, and comparative effectiveness research has the potential to accelerate the application of new evidence and knowledge to patient care. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Montreal Accord on Patient-Reported Outcomes (PROs) use series - Paper 3: patient-reported outcomes can facilitate shared decision-making and guide self-management.

    Science.gov (United States)

    Noonan, Vanessa K; Lyddiatt, Anne; Ware, Patrick; Jaglal, Susan B; Riopelle, Richard J; Bingham, Clifton O; Figueiredo, Sabrina; Sawatzky, Richard; Santana, Maria; Bartlett, Susan J; Ahmed, Sara

    2017-09-01

    There is a shift toward making health care patient centered, whereby patients are part of medical decision-making and take responsibility for managing their health. Patient-reported outcomes (PROs) capture the patient voice and can be used to engage patients in medical decision-making. The objective of this paper is to present important factors from patients', clinicians', researchers', and decision-makers' perspectives that influence successful adoption of PROs in clinical practice. Factors recommended in this paper were informed by a patient partner. Based on themes arising from the Montreal Accord proceedings, we describe factors that influence the adoption of PROs and how PROs can have a positive effect by enhancing communication and providing opportunities to engage patients, carers, and clinicians in care. Consideration of patient factors (e.g., health literacy), family support and networks (e.g., peer-support networks), technology (e.g., e-health), and health care system factors (e.g., resources to implement PROs) is necessary to ensure PROs are successfully adopted. PRO evaluation plans most likely to succeed over the long term are those incorporating PROs identified by patients as necessary for self-management and that coincide with providers' needs for collaboratively developing treatment plans with patients and families. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Vertical distribution of hydrocarbons in the low troposphere below and above the mixing height: Tethered balloon measurements in Milan, Italy

    Energy Technology Data Exchange (ETDEWEB)

    Sangiorgi, G., E-mail: giorgia.sangiorgi1@unimib.it [POLARIS Research Centre, Department of Environmental Sciences, University of Milano-Bicocca, piazza della Scienza 1, 20126 Milano (Italy); Ferrero, L.; Perrone, M.G.; Bolzacchini, E. [POLARIS Research Centre, Department of Environmental Sciences, University of Milano-Bicocca, piazza della Scienza 1, 20126 Milano (Italy); Duane, M. [Institute for Environment and Sustainability, EU Joint Research Centre Ispra, 21020 Ispra, Varese (Italy); Larsen, B.R. [Institute for Health and Consumer Protection, EU Joint Research Centre Ispra, 21020 Ispra, Varese (Italy)

    2011-12-15

    A novel approach for measuring vertical profiles of HCs and particle number concentrations was described and applied in the low troposphere over Milan (Italy) during typical spring and summer days. Particle profiles yielded nearly homogeneous concentrations below the mixing height, with level-to-ground concentration ratios of 92-97%, while HCs showed a more pronounced decrease (74-95%). Vertical mixing and photochemical loss of HCs were demonstrated to cause these gradients. Much lower concentrations were observed for the profiles above the mixing height, where the HC mixtures showed also a different composition, which was partially explained by the horizontal advection of air with HC sources different to those prevailing at the site. The application of pseudo-first order kinetics for reactions between HCs and the hydroxyl radical allowed for the estimation of the vertical mixing time scale in the order of 100 {+-} 20 min. - Graphical abstract: Display Omitted Highlights: > Experimental vertical profiles of HCs and particle concentration by tethered balloon. > Effect of mixing height on the vertical distribution of HCs and particles. > Effect of tropospheric reactivity on vertical profiles of HCs. > Pseudo-first order kinetic reaction of HCs in convective systems. - Vertical transport and photochemical loss of HCs below and above the mixing height were studied by means of a novel and simple approach.

  13. Vertical distribution of hydrocarbons in the low troposphere below and above the mixing height: Tethered balloon measurements in Milan, Italy

    International Nuclear Information System (INIS)

    Sangiorgi, G.; Ferrero, L.; Perrone, M.G.; Bolzacchini, E.; Duane, M.; Larsen, B.R.

    2011-01-01

    A novel approach for measuring vertical profiles of HCs and particle number concentrations was described and applied in the low troposphere over Milan (Italy) during typical spring and summer days. Particle profiles yielded nearly homogeneous concentrations below the mixing height, with level-to-ground concentration ratios of 92-97%, while HCs showed a more pronounced decrease (74-95%). Vertical mixing and photochemical loss of HCs were demonstrated to cause these gradients. Much lower concentrations were observed for the profiles above the mixing height, where the HC mixtures showed also a different composition, which was partially explained by the horizontal advection of air with HC sources different to those prevailing at the site. The application of pseudo-first order kinetics for reactions between HCs and the hydroxyl radical allowed for the estimation of the vertical mixing time scale in the order of 100 ± 20 min. - Graphical abstract: Display Omitted Highlights: → Experimental vertical profiles of HCs and particle concentration by tethered balloon. → Effect of mixing height on the vertical distribution of HCs and particles. → Effect of tropospheric reactivity on vertical profiles of HCs. → Pseudo-first order kinetic reaction of HCs in convective systems. - Vertical transport and photochemical loss of HCs below and above the mixing height were studied by means of a novel and simple approach.

  14. Ethnic differences in trabecular meshwork height by optical coherence tomography.

    Science.gov (United States)

    Chen, Rebecca I; Barbosa, Diego T; Hsu, Chi-Hsin; Porco, Travis C; Lin, Shan C

    2015-04-01

    Differences in ocular anatomy may contribute to ethnic differences in glaucoma risk. Because the trabecular meshwork (TM) plays an important role in aqueous outflow, its anatomy in relation to at-risk populations may provide insight into a potential contributor to elevated intraocular pressure and thus to probability of glaucoma development. To investigate whether differences exist in TM height between ethnic groups. This prospective study took place from January 1, 2012, to December 31, 2013. Adult patients who self-reported as being of white, Asian, Hispanic, or African American ethnicity were recruited from ophthalmology clinics at the University of California, San Francisco. The TM height was assessed using spectral-domain anterior segment optical coherence tomography. Trabecular meshwork height was measured from the scleral spur to the Schwalbe line. We hypothesized that ethnicities with a higher prevalence of glaucoma would tend to have shorter TM heights. We collected data from 460 eyes of 291 participants after excluding 34 optical coherence tomographic scans owing to poor image quality. The final sample was 32.2% white, 45.1% Asian, 10.5% African American, and 12.1% Hispanic. There were 64.2% women, and the mean age was 68.1 years. The mean (SD) TM height among all eyes included in the study was 836 (131) μm. The mean (SD) TM height was characterized among white (851 [131] μm), Asian (843 [126] μm), Hispanic (822 [147] μm), and African American (771 [118] μm) persons. Ethnicity was not associated with TM height overall (P = .23, linear mixed regression model). However, the TM heights of African American participants (771 μm) were shorter than those of white (851 μm; adjusted difference 95% CI, -119.8 to -8.1; P = .02) and Asian (843 μm; adjusted difference 95% CI, -117.4 to -10.8; P = .02) participants. Although TM height is not associated with ethnicity overall, African American individuals have shorter TM heights compared with Asian and white

  15. Neural network cloud top pressure and height for MODIS

    Science.gov (United States)

    Håkansson, Nina; Adok, Claudia; Thoss, Anke; Scheirer, Ronald; Hörnquist, Sara

    2018-06-01

    Cloud top height retrieval from imager instruments is important for nowcasting and for satellite climate data records. A neural network approach for cloud top height retrieval from the imager instrument MODIS (Moderate Resolution Imaging Spectroradiometer) is presented. The neural networks are trained using cloud top layer pressure data from the CALIOP (Cloud-Aerosol Lidar with Orthogonal Polarization) dataset. Results are compared with two operational reference algorithms for cloud top height: the MODIS Collection 6 Level 2 height product and the cloud top temperature and height algorithm in the 2014 version of the NWC SAF (EUMETSAT (European Organization for the Exploitation of Meteorological Satellites) Satellite Application Facility on Support to Nowcasting and Very Short Range Forecasting) PPS (Polar Platform System). All three techniques are evaluated using both CALIOP and CPR (Cloud Profiling Radar for CloudSat (CLOUD SATellite)) height. Instruments like AVHRR (Advanced Very High Resolution Radiometer) and VIIRS (Visible Infrared Imaging Radiometer Suite) contain fewer channels useful for cloud top height retrievals than MODIS, therefore several different neural networks are investigated to test how infrared channel selection influences retrieval performance. Also a network with only channels available for the AVHRR1 instrument is trained and evaluated. To examine the contribution of different variables, networks with fewer variables are trained. It is shown that variables containing imager information for neighboring pixels are very important. The error distributions of the involved cloud top height algorithms are found to be non-Gaussian. Different descriptive statistic measures are presented and it is exemplified that bias and SD (standard deviation) can be misleading for non-Gaussian distributions. The median and mode are found to better describe the tendency of the error distributions and IQR (interquartile range) and MAE (mean absolute error) are found

  16. Laparoscopic Heller Myotomy vs Per Oral Endoscopic Myotomy: Patient-Reported Outcomes at a Single Institution.

    Science.gov (United States)

    Hanna, Andrew N; Datta, Jashodeep; Ginzberg, Sara; Dasher, Kevin; Ginsberg, Gregory G; Dempsey, Daniel T

    2018-04-01

    Although laparoscopic Heller myotomy (LHM) has been the standard of care for achalasia, per oral endoscopic myotomy (POEM) has gained popularity as a viable alternative. This retrospective study aimed to compare patient-reported outcomes between LHM and POEM in a consecutive series of achalasia patients with more than 1 year of follow-up. We reviewed demographic and procedure-related data for patients who underwent either LHM or POEM for achalasia between January 2011 and May 2016. Phone interviews were conducted assessing post-procedure achalasia symptoms via the Eckardt score and achalasia severity questionnaire (ASQ). Demographics, disease factors, and survey results were compared between LHM and POEM patients using univariate analysis. Significant predictors of procedure failure were analyzed using univariate and multivariate analysis. There were no serious complications in 110 consecutive patients who underwent LHM or POEM during the study period, and 96 (87%) patients completed phone surveys. There was a nonsignificant trend toward better patient-reported outcomes with POEM. There were significant differences in patient characteristics including sex, achalasia type, mean residual lower esophageal pressure (rLESP), and follow-up time. The only univariate predictors of an unsatisfactory Eckardt score or ASQ were longer follow-up and lower rLESP, with follow-up length being the only predictor on multivariate analysis. There were significant demographic and clinical differences in patient selection for POEM vs LHM in our group. Although the 2 procedures have similar patient-reported effectiveness, subjective outcomes seem to decline as a result of time rather than procedure type. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Hair loss in women.

    Science.gov (United States)

    Harfmann, Katya L; Bechtel, Mark A

    2015-03-01

    Hair loss is a common cause of morbidity for many women. As a key member of the woman's health care team, the obstetrician/gynecologist may be the first person to evaluate the complaint of hair loss. Common types of nonscarring hair loss, including female pattern hair loss and telogen effluvium, may be diagnosed and managed by the obstetrician/gynecologist. A systematic approach to diagnosis and management of these common forms of hair loss is presented.

  18. Development of a patient-reported outcome instrument for patients with lumbar radicular pain

    DEFF Research Database (Denmark)

    Ibsen, Charlotte; Schiøttz-Christensen, Berit; Handberg, Charlotte

    and ICF Rehabilitation Set. Items in the ICF-PRO are developed within methods and terminology of The Patient-Reported Outcomes Measurement Information System (PROMIS®). The development process contains five phases (figure 1). Results This poster presents preliminary results from phase 1-3. 89...... the focus group identified three themes: 'Simplicity', 'Application' and 'Individuality' representing elements of most importance for the patients toward a patient centered consultation (figure 2). Conclusions We found that ‘Simplicity’, ‘Application’ and ‘Individuality’ was essential to patients to lead...

  19. Patient reported outcomes in patients undergoing arthroscopic partial meniscectomy for traumatic or degenerative meniscal tears

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Englund, Martin; Christensen, Robin

    2017-01-01

    orthopaedic departments in the Region of Southern Denmark. Participants were recruited between 1 February 2013 and 31 January 2014, and at one of the original four hospitals from 1 February 2014 to 31 January 2015. PARTICIPANTS: Individuals selected from Knee Arthroscopy Cohort Southern Denmark, aged 18...... on knee pathology. Patient reported outcomes were recorded via online questionnaires. MAIN OUTCOME MEASURES: Primary outcome was the average between-group difference in change on four of five subscales of the knee injury and osteoarthritis outcome score (KOOS). The four subscales covered pain, symptoms...

  20. Feasibility of 4 patient-reported outcome measures in a registry setting

    DEFF Research Database (Denmark)

    Paulsen, Aksel; Pedersen, Alma Becic; Overgaard, Søren

    2012-01-01

    Background and purpose Feasibility is an important parameter when choosing which patient-reported outcomes (PRO) to use in a study. We assessed the feasibility of PROs in a hip registry setting. Methods Primary total hip arthroplasty (THA) patients (n = 5,747) who had been operated on 1-2, 5.......1% to 46%, respectively. Missing items ranged from 1.2% to 3.4%, and 0.8-4.3% required manual validation (p analysis, depending on descriptive factor and choice of PRO. Interpretation All 4 PROs fulfilled...

  1. Case-mix & patients' reports of outcome in Independent Sector Treatment Centres: Comparison with NHS providers.

    Science.gov (United States)

    Browne, John; Jamieson, Liz; Lewsey, Jim; van der Meulen, Jan; Copley, Lynn; Black, Nick

    2008-04-09

    There has been considerable concern expressed about the outcomes achieved in Independent Sector Treatment Centres (ISTCs) introduced in England since 2003. Our aim was to compare the case-mix and patients' reported outcomes of surgery in ISTCs and in NHS providers. Prospective cohort study of 769 patients treated in six ISTCs and 1895 treated in 20 NHS providers (acute hospitals and treatment centres) in England during 2006-07. Participants underwent one of three day surgery procedures (inguinal hernia repair, varicose vein surgery, cataract extraction) or hip or knee replacement. Change in patient-reported health status and health related quality of life (measured using a disease-specific and a generic (EQ-5D) instrument) was assessed either 3-months (day surgery) or 6-months (hip/knee) after surgery. In addition patient-reported post-operative complications and an overall assessment of success of surgery were collected. Outcome measures were adjusted (using multivariable regression) for patient characteristics (disease severity, duration of symptoms, age, sex, socioeconomic status, general health, previous similar surgery, comorbidity). Post-operative response rates varied by procedure (73%-88%) and were similar for those treated in ISTCs and NHS facilities. Patients treated in ISTCs were healthier, were less likely to have any comorbidity and, for those undergoing cataract surgery or joint replacement, their primary condition was less severe. Those undergoing hernia repair or joint replacement were less likely to have had similar surgery before. When adjustment was made for pre-operative characteristics, patients undergoing cataract surgery or hip replacement in ISTCs achieved a slightly greater improvement in functional status and quality of life than those treated in NHS facilities, while the opposite was true of patients undergoing hernia repair. No significant differences were found for the two other procedures. Patients treated in ISTCs were less likely to

  2. Are validated patient-reported outcomes used on children in pediatric otolaryngology? A systematic review.

    Science.gov (United States)

    Wong, Kevin; Piraquive, Jacquelyn; Troiano, Chelsea A; Sulibhavi, Anita; Grundfast, Kenneth M; Levi, Jessica R

    2018-02-01

    Review the pediatric otolaryngology literature to 1) identify studies in which children completed patient-reported outcome (PRO) measures and 2) appraise the psychometric quality and validity of these PROs as they apply to pediatrics. In October 2016, a systematic review was performed by two reviewers on PubMed/MEDLINE and EMBASE for all otolaryngology-related studies that utilized PROs in children. Inclusion criteria included articles that required children (ageotolaryngology and some studies utilized PROs that were not validated or not validated for use in this age group. Future efforts to design and validate more instruments may be warranted. Copyright © 2017. Published by Elsevier B.V.

  3. Patient-Reported Outcomes and Fatigue in Patients with Chronic Hepatitis C Infection.

    Science.gov (United States)

    Golabi, Pegah; Sayiner, Mehmet; Bush, Haley; Gerber, Lynn H; Younossi, Zobair M

    2017-08-01

    Fatigue is a common symptom. Diagnosis is difficult. Fatigue is often a complex symptom. In the recent years, fatigue has gained considerable amount of attention. It has 2 major types, central and peripheral, which may occur together or alone. Although fatigue has many strong relations with depression and sleep disorders, it is a separate entity. For the diagnosis of fatigue, self-reports and patient-reported outcomes are highly valuable tools because these methods can reflect patients' perceptions. Treating the underlying disease with newly developed direct-acting antivirals often improves the perceived fatigue. Healthy lifestyle changes are the cornerstone of the treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Discrepancies between patient-reported outcome measures when assessing urinary incontinence or pelvic-prolapse surgery

    DEFF Research Database (Denmark)

    Larsen, Michael Due; Lose, Gunnar; Guldberg, Rikke

    2016-01-01

    INTRODUCTION AND HYPOTHESIS: In order to assess the outcome following surgery for urinary incontinence (UI) and pelvic organ prolapse (POP) the importance of patient-reported outcome measures, in addition to the clinical objective measures, has been recognised. The International Consultation...... on Incontinence has initiated the development and evaluation of disease-specific questionnaires (ICIQ) to compare the patient's degree of improvement. Alternatively, the Patient's Global Impression of Improvement (PGI-I score) with an inherent before-after assessment has been widely accepted in recent studies...

  5. Regional Distribution of Forest Height and Biomass from Multisensor Data Fusion

    Science.gov (United States)

    Yu, Yifan; Saatchi, Sassan; Heath, Linda S.; LaPoint, Elizabeth; Myneni, Ranga; Knyazikhin, Yuri

    2010-01-01

    Elevation data acquired from radar interferometry at C-band from SRTM are used in data fusion techniques to estimate regional scale forest height and aboveground live biomass (AGLB) over the state of Maine. Two fusion techniques have been developed to perform post-processing and parameter estimations from four data sets: 1 arc sec National Elevation Data (NED), SRTM derived elevation (30 m), Landsat Enhanced Thematic Mapper (ETM) bands (30 m), derived vegetation index (VI) and NLCD2001 land cover map. The first fusion algorithm corrects for missing or erroneous NED data using an iterative interpolation approach and produces distribution of scattering phase centers from SRTM-NED in three dominant forest types of evergreen conifers, deciduous, and mixed stands. The second fusion technique integrates the USDA Forest Service, Forest Inventory and Analysis (FIA) ground-based plot data to develop an algorithm to transform the scattering phase centers into mean forest height and aboveground biomass. Height estimates over evergreen (R2 = 0.86, P forests (R2 = 0.93, P forests were less accurate because of the winter acquisition of SRTM data and loss of scattering phase center from tree ]surface interaction. We used two methods to estimate AGLB; algorithms based on direct estimation from the scattering phase center produced higher precision (R2 = 0.79, RMSE = 25 Mg/ha) than those estimated from forest height (R2 = 0.25, RMSE = 66 Mg/ha). We discuss sources of uncertainty and implications of the results in the context of mapping regional and continental scale forest biomass distribution.

  6. Accuracy of Jump-Mat Systems for Measuring Jump Height.

    Science.gov (United States)

    Pueo, Basilio; Lipinska, Patrycja; Jiménez-Olmedo, José M; Zmijewski, Piotr; Hopkins, Will G

    2017-08-01

    Vertical-jump tests are commonly used to evaluate lower-limb power of athletes and nonathletes. Several types of equipment are available for this purpose. To compare the error of measurement of 2 jump-mat systems (Chronojump-Boscosystem and Globus Ergo Tester) with that of a motion-capture system as a criterion and to determine the modifying effect of foot length on jump height. Thirty-one young adult men alternated 4 countermovement jumps with 4 squat jumps. Mean jump height and standard deviations representing technical error of measurement arising from each device and variability arising from the subjects themselves were estimated with a novel mixed model and evaluated via standardization and magnitude-based inference. The jump-mat systems produced nearly identical measures of jump height (differences in means and in technical errors of measurement ≤1 mm). Countermovement and squat-jump height were both 13.6 cm higher with motion capture (90% confidence limits ±0.3 cm), but this very large difference was reduced to small unclear differences when adjusted to a foot length of zero. Variability in countermovement and squat-jump height arising from the subjects was small (1.1 and 1.5 cm, respectively, 90% confidence limits ±0.3 cm); technical error of motion capture was similar in magnitude (1.7 and 1.6 cm, ±0.3 and ±0.4 cm), and that of the jump mats was similar or smaller (1.2 and 0.3 cm, ±0.5 and ±0.9 cm). The jump-mat systems provide trustworthy measurements for monitoring changes in jump height. Foot length can explain the substantially higher jump height observed with motion capture.

  7. Estrogen-mediated Height Control in Girls with Marfan Syndrome.

    Science.gov (United States)

    Lee, Dong-Yun; Hyun, Hye Sun; Huh, Rimm; Jin, Dong-Kyu; Kim, Duk-Kyung; Yoon, Byung-Koo; Choi, DooSeok

    2016-02-01

    This study evaluated the efficacy of a stepwise regimen of estradiol valerate for height control in girls with Marfan syndrome. Eight girls with Marfan syndrome who had completed estrogen treatment for height control were included. Estradiol valerate was started at a dose of 2 mg/day, and then was increased. The projected final height was estimated using the initial height percentile (on a disease-specific growth curve for Korean Marfan syndrome [gcPFHt]), and the initial bone age (baPFHt). After the estrogen treatment, the projected final height was compared to the actual final height (FHt). The median baseline chronological and bone age were 10.0 and 10.5 years, respectively. After a median of 36.5 months of treatment, the median FHt (172.6 cm) was shorter than the median gcPFHt (181.0 cm) and baPFHt (175.9 cm). In the six patients who started treatment before the age of 11 years, the median FHt (171.8 cm) was shorter than the median gcPFHt (181.5 cm) and baPFHt (177.4 cm) after treatment. The median differences between the FHt and gcPFHt and baPFHt were 9.2 and 8.3 cm, respectively. In two patients started treatment after the age of 11, the differences between FHt and gcPFHt, and baPFHt after treatment were -4 and 1.4 cm, and -1.2 and 0 cm for each case, respectively. A stepwise increasing regimen of estradiol valerate may be an effective treatment for height control in girls with Marfan syndrome, especially when started under 11 years old.

  8. Influence of real and virtual heights on standing balance.

    Science.gov (United States)

    Cleworth, Taylor W; Horslen, Brian C; Carpenter, Mark G

    2012-06-01

    Fear and anxiety induced by threatening scenarios, such as standing on elevated surfaces, have been shown to influence postural control in young adults. There is also a need to understand how postural threat influences postural control in populations with balance deficits and risk of falls. However, safety and feasibility issues limit opportunities to place such populations in physically threatening scenarios. Virtual reality (VR) has successfully been used to simulate threatening environments, although it is unclear whether the same postural changes can be elicited by changes in virtual and real threat conditions. Therefore, the purpose of this study was to compare the effects of real and virtual heights on changes to standing postural control, electrodermal activity (EDA) and psycho-social state. Seventeen subjects stood at low and high heights in both real and virtual environments matched in scale and visual detail. A repeated measures ANOVA revealed increases with height, independent of visual environment, in EDA, anxiety, fear, and center of pressure (COP) frequency, and decreases with height in perceived stability, balance confidence and COP amplitude. Interaction effects were seen for fear and COP mean position; where real elicited larger changes with height than VR. This study demonstrates the utility of VR, as simulated heights resulted in changes to postural, autonomic and psycho-social measures similar to those seen at real heights. As a result, VR may be a useful tool for studying threat related changes in postural control in populations at risk of falls, and to screen and rehabilitate balance deficits associated with fear and anxiety. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Predicting human height by Victorian and genomic methods.

    Science.gov (United States)

    Aulchenko, Yurii S; Struchalin, Maksim V; Belonogova, Nadezhda M; Axenovich, Tatiana I; Weedon, Michael N; Hofman, Albert; Uitterlinden, Andre G; Kayser, Manfred; Oostra, Ben A; van Duijn, Cornelia M; Janssens, A Cecile J W; Borodin, Pavel M

    2009-08-01

    In the Victorian era, Sir Francis Galton showed that 'when dealing with the transmission of stature from parents to children, the average height of the two parents, ... is all we need care to know about them' (1886). One hundred and twenty-two years after Galton's work was published, 54 loci showing strong statistical evidence for association to human height were described, providing us with potential genomic means of human height prediction. In a population-based study of 5748 people, we find that a 54-loci genomic profile explained 4-6% of the sex- and age-adjusted height variance, and had limited ability to discriminate tall/short people, as characterized by the area under the receiver-operating characteristic curve (AUC). In a family-based study of 550 people, with both parents having height measurements, we find that the Galtonian mid-parental prediction method explained 40% of the sex- and age-adjusted height variance, and showed high discriminative accuracy. We have also explored how much variance a genomic profile should explain to reach certain AUC values. For highly heritable traits such as height, we conclude that in applications in which parental phenotypic information is available (eg, medicine), the Victorian Galton's method will long stay unsurpassed, in terms of both discriminative accuracy and costs. For less heritable traits, and in situations in which parental information is not available (eg, forensics), genomic methods may provide an alternative, given that the variants determining an essential proportion of the trait's variation can be identified.

  10. Patient-reported outcome measures for patients with cerebral aneurysms acquired via social media: data from a large nationwide sample.

    Science.gov (United States)

    Chen, Michael; Mangubat, Erwin; Ouyang, Bichun

    2016-01-01

    With greater survival rates, patient-reported outcome measures (PROMs) among survivors of ruptured cerebral aneurysm should be an increasing concern among neurointerventionalists. Prior studies were limited in scale and generalizability. Our study aims were to (1) evaluate the validity of cerebral aneurysm PROMs obtained from social media; (2) determine the persistence of PROMs over time; and (3) determine what PROMs still exist in those with no physical impairments. By engaging national brain aneurysm support groups and using an online questionnaire modeled after the generic EQ-5D instrument, we asked respondents to classify their health in five dimensions including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression using a 3-point Likert scale. In 2 months we received 604 responses from 46 states in the USA. Our cohort of ruptured aneurysm respondents reported PROMs similar to previously published series. Over time, headache and anxiety improved while depression, level of exercise, and return to work remained unchanged. We found that memory worsened after 2 years. Among those without any physical impairment, rates of 20.6%, 14.9%, 12.6%, and 23% were seen for significant headaches, significant memory loss, significant depression, and sense of life being negatively affected, respectively. Despite this novel study design, we obtained results comparable to prior studies. These results suggest that many patients with ruptured cerebral aneurysms, regardless of whether they are >2 years after the event and/or free of physical impairment, struggle with a poor quality of life. The latency, scale, and low cost of this study design may accelerate future cerebral aneurysm PROM research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Physiological pattern of lumbar disc height; Physiologisches Muster lumbaler Bandscheibenhoehen

    Energy Technology Data Exchange (ETDEWEB)

    Biggemann, M [Radiologische Klinik des Evangelischen Krankenhauses Bethesda, Duisburg (Germany); Frobin, W; Brinckmann, P [Muenster Univ. (Germany). Inst. fuer Experimentelle Biomechanik

    1997-07-01

    Purpose of this study is to present a new method of quantifying objectively the height of all discs in lateral radiographs of the lumbar spine and of analysing the normal craniocaudal sequence pattern of lumbar disc heights. Methods: The new parameter is the ventrally measured disc height corrected for the dependence on the angle of lordosis by normalisation to mean angles observed in the erect posture of healthy persons. To eliminate radiographic magnification, the corrected ventral height is related to the mean depth of the cranially adjoining vertebra. In this manner lumbar disc heights were objectively measured in young, mature and healthy persons (146 males and 65 females). The craniocaudal sequence pattern was analysed by mean values from all persons and by height differences of adjoining discs in each individual lumbar spine. Results: Mean normative values demonstrated an increase in disc height between L1/L2 and L4/L5 and a constant or decreasing disc height between L4/L5 and L5/S1. However, this `physiological sequence of disc height in the statistical mean` was observed in only 36% of normal males and 55% of normal females. Conclusion: The radiological pattern of the `physiological sequence of lumbar disc height` leads to a relevant portion of false positive pathological results especially at L4/L5. An increase of disc height from L4/L5 to L5/S1 may be normal. The recognition of decreased disc height should be based on an abrupt change in the heights of adjoining discs and not on a deviation from a craniocaudal sequence pattern. (orig.) [Deutsch] Ziel dieser Arbeit ist es, einen neuen Parameter zur objektiven Messung der Hoehen aller auf einer seitlichen Uebersichtsaufnahme der LWS erkennbaren Bandscheiben vorzustellen und die physiologische kraniokaudale Diskushoehensequenz neu zu dokumentieren. Methode: Bei dem neuen Messverfahren wird die Bandscheibenhoehe ventral gemessen, zur Korrektur ihrer Haltungsabhaengigkeit auf Standardwinkel (mittlere Winkel

  12. ANALYSIS AND CORRECTION OF SYSTEMATIC HEIGHT MODEL ERRORS

    Directory of Open Access Journals (Sweden)

    K. Jacobsen

    2016-06-01

    Full Text Available The geometry of digital height models (DHM determined with optical satellite stereo combinations depends upon the image orientation, influenced by the satellite camera, the system calibration and attitude registration. As standard these days the image orientation is available in form of rational polynomial coefficients (RPC. Usually a bias correction of the RPC based on ground control points is required. In most cases the bias correction requires affine transformation, sometimes only shifts, in image or object space. For some satellites and some cases, as caused by small base length, such an image orientation does not lead to the possible accuracy of height models. As reported e.g. by Yong-hua et al. 2015 and Zhang et al. 2015, especially the Chinese stereo satellite ZiYuan-3 (ZY-3 has a limited calibration accuracy and just an attitude recording of 4 Hz which may not be satisfying. Zhang et al. 2015 tried to improve the attitude based on the color sensor bands of ZY-3, but the color images are not always available as also detailed satellite orientation information. There is a tendency of systematic deformation at a Pléiades tri-stereo combination with small base length. The small base length enlarges small systematic errors to object space. But also in some other satellite stereo combinations systematic height model errors have been detected. The largest influence is the not satisfying leveling of height models, but also low frequency height deformations can be seen. A tilt of the DHM by theory can be eliminated by ground control points (GCP, but often the GCP accuracy and distribution is not optimal, not allowing a correct leveling of the height model. In addition a model deformation at GCP locations may lead to not optimal DHM leveling. Supported by reference height models better accuracy has been reached. As reference height model the Shuttle Radar Topography Mission (SRTM digital surface model (DSM or the new AW3D30 DSM, based on ALOS

  13. Study and Evaluation of Ultrasound System for Detecting the Height of Corn Canopy

    Directory of Open Access Journals (Sweden)

    T Mesri Gundoshmian

    2017-10-01

    measured accurately by ultrasonic technology. According to the results, identifying the presence or absence of plant, precision control of the operations (e.g. spraying and measuring the height of the plants (to set the cutting height at combine harvester. Obviously, the produced device can identify plant height with precision, and can use in different phases of precision agriculture such as seeding row identification, machinery path determination to minimize plant’s loss, poison optimization and harvesting.

  14. PREGNANCY LOSS IN MARES

    Directory of Open Access Journals (Sweden)

    Tibary A

    2015-12-01

    Full Text Available Pregnancy loss is an important aspect of equine practice due to the economic and emotional loss that it engenders. Pregnancy loss is often divided in two categories: early pregnancy loss (EPL or embryonic death (ED (first 42 days and fetal losses (after 42 days. Diagnosis of the causes of pregnancy loss is often very challenging. Many of the causes of EPL remain poorly documented but studies on embryo development and embryo-uterine interaction have been able to shed some light on predisposing factors. Fetal losses or abortions are dominated by infectious causes and particularly bacterial placentitis. Detailed reviews of pregnancy loss were recently published by the authors (Tibary et al., 2012; Tibary and Pearson, 2012; Tibary et al., 2014. The objective of this paper is to provide an overview of the epidemiology, etiology, diagnosis and prevention of pregnancy loss in the mare.

  15. Proximal alveolar bone loss in a longitudinal radiographic investigation

    International Nuclear Information System (INIS)

    Lavstvedt, S.; Bolin, A.; Henrikson, C.O.

    1986-01-01

    Four hundred and six individuals from an unselected sample from the County of Stockholm aged 18 to 65 years in 1970 were examined radiographically in 1970 and 1980. The differences in proximal alveolar bone height were recorded, attention being paid to the divergences in projection between the two investigations. The mean of the alveolar bone differnce was 5.5% of the mean root length, which corresponds to an average annual bone loss of 0.09 mm. Ninety per cent of the individuals had a difference in alveolar bone height of less than 10% of the root length, that is an average bone loss of 1.6 mm or less during 10 years. By linear regression analysis it was shown that the difference in alveolar bone height is a function of the initial bone loss; that is, the greater the initial bone loss, the greater the alveolar bone loss during the 10-year period. The result of the regression analysis may facilitate predictions of alveolar bone loss

  16. Foot and Ankle Kinematics During Descent From Varying Step Heights.

    Science.gov (United States)

    Gerstle, Emily E; O'Connor, Kristian; Keenan, Kevin G; Cobb, Stephen C

    2017-12-01

    In the general population, one-third of incidences during step negotiation occur during the transition to level walking. Furthermore, falls during curb negotiation are a common cause of injury in older adults. Distal foot kinematics may be an important factor in determining injury risk associated with transition step negotiation. The purpose of this study was to identify foot and ankle kinematics of uninjured individuals during descent from varying step heights. A 7-segment foot model was used to quantify kinematics as participants walked on a level walkway, stepped down a single step (heights: 5 cm, 15 cm, 25 cm), and continued walking. As step height increased, landing strategy transitioned from the rearfoot to the forefoot, and the rearfoot, lateral and medial midfoot, and medial forefoot became more plantar flexed. During weight acceptance, sagittal plane range of motion of the rearfoot, lateral midfoot, and medial and lateral forefoot increased as step height increased. The changes in landing strategy and distal foot function suggest a less stable ankle position at initial contact and increased demand on the distal foot at initial contact and through the weight acceptance phase of transition step negotiation as step height increases.

  17. Falls from heights in and around the city of Batman.

    Science.gov (United States)

    Al, Behçet; Yildirim, Cuma; Coban, Sacid

    2009-03-01

    We evaluated the demographic data, mortality rates, fall causes, and post-mortem findings of individuals who fell from heights. Five hundred thirty-eight patients who sustained injuries after an accidental fall from heights were entered into the study. Our cases were collected prospectively in Batman over a seven- month period. The mean age was 12.4+/-3.22 years (3 months-98 years); 56.5% of patients were under 6 years old and 83.5% were under 20 years old. The mean fall height was 3.2+/-2.4 m. The mortality rate was 2.2%, and was highest among the patients who fell from flat-roofed houses. The most common injuries were to the head, and 100% of those who died had a head injury. Six patients were followed because of abdominal bleeding and 141 patients due to extremity fractures; 6.7% of patients were operated on and 83.8% of patients were treated in the emergency department. The results of this study were at variance with literature data with respect to the following: falls from heights were most common in the 0-5 years of age group. Craniocerebral trauma is the most common injury in fatal falls. Males had a higher rate of falls from height than females.

  18. A generalized multivariate regression model for modelling ocean wave heights

    Science.gov (United States)

    Wang, X. L.; Feng, Y.; Swail, V. R.

    2012-04-01

    In this study, a generalized multivariate linear regression model is developed to represent the relationship between 6-hourly ocean significant wave heights (Hs) and the corresponding 6-hourly mean sea level pressure (MSLP) fields. The model is calibrated using the ERA-Interim reanalysis of Hs and MSLP fields for 1981-2000, and is validated using the ERA-Interim reanalysis for 2001-2010 and ERA40 reanalysis of Hs and MSLP for 1958-2001. The performance of the fitted model is evaluated in terms of Pierce skill score, frequency bias index, and correlation skill score. Being not normally distributed, wave heights are subjected to a data adaptive Box-Cox transformation before being used in the model fitting. Also, since 6-hourly data are being modelled, lag-1 autocorrelation must be and is accounted for. The models with and without Box-Cox transformation, and with and without accounting for autocorrelation, are inter-compared in terms of their prediction skills. The fitted MSLP-Hs relationship is then used to reconstruct historical wave height climate from the 6-hourly MSLP fields taken from the Twentieth Century Reanalysis (20CR, Compo et al. 2011), and to project possible future wave height climates using CMIP5 model simulations of MSLP fields. The reconstructed and projected wave heights, both seasonal means and maxima, are subject to a trend analysis that allows for non-linear (polynomial) trends.

  19. Comparison of mixing height parameterizations with profiles measurements

    Energy Technology Data Exchange (ETDEWEB)

    Jaquier, A.; Stuebi, R.; Tercier, P. [Swiss Meteorological Inst., SMI - MeteoSwiss, Payerne (Switzerland)

    1997-10-01

    Different meteorological pre-processors for dispersion studies are available to derive the atmospheric boundary layer mixing height (MH). The analysis of their performances has been reviewed in the framework of the European COST Action 710. In this project, the computed mixing height values have been compared with data derived mostly from aero-logical sounding analysis and Sodar measurements. Since then, a new analysis of a low-tropospheric wind profiler (WP) data has been performed taking advantage of its high data sampling ({delta}t {approx} 30 sec.). The comparison between these recent results and aero-logical sounding, Sodar data, as well as to meteorological pre-processors calculations are reported for three periods of several days corresponding to different meteorological situations. In convective conditions, the pre-processors give reasonable level, the mixing height growing rate is in fair agreement with the measured one. In stable cloudy daytime conditions, the modeled mixing height does not correspond to any measured height. (LN)

  20. Changes in interdental papillae heights following alignment of anterior teeth.

    Science.gov (United States)

    Kandasamy, Sanjivan; Goonewardene, Mithran; Tennant, Marc

    2007-05-01

    Orthodontic alignment of overlapped incisors can reduce the apparent heights of the interdental papillae leading to unsightly dark triangles or open gingival embrasures. To determine if certain pretreatment contact point relationships between the maxillary anterior teeth were accompanied by changes in the heights of the interdental papillae after orthodontic alignment. Pre- and post-treatment intra-oral 35 mm slides, lateral cephalometric radiographs and study casts of 143 patients (60 males, 83 females) between 13 and 16 years of age were used. The patients had diastamata closed, imbricated teeth aligned and palatally or labially placed teeth repositioned. A sample of 25 patients (12 males, 13 females) between 13 and 16 years of age who had well-aligned anterior teeth at the start of treatment acted as a control group. All patients were treated for approximately 18 months. The clinical crowns of the maxillary incisors and the heights of the interdental papilla between the incisors were measured on projected images of the slides. The percentage increases or reductions in the heights of the interdental papillae were compared. The heights of the interdental papillae increased following palatal movement of labially placed (p teeth and the intrusion of one tooth relative to another. On the other hand, dark triangles are more likely to develop following labial movement of imbricated or palatally placed incisors and closure of a diastema. Clinicians should be alert to the possibility of dark triangles developing in the latter group, particularly in older patients.

  1. Provider Factors and Patient-Reported Healthcare Discrimination in the Diabetes Study of California (DISTANCE)

    Science.gov (United States)

    Lyles, Courtney R.; Karter, Andrew J.; Young, Bessie A.; Spigner, Clarence; Grembowski, David; Schillinger, Dean; Adler, Nancy

    2011-01-01

    Objective We examined provider-level factors and reported discrimination in the healthcare setting. Methods With data from the Diabetes Study of Northern California (DISTANCE)—a race-stratified survey of diabetes patients in Kaiser Permanente Northern California—we analyzed patient-reported racial/ethnic discrimination from providers. Primary exposures were characteristics of the primary care provider (PCP, who coordinates care in this system), including specialty/type, and patient-provider relationship variables including racial concordance. Results Subjects (n=12,151) included 20% black, 20% Latino, 23% Asian, 30% white, and 6% other patients, with 2% to 8% reporting discrimination by racial/ethnic group. Patients seeing nurse practitioners as their PCP (OR=0.09; 95% CI: 0.01–0.67), those rating their provider higher on communication (OR=0.70; 95% CI: 0.66–0.74) were less likely to report discrimination, while those with more visits (OR=1.10; 95% CI: 1.03–1.18) were more likely to report discrimination. Racial concordance was not significant once adjusting for patient race/ethnicity. Conclusions Among diverse diabetes patients in managed care, provider type and communication were significantly related to patient-reported discrimination. Practice Implications Given potential negative impacts on patient satisfaction and treatment decisions, future studies should investigate which interpersonal aspects of the provider-patient relationship reduce patient perceptions of unfair treatment. PMID:21605956

  2. Patient-reported changes in communication after computer-based script training for aphasia.

    Science.gov (United States)

    Manheim, Larry M; Halper, Anita S; Cherney, Leora

    2009-04-01

    To evaluate changes in patient-reported communication difficulty after a home-based, computer-delivered intervention designed to improve conversational skills in adults with aphasia. Delayed treatment design with baseline, preintervention, postintervention, and follow-up observations. Outpatient rehabilitation. Twenty subjects with chronic aphasia. Sessions with the speech-language pathologist to develop personally relevant conversational scripts, followed by 9 weeks of intensive home practice using a computer program loaded on a laptop, and weekly monitoring visits with the speech-language pathologist. Communication Difficulty (CD) subscale of the Burden of Stroke Scale (BOSS). The intervention resulted in a statistically and clinically significant decrease of 6.79 points (P=.038) in the CD subscale of the BOSS during the intervention, maintained during the follow-up period. The findings of this study provide positive albeit preliminary and limited support for the use of a home-based, computer-delivered language intervention program for improving patient-reported communication outcomes in adults with chronic aphasia. Additional research will be required to examine the efficacy and effectiveness of this intervention.

  3. Patient-Reported Outcome questionnaires for hip arthroscopy: a systematic review of the psychometric evidence

    Science.gov (United States)

    2011-01-01

    Background Hip arthroscopies are often used in the treatment of intra-articular hip injuries. Patient-reported outcomes (PRO) are an important parameter in evaluating treatment. It is unclear which PRO questionnaires are specifically available for hip arthroscopy patients. The aim of this systematic review was to investigate which PRO questionnaires are valid and reliable in the evaluation of patients undergoing hip arthroscopy. Methods A search was conducted in Pubmed, Medline, CINAHL, the Cochrane Library, Pedro, EMBASE and Web of Science from 1931 to October 2010. Studies assessing the quality of PRO questionnaires in the evaluation of patients undergoing hip arthroscopy were included. The quality of the questionnaires was evaluated by the psychometric properties of the outcome measures. The quality of the articles investigating the questionnaires was assessed by the COSMIN list. Results Five articles identified three questionnaires; the Modified Harris Hip Score (MHHS), the Nonarthritic Hip Score (NAHS) and the Hip Outcome Score (HOS). The NAHS scored best on the content validity, whereas the HOS scored best on agreement, internal consistency, reliability and responsiveness. The quality of the articles describing the HOS scored highest. The NAHS is the best quality questionnaire. The articles describing the HOS are the best quality articles. Conclusions This systematic review shows that there is no conclusive evidence for the use of a single patient-reported outcome questionnaire in the evaluation of patients undergoing hip arthroscopy. Based on available psychometric evidence we recommend using a combination of the NAHS and the HOS for patients undergoing hip arthroscopy. PMID:21619610

  4. Methods for interpreting change over time in patient-reported outcome measures.

    Science.gov (United States)

    Wyrwich, K W; Norquist, J M; Lenderking, W R; Acaster, S

    2013-04-01

    Interpretation guidelines are needed for patient-reported outcome (PRO) measures' change scores to evaluate efficacy of an intervention and to communicate PRO results to regulators, patients, physicians, and providers. The 2009 Food and Drug Administration (FDA) Guidance for Industry Patient-Reported Outcomes (PRO) Measures: Use in Medical Product Development to Support Labeling Claims (hereafter referred to as the final FDA PRO Guidance) provides some recommendations for the interpretation of change in PRO scores as evidence of treatment efficacy. This article reviews the evolution of the methods and the terminology used to describe and aid in the communication of meaningful PRO change score thresholds. Anchor- and distribution-based methods have played important roles, and the FDA has recently stressed the importance of cross-sectional patient global assessments of concept as anchor-based methods for estimation of the responder definition, which describes an individual-level treatment benefit. The final FDA PRO Guidance proposes the cumulative distribution function (CDF) of responses as a useful method to depict the effect of treatments across the study population. While CDFs serve an important role, they should not be a replacement for the careful investigation of a PRO's relevant responder definition using anchor-based methods and providing stakeholders with a relevant threshold for the interpretation of change over time.

  5. Representing Information in Patient Reports Using Natural Language Processing and the Extensible Markup Language

    Science.gov (United States)

    Friedman, Carol; Hripcsak, George; Shagina, Lyuda; Liu, Hongfang

    1999-01-01

    Objective: To design a document model that provides reliable and efficient access to clinical information in patient reports for a broad range of clinical applications, and to implement an automated method using natural language processing that maps textual reports to a form consistent with the model. Methods: A document model that encodes structured clinical information in patient reports while retaining the original contents was designed using the extensible markup language (XML), and a document type definition (DTD) was created. An existing natural language processor (NLP) was modified to generate output consistent with the model. Two hundred reports were processed using the modified NLP system, and the XML output that was generated was validated using an XML validating parser. Results: The modified NLP system successfully processed all 200 reports. The output of one report was invalid, and 199 reports were valid XML forms consistent with the DTD. Conclusions: Natural language processing can be used to automatically create an enriched document that contains a structured component whose elements are linked to portions of the original textual report. This integrated document model provides a representation where documents containing specific information can be accurately and efficiently retrieved by querying the structured components. If manual review of the documents is desired, the salient information in the original reports can also be identified and highlighted. Using an XML model of tagging provides an additional benefit in that software tools that manipulate XML documents are readily available. PMID:9925230

  6. Association between visual impairment and patient-reported visual disability at different stages of cataract surgery.

    Science.gov (United States)

    Acosta-Rojas, E Ruthy; Comas, Mercè; Sala, Maria; Castells, Xavier

    2006-10-01

    To evaluate the association between visual impairment (visual acuity, contrast sensitivity, stereopsis) and patient-reported visual disability at different stages of cataract surgery. A cohort of 104 patients aged 60 years and over with bilateral cataract was assessed preoperatively, after first-eye surgery (monocular pseudophakia) and after second-eye surgery (binocular pseudophakia). Partial correlation coefficients (PCC) and linear regression models were calculated. In patients with bilateral cataracts, visual disability was associated with visual acuity (PCC = -0.30) and, to a lesser extent, with contrast sensitivity (PCC = 0.16) and stereopsis (PCC = -0.09). In monocular and binocular pseudophakia, visual disability was more strongly associated with stereopsis (PCC = -0.26 monocular and -0.51 binocular) and contrast sensitivity (PCC = 0.18 monocular and 0.34 binocular) than with visual acuity (PCC = -0.18 monocular and -0.18 binocular). Visual acuity, contrast sensitivity and stereopsis accounted for between 17% and 42% of variance in visual disability. The association of visual impairment with patient-reported visual disability differed at each stage of cataract surgery. Measuring other forms of visual impairment independently from visual acuity, such as contrast sensitivity or stereopsis, could be important in evaluating both needs and outcomes in cataract surgery. More comprehensive assessment of the impact of cataract on patients should include measurement of both visual impairment and visual disability.

  7. Patient-Reported Outcomes in Patients with Chronic Kidney Disease and Kidney Transplant—Part 1

    Directory of Open Access Journals (Sweden)

    Evan Tang

    2018-01-01

    Full Text Available Chronic kidney disease (CKD is a complex medical condition that is associated with several comorbidities and requires comprehensive medical management. Given the chronic nature of the condition, its frequent association with psychosocial distress, and its very significant symptom burden, the subjective patient experience is key toward understanding the true impact of CKD on the patients’ life. Patient-reported outcome measures are important tools that can be used to support patient-centered care and patient engagement during the complex management of patients with CKD. The routine collection and use of patient-reported outcomes (PROs in clinical practice may improve quality of care and outcomes, and may provide useful data to understand the disease from both an individual and a population perspective. Many tools used to measure PROs focus on assessing health-related quality of life, which is significantly impaired among patients with CKD. Health-related quality of life, in addition to being an important outcome itself, is associated with clinical outcomes such as health care use and mortality. In Part 1 of this review, we provide an overview of PROs and implications of their use in the context of CKD. In Part 2, we will review the selection of appropriate measures and the relevant domains of interest for patients with CKD.

  8. The Role of Patient-Reported Outcome Measures in Value-Based Payment Reform.

    Science.gov (United States)

    Squitieri, Lee; Bozic, Kevin J; Pusic, Andrea L

    2017-06-01

    The U.S. health care system is currently experiencing profound change. Pressure to improve the quality of patient care and control costs have caused a rapid shift from traditional volume-driven fee-for-service reimbursement to value-based payment models. Under the 2015 Medicare Access and Children's Health Insurance Program Reauthorization Act, providers will be evaluated on the basis of quality and cost efficiency and ultimately receive adjusted reimbursement as per their performance. Although current performance metrics do not incorporate patient-reported outcome measures (PROMs), many wonder whether and how PROMs will eventually fit into value-based payment reform. On November 17, 2016, the second annual Patient-Reported Outcomes in Healthcare Conference brought together international stakeholders across all health care disciplines to discuss the potential role of PROs in value-based health care reform. The purpose of this article was to summarize the findings from this conference in the context of recent literature and guidelines to inform implementation of PROs in value-based payment models. Recommendations for evaluating key perspectives and measurement goals are made to facilitate appropriate use of PROMs to best benefit and amplify the voice of our patients. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  9. Relationship between patient-reported and objective measurements of hand function in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    S.M. Günay

    2016-12-01

    Full Text Available Rheumatoid arthritis (RA often results in impairments in upper extremities, especially in the small joints of hand. Involvement of hand brings limitations in activities of daily living. However, it is commonly observed that patient-reported functional status of hand does not always corresponds to their actual physical performance in the clinical setting. The aim of this pilot study is to investigate the relationship between patient self-reported and objectively measured hand functions in patients with RA. Twenty-six patients (51±13 years with RA diagnosis participated in the study. Hand grip and pinch (lateral, bipod, tripod strengths were measured and Jebsen Hand Function Test (JHFT was performed for objective functional performance. Duruöz Hand Index and Beck Depression Inventory - Turkish version were completed by patients. Grip and all three-pinch strength results significantly correlated with Duruöz Hand Index scores (p<0.05. JHFT results except the sentence writing also correlated with the Duruöz scores (p<0.05. Our results showed that self-reported outcome scales might be used for determining functional level of hand in patients with RA in rheumatology practice. Objective quantitative functional tests are the best methods in evaluating functional level of hand, but require valid and reliable equipment with accurate calibration. Therefore, in case of unavailability of objective assessment tools, patient-reported scales may also reflect the real status of hand functions.

  10. Discordance Between Physician Assessment and Patient-Reported Depressive Symptoms in Parkinson Disease.

    Science.gov (United States)

    Lachner, Christian; Armstrong, Melissa J; Gruber-Baldini, Ann L; Rezvani, Zahra; Reich, Stephen G; Fishman, Paul S; Salazar, Richard; Shulman, Lisa M

    2017-07-01

    To assess concordance between physician assessment and patient-reported symptoms when screening for depression in Parkinson disease (dPD). Depression in Parkinson disease is highly prevalent (∼40%) and has a significant impact on quality of life and disability, yet physician recognition and treatment remain inadequate. One thousand seventy-six patients with PD completed the Brief Symptom Inventory-18 (BSI-18), a screening questionnaire for psychiatric symptoms, which was compared to item #3 (depression) on the Unified Parkinson's Disease Rating Scale (UPDRS). The mean BSI-18 depression score was 51.4 (9.7). Of the 170 (16%) patients screening positive for dPD on the BSI-18, 104 (61%) were not recognized as depressed by neurologists on the UPDRS. Factors associated with lower neurologist recognition included male gender, better mental health quality of life, and lack of antidepressant use. More than 60% of patients screening positive for depression on self-report were not recognized by neurologists on the UPDRS. A patient-reported screening tool for depression may improve recognition and management of dPD.

  11. Investigation and Determination of Corn Combine Harvester Losses to Introduce Appropriate Methods to Reduce Losses

    Directory of Open Access Journals (Sweden)

    M.R Mostofi Sarkari

    2011-03-01

    Full Text Available Corn harvesting involves some losses. These losses result in decreased benefits. It is almost impossible to lower losses to zero percent but it can be controlled in an acceptable level. As a result of this research, appropriate methods are introduced to decrease losses and reduce waste. In this project, losses in different part of combine were measured and evaluated according to the available standard method (ASAE S396.2 & S343.3. Harvesting losses include preharvest and during harvest losses comprising ear loss and kernal loss in the header, cylinder and cleaning losses. This project was conducted on farmers’ lands in Gazvin province. Some assessments related to yield factors were evaluated in different parts of farm with specified area, e.g. Plant height, ear number, stem diameter, ear diameter, cob diameter, row/ear and seed/row. All losses evaluated in three treatments which they were: seed moisture content (w.b. in three levels of 19%, 23% and 27%, ground speed in three levels of 0.8, 1.2 and 1.6 ms-1 and cylinder speed of 400, 600 and 800 rpm. The split plot experimental design based on the randomised complete block design (RCBD was used to evaluate treatments. Measured losses compared with standard values to introduce the proper methods to decrease losses and proper adjustments. The results show that appropriate seed moisture content, cylinder and ground speed were 23%, 400 rpm and 1.2 ms-1, respectively. They had minimum total loss which WAS 1.55%, 2.65% and 2.34%, respectivily. The results also show that there was an ear loss in preharvest loss (because of bad weather condition that was 0.95-5.42%, also kernal loss on the header and cylinder loss which all related to improper adjustment of combine but total loss was in an acceptable level and standard. It was variable from 1.55% to 4.02%. Other parameters such as using inexperienced driver, improper combine adjustment, and also nonuniformity of field and ear moisture content in

  12. Corona helps curb losses

    Energy Technology Data Exchange (ETDEWEB)

    Laasonen, M.; Lahtinen, M.; Lustre, L.

    1996-11-01

    The greatest power losses in electricity transmission arise through a phenomenon called load losses. Corona losses caused by the surface discharge of electricity also constitute a considerable cost item. IVS, the nationwide network company, is investigating corona- induced losses, and has also commissioned similar research from IVO International, the Technical Research Centre of Finland (VTT) and from Tampere University of Technology. The research work strives to gain more in-depth knowledge on the phenomenon of frosting and its impact on corona losses. The correct prediction of frost helps reduce corona losses, while also cutting costs considerably. (orig.)

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  14. Patient-Reported Esthetic and Functional Outcomes of Primary Total Laparoscopic Intestinal Vaginoplasty in Transgender Women With Penoscrotal Hypoplasia

    NARCIS (Netherlands)

    Bouman, M.B.; Sluis, W.B. van der; Woudenberg Hamstra, L.E. van; Buncamper, M.E.; Kreukels, B.P.; Meijerink, W.J.H.J.; Mullender, M.G.

    2016-01-01

    INTRODUCTION: Puberty-suppressing hormonal treatment may result in penoscrotal hypoplasia in transgender women, making standard penile inversion vaginoplasty not feasible. For these patients, intestinal vaginoplasty is a surgical alternative, but knowledge on patient-reported postoperative outcomes

  15. Variation of boundary-layer wind spectra with height

    DEFF Research Database (Denmark)

    Larsén, Xiaoli Guo; Petersen, Erik L.; Larsen, Søren Ejling

    2018-01-01

    This study revisits the height dependence of the wind speed power spectrum from the synoptic scale to the spectral gap. Measurements from cup anemometers and sonics at heights of 15 m to 244 m are used. The measurements are from one land site, one coastal land‐based site and three offshore sites...... the atmospheric tide. The second finding regards the height dependence of the general spectrum. We describe the dependence through a so‐called effective roughness, which is calculated from wind spectra and represents the energy removal at different frequencies, and thus surface conditions in the footprint areas....... The generalizable spectral properties of winds presented herein may prove useful for validating numerical models....

  16. Retrieving Smoke Aerosol Height from DSCOVR/EPIC

    Science.gov (United States)

    Xu, X.; Wang, J.; Wang, Y.

    2017-12-01

    Unlike industrial pollutant particles that are often confined within the planetary boundary layer, smoke from forest and agriculture fires can inject massive carbonaceous aerosols into the upper troposphere due to the intense pyro-convection. Sensitivity of weather and climate to absorbing carbonaceous aerosols is regulated by the altitude of those aerosol layers. However, aerosol height information remains limited from passive satellite sensors. Here we present an algorithm to estimate smoke aerosol height from radiances in the oxygen A and B bands measured by the Earth Polychromatic Imaging Camera (EPIC) from the Deep Space Climate Observatory (DSCOVR). With a suit of case studies and validation efforts, we demonstrate that smoke aerosol height can be well retrieved over both ocean and land surfaces multiple times daily.

  17. FERDO/FERD, Unfolding of Pulse-Height Spectrometer Spectra

    International Nuclear Information System (INIS)

    Rust, B.W.; Ingersoll, D.T.; Burrus, W.R.

    1985-01-01

    1 - Description of problem or function: FERDO and FERD are unfolding codes which can be used to correct observed pulse-height distributions for the non-ideal response of a pulse-height spectrometer or to solve poorly conditioned linear equations. 2 - Method of solution: It is assumed that the response of the spectrometer is given by Ax = b, where A is the spectrometer response function matrix, x is the unknown spectrum, and b is the pulse-height distribution. FERDO does not resolve directly for x but instead solves for p = Wx, where W is a 'window function matrix'. Typically, W is the resolution function of an ideal spectrometer which has a single Gaussian response. The effective resolution of the unfolding solution may be varied by the choice of W. Confidence intervals are found for each element of the solution p

  18. Improved pulse-height store for A/D conversion

    Energy Technology Data Exchange (ETDEWEB)

    Casoli, P [Montedel S.p.a., Laben Division, Via Bassini 15, Milano, Italy; Maranesi, P [Politecnico di Milano (Italy). Centro Studi Nucleari E. Fermi

    1979-11-15

    A new pulse-height store is described. Suitable contrivances improve integral linearity and reduce the differential errors that generally occur at signal amplitudes near the lower threshold. No degradations appear at high rates of input events. The electrical specifications of the pulse-height store are determined through a series of measurements described in the final part of the paper. In order to test the circuit in the most significant way, it has been connected to a fast successive-approximation conversion module which uses the sliding-scale technique for channel width equalisation, thus implementing a complete analog-to-digital converter (ADC) for nuclear spectrometry. The performances of the pulse-height store have been deduced from the behavior of the whole system.

  19. Climatology and evolution of the mixing height over water

    Energy Technology Data Exchange (ETDEWEB)

    Sempreviva, A.M. [Istituto di Fisica dell`Atmosfera, CNR, Rome (Italy); Grynig, S.E. [Risoe National Lab., Roskilde (Denmark)

    1997-10-01

    In this paper we present results from an experimental investigation on the height of the mixed layer h, using a meteorological station located on the Danish island of Anholt. The station was operational for two years from September 1990 to October 1992. We present the analysis of two years of radio-sounding showing the average daily evolution of h. Furthermore observations of the mixed layer growth under near-neutral and unstable atmospheric conditions during six consecutive days has been modelled using a simple zero-order mixed-layer height model. Finally we have compared the evolution of the mixing height from the model with the evolution of the correlation coefficient between temperature and humidity to study the influence of the deepness of the convective layer on the mechanism of the correlation between temperature and humidity in the surface layer. (au)

  20. Program Merges SAR Data on Terrain and Vegetation Heights

    Science.gov (United States)

    Siqueira, Paul; Hensley, Scott; Rodriguez, Ernesto; Simard, Marc

    2007-01-01

    X/P Merge is a computer program that estimates ground-surface elevations and vegetation heights from multiple sets of data acquired by the GeoSAR instrument [a terrain-mapping synthetic-aperture radar (SAR) system that operates in the X and bands]. X/P Merge software combines data from X- and P-band digital elevation models, SAR backscatter magnitudes, and interferometric correlation magnitudes into a simplified set of output topographical maps of ground-surface elevation and tree height.

  1. Vowel Height Allophony and Dorsal Place Contrasts in Cochabamba Quechua.

    Science.gov (United States)

    Gallagher, Gillian

    2016-01-01

    This paper reports on the results of two studies investigating the role of allophony in cueing phonemic contrasts. In Cochabamba Quechua, the uvularvelar place distinction is often cued by additional differences in the height of the surrounding vowels. An acoustic study documents the lowering effect of a preceding tautomorphemic or a following heteromorphemic uvular on the high vowels /i u/. A discrimination study finds that vowel height is a significant cue to the velar-uvular place contrast. These findings support a view of contrasts as collections of distinguishing properties, as opposed to oppositions in a single distinctive feature. © 2016 S. Karger AG, Basel.

  2. Sampling rare fluctuations of height in the Oslo ricepile model

    International Nuclear Information System (INIS)

    Pradhan, Punyabrata; Dhar, Deepak

    2007-01-01

    We describe a new Monte Carlo algorithm for studying large deviations of the height of the pile from its mean value in the Oslo ricepile model. We have used it to generate events which have probabilities of order 10 -1000 . These simulations check our qualitative argument (Pradhan P and Dhar D 2006 Phys. Rev. E 73 021303) that in the steady state of the Oslo ricepile model the probability of large negative height fluctuations Δh = -αL about the mean varies as exp(-κα 4 L 3 ) as L → ∞ with α held fixed and κ > 0

  3. Characteristics of emulsion chamber family events produced at low heights

    International Nuclear Information System (INIS)

    Jing, G.; Jing, C.; Zhu, Q.; Ding, L.

    1985-01-01

    The uncertainty of primary cosmic ray composition at 10 to the 14th power -10 to the 16th power eV is well known making the study of nuclear interaction mechanisms more difficult. Experimentally if one can identify effectively the family events produced at low heights, then an induced by primary protons might be separated. In this paper an attempt is made to simulate a family of events under the conditions of a mountain emulsion chamber experiments using a reasonable model. The aim is to search for the dependence of some experimentally observable quantities on the interaction height

  4. Telogen Effluvium Hair Loss

    Science.gov (United States)

    ... Category: Share: Yes No, Keep Private Telogen Effluvium Hair Loss Share | It is normal to lose up to ... months after the "shock". This sudden increase in hair loss, usually described as the hair coming out in ...

  5. Recurrent pregnancy loss

    DEFF Research Database (Denmark)

    Egerup, P; Kolte, A M; Larsen, E C

    2016-01-01

    STUDY QUESTION: Is there a different prognostic impact for consecutive and non-consecutive early pregnancy losses in women with secondary recurrent pregnancy loss (RPL)? SUMMARY ANSWER: Only consecutive early pregnancy losses after the last birth have a statistically significant negative prognostic...... impact in women with secondary RPL. WHAT IS KNOWN ALREADY: The risk of a new pregnancy loss increases with the number of previous pregnancy losses in patients with RPL. Second trimester losses seem to exhibit a stronger negative impact than early losses. It is unknown whether the sequence of pregnancy...... losses plays a role for the prognosis in patients with a prior birth. STUDY DESIGN, SIZE, DURATION: This retrospective cohort study of pregnancy outcome in patients with unexplained secondary RPL included in three previously published, Danish double-blinded placebo-controlled trials of intravenous...

  6. Genes and Hearing Loss

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Genes and Hearing Loss Genes and Hearing Loss Patient ... mutation may only have dystopia canthorum. How Do Genes Work? Genes are a road map for the ...

  7. Menopause and Bone Loss

    Science.gov (United States)

    Fact Sheet & Menopause Bone Loss How are bone loss and menopause related? Throughout life your body keeps a balance between the ... lose bone faster than it can be replaced. Menopause—the time when menstrual periods end, which usually ...

  8. OI Issues: Hearing Loss

    Science.gov (United States)

    ... signals normally to the brain. In addition, hearing losses are classified according to the degree of severity: • Mild, • Moderate, • Severe, • Profound. Hearing losses are also classified according to the sound frequency ...

  9. Early Pregnancy Loss

    Science.gov (United States)

    ... go on to have successful pregnancies. Repeated pregnancy losses are rare. Testing and evaluation can be done ... find a cause if you have several pregnancy losses. Even if no cause is found, most couples ...

  10. Occupational hearing loss

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001048.htm Occupational hearing loss To use the sharing features on this page, please enable JavaScript. Occupational hearing loss is damage to the inner ear from noise ...

  11. Pregnancy Loss and Miscarriage

    Science.gov (United States)

    ... D linked to miscarriage among women with prior pregnancy loss Release: Anti-HIV drug combination does not increase preterm birth risk, study suggests Release: Elevated blood pressure before pregnancy may increase chance of pregnancy loss All related ...

  12. Coping with Memory Loss

    Science.gov (United States)

    ... Consumers Home For Consumers Consumer Updates Coping With Memory Loss Share Tweet Linkedin Pin it More sharing ... be evaluated by a health professional. What Causes Memory Loss? Anything that affects cognition—the process of ...

  13. Weight Loss Surgery

    Science.gov (United States)

    Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you cannot lose weight ... obesity. There are different types of weight loss surgery. They often limit the amount of food you ...

  14. Myopic loss aversion revisited

    OpenAIRE

    Blavatskyy, Pavlo; Pogrebna, Ganna

    2009-01-01

    In this paper we reexamine several experimental papers on myopic loss aversion by analyzing individual rather than aggregate choice patterns. We find that the behavior of the majority of subjects is inconsistent with the hypothesis of myopic loss aversion.

  15. Sea Surface Height, Absolute, Aviso, 0.25 degrees, Global, Science Quality

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Aviso Absolute Sea Surface Height is the Sea Surface Height Deviation plus the long term mean dynamic height. This is Science Quality data.

  16. Using patient-reported outcomes in schizophrenia: the Scottish Schizophrenia Outcomes Study.

    Science.gov (United States)

    Hunter, Robert; Cameron, Rosie; Norrie, John

    2009-02-01

    The primary aim of the Scottish Schizophrenia Outcomes Study (SSOS) was to assess the feasibility and utility of routinely collecting outcome data in everyday clinical settings. Data were collected over three years in the Scottish National Health Service (NHS). There were two secondary aims of SSOS: first, to compare data from patient-rated, objective, and clinician-rated outcomes, and second, to describe trends in outcome data and service use across Scotland over the three years of the study (2002-2005). This study used a naturalistic, longitudinal, observational cohort design. A representative sample of 1,015 persons with ICD-10 F20-F29 diagnoses (schizophrenia, schizotypal disorders, or delusional disorders) was assessed annually using the clinician-rated measure, the Health of the Nation Outcome Scale (HoNOS), and the patient-reported assessment, the Avon Mental Health Measure (Avon). Objective outcomes data and information on services and interventions were collected. Data were analyzed with regression modeling. Of the 1,015 persons recruited, 78% of the cohort (N=789) completed the study. Over the study period, significant decreases were seen in the number of hospitalizations, incidence of attempted suicide and self-harm, and civil detentions. Avon scores indicated significant improvement on all subscales (behavior, social, access, and mental health) and on the total score. However, HoNOS scores on the behavior and symptom subscales did not change, scores on the impairment subscale increased significantly (indicating increased levels of impairment), and scores on the social subscale decreased significantly (indicating improved social functioning). This study has demonstrated that it is feasible within the Scottish NHS to routinely collect meaningful outcomes data in schizophrenia. Patient-reported assessments were also successfully collected and used in care plans. This model shows that it is possible to incorporate patient-reported assessments into routine

  17. Study protocol: patient reported outcomes for bladder management strategies in spinal cord injury.

    Science.gov (United States)

    Patel, Darshan P; Lenherr, Sara M; Stoffel, John T; Elliott, Sean P; Welk, Blayne; Presson, Angela P; Jha, Amitabh; Rosenbluth, Jeffrey; Myers, Jeremy B

    2017-10-10

    The majority of spinal cord injury (SCI) patients have urinary issues, such as incontinence, retention, and frequency. These problems place a significant burden on patients' physical health and quality of life (QoL). There are a wide variety of bladder management strategies available to patients with no clear guidelines on appropriate selection. Inappropriate bladder management can cause hospitalizations and serious complications, such as urosepsis and renal failure. Patients believe that both independence and ability to carry out daily activities are just as important as physical health in selecting the right bladder-management strategy but little is known about patient's QoL with different bladder managements. Our study's aim is to assess patient reported QoL measures with various bladder managements after SCI. This manuscript describes the approach, study design and common data elements for our central study. This is a multi-institutional prospective cohort study comparing three different bladder-management strategies (clean intermittent catheterization, indwelling catheters, and surgery). Information collected from participants includes demographics, past medical and surgical history, injury characteristics, current and past bladder management, and SCI /bladder-related complications. Patient reported outcomes and QoL questionnaires were administered at enrollment and every 3 months for 1 year. Aims of this study protocol are: (1) to assess baseline QoL differences between the three different bladder-management strategies; (2) determine QoL impact when those using either form of catheter management undergo a surgery over the 1 year of follow-up among patients eligible for surgery; (3) assess the effects of changes in bladder management and complications on QoL over a 1-year longitudinal follow-up. By providing information about patient-reported outcomes associated with different bladder management strategies after SCI, and the impact of bladder management

  18. Patient-reported symptom distress, and most bothersome issues, before and during cancer treatment

    Directory of Open Access Journals (Sweden)

    Hong F

    2016-09-01

    Full Text Available Fangxin Hong,1,2 Traci M Blonquist,1 Barbara Halpenny,3 Donna L Berry,3,4 1Department of Biostatistics and Computational Biology, Dana‑Farber Cancer Institute, Boston, MA, USA;2Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA; 3Department of Nursing and Patient Care Services, The Phyllis F. Cantor Center, Dana-Farber Cancer Institute, Boston, MA, USA; 4Department of Medicine, Harvard Medical School, Boston, MA, USA Introduction: Frequently reported symptoms and treatment side effects may not be the most bothersome issues to patients with cancer. The purpose of this study was to investigate patient-reported symptom distress and bothersome issues among participants with cancer. Methods: Participants completed the Symptom Distress Scale-15 before treatment (T1 and during cancer treatment (T2 and reported up to two most bothersome issues among symptoms rated with moderate-to-severe distress. We compared symptom ratings and perceived bother and explored two approaches predicting patients’ most bothersome issues: worst absolute symptom score or worst change from pretreatment. Results: Significantly, (P≤0.0002 more patients reported moderate-to-severe distress at T2 for eight of 13 symptoms. At T1, 81% of patients reported one and 56% reported multiple symptoms with moderate-to-severe distress, while at T2, 89% reported one and 69% reported multiple symptoms with moderate-to-severe distress. Impact on sexual activity/interest, pain, fatigue, and insomnia were the most prevalent symptoms with moderate-to-severe distress. Fatigue, pain, and insomnia were perceived most often as bothersome. When one symptom was rated moderate-to-severe, predictive accuracy of the absolute score was 46% and 48% (T1 & T2 and 38% with the change score (T2–T1. When two or more symptoms were rated moderate-to-severe, predictive accuracy of the absolute score was 76% and 79% (T1 & T2 and 70% with the change score (T2–T1. Conclusion: More

  19. Beyond FEV1 in COPD: a review of patient-reported outcomes and their measurement

    Directory of Open Access Journals (Sweden)

    Jones P

    2012-10-01

    Full Text Available Paul Jones,1 Marc Miravitlles,2 Thys van der Molen,3 Karoly Kulich41Division of Clinical Science, University of London, London, UK; 2Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Ciber de Enfermedades Respiratorias, Barcelona, Spain; 3Department of Primary Care, University Medical Centre Groningen, Groningen, The Netherlands; 4Novartis Pharma AG, Basel, SwitzerlandAbstract: Patients with chronic obstructive pulmonary disease (COPD present with a variety of symptoms and pathological consequences. Although primarily viewed as a respiratory disease, COPD has both pulmonary and extrapulmonary effects, which have an impact on many aspects of physical, emotional, and mental well-being. Traditional assessment of COPD relies heavily on measuring lung function, specifically forced expiratory volume in 1 second (FEV1. However, the evidence suggests that FEV1 is a relatively poor correlate of symptoms such as breathlessness and the impact of COPD on daily life. Furthermore, many consequences of the disease, including anxiety and depression and the ability to perform daily activities, can only be described and reported reliably by the patient. Thus, in order to provide a comprehensive view of the effects of interventions in clinical trials, it is essential that spirometry is accompanied by assessments using patient-reported outcome (PRO instruments. We provide an overview of patient-reported outcome concepts in COPD, such as breathlessness, physical functioning, and health status, and evaluate the tools used for measuring these concepts. Particular attention is given to the newly developed instruments emerging in response to recent regulatory guidelines for the development and use of PROs in clinical trials. We conclude that although data from the development and validation of these new PRO instruments are emerging, to build the body of evidence that supports the use of a new instrument takes many years. Furthermore, new

  20. Psychometric validation of patient-reported outcome measures assessing chronic constipation

    Directory of Open Access Journals (Sweden)

    Nelson LM

    2014-09-01

    Full Text Available Lauren M Nelson,1 Valerie SL Williams,1 Sheri E Fehnel,1 Robyn T Carson,2 James MacDougall,3 Mollie J Baird,3 Stavros Tourkodimitris,2 Caroline B Kurtz,3 Jeffrey M Johnston31RTI Health Solutions, Durham, NC, USA; 2Forest Research Institute, Jersey City, NJ, USA; 3Ironwood Pharmaceuticals, Cambridge, MA, USABackground: Measures assessing treatment outcomes in previous CC clinical trials have not met the requirements described in the US Food and Drug Administration's guidance on patient-reported outcomes.Aim: Psychometric analyses using data from one Phase IIb study and two Phase III trials of linaclotide for the treatment of chronic constipation (CC were conducted to document the measurement properties of patient-reported CC Symptom Severity Measures.Study methods: Each study had a multicenter, randomized, double-blind, placebo-controlled, parallel-group design, comparing placebo to four doses of oral linaclotide taken once daily for 4 weeks in the Phase IIb dose-ranging study (n=307 and to two doses of linaclotide taken once daily for 12 weeks in the Phase III trials (n=1,272. The CC Symptom Severity Measures addressing bowel function (Bowel Movement Frequency, Stool Consistency, Straining and abdominal symptoms (Bloating, Abdominal Discomfort, Abdominal Pain were administered daily using interactive voice-response system technology. Intraclass correlations, Pearson correlations, factor analyses, F-tests, and effect sizes were computed.Results: The CC Symptom Severity Measures demonstrated satisfactory test–retest reliability and construct validity. Factor analyses indicated one factor for abdominal symptoms and another for bowel symptoms. Known-groups F-tests substantiated the discriminating ability of the CC Symptom Severity Measures. Responsiveness statistics were moderate to strong, indicating that these measures are capable of detecting change.Conclusion: In large studies of CC patients, linaclotide significantly improved abdominal and

  1. Financial Hardship and Patient-Reported Outcomes after Hematopoietic Cell Transplantation

    Science.gov (United States)

    Abel, Gregory A.; Albelda, Randy; Khera, Nandita; Hahn, Theresa; Salas Coronado, Diana Y.; Odejide, Oreofe O.; Bona, Kira; Tucker-Seeley, Reginald; Soiffer, Robert

    2016-01-01

    Although hematopoietic cell transplantation (HCT) is the only curative therapy for many advanced hematologic cancers, little is known about the financial hardship experienced by HCT patients, nor the association of hardship with patient-reported outcomes. We mailed a 43-item survey to adult patients approximately 180 days post first autologous or allogeneic HCT at three high-volume centers. We assessed decreases in household income, difficulty with HCT-related costs such as need to relocate or travel, and two types of hardship: “hardship_1” (reporting one or two of the following: dissatisfaction with present finances, difficulty meeting monthly bill payments, or not having enough money at the end of the month), and “hardship_2” (reporting all three). Patient-reported stress was measured with the Perceived Stress Scale (PSS-4), and seven-point scales were provided for perceptions of overall quality of life (QOL) and health. 325 of 499 surveys (65.1%) were received. The median days since HCT was 173; 47% underwent an allogeneic HCT, 60% were male, 51% were > 60 years old, and 92% were white. Overall, 46% reported income decline post-HCT, 56% reported “hardship_1” and 15% “hardship 2.” In multivariable models controlling for income, those reporting difficulty paying for HCT-related costs were more likely to report financial hardship (OR 6.9 [3.8, 12.3]). “Hardship_1” was associated with QOL below the median (OR 2.9 [1.7, 4.9]), health status below the median (OR 2.2 [1.3, 3.6]), and stress above the median (OR 2.1 [1.3, 3.5]). In this sizable cohort of HCT patients, financial hardship was prevalent, and associated with worse QOL and higher levels of perceived stress. Interventions to address patient financial hardship—especially those that ameliorate HCT-specific costs—are likely to improve patient-reported outcomes. PMID:27184627

  2. Financial Hardship and Patient-Reported Outcomes after Hematopoietic Cell Transplantation.

    Science.gov (United States)

    Abel, Gregory A; Albelda, Randy; Khera, Nandita; Hahn, Theresa; Salas Coronado, Diana Y; Odejide, Oreofe O; Bona, Kira; Tucker-Seeley, Reginald; Soiffer, Robert

    2016-08-01

    Although hematopoietic cell transplantation (HCT) is the only curative therapy for many advanced hematologic cancers, little is known about the financial hardship experienced by HCT patients nor the association of hardship with patient-reported outcomes. We mailed a 43-item survey to adult patients approximately 180 days after their first autologous or allogeneic HCT at 3 high-volume centers. We assessed decreases in household income; difficulty with HCT-related costs, such as need to relocate or travel; and 2 types of hardship: hardship_1 (reporting 1 or 2 of the following: dissatisfaction with present finances, difficulty meeting monthly bill payments, or not having enough money at the end of the month) and "hardship_2" (reporting all 3). Patient-reported stress was measured with the Perceived Stress Scale-4, and 7-point scales were provided for perceptions of overall quality of life (QOL) and health. In total, 325 of 499 surveys (65.1%) were received. The median days since HCT was 173; 47% underwent an allogeneic HCT, 60% were male, 51% were > 60 years old, and 92% were white. Overall, 46% reported income decline after HCT, 56% reported hardship_1, and 15% reported hardship_2. In multivariable models controlling for income, those reporting difficulty paying for HCT-related costs were more likely to report financial hardship (odds ratio, 6.9; 95% confidence interval, 3.8 to 12.3). Hardship_1 was associated with QOL below the median (odds ratio, 2.9; 95% confidence interval, 1.7 to 4.9), health status below the median (odds ratio, 2.2; 95% confidence interval, 1.3 to 3.6), and stress above the median (odds ratio, 2.1; 95% confidence interval, 1.3 to 3.5). In this sizable cohort of HCT patients, financial hardship was prevalent and associated with worse QOL and higher levels of perceived stress. Interventions to address patient financial hardship-especially those that ameliorate HCT-specific costs-are likely to improve patient-reported outcomes. Copyright © 2016

  3. Measuring urban tree loss dynamics across residential landscapes.

    Science.gov (United States)

    Ossola, Alessandro; Hopton, Matthew E

    2018-01-15

    The spatial arrangement of urban vegetation depends on urban morphology and socio-economic settings. Urban vegetation changes over time because of human management. Urban trees are removed due to hazard prevention or aesthetic preferences. Previous research attributed tree loss to decreases in canopy cover. However, this provides little information about location and structural characteristics of trees lost, as well as environmental and social factors affecting tree loss dynamics. This is particularly relevant in residential landscapes where access to residential parcels for field surveys is limited. We tested whether multi-temporal airborne LiDAR and multi-spectral imagery collected at a 5-year interval can be used to investigate urban tree loss dynamics across residential landscapes in Denver, CO and Milwaukee, WI, covering 400,705 residential parcels in 444 census tracts. Position and stem height of trees lost were extracted from canopy height models calculated as the difference between final (year 5) and initial (year 0) vegetation height derived from LiDAR. Multivariate regression models were used to predict number and height of tree stems lost in residential parcels in each census tract based on urban morphological and socio-economic variables. A total of 28,427 stems were lost from residential parcels in Denver and Milwaukee over 5years. Overall, 7% of residential parcels lost one stem, averaging 90.87 stems per km 2 . Average stem height was 10.16m, though trees lost in Denver were taller compared to Milwaukee. The number of stems lost was higher in neighborhoods with higher canopy cover and developed before the 1970s. However, socio-economic characteristics had little effect on tree loss dynamics. The study provides a simple method for measuring urban tree loss dynamics within and across entire cities, and represents a further step toward high resolution assessments of the three-dimensional change of urban vegetation at large spatial scales. Published by

  4. The height of the atmospheric boundary layer during unstable conditions

    Energy Technology Data Exchange (ETDEWEB)

    Gryning, S.E.

    2005-11-01

    The height of the convective atmospheric boundary layer, also called the mixed-layer, is one of the fundamental parameters that characterise the structure of the atmosphere near the ground. It has many theoretical and practical applications such as the prediction of air pollution concentrations, surface temperature and the scaling of turbulence. However, as pointed out by Builtjes (2001) in a review paper on Major Twentieth Century Milestones in Air Pollution Modelling and Its Application, the weakest point in meteorology data is still the determination of the height of the mixed-layer, the so-called mixing height. A simple applied model for the height of the mixed-layer over homogeneous terrain is suggested in chapter 2. It is based on a parameterised budget for the turbulent kinetic energy. In the model basically three terms - the spin-up term and the production of mechanical and convective turbulent kinetic energy - control the growth of the mixed layer. The interplay between the three terms is related to the meteorological conditions and the height of the mixed layer. A stable layer, the so-called entrainment zone, which is confined between the mixed layer and the free air above, caps the mixed layer. A parameterisation of the depth of the entrainment zone is also suggested, and used to devise a combined model for the height of the mixed layer and the entrainment zone. Another important aspect of the mixed layer development exists in coastal areas where an internal boundary layer forms downwind from the coastline. A model for the growth of the internal boundary layer is developed in analogy with the model for mixed layer development over homogeneous terrain. The strength of this model is that it can operate on a very fine spatial resolution with minor computer resources. Chapter 3 deals with the validation of the models. It is based in parts on data from the literature, and on own measurements. For the validation of the formation of the internal boundary layer

  5. Help! It's Hair Loss!

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Hair Loss KidsHealth / For Kids / Hair Loss What's in this ... head are in the resting phase. What Causes Hair Loss? Men, especially older men, are the ones who ...

  6. Proven Weight Loss Methods

    Science.gov (United States)

    Fact Sheet Proven Weight Loss Methods What can weight loss do for you? Losing weight can improve your health in a number of ways. It can lower ... at www.hormone.org/Spanish . Proven Weight Loss Methods Fact Sheet www.hormone.org

  7. Patient reported allergies are a risk factor for poor outcomes in total hip and knee arthroplasty.

    Science.gov (United States)

    Graves, Christopher M; Otero, Jesse E; Gao, Yubo; Goetz, Devon D; Willenborg, Melissa D; Callaghan, John J

    2014-09-01

    We evaluated 459 patients undergoing THA or TKA who completed preoperative and postoperative WOMAC and/or SF36 surveys. Medical comorbidities and reported allergies were also recorded. Evaluation of surveys was compared for patients with or without 4 or more reported allergies using statistical methods. Patients with 4 or more reported allergies had less improvement on SF36 Physical Component Score (∆PCS=4.2) than those with 0-3 allergies (∆PCS=10.0, P=0.0002). Regression analysis showed that this change was independent of self-reported comorbidities. Patients reporting 4 or more allergies also had less improvement in WOMAC function (∆F=21.4) than those with 0-3 allergies (∆F = 27.2, P=0.036). Similar nonsignificant trends occurred in SF36 mental and WOMAC pain and stiffness scores. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Feasibility of the collection of patient-reported outcomes in an ambulatory neurology clinic.

    Science.gov (United States)

    Moura, Lidia M V R; Schwamm, Eli; Moura Junior, Valdery; Seitz, Michael P; Hsu, John; Cole, Andrew J; Schwamm, Lee H

    2016-12-06

    To determine whether patients could self-report physical and mental health assessments in the waiting room and whether these assessments would be associated with modified Rankin Scale (mRS) and Quality of Life in Epilepsy (QOLIE-10) scores. We offered iPad-based surveys to consecutive adult neurology patients at check-in to collect patient-reported outcome measures (PROMs). We collected demographic and clinical data on 6,075 patients through survey or administrative claims and PROMs from participating patients. We compared demographic characteristics of participants and nonparticipants and tested associations between physical and mental health scores and mRS and QOLIE-10. Of 6,075 patients seen by neurologists during the study period, 2,992 (49.3%) participated in the survey. Compared to nonparticipating patients, participating patients more often were privately insured (53.5% vs 42.7%, p neurology (nonsubspecialty) clinics (53.1% vs 46.6%, p Neurology.

  9. Development of a patient-reported outcome instrument for patients with lumbar radicular pain

    DEFF Research Database (Denmark)

    Ibsen, Charlotte; Schiøttz-Christensen, Berit; Nielsen, Claus Vinther

    Background: Low back pain (LBP) is the leading contributor to years lived with disability. It is a complex biopsychosocial phenomenon where complete differential diagnosis and assessment is difficult and needs to be comprehensive. Therefore a biopsychosocial approach is recommended. Substantial...... pain. Methods: The development of the PRO will be based on ICF Comprehensive Core Set for Low Back Pain and Rehabilitation Set and existing items from the The Patient-Reported Outcomes Measurement Information System (PROMIS®). The development process will be divided into five steps: 1. Linking PROMIS....... Conclusion(s) : A PRO instrument is developed to systematise and qualify the description on functioning among patients with lumbar radicular pain. The development process is in progress and next step is to engage patients and clinicians in the development process.  Implications : With development of this PRO...

  10. Patient-reported causes of heart failure in a large European sample

    DEFF Research Database (Denmark)

    Timmermans, Ivy; Denollet, Johan; Pedersen, Susanne S.

    2018-01-01

    ), psychosocial (35%, mainly (work-related) stress), and natural causes (32%, mainly heredity). There were socio-demographic, clinical and psychological group differences between the various categories, and large discrepancies between prevalence of physical risk factors according to medical records and patient...... distress (OR = 1.54, 95% CI = 0.94–2.51, p = 0.09), and behavioral causes and a less threatening view of heart failure (OR = 0.64, 95% CI = 0.40–1.01, p = 0.06). Conclusion: European patients most frequently reported comorbidities, smoking, stress, and heredity as heart failure causes, but their causal......Background: Patients diagnosed with chronic diseases develop perceptions about their disease and its causes, which may influence health behavior and emotional well-being. This is the first study to examine patient-reported causes and their correlates in patients with heart failure. Methods...

  11. Emerging good practices for Translatability Assessment (TA) of Patient-Reported Outcome (PRO) measures.

    Science.gov (United States)

    Acquadro, Catherine; Patrick, Donald L; Eremenco, Sonya; Martin, Mona L; Kuliś, Dagmara; Correia, Helena; Conway, Katrin

    2017-01-01

    This paper presents emerging Good Practices for Translatability Assessment (TA) of Patient-Reported Outcome (PRO) Measures. The ISOQOL Translation and Cultural Adaptation Special Interest Group (TCA-SIG) undertook the review of several TA approaches, with the collaboration of organizations who are involved in conducting TA, and members of the TCA-SIG. The effort led to agreement by the writing group on Good Practices for 1) the terminology to be used in referring to translatability process, 2) the best definition of TA, 3) the methodology that is recommended at each step of the process, 4) the persons involved in TA, 5) the timing of assessment, 6) the review criteria for TA, and 7) the recommendations to be made at the end of the TA process. With input from the TCA-SIG membership and in consultation with experts in the field, these emerging good practices can guide the future use of TA in the development of PROs.

  12. Patient reported outcomes in patients undergoing arthroscopic partial meniscectomy for traumatic or degenerative meniscal tears

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Englund, Martin; Christensen, Robin

    2017-01-01

    OBJECTIVES: To compare patient reported outcomes from before surgery to 52 weeks after surgery between individuals undergoing arthroscopic partial meniscectomy for traumatic meniscal tears and those for degenerative meniscal tears. DESIGN: Comparative prospective cohort study. SETTING: Four public......-55, and undergoing arthroscopic partial meniscectomy for a traumatic or degenerative meniscal tear (defined by a combination of age and symptom onset). INTERVENTIONS: Both participant groups underwent arthroscopic partial meniscectomy for a meniscal tear, with operating surgeons recording relevant information......% women) with a traumatic or degenerative meniscal tear (n=141, mean age 38.7 years (standard deviation 10.9); n=256, 46.6 years (6.4); respectively) were included in the main analysis. At 52 weeks after arthroscopic partial meniscectomy, 55 (14%) patients were lost to follow-up. Statistically...

  13. Patient-reported outcome and risk of revision after shoulder replacement for osteoarthritis

    DEFF Research Database (Denmark)

    Rasmussen, Jeppe V; Polk, Anne; Brorson, Stig

    2014-01-01

    PURPOSE: We used patient-reported outcome and risk of revision to compare hemiarthroplasty (HA) with total shoulder arthroplasty (TSA) and stemmed hemiarthroplasty (SHA) with resurfacing hemiarthroplasty (RHA) in patients with glenohumeral osteoarthritis. PATIENTS AND METHODS: We included all...... of presentation, the raw scores were converted to a percentage of the maximum score. Revision rates were calculated by checking reported revisions to the DSR until December 2011. WOOS and risk of revision were adjusted for age, sex, previous surgery, and type of osteoarthritis. RESULTS: There were 113 TSAs...... and 1096 HAs (837 RHAs and 259 SHAs). Patients treated with TSA generally had a better WOOS, exceeding the predefined minimal clinically important difference, at 1 year (mean difference 10, p

  14. Operation for recurrent cystocele with anterior colporrhaphy or non-absorbable mesh: patient reported outcomes

    DEFF Research Database (Denmark)

    Nüssler, Emil Karl; Greisen, Susanne; Kesmodel, Ulrik Schiøler

    2013-01-01

    Abstract INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare patient reported outcomes and complications after repair of recurrent anterior vaginal wall prolapse in routine health care settings using standard anterior colporrhaphy or non-absorbable mesh. METHODS: The study is based...... on prospective data from the Swedish National Register for Gynaecological Surgery. 286 women were operated on for recurrent anterior vaginal wall prolapse in 2008-2010; 157 women had an anterior colporrhaphy and 129 were operated on with a non-absorbable mesh. Pre-, and perioperative data were collected from...... (0.6 %) in the anterior colporrhaphy group (p = 0.58). The infection rate was higher after mesh (8.5 %) than after anterior colporrhaphy (2.5 %; OR 3.19 ; 1.07-14.25). CONCLUSION: Implantation of synthetic mesh during operation for recurrent cystocele more than doubled the cure rate, whereas...

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

    DEFF Research Database (Denmark)

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

    2018-01-01

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

  16. Establishing a Nation Wide Infrastructure for Systematic Use of Patient Reported Information.

    Science.gov (United States)

    Jensen, Sanne; Lyng, Karen Marie

    2018-01-01

    In Denmark, we have set up a program to establish a nationwide infrastructure for Patient Reported Outcome (PRO) questionnaires. The effort is divided into an IT infrastructure part and a questionnaire development part. This paper describes how development and evaluation are closely knit together in the two tracks, as complexity is high in the PRO field and IT infrastructure, legal issues, various clinical workflows and the numerous stakeholders have to be taken into account concurrently. In the design process, we have thus used a participatory design approach to ensure a high level of active stakeholder involvement and capability of addressing all the relevant issues. In the next phases, we will apply the IT infrastructure in the planned full-scale evaluation of the questionnaires developed in the first phase, while we continue to develop new national questionnaires.

  17. Utilization of patient-reported outcomes as a step towards collaborative medicine.

    Science.gov (United States)

    Blackwell, Laura S; Marciel, Kristen K; Quittner, Alexandra L

    2013-09-01

    Patient-reported outcomes (PROs) have been successfully developed for a variety of chronic respiratory diseases, such as asthma and cystic fibrosis (CF). They have recently been used to evaluate the efficacy of new medications and assess current patient functioning. Although regulatory bodies have favored PROs that measures symptoms, other domains of functioning, such as treatment burden, should be considered. This review examines current guidelines for the development and application of PROs in clinical trials, describes methods for selecting appropriate measures for paediatric populations, and presents a model incorporating PROs into clinical practice. Guidance on interpretation of these measures and graphic presentation of results are illustrated. PROs can serve as the link between the health care provider and patient to foster collaborative and personalized medicine. This model promotes greater patient responsibility, facilitates communication with providers, encourages shared decision-making, and enhances adherence. Published by Elsevier Ltd.

  18. Intercentre variance in patient reported outcomes is lower than objective rheumatoid arthritis activity measures

    DEFF Research Database (Denmark)

    Khan, Nasim Ahmed; Spencer, Horace Jack; Nikiphorou, Elena

    2017-01-01

    Objective: To assess intercentre variability in the ACR core set measures, DAS28 based on three variables (DAS28v3) and Routine Assessment of Patient Index Data 3 in a multinational study. Methods: Seven thousand and twenty-three patients were recruited (84 centres; 30 countries) using a standard...... built to adjust for the remaining ACR core set measure (for each ACR core set measure or each composite index), socio-demographics and medical characteristics. ANOVA and analysis of covariance models yielded similar results, and ANOVA tables were used to present variance attributable to recruiting...... centre. Results: The proportion of variances attributable to recruiting centre was lower for patient reported outcomes (PROs: pain, HAQ, patient global) compared with objective measures (joint counts, ESR, physician global) in all models. In the full model, variance in PROs attributable to recruiting...

  19. Case-mix & patients' reports of outcome in Independent Sector Treatment Centres: Comparison with NHS providers

    Directory of Open Access Journals (Sweden)

    van der Meulen Jan

    2008-04-01

    Full Text Available Abstract Background There has been considerable concern expressed about the outcomes achieved in Independent Sector Treatment Centres (ISTCs introduced in England since 2003. Our aim was to compare the case-mix and patients' reported outcomes of surgery in ISTCs and in NHS providers. Methods Prospective cohort study of 769 patients treated in six ISTCs and 1895 treated in 20 NHS providers (acute hospitals and treatment centres in England during 2006–07. Participants underwent one of three day surgery procedures (inguinal hernia repair, varicose vein surgery, cataract extraction or hip or knee replacement. Change in patient-reported health status and health related quality of life (measured using a disease-specific and a generic (EQ-5D instrument was assessed either 3-months (day surgery or 6-months (hip/knee after surgery. In addition patient-reported post-operative complications and an overall assessment of success of surgery were collected. Outcome measures were adjusted (using multivariable regression for patient characteristics (disease severity, duration of symptoms, age, sex, socioeconomic status, general health, previous similar surgery, comorbidity. Results Post-operative response rates varied by procedure (73%–88% and were similar for those treated in ISTCs and NHS facilities. Patients treated in ISTCs were healthier, were less likely to have any comorbidity and, for those undergoing cataract surgery or joint replacement, their primary condition was less severe. Those undergoing hernia repair or joint replacement were less likely to have had similar surgery before. When adjustment was made for pre-operative characteristics, patients undergoing cataract surgery or hip replacement in ISTCs achieved a slightly greater improvement in functional status and quality of life than those treated in NHS facilities, while the opposite was true of patients undergoing hernia repair. No significant differences were found for the two other

  20. Associations Between Relative Value Units and Patient-Reported Back Pain and Disability

    Directory of Open Access Journals (Sweden)

    Laura S. Gold PhD

    2017-01-01

    Full Text Available Objective: To describe associations between health care utilization measures and patient-reported outcomes (PROs. Method: Primary data were collected from patients ≥65 years with low back pain visits from 2011 to 2013. Six PROs of pain and functionality were collected 12 and 24 months after the index visits and total and spine-specific relative value units (RVUs from electronic health records were tabulated over 1 year. We calculated correlation coefficients between RVUs and 12- and 24-month PROs and conducted linear regressions with each 12- and 24-month PRO as the outcome variables and RVUs as predictors of interest. Results: We observed very weak correlations between worse PROs at 12 and 24 months and greater 12-month utilization. In regression analyses, we observed slight associations between greater utilization and worse 12- and 24-month PROs. Discussion: We found that 12-month health care utilization is not strongly associated with PROs at 12 or 24 months.

  1. Patient-reported outcomes in insomnia: development of a conceptual framework and endpoint model.

    Science.gov (United States)

    Kleinman, Leah; Buysse, Daniel J; Harding, Gale; Lichstein, Kenneth; Kalsekar, Anupama; Roth, Thomas

    2013-01-01

    This article describes qualitative research conducted with patients with clinical diagnoses of insomnia and focuses on the development of a conceptual framework and endpoint model that identifies a hierarchy and interrelationships of potential outcomes in insomnia research. Focus groups were convened to discuss how patients experience insomnia and to generate items for patient-reported questionnaires on insomnia and associated daytime consequences. Results for the focus group produced two conceptual frameworks: one for sleep and one for daytime impairment. Each conceptual framework consists of hypothesized domains and items in each domain based on patient language taken from the focus group. These item pools may ultimately serve as a basis to develop new questionnaires to assess insomnia.

  2. Patient-Reported Outcome and Quality of Life Instruments Database (PROQOLID: Frequently asked questions

    Directory of Open Access Journals (Sweden)

    Perrier Laure-Lou

    2005-03-01

    Full Text Available Abstract The exponential development of Patient-Reported Outcomes (PRO measures in clinical research has led to the creation of the Patient-Reported Outcome and Quality of Life Instruments Database (PROQOLID to facilitate the selection process of PRO measures in clinical research. The project was initiated by Mapi Research Trust in Lyon, France. Initially called QOLID (Quality of Life Instruments Database, the project's purpose was to provide all those involved in health care evaluation with a comprehensive and unique source of information on PRO and HRQOL measures available through the Internet. PROQOLID currently describes more than 470 PRO instruments in a structured format. It is available in two levels, non-subscribers and subscribers, at http://www.proqolid.org. The first level is free of charge and contains 14 categories of basic useful information on the instruments (e.g. author, objective, original language, list of existing translations, etc.. The second level provides significantly more information about the instruments. It includes review copies of over 350 original instruments, 120 user manuals and 350 translations. Most are available in PDF format. This level is only accessible to annual subscribers. PROQOLID is updated in close collaboration with the instruments' authors on a regular basis. Fifty or more new instruments are added to the database annually. Today, all of the major pharmaceutical companies, prestigious institutions (such as the FDA, the NIH's National Cancer Institute, the U.S. Veterans Administration, dozens of universities, public institutions and researchers subscribe to PROQOLID on a yearly basis. More than 800 users per day routinely visit the database.

  3. Patient-reported impact of spondyloarthritis on work disability and working life: the ATLANTIS survey.

    Science.gov (United States)

    Ramonda, Roberta; Marchesoni, Antonio; Carletto, Antonio; Bianchi, Gerolamo; Cutolo, Maurizio; Ferraccioli, Gianfranco; Fusaro, Enrico; De Vita, Salvatore; Galeazzi, Mauro; Gerli, Roberto; Matucci-Cerinic, Marco; Minisola, Giovanni; Montecucco, Carlomaurizio; Pellerito, Raffaele; Salaffi, Fausto; Paolazzi, Giuseppe; Sarzi-Puttini, Piercarlo; Scarpa, Raffaele; Bagnato, Gianfilippo; Triolo, Giovanni; Valesini, Guido; Punzi, Leonardo; Olivieri, Ignazio

    2016-04-01

    The aim was to establish how patients experience the impact of spondyloarthritis (SpA) on work disability and working life. The survey was performed in 17/20 regions in Italy (1 January to 31 March 2013). A multiple-choice questionnaire was published on the official website of the sponsor - the National Association of Rheumatic Patients (ANMAR) - and hard-copies were distributed at outpatient clinics for rheumatic patients. Respondents (n = 770) were of both sexes (56 % men), educated (62 % at high school or more), of working age (75 % aged ≤60 years), and affected by SpA. The most common types diagnosed were ankylosing spondylitis (AS) (39 %) and psoriatic arthritis (PsA) (36 %). Respondents were working full-time (45 %), part-time (8 %) or had retired (22 %); 15 % were unemployed (for reasons linked to the disease or for other reasons, students or housewives). Patients reported disability (39 %), were receiving disability benefits (34 %), were experiencing important limitations that were hindering their professional development/career (36 %) and some had to change/leave their job or lost it because of SpA (21 %). Employed respondents (n = 383) had worked on average 32.2 h in the last 7 days. More hours of work were lost over the last 7 days due to SpA (2.39 h vs 1.67 h). The indirect costs of the disease amounted to €106/week for patients reporting well-being/good physical conditions/improvement and €216/week for those reporting permanent impairment. Most patients were in the midst of their productive years and were experiencing considerable difficulties in carrying out their job because of the disease: half of them reported disability and one third were experiencing important limitations in their career perspective.

  4. Electronic patient-reported data capture as a foundation of rapid learning cancer care.

    Science.gov (United States)

    Abernethy, Amy P; Ahmad, Asif; Zafar, S Yousuf; Wheeler, Jane L; Reese, Jennifer Barsky; Lyerly, H Kim

    2010-06-01

    "Rapid learning healthcare" presents a new infrastructure to support comparative effectiveness research. By leveraging heterogeneous datasets (eg, clinical, administrative, genomic, registry, and research), health information technology, and sophisticated iterative analyses, rapid learning healthcare provides a real-time framework in which clinical studies can evaluate the relative impact of therapeutic approaches on a diverse array of measures. This article describes an effort, at 1 academic medical center, to demonstrate what rapid learning healthcare might look like in operation. The article describes the process of developing and testing the components of this new model of integrated clinical/research function, with the pilot site being an academic oncology clinic and with electronic patient-reported outcomes (ePROs) being the foundational dataset. Steps included: feasibility study of the ePRO system; validation study of ePRO collection across 3 cancers; linking ePRO and other datasets; implementation; stakeholder alignment and buy in, and; demonstration through use cases. Two use cases are presented; participants were metastatic breast cancer (n = 65) and gastrointestinal cancer (n = 113) patients at 2 academic medical centers. (1) Patient-reported symptom data were collected with tablet computers; patients with breast and gastrointestinal cancer indicated high levels of sexual distress, which prompted multidisciplinary response, design of an intervention, and successful application for funding to study the intervention's impact. (2) The system evaluated the longitudinal impact of a psychosocial care program provided to patients with breast cancer. Participants used tablet computers to complete PRO surveys; data indicated significant impact on psychosocial outcomes, notably distress and despair, despite advanced disease. Results return to the clinic, allowing iterative update and evaluation. An ePRO-based rapid learning cancer clinic is feasible, providing

  5. Mining telemonitored physiological data and patient-reported outcomes of congestive heart failure patients.

    Science.gov (United States)

    Mlakar, Miha; Puddu, Paolo Emilio; Somrak, Maja; Bonfiglio, Silvio; Luštrek, Mitja

    2018-01-01

    This paper addresses patient-reported outcomes (PROs) and telemonitoring in congestive heart failure (CHF), both increasingly important topics. The interest in CHF trials is shifting from hard end-points such as hospitalization and mortality, to softer end-points such health-related quality of life. However, the relation of these softer end-points to objective parameters is not well studied. Telemonitoring is suitable for collecting both patient-reported outcomes and objective parameters. Most telemonitoring studies, however, do not take full advantage of the available sensor technology and intelligent data analysis. The Chiron clinical observational study was performed among 24 CHF patients (17 men and 7 women, age 62.9 ± 9.4 years, 15 NYHA class II and 9 class III, 10 of ishaemic, aetiology, 6 dilated, 2 valvular, and 6 of multiple aetiologies or cardiomyopathy) in Italy and UK. A large number of physiological and ambient parameters were collected by wearable and other devices, together with PROs describing how well the patients felt, over 1,086 days of observation. The resulting data were mined for relations between the objective parameters and the PROs. The objective parameters (humidity, ambient temperature, blood pressure, SpO2, and sweeting intensity) could predict the PROs with accuracies up to 86% and AUC up to 0.83, making this the first report providing evidence for ambient and physiological parameters to be objectively related to PROs in CHF patients. We also analyzed the relations in the predictive models, gaining some insights into what affects the feeling of health, which was also generally not attempted in previous investigations. The paper strongly points to the possibility of using PROs as primary end-points in future trials.

  6. The PU-PROM: A patient-reported outcome measure for peptic ulcer disease.

    Science.gov (United States)

    Liu, Na; Lv, Jing; Liu, Jinchun; Zhang, Yanbo

    2017-12-01

    Patient-reported outcome measure (PROM) conceived to enable description of treatment-related effects, from the patient perspective, bring the potential to improve in clinical research, and to provide patients with accurate information. Therefore, the aim of this study was to develop a patient-centred peptic ulcer patient-reported outcome measure (PU-PROM) and evaluate its reliability, validity, differential item functioning (DIF) and feasibility. To develop a conceptual framework and item pool for the PU-PROM, we performed a literature review and consulted other measures created in China and other countries. Beyond that, we interviewed 10 patients with peptic ulcers, and consulted six key experts to ensure that all germane parameters were included. In the first item selection phase, classical test theory and item response theory were used to select and adjust items to shape the preliminary measure completed by 130 patients and 50 controls. In the next phase, the measure was evaluated used the same methods with 492 patients and 124 controls. Finally, we used the same population in the second item reselection to assess the reliability, validity, DIF and feasibility of the final measure. The final peptic ulcer PRO measure comprised four domains (physiology, psychology, society and treatment), with 11 subdomains, and 54 items. The Cronbach's α coefficient of each subdomain for the measure was >0.800. Confirmatory factory analysis indicated that the construct validity fulfilled expectations. Model fit indices, such as RMR, RMSEA, NFI, NNFI, CFI and IFI, showed acceptable fit. The measure showed a good response rate. The peptic ulcer PRO measure had good reliability, validity, DIF and feasibility, and can be used as a clinical research evaluation instrument with patients with peptic ulcers to assess their condition focus on treatment. This measure may also be applied in other health areas, especially in clinical trials of new drugs, and may be helpful in clinical

  7. Prospective analysis of patient-reported late toxicity following pelvic radiotherapy for gynaecological cancer

    International Nuclear Information System (INIS)

    Barraclough, Lisa H.; Routledge, Jacqueline A.; Farnell, Damian J.J.; Burns, Meriel P.; Swindell, Ric; Livsey, Jacqueline E.; Davidson, Susan E.

    2012-01-01

    Background and purpose: As late radiotherapy toxicity impacts negatively on the quality-of-life of cancer survivors and is often under reported, a study was set up to prospectively collect patient-reported data in an unselected series of patients with gynaecological malignancy. Aim 1 – To provide 3 year results for the longitudinal study. Aim 2 – To improve the questionnaire used to collect data by identifying redundant items and modifying for use to collect Common Terminology Criteria for Adverse Events (CTCAE) data. Material and methods: Aim 1 – Patient reported outcome data were collected prospectively by 226 patients before and up to 3 years following radiotherapy for gynaecological cancer using a questionnaire developed to collect LENT subjective data. Aim 2 – A factor analysis was performed to identify which questions gave the most and least information. Results: Aim 1 – Faecal urgency and incontinence (all grades) peaked at 79% and 24%, respectively at 1 year then settled to 69% and 18% at 3 years, respectively. Urinary urgency (all grades) increased with time and was described in 75% at 3 years. Other symptoms reported at 3 years include diarrhoea in 12%, urinary incontinence in 27% and vaginal dryness in 29%. A third of patients did not feel their sex life had changed following treatment, while a quarter felt that it had. Aim 2 – some questions overlapped and others were non-specific. The questionnaire has subsequently been altered. Conclusions: The extent of late toxicity is substantial. This detailed information is important for both patients and clinicians in terms of treatment decisions and follow-up care. The LENT questionnaire provides a feasible tool for capture of this information in the clinic.

  8. Quality of life and urolithiasis: the patient - reported outcomes measurement information system (PROMIS

    Directory of Open Access Journals (Sweden)

    Nishant Patel

    Full Text Available ABSTRACT Background: With a high rate of recurrence, urolithiasis is a chronic disease that impacts quality of life. The Patient Reported Outcomes Measurement Information System is an NIH validated questionnaire to assess patient quality of life. We evaluated the impact of urolithiasis on quality of life using the NIH-sponsored PROMIS-43 questionnaire. Materials and Methods: Patients reporting to the kidney stone clinic were interviewed to collect information on stone history and demographic information and were asked to complete the PROMIS-43 questionnaire. Quality of life scores were analyzed using gender and age matched groups for the general US population. Statistical comparisons were made based on demographic information and patient stone history. Statistical significance was P<0.05. Results: 103 patients completed the survey. 36% of respondents were male, the average age of the group was 52 years old, with 58% primary income earners, and 35% primary caregivers. 7% had never passed a stone or had a procedure while 17% passed 10 or more stones in their lifetime. Overall, pain and physical function were worse in patients with urolithiasis. Primary income earners had better quality of life while primary caregivers and those with other chronic medical conditions were worse. Patients on dietary and medical therapy had better quality of life scores. Conclusions: Urolithiasis patients subjectively have worse pain and physical function than the general population. The impact of pain on quality of life was greatest in those patients who had more stone episodes, underscoring the importance of preventive measures. Stone prevention measures improve quality of life.

  9. OMERACT Endorsement of Patient-reported Outcome Instruments in Antineutrophil Cytoplasmic Antibody–associated Vasculitis

    Science.gov (United States)

    Robson, Joanna C.; Tomasson, Gunnar; Milman, Nataliya; Ashdown, Sue; Boonen, Annelies; Casey, George C.; Cronholm, Peter F.; Cuthbertson, David; Dawson, Jill; Direskeneli, Haner; Easley, Ebony; Kermani, Tanaz A.; Farrar, John T.; Gebhart, Don; Lanier, Georgia; Luqmani, Raashid A.; Mahr, Alfred; McAlear, Carol A.; Peck, Jacqueline; Shea, Beverley; Shea, Judy A.; Sreih, Antoine G.; Tugwell, Peter S.; Merkel, Peter A.

    2018-01-01

    Objective The antineutrophil cytoplasmic antibody–associated vasculitides (AAV) are multiorgan diseases. Patients with AAV report impairment in their health-related quality of life (HRQOL) and have different priorities regarding disease assessment compared with physicians. The Outcome Measures in Rheumatology (OMERACT) Vasculitis Working Group previously received endorsement for a core set of domains in AAV. Two approaches to measure patient-reported outcomes (PRO) were presented at OMERACT 2016. Methods A novel 5-step tool was used to facilitate assessment of the instruments by delegates: the OMERACT Filter 2.0 Instrument Selection Algorithm, with a red-amber-green checklist of questions, including (1) good match with domain (face and content validity), (2) feasibility, (3) do numeric scores make sense (construct validity)?, (4) overall ratings of discrimination, and (5) can individual thresholds of meaning be defined? Delegates gave an overall endorsement. Three generic Patient-Reported Outcomes Measurement Information System (PROMIS) instruments (fatigue, physical functioning, and pain interference) and a disease-specific PRO, the AAV-PRO (6 domains related to symptoms and HRQOL), were presented. Results OMERACT delegates endorsed the use of the PROMIS instruments for fatigue, physical functioning, and pain interference (87.6% overall endorsement) and the disease-specific AAV-PRO instrument (89.4% overall endorsement). Conclusion The OMERACT Vasculitis Working Group gained endorsement by OMERACT for use of the PROMIS and the AAV-PRO in clinical trials of vasculitis. These instruments are complementary to each other. The PROMIS and the AAV-PRO need further work to assess their utility in longitudinal settings, including their ability to discriminate between treatments of varying efficacy in the setting of a randomized controlled trial. PMID:28864650

  10. Measuring the quality of patient-centered care: why patient-reported measures are critical to reliable assessment

    Directory of Open Access Journals (Sweden)

    Tzelepis F

    2015-06-01

    Full Text Available Flora Tzelepis, Robert W Sanson-Fisher, Alison C Zucca, Elizabeth A FradgleyPriority Research Centre for Health Behaviour, University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, AustraliaPurpose: The Institute of Medicine (IOM identified patient-centeredness as crucial to quality health care. The IOM endorsed six patient-centeredness dimensions that stipulated that care must be: respectful to patients’ values, preferences, and expressed needs; coordinated and integrated; provide information, communication, and education; ensure physical comfort; provide emotional support; and involve family and friends. Patient-reported measures examine the patient’s perspective and are essential to the accurate assessment of patient-centered care. This article’s objectives are to: 1 use the six IOM-endorsed patient-centeredness dimensions as a framework to outline why patient-reported measures are crucial to the reliable measurement of patient-centered care; and 2 to identify existing patient-reported measures that assess each patient-centered care dimension.Methods: For each IOM-endorsed patient-centeredness dimension, the published literature was searched to highlight the essential role of patients in assessing patient-centered care and informing quality improvement efforts. Existing literature was also searched to identify examples of patient-reported measures that assess each patient-centeredness dimension.Conclusion: Patient-reported measures are arguably the best way to measure patient-centeredness. For instance, patients are best positioned to determine whether care aligns with patient values, preferences, and needs and the Measure of Patient Preferences is an example of a patient-reported measure that does so. Furthermore, only the patient knows whether they received the level of information desired, and if information was understood and can be recalled. Patient-reported measures that examine information provision include

  11. Baldcypress Height-Diamter Equations and Their Prediction Confindence Intervals

    Science.gov (United States)

    Bernard R. Parresol

    1992-01-01

    Height-diameter relationships are an important component in yield estimation, stand description, and damage appraisals. A nonlinear exponential function used extensively in the northwest United States was chosen for bald cypress (Taxodium distichum (L.) Rich.). Homogeneity and normality of residuals were examined, and the function as well as the...

  12. Parturient symphysio-fundal height and abdominal girth ...

    African Journals Online (AJOL)

    Birth weight is known to influence morbidity and mortality. Simple measures to predict birth weight before delivery would therefore be useful in order to plan a delivery. Maternal parturient symphysio-fundal height has been used to detect Low Birth Weight. This study aims at predicting the fetal weight using the maternal ...

  13. Jump Shrug Height and Landing Forces Across Various Loads.

    Science.gov (United States)

    Suchomel, Timothy J; Taber, Christopher B; Wright, Glenn A

    2016-01-01

    The purpose of this study was to examine the effect that load has on the mechanics of the jump shrug. Fifteen track and field and club/intramural athletes (age 21.7 ± 1.3 y, height 180.9 ± 6.6 cm, body mass 84.7 ± 13.2 kg, 1-repetition-maximum (1RM) hang power clean 109.1 ± 17.2 kg) performed repetitions of the jump shrug at 30%, 45%, 65%, and 80% of their 1RM hang power clean. Jump height, peak landing force, and potential energy of the system at jump-shrug apex were compared between loads using a series of 1-way repeated-measures ANOVAs. Statistical differences in jump height (P .05). The greatest magnitudes of jump height, peak landing force, and potential energy of the system at the apex of the jump shrug occurred at 30% 1RM hang power clean and decreased as the external load increased from 45% to 80% 1RM hang power clean. Relationships between peak landing force and potential energy of the system at jump-shrug apex indicate that the landing forces produced during the jump shrug may be due to the landing strategy used by the athletes, especially at lighter loads. Practitioners may prescribe heavier loads during the jump-shrug exercise without viewing landing force as a potential limitation.

  14. The association between Helicobacter pylori infection and adult height

    International Nuclear Information System (INIS)

    Moayyedi, Paul; Forman, David; Duffett, Sara; Mason, Su; Brown, Julia; Crocombe, Will; Feltbower, Richard; Axon, Anthony

    2005-01-01

    Objectives: A cross-sectional survey was performed to evaluate the association between H. pylori and adult height. Methods: H. pylori infection was assessed using a 13 C-urea breath test and height measured by a research nurse using a stadiometer in participants between the ages of 40-49 years. Results: Height was measured in 2932/3682 participants that attended and were evaluable. H. pylori infected women were 1.4 cm shorter than uninfected women (95% confidence interval, CI=0.7-2.1 cm) and this statistically significant difference persisted after adjusting for age, ethnicity, childhood and present socio-economic status (H. pylori positives 0.79 cm shorter; 95%CI: 0.05-1.52 cm). H. pylori positive men were 0.7 cm shorter than uninfected men but this did not reach statistical significance (95% CI: -0.1-1.5 cm). Conclusion: Although H. pylori infection is associated with reduced adult height in women, this maybe due to residual confounding

  15. Estimates of forest canopy height and aboveground biomass using ICESat.

    Science.gov (United States)

    Michael A. Lefsky; David J. Harding; Michael Keller; Warren B. Cohen; Claudia C. Carabajal; Fernando Del Bom; Maria O. Hunter; Raimundo Jr. de Oliveira

    2005-01-01

    Exchange of carbon between forests and the atmosphere is a vital component of the global carbon cycle. Satellite laser altimetry has a unique capability for estimating forest canopy height, which has a direct and increasingly well understood relationship to aboveground carbon storage. While the Geoscience Laser Altimeter System (GLAS) onboard the Ice, Cloud and land...

  16. stem and standing heights in bantu and white south africans

    African Journals Online (AJOL)

    1971-05-29

    May 29, 1971 ... Sitting and standing heights have been recorded for Bantu and Whites, males and females. It !Vas found that Bantu males and females have relatively longer lower extremities than White South African males and females. Anthropo- metric differences account for only about 15% of the actual observed ...

  17. Tree height integrated into pantropical forest biomass estimates

    NARCIS (Netherlands)

    Feldpausch, T.R.; Lloyd, J.; Lewis, S.L.; Brienen, R.J.W.; Gloor, M.; Montegudo Mendoza, A.; Arets, E.J.M.M.

    2012-01-01

    Aboveground tropical tree biomass and carbon storage estimates commonly ignore tree height (H). We estimate the effect of incorporating H on tropics-wide forest biomass estimates in 327 plots across four continents using 42 656 H and diameter measurements and harvested trees from 20 sites to answer

  18. Output pulse height distribution of the GM counters

    International Nuclear Information System (INIS)

    Zhang Songshou; Xiong Jianping

    1995-01-01

    The GM counters are the radiation detectors most in use. It has special advantages compared with other detectors. This paper introduces the output pulse height distribution of the GM counters, gives the measuring instruments and methods. The measuring results, some discussions, and useful conclusion are given as well

  19. 76 FR 77696 - Establishment of the Naches Heights Viticultural Area

    Science.gov (United States)

    2011-12-14

    ... Decision. SUMMARY: This final rule establishes the 13,254-acre ``Naches Heights'' viticultural area in... origin of their wines and to allow consumers to better identify wines they may purchase. DATES: Effective... consumers to identify wines they may purchase. Establishment of a viticultural area is neither an approval...

  20. Intrapartum symphysio-fundal height measurement as a predictor of ...

    African Journals Online (AJOL)

    Background: Low birth weight (LBW) increases the risk of perinatal morbidity and mortality and of the long term neurologic and developmental disorders. Early identification of LBW is necessary to decrease complications and enhance the survival of the newborn. Aim: To determine the usefulness of symphysio-fundal height ...

  1. Many sequence variants affecting diversity of adult human height

    DEFF Research Database (Denmark)

    Gudbjartsson, Daniel F; Walters, G Bragi; Thorleifsson, Gudmar

    2008-01-01

    .3 and 0.6 cm and, taken together, they explain around 3.7% of the population variation in height. The genes neighboring the identified loci cluster in biological processes related to skeletal development and mitosis. Association to three previously reported loci are replicated in our analyses...

  2. Assortative mating for human height : A meta-analysis

    NARCIS (Netherlands)

    Stulp, Gert; Simons, Mirre J. P.; Grasman, Sara; Pollet, Thomas V.

    ObjectivesThe study of assortative mating for height has a rich history in human biology. Although the positive correlation between the stature of spouses has often been noted in western populations, recent papers suggest that mating patterns for stature are not universal. The objective of this

  3. Individual tree diameter, height, and volume functions for longleaf pine

    Science.gov (United States)

    Carlos A. Gonzalez-Benecke; Salvador A. Gezan; Timothy A. Martin; Wendell P. Cropper; Lisa J. Samuelson; Daniel J. Leduc

    2014-01-01

    Currently, little information is available to estimate individual tree attributes for longleaf pine (Pinus palustris Mill.), an important tree species of the southeastern United States. The majority of available models are local, relying on stem diameter outside bark at breast height (dbh, cm) and not including stand-level parameters. We developed...

  4. Wave Height Distribution Observed by Ships in the North Atlantic

    DEFF Research Database (Denmark)

    Olsen, Anders Smærup; Schrøter, Carsten; Jensen, Jørgen Juncher

    2005-01-01

    for the significant wave height, the relative speed and the ship heading relative to the wave direction is given. This distribution shows that for higher waves the crews avoid sailing in following sea and as expected the speed is decreased in higher waves. There is, however, still a relatively high probability...

  5. Encountered Wave Height Distributions for Ships in the North Atlantic

    DEFF Research Database (Denmark)

    Olsen, Anders Smærup; Schrøter, C.; Jensen, Jørgen Juncher

    2004-01-01

    About 20 000 observations of wave heights taken on board vessels sailing in the North Atlantic are presented. The data covers year 2002 and 2003 and stem from a variety of ship types. From the preliminary analysis of the data some conclusions are reached about the effect of weather routing whether...

  6. SYMMETRICAL (AND GENERIC) ALGORITHMS FOR HEIGHT BALANCED TREES

    NARCIS (Netherlands)

    BRON, C

    1990-01-01

    Most algorithms for height balanced trees (or AVL-trees, after Adelson-Velskii and Landis [1]) suffer from a lack of exploitation of the symmetry of balance restoring operations when insertions and deletions in such tree structures are being made. Either we find algorithms in duplicate (i.e.,

  7. Tree height-diameter allometry across the United States.

    Science.gov (United States)

    Hulshof, Catherine M; Swenson, Nathan G; Weiser, Michael D

    2015-03-01

    The relationship between tree height and diameter is fundamental in determining community and ecosystem structure as well as estimates of biomass and carbon storage. Yet our understanding of how tree allometry relates to climate and whole organismal function is limited. We used the Forest Inventory and Analysis National Program database to determine height-diameter allometries of 2,976,937 individuals of 293 tree species across the United States. The shape of the allometric relationship was determined by comparing linear and nonlinear functional forms. Mixed-effects models were used to test for allometric differences due to climate and floristic (between angiosperms and gymnosperms) and functional groups (leaf habit and shade tolerance). Tree allometry significantly differed across the United States largely because of climate. Temperature, and to some extent precipitation, in part explained tree allometric variation. The magnitude of allometric variation due to climate, however, had a phylogenetic signal. Specifically, angiosperm allometry was more sensitive to differences in temperature compared to gymnosperms. Most notably, angiosperm height was more negatively influenced by increasing temperature variability, whereas gymnosperm height was negatively influenced by decreasing precipitation and increasing altitude. There was little evidence to suggest that shade tolerance influenced tree allometry except for very shade-intolerant trees which were taller for any given diameter. Tree allometry is plastic rather than fixed and scaling parameters vary around predicted central tendencies. This allometric variation provides insight into life-history strategies, phylogenetic history, and environmental limitations at biogeographical scales.

  8. Predicting human height by Victorian and genomic methods

    NARCIS (Netherlands)

    Y.S. Aulchenko (Yurii); M.V. Struchalin (Maksim); N.M. Belonogova (Nadezhda); T.I. Axenovich (Tatiana); M.N. Weedon (Michael); A. Hofman (Albert); A.G. Uitterlinden (André); M.H. Kayser (Manfred); B.A. Oostra (Ben); P. Tikka-Kleemola (Päivi); A.C.J.W. Janssens (Cécile); P.M. Borodin (Pavel)

    2009-01-01

    textabstractIn the Victorian era, Sir Francis Galton showed that 'when dealing with the transmission of stature from parents to children, the average height of the two parents, ... is all we need care to know about them' (1886). One hundred and twenty-two years after Galton's work was published, 54

  9. Height suppression of tomato plug seedlings by an environment ...

    African Journals Online (AJOL)

    Experiments were conducted to investigate appropriate concentrations of plant growth retardants (PGRs) and duration of seed soaking in order to suppress hypocotyl length and plug seedling height of 2 tomato cultivars ( Lycopersicum esculentum Mill. cv. Seogeon and Seokwang). Daminozide (B-9), uniconazole ...

  10. Nest height of the red bishop ( Eupiectes orix ) | Woodall | African ...

    African Journals Online (AJOL)

    Heights of nests and reeds in a colony of red bishops (Euplectes orix) in Phragmites mauritianus reeds on the Makabusi River, Zimbabwe were measured in two breeding seasons. Nests were placed high in the reeds with fewer above the mean and more below the mean than in a normal distribution. During the course of a ...

  11. The role of height in the sex difference in intelligence.

    Science.gov (United States)

    Kanazawa, Satoshi; Reyniers, Diane J

    2009-01-01

    Recent studies conclude that men on average have higher intelligence than women by 3-5 IQ points. However, the ultimate evolutionary question of why men should have evolved to have higher intelligence than women remains. We suggest that men may have slightly higher intelligence than women through 4 mechanisms: (1) assortative mating of intelligent men and beautiful women, (2) assortative mating of tall men and beautiful women, (3) an extrinsic correlation between height and intelligence produced by Mechanisms 1 and 2, and (4) a higher-than-expected offspring sex ratio (more sons) among tall (and hence intelligent) parents. Consistent with our suggestion, we show that men may have higher IQs than women because they are taller, and once we control for height women have slightly higher IQs than men.The correlation between height and IQ and the female advantage in intelligence persist even after we control for health as a measure of genetic quality, as well as physical attractiveness, age, race, education, and earnings. Height is also strongly associated with intelligence within each sex.

  12. Inheritance of culm height and grain yield in durum wheat

    International Nuclear Information System (INIS)

    Filev, K.

    1984-01-01

    Results from a study of GA sensitive and GA insensitive durum wheat mutants and cultivars in relation with their culm height and 1000 grain weight are presented. With increasing culm height, the GA response also increased. A positive correlation between plant height and GA response was found. Crosses were made between durum wheats and the F 1 and F 2 progenies were analysed. A different inheritance in F 1 and segregation in F 2 was obtained in crosses of a semi-dwarf, GA insensitive [1] line with GA sensitive (S) lines differing in height, medium (93.2cm) and tall (133.5cm). In a reciprocal cross, semi-dwarf - I with medium - S, the semi-dwarf type was dominant in F 1 , suggesting that their semi-dwarfing genes were not allelic. When the semi-dwarf - I and tall - S were crossed an intermediate inheritance in F 1 was observed. In the F 2 generation from crosses semi-dwarf - I with medium - S with semi-dwarf - I, a phenotypic dihybred segregation 9:3:3:1 was observed. In crosses semi-dwarf - I with tall - S different variation curves were obtained. Semi-dwarfs with high productivity were observed in F 2 , a fact indicating that lodging resistant lines with high yields could be selected. (author)

  13. HEIGHT VARIATION OF THE VECTOR MAGNETIC FIELD IN SOLAR SPICULES

    Energy Technology Data Exchange (ETDEWEB)

    Suárez, D. Orozco; Ramos, A. Asensio; Bueno, J. Trujillo, E-mail: dorozco@iac.es [Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife (Spain)

    2015-04-20

    Proving the magnetic configuration of solar spicules has hitherto been difficult due to the lack of spatial resolution and image stability during off-limb ground-based observations. We report spectropolarimetric observations of spicules taken in the He i 1083 nm spectral region with the Tenerife Infrared Polarimeter II at the German Vacuum Tower Telescope of the Observatorio del Teide (Tenerife, Canary Islands, Spain). The data provide the variation with geometrical height of the Stokes I, Q, U, and V profiles, whose encoded information allows the determination of the magnetic field vector by means of the HAZEL inversion code. The inferred results show that the average magnetic field strength at the base of solar spicules is about 80 gauss, and then it decreases rapidly with height to about 30 gauss at a height of 3000 km above the visible solar surface. Moreover, the magnetic field vector is close to vertical at the base of the chromosphere and has mid-inclinations (about 50°) above 2 Mm height.

  14. Modular invariants for affine SU(3) theories at prime heights

    International Nuclear Information System (INIS)

    Ruelle, P.; Thiran, E.; Weyers, J.

    1990-01-01

    A proof is given for the existence of two and only two modular invariant partition functions in affine SU(3) k theories at heights n=k+3 which are prime numbers. Arithmetic properties of the ring of algabraic integers Z(ω) which is related to SU(3) weights are extensively used. (orig.)

  15. Significant wave height retrieval from synthetic radar images

    NARCIS (Netherlands)

    Wijaya, Andreas Parama; van Groesen, Embrecht W.C.

    2014-01-01

    In many offshore activities radar imagery is used to observe and predict ocean waves. An important issue in analyzing the radar images is to resolve the significant wave height. Different from 3DFFT methods that use an estimate related to the square root of the signal-to-noise ratio of radar images,

  16. A Fast Time-to-Pulse Height Converter

    Energy Technology Data Exchange (ETDEWEB)

    Aspelund, O

    1962-12-15

    A fast time-to-pulse height converter representing a development of Green and Bell's gated beam converter is described. The converter is compatible with 2 input pulses in the stop channel and exhibits excellent linearity and time resolution properties. High stability and large output pulses are obtained by using a large time constant in the converting network.

  17. An investigation of cloud base height in Chiang Mai

    Science.gov (United States)

    Peengam, S.; Tohsing, K.

    2017-09-01

    Clouds play very important role in the variation of surface solar radiation and rain formation. To understand this role, it is necessary to know the physical and geometrical of properties of cloud. However, clouds vary with location and time, which lead to a difficulty to obtain their properties. In this work, a ceilometer was installed at a station of the Royal Rainmaking and Agricultural Aviation Department in Chiang Mai (17.80° N, 98.43° E) in order to measure cloud base height. The cloud base height data from this instrument were compared with those obtained from LiDAR, a more sophisticated instrument installed at the same site. It was found that the cloud base height from both instruments was in reasonable agreement, with root mean square difference (RMSD) and mean bias difference (MBD) of 19.21% and 1.58%, respectively. Afterward, a six-month period (August, 2016-January, 2017) of data from the ceilometer was analyzed. The results show that mean cloud base height during this period is 1.5 km, meaning that most clouds are in the category of low-level cloud.

  18. The mount Cameroon height determined from ground gravity data ...

    African Journals Online (AJOL)

    Abstract This paper deals with the accurate determination of mount Cameroon orthometric height, by combining ground gravity data, global navigation satellite system (GNSS) observations and global geopotential models. The elevation of the highest point (Fako) is computed above the WGS84 reference ellipsoid.

  19. Association between height and coronary heart disease mortality

    DEFF Research Database (Denmark)

    Silventoinen, Karri; Zdravkovic, Slobodan; Skytthe, Axel

    2006-01-01

    An inverse association between height and risk of coronary heart disease (CHD) is well demonstrated, but it is not known whether this association is because of genetic factors, socioeconomic background, or other environmental factors. Four population-based twin cohorts with register-based follow...

  20. Exploring RSSI Dependency on Height in UHF for throughput optimisation

    CSIR Research Space (South Africa)

    Maliwatu, R

    2016-11-01

    Full Text Available in the area. When raised beyond 8.5 m further signal strength gain stifles, possibly due to effects of multi-path fading. The contribution of this paper is firstly, the implication of Received Signal Strength Indicator (RSSI) dependency on height and secondly...

  1. Comparative analysis of extracted heights from topographic maps ...

    African Journals Online (AJOL)

    Topographic maps represent the three-dimensional landscape by providing relief information in the form of contours in addition to plan information on which natural and man-made landmarks are quite accurately represented. Height information, extractible from topographic maps, comes in handy for most land use planning.

  2. Height-diameter allometry of tropical forest trees

    Science.gov (United States)

    T.R. Feldpausch; L. Banin; O.L. Phillips; T.R. Baker; S.L. Lewis; C.A. Quesada; K. Affum-Baffoe; E.J.M.M. Arets; N.J. Berry; M. Bird; E.S. Brondizio; P de Camargo; J. Chave; G. Djagbletey; T.F. Domingues; M. Drescher; P.M. Fearnside; M.B. Franca; N.M. Fyllas; G. Lopez-Gonzalez; A. Hladik; N. Higuchi; M.O. Hunter; Y. Iida; K.A. Salim; A.R. Kassim; M. Keller; J. Kemp; D.A. King; J.C. Lovett; B.S. Marimon; B.H. Marimon-Junior; E. Lenza; A.R. Marshall; D.J. Metcalfe; E.T.A. Mitchard; E.F. Moran; B.W. Nelson; R. Nilus; E.M. Nogueira; M. Palace; S. Patiño; K.S.-H. Peh; M.T. Raventos; J.M. Reitsma; G. Saiz; F. Schrodt; B. Sonke; H.E. Taedoumg; S. Tan; L. White; H. Woll; J. Lloyd

    2011-01-01

    Tropical tree height-diameter (H:D) relationships may vary by forest type and region making large-scale estimates of above-ground biomass subject to bias if they ignore these differences in stem allometry. We have therefore developed a new global tropical forest database consisting of 39 955 concurrent H and D measurements encompassing 283 sites in 22 tropical...

  3. Development and evaluation of weight and height reference ...

    African Journals Online (AJOL)

    While international reference standard exists, it has been suggested that locally generated norms would be more realistic and appropriate, especially in adults where great variations in stature among nations exist. This study was undertaken to develop a table of reference standard for weight and height for young adults in

  4. NASA Green Propulsion Technologies Pushing Aviation to New Heights

    Science.gov (United States)

    Free, James M.; Jennings, Francis T.; Adanich, Emery; Del Rosario, Ruben; Felder, James L.

    2014-01-01

    Center Director Free is providing the Keynote at the Disruptive Propulsion Conference, sponsored by Cranfield University, Cranfield, Bedfordshire, England in November. Director Free will be presenting a PowerPoint presentation titled, NASA Green Propulsion Technologies Pushing Aviation to New Heights at both the conference and a meeting at the Royal Aeronautical Society.

  5. Stereoscopic, thermal, and true deep cumulus cloud top heights

    Science.gov (United States)

    Llewellyn-Jones, D. T.; Corlett, G. K.; Lawrence, S. P.; Remedios, J. J.; Sherwood, S. C.; Chae, J.; Minnis, P.; McGill, M.

    2004-05-01

    We compare cloud-top height estimates from several sensors: thermal tops from GOES-8 and MODIS, stereoscopic tops from MISR, and directly measured heights from the Goddard Cloud Physics Lidar on board the ER-2, all collected during the CRYSTAL-FACE field campaign. Comparisons reveal a persistent 1-2 km underestimation of cloud-top heights by thermal imagery, even when the finite optical extinctions near cloud top and in thin overlying cirrus are taken into account. The most severe underestimates occur for the tallest clouds. The MISR "best-sinds" and lidar estimates disagree in very similar ways with thermally estimated tops, which we take as evidence of excellent performance by MISR. Encouraged by this, we use MISR to examine variations in cloud penetration and thermal top height errors in several locations of tropical deep convection over multiple seasons. The goals of this are, first, to learn how cloud penetration depends on the near-tropopause environment; and second, to gain further insight into the mysterious underestimation of tops by thermal imagery.

  6. Maternal height and child mortality in 42 developing countries.

    Science.gov (United States)

    Monden, Christiaan W S; Smits, Jeroen

    2009-01-01

    Previous research reports mixed results about the association between maternal height and child mortality. Some studies suggest that the negative association might be stronger in contexts with fewer resources. This hypothesis has yet not been tested in a cross-nationally comparative design. We use data on 307,223 children born to 194,835 women in 444 districts of 42 developing countries to estimate the association between maternal height and child mortality and test whether this association is modified by indicators at the level of the household (like sex, age and twin status of the child and socio-economic characteristics of the mother and her partner), district (regional level of development, public health facilities and female occupational attainment) and country (GDP per capita). We find a robust negative effect of logged maternal height on child mortality. The effect of maternal health is strongest for women with least education and is more important in the first year after birth and for twin births. The indicators of development at the district and country level do not modify the effect of maternal height. (c) 2008 Wiley-Liss, Inc.

  7. Reduced Height (Rht Alleles Affect Wheat Grain Quality.

    Directory of Open Access Journals (Sweden)

    Richard Casebow

    Full Text Available The effects of dwarfing alleles (reduced height, Rht in near isogenic lines on wheat grain quality are characterised in field experiments and related to effects on crop height, grain yield and GA-sensitivity. Alleles included those that conferred GA-insensitivity (Rht-B1b, Rht-B1c, Rht-D1b, Rht-D1c as well as those that retained GA-sensitivity (rht(tall, Rht8, Rht8 + Ppd-D1a, Rht12. Full characterisation was facilitated by including factors with which the effects of Rht alleles are known to interact for grain yield (i.e. system, [conventional or organic]; tillage intensity [plough-based, minimum or zero]; nitrogen fertilizer level [0-450 kg N/ha]; and genetic backgrounds varying in height [cvs Maris Huntsman, Maris Widgeon, and Mercia]. Allele effects on mean grain weight and grain specific weight were positively associated with final crop height: dwarfing reduced these quality criteria irrespective of crop management or GA-sensitivity. In all but two experiments the effects of dwarfing alleles on grain nitrogen and sulphur concentrations were closely and negatively related to effects on grain yield, e.g. a quadratic relationship between grain yield and crop height manipulated by the GA-insensitive alleles was mirrored by quadratic relationships for nitrogen and sulphur concentrations: the highest yields and most dilute concentrations occurred around 80cm. In one of the two exceptional experiments the GA-insensitive Rht-B1b and Rht-B1c significantly (P<0.05 reduced grain nitrogen concentration in the absence of an effect on yield, and in the remaining experiment the GA-sensitive Rht8 significantly reduced both grain yield and grain nitrogen concentration simultaneously. When Rht alleles diluted grain nitrogen concentration, N:S ratios and SDS-sedimentation volumes were often improved. Hagberg falling number (HFN was negatively related to crop height but benefits from dwarfing were only seen for GA-insensitive alleles. For HFN, therefore, there

  8. Reduced Height (Rht) Alleles Affect Wheat Grain Quality.

    Science.gov (United States)

    Casebow, Richard; Hadley, Caroline; Uppal, Rajneet; Addisu, Molla; Loddo, Stefano; Kowalski, Ania; Griffiths, Simon; Gooding, Mike

    2016-01-01

    The effects of dwarfing alleles (reduced height, Rht) in near isogenic lines on wheat grain quality are characterised in field experiments and related to effects on crop height, grain yield and GA-sensitivity. Alleles included those that conferred GA-insensitivity (Rht-B1b, Rht-B1c, Rht-D1b, Rht-D1c) as well as those that retained GA-sensitivity (rht(tall), Rht8, Rht8 + Ppd-D1a, Rht12). Full characterisation was facilitated by including factors with which the effects of Rht alleles are known to interact for grain yield (i.e. system, [conventional or organic]; tillage intensity [plough-based, minimum or zero]; nitrogen fertilizer level [0-450 kg N/ha]; and genetic backgrounds varying in height [cvs Maris Huntsman, Maris Widgeon, and Mercia]. Allele effects on mean grain weight and grain specific weight were positively associated with final crop height: dwarfing reduced these quality criteria irrespective of crop management or GA-sensitivity. In all but two experiments the effects of dwarfing alleles on grain nitrogen and sulphur concentrations were closely and negatively related to effects on grain yield, e.g. a quadratic relationship between grain yield and crop height manipulated by the GA-insensitive alleles was mirrored by quadratic relationships for nitrogen and sulphur concentrations: the highest yields and most dilute concentrations occurred around 80cm. In one of the two exceptional experiments the GA-insensitive Rht-B1b and Rht-B1c significantly (Pgrain nitrogen concentration in the absence of an effect on yield, and in the remaining experiment the GA-sensitive Rht8 significantly reduced both grain yield and grain nitrogen concentration simultaneously. When Rht alleles diluted grain nitrogen concentration, N:S ratios and SDS-sedimentation volumes were often improved. Hagberg falling number (HFN) was negatively related to crop height but benefits from dwarfing were only seen for GA-insensitive alleles. For HFN, therefore, there was the strongest evidence for

  9. Energy losses in switches

    International Nuclear Information System (INIS)

    Martin, T.H.; Seamen, J.F.; Jobe, D.O.

    1993-01-01

    The authors experiments show energy losses between 2 and 10 times that of the resistive time predictions. The experiments used hydrogen, helium, air, nitrogen, SF 6 polyethylene, and water for the switching dielectric. Previously underestimated switch losses have caused over predicting the accelerator outputs. Accurate estimation of these losses is now necessary for new high-efficiency pulsed power devices where the switching losses constitute the major portion of the total energy loss. They found that the switch energy losses scale as (V peak I peak ) 1.1846 . When using this scaling, the energy losses in any of the tested dielectrics are almost the same. This relationship is valid for several orders of magnitude and suggested a theoretical basis for these results. Currents up to .65 MA, with voltages to 3 MV were applied to various gaps during these experiments. The authors data and the developed theory indicates that the switch power loss continues for a much longer time than the resistive time, with peak power loss generally occurring at peak current in a ranging discharge instead of the early current time. All of the experiments were circuit code modeled after developing a new switch loss version based on the theory. The circuit code predicts switch energy loss and peak currents as a function of time. During analysis of the data they noticed slight constant offsets between the theory and data that depended on the dielectric. They modified the plasma conductivity for each tested dielectric to lessen this offset

  10. Beam Loss in Linacs

    CERN Document Server

    Plum, M.A.

    2016-01-01

    Beam loss is a critical issue in high-intensity accelerators, and much effort is expended during both the design and operation phases to minimize the loss and to keep it to manageable levels. As new accelerators become ever more powerful, beam loss becomes even more critical. Linacs for H- ion beams, such as the one at the Oak Ridge Spallation Neutron Source, have many more loss mechanisms compared to H+ (proton) linacs, such as the one being designed for the European Spallation Neutron Source. Interesting H- beam loss mechanisms include residual gas stripping, H+ capture and acceleration, field stripping, black-body radiation and the recently discovered intra-beam stripping mechanism. Beam halo formation, and ion source or RF turn on/off transients, are examples of beam loss mechanisms that are common for both H+ and H- accelerators. Machine protection systems play an important role in limiting the beam loss.

  11. Growth and Final Height Among Children With Phenylketonuria.

    Science.gov (United States)

    Thiele, Alena G; Gausche, Ruth; Lindenberg, Cornelia; Beger, Christoph; Arelin, Maria; Rohde, Carmen; Mütze, Ulrike; Weigel, Johannes F; Mohnike, Klaus; Baerwald, Christoph; Scholz, Markus; Kiess, Wieland; Pfäffle, Roland; Beblo, Skadi

    2017-11-01

    Growth is an important criterion to evaluate health in childhood and adolescence, especially in patients depending on special dietary treatment. Phenylketonuria (PKU) is the most common inherited disease of amino acid metabolism. Patients with PKU depend on a special phenylalanine-restricted diet, low in natural protein. The study aimed to evaluate growth, growth rate, and target height in 224 patients with PKU. Retrospective, longitudinal analysis of standardized, yearly measurements of height, weight, and calculated growth rate (SD score [SDS]) of patients with PKU aged 0 to 18 years were conducted by using the national computerized CrescNet database. Inclusion was restricted to patients carried to term with a confirmed diagnosis of PKU or mild hyperphenylalaninemia determined by newborn screening and early treatment initiation. From birth to adulthood, patients with PKU were significantly shorter than healthy German children (height SDS at 18 years: -0.882 ± 0.108, P < .001). They missed their target height by 3 cm by adulthood (women: P = .02) and 5 cm (men: P = .01). In patients receiving casein hydrolysate during childhood, this was more pronounced compared with patients receiving amino acid mixtures ( P < .001). Growth rate was significantly reduced during their first 2 years of life and in puberty (growth rate SDS: -1.1 to -0.5 m/year, P < .001 and -0.5; P < .02). Early diagnosed, treated, and continuously monitored patients with PKU showed reduced height from birth onward. During the last 2 decades, this phenomenon attenuated, probably because of advances in PKU therapy related to protein supplements and special low-protein foods. Copyright © 2017 by the American Academy of Pediatrics.

  12. Particles of bottom and suspended sediments: height of rise

    Directory of Open Access Journals (Sweden)

    Khodzinskaya Anna Gennadievna

    2014-12-01

    Full Text Available In the article, characteristic values of dynamic sizes of bottom and suspended sediments, including their probabilistic assessment, are considered. The article presents the processing results in respect of the experimental data for bottom and suspended sediments, obtained in the laboratory environment using samples and filming methods. The experiments have proven that the dynamic hydraulic size determines the height of rise for the particles of the saltation load, rather than suspended ones. In the laboratory environment, the maximal height of rise is mainly driven by the relative flow depth. According to the assessment made by the co-authors, depths of flows employed in the experiments designated for the identification of heights of rises, were comparable to saltation heights of particles. Besides, the saltation height of particles, having relative density well below 2.65, nearly always exceeded half of the depth of the laboratory flow. Hydrodynamic conditions favourable for the separation and motion of artificial particles in coarse surface tanks are far different from the motion of sand particles on the bottom of lowland rivers. Values of hydraulic resistance ratios typical for laboratory experiments by far exceed their values typical for lowland rivers, and it means that the conditions of the experiments performed in the laboratory were similar to those typical for mountain rivers. The research findings have proven that the particle separation and motion pattern, if artificial particles are made of the materials demonstrating variable density and elasticity values and if loose particles travel over fixed ones, is different from the pattern typical for natural particles having variable coarseness.

  13. [Influence of Mapuche origin and socioeconomic conditions on adult height].

    Science.gov (United States)

    Erazo B, Marcia; Amigo C, Hugo; Bustos M, Patricia

    2005-04-01

    Studies in Chilean adults of low socioeconomic level suggest that their low height is likely to be due to their indigenous background. However this group also has been marginalized from socioeconomic development. To determine the influence of Mapuche ethnic origin and socioeconomic factors on the height of adults. In a cross sectional design, the height of 1,293 adults (528 males and 765 females) of Mapuche and non Mapuche origin were studied in the Araucania Region (Southern Chile) and in the Metropolitan Region (Central Chile). Subjects with Mapuche surnames were considered as pertaining to this ethnic community and those with Spanish surnames were considered as non Mapuche. Linear regression models were done, stratifying by sex, considering ethnic origin, to live in counties of different social vulnerability, and the level of family poverty. Among males, the mean height was 166.6+/-7.3 cm and among females, the figure was 153.6+/-5.9 cm. Mapuche subjects were significantly shorter: -3.2 cm (95% Confidence Interval (CI) -4.0 to -2.3) among females and -4.8 cm (CI -6.0 to -3.6) among males (non adjusted models). This deficit increased to -4.5 and -7.6 cm among females and males, respectively when they lived in poverty and in areas with highest social vulnerability. These differences decreased significantly if Mapuche subjects lived in communities with low social vulnerability and less poverty (-0.59 and -1.14 cm among females and males respectively). The studied population had low height, being lower in Mapuche subjects. The differences decreased among subjects living in counties of less vulnerability and less family poverty.

  14. The effect of crate height on the behavior of female turkeys during commercial pre-slaughter transportation.

    Science.gov (United States)

    Di Martino, Guido; Capello, Katia; Stefani, Anna Lisa; Tripepi, Luca; Garbo, Angelica; Speri, Marina; Trolese, Matteo; Brichese, Michele; Marangon, Stefano; Bonfanti, Lebana

    2017-10-01

    Limited information is available on suitable height of transport crates for turkeys. We compared behaviors and physiological indicators of four groups of 10 female turkeys each confined in either conventional (38.5 cm height) or experimental (77 cm height) crates during six commercial pre-slaughter transportations for 86 km (76 ± 4 min) along two tracts with one-lane streets, crossroads, bends, roundabouts (S1 and S2) and a highway tract (H) between S1 and S2. Only 36% of birds in the higher crates maintained a standing position. In conventional versus experimental crates, the frequency of rising attempts was five/bird/hour versus less than one/bird/hour, while wing flapping was seven/bird/hour versus 20/bird/hour, and balance loss was one versus four/bird/hour. The behaviors of both groups differed significantly according to the route tract, with a lower frequency of stress-related behaviors at H. No scratches, fractures or hematomas were detected in any birds after transportation. Crate height had no significant effect on hemato-biochemical markers. These results suggest that crates enabling a standing position may increase potentially dangerous behaviors. Moreover, busy and curvy routes should be avoided, as they may contribute to increasing the frequency of stress-related behaviors. © 2017 Japanese Society of Animal Science.

  15. BMI calculation in older people: The effect of using direct and surrogate measures of height in a community-based setting.

    Science.gov (United States)

    Butler, Rose; McClinchy, Jane; Morreale-Parker, Claudia; Marsh, Wendy; Rennie, Kirsten L

    2017-12-01

    There is currently no consensus on which measure of height should be used in older people's body mass index (BMI) calculation. Most estimates of nutritional status include a measurement of body weight and height which should be reliable and accurate, however at present several different methods are used interchangeably. BMI, a key marker in malnutrition assessment, does not reflect age-related changes in height or changes in body composition such as loss of muscle mass or presence of oedema. The aim of this pilot study was to assess how the use of direct and surrogate measures of height impacts on BMI calculation in people aged ≥75 years. A cross-sectional study of 64 free-living older people (75-96 yrs) quantified height by two direct measurements, current height (H C ), and self-report (H R ) and surrogate equations using knee height (H K ) and ulna length (H U ). BMI calculated from current height measurement (BMI C ) was compared with BMI calculated using self-reported height (BMI R ) and height estimated from surrogate equations for knee height (BMI K ) and ulna length (BMI U ). Median difference of BMI C -BMI R was 2.31 kg/m 2 . BMI K gave the closest correlation to BMI C . The percentage of study participants identified at increased risk of under-nutrition (BMI BMI; from 5% (BMI C ), 7.8% (BMI K ), 12.5% (BMI U ), to 14% (BMI R ) respectively. The results of this pilot study in a relatively healthy sample of older people suggest that interchangeable use of current and reported height in people ≥75 years can introduce substantial significant systematic error. This discrepancy could impact nutritional assessment of older people in poor health and lead to misclassification during nutritional screening if other visual and clinical clues are not taken into account. This could result in long-term clinical and cost implications if individuals who need nutrition support are not correctly identified. A consensus is required on which method should be used to

  16. Payer Perspectives on Patient-Reported Outcomes in Health Care Decision Making: Oncology Examples.

    Science.gov (United States)

    Brogan, Andrew P; DeMuro, Carla; Barrett, Amy M; D'Alessio, Denise; Bal, Vasudha; Hogue, Susan L

    2017-02-01

    Health authorities and payers increasingly recognize the importance of patient perspectives and patient-reported outcomes (PROs) in health care decision making. However, given the broad variety of PRO endpoints included in clinical programs and variations in the timing of PRO data collection and country-specific needs, the role of PRO data in reimbursement decisions requires characterization. To (a) determine the effect of PRO data on market access and reimbursement decisions for oncology products in multiple markets and (b) assess the effect of PRO data collected after clinical progression on payer decision making. A 3-part assessment (targeted literature review, qualitative one-on-one interviews, and online survey) was undertaken. Published literature was identified through searches in PubMed/MEDLINE and Embase. In addition, a targeted search was conducted of health technology assessment (HTA) agency websites in the United States, the United Kingdom, France, and Germany. Qualitative one-on-one interviews were conducted with 16 payers from the RTI Health Solutions global advisory panel in 14 markets (Australia, Brazil, France, Germany, Italy, South Korea, Netherlands, Poland, Spain, Sweden, Taiwan, Turkey, the United Kingdom, and the United States [n = 3]). Of the 200 payers and payer advisors from the global advisory panel invited to participate in the online survey, 20 respondents (China, France, Germany, Spain [n = 2], Taiwan, the United Kingdom, and the United States [n = 13]) completed the survey, and 6 respondents (Australia, South Korea, and the United States [n = 4]) partially completed the survey. Reviews of the literature and publicly available HTAs and reimbursement decisions suggested that HTA bodies and payers have varying experience with and confidence in PRO data. Payers participating in the survey indicated that PRO data may be especially influential in oncology compared with other therapeutic areas. Payers surveyed offered little differentiation

  17. Total body height estimation using sacrum height in Anatolian Caucasians: multidetector computed tomography-based virtual anthropometry

    Energy Technology Data Exchange (ETDEWEB)

    Karakas, Hakki Muammer [Inonu University Medical Faculty, Turgut Ozal Medical Center, Department of Radiology, Malatya (Turkey); Celbis, Osman [Inonu University Medical Faculty Turgut Ozal Medical Center, Department of Forensic Medicine, Malatya (Turkey); Harma, Ahmet [Inonu University Medical Faculty Turgut Ozal Medical Center, Department of Orthopaedics and Traumatology, Malatya (Turkey); Alicioglu, Banu [Trakya University Medical Faculty, Department of Radiology, Edirne (Turkey); Trakya University Health Sciences Institute, Department of Anatomy, Edirne (Turkey)

    2011-05-15

    Estimation of total body height is a major step when a subject has to be identified from his/her skeletal structures. In the presence of decomposed skeletons and missing bones, estimation is usually based on regression equation for intact long bones. If these bones are fragmented or missing, alternative structures must be used. In this study, the value of sacrum height (SH) in total body height (TBH) estimation was investigated in a contemporary population of adult Anatolian Caucasians. Sixty-six men (41.6 {+-} 14.9 years) and 43 women (41.1 {+-} 14.2 years) were scanned with 64-row multidetector computed tomography (MDCT) to obtain high-resolution anthropometric data. SH of midsagittal sections was electronically measured. The technique and methodology were validated on a standard skeletal model. Sacrum height was 111.2 {+-} 12.6 mm (77-138 mm) in men and 104.7 {+-} 8.2 (89-125 mm) in women. The difference between the two sexes regarding SH was significant (p < 0.0001). SH did not significantly correlate with age in men, whereas the correlation was significant in women (p < 0.03). The correlation between SH and the stature was significant in men (r = 0.427, p < 0.0001) and was insignificant in women. For men the regression equation was [Stature = (0.306 x SH)+137.9] (r = 0.54, SEE = 56.9, p < 0.0001). Sacrum height is not susceptible to sex, or to age in men. In the presence of incomplete male skeletons, SH helps to determine the stature. This study is also one of the initial applications of MDCT in virtual anthropometric research. (orig.)

  18. Total body height estimation using sacrum height in Anatolian Caucasians: multidetector computed tomography-based virtual anthropometry

    International Nuclear Information System (INIS)

    Karakas, Hakki Muammer; Celbis, Osman; Harma, Ahmet; Alicioglu, Banu

    2011-01-01

    Estimation of total body height is a major step when a subject has to be identified from his/her skeletal structures. In the presence of decomposed skeletons and missing bones, estimation is usually based on regression equation for intact long bones. If these bones are fragmented or missing, alternative structures must be used. In this study, the value of sacrum height (SH) in total body height (TBH) estimation was investigated in a contemporary population of adult Anatolian Caucasians. Sixty-six men (41.6 ± 14.9 years) and 43 women (41.1 ± 14.2 years) were scanned with 64-row multidetector computed tomography (MDCT) to obtain high-resolution anthropometric data. SH of midsagittal sections was electronically measured. The technique and methodology were validated on a standard skeletal model. Sacrum height was 111.2 ± 12.6 mm (77-138 mm) in men and 104.7 ± 8.2 (89-125 mm) in women. The difference between the two sexes regarding SH was significant (p < 0.0001). SH did not significantly correlate with age in men, whereas the correlation was significant in women (p < 0.03). The correlation between SH and the stature was significant in men (r = 0.427, p < 0.0001) and was insignificant in women. For men the regression equation was [Stature = (0.306 x SH)+137.9] (r = 0.54, SEE = 56.9, p < 0.0001). Sacrum height is not susceptible to sex, or to age in men. In the presence of incomplete male skeletons, SH helps to determine the stature. This study is also one of the initial applications of MDCT in virtual anthropometric research. (orig.)

  19. After massive weight loss: patients' expectations of body contouring surgery.

    Science.gov (United States)

    Kitzinger, Hugo B; Abayev, Sara; Pittermann, Anna; Karle, Birgit; Bohdjalian, Arthur; Langer, Felix B; Prager, Gerhard; Frey, Manfred

    2012-04-01

    Massive weight loss following bariatric surgery leads to excess skin with functional and aesthetic impairments. Surplus skin can then contribute to problems with additional weight loss or gain. The aims of the current study were to evaluate the frequency of massive soft tissue development in gastric bypass patients, to determine whether males and females experience similar post-bypass body changes, and to learn about the expectations and impairments related to body contouring surgery. A questionnaire addressing information on the satisfaction of body image, quality of life, and expectation of body contouring surgery following massive weight loss was mailed to 425 patients who had undergone gastric bypass surgery between 2003 and 2009. Of these 425 individuals, 252 (59%) patients completed the survey. Ninety percent of women and 88% of men surveyed rated their appearance following massive weight loss as satisfactory, good, or very good. However, 96% of all patients developed surplus skin, which caused intertriginous dermatitis and itching. In addition, patients reported problems with physical activity (playing sports) and finding clothing that fit appropriately. Moreover, 75% of female and 68% of male patients reported desiring body contouring surgery. The most important expectation of body contouring surgery was improved appearance, followed by improved self-confidence and quality of life. Surplus skin resulting from gastric bypass surgery is a common issue that causes functional and aesthetic impairments in patients. Consequently, this increases the desire for body contouring surgery with high expectations for the aesthetic outcome as well as improved life satisfaction.

  20. Gridded 5-day mean sea surface height anomaly and significant wave height from Jason-1 and OSTM/Jason-2 satellites (NODC Accession 0065055)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This accession contains the gridded 5-day mean sea surface height anomaly (SSHA) and Ku Band significant wave height (SWH-KU) observed from Jason-1 and OSTM/Jason-2...

  1. Patient-Reported Outcomes and Total Health Care Expenditure in Prediction of Patient Satisfaction: Results From a National Study

    Science.gov (United States)

    Zhang, Weiping; Chen, Wei; Bounsanga, Jerry; Cheng, Christine; Franklin, Jeremy D; Crum, Anthony B; Voss, Maren W; Hon, Shirley D

    2015-01-01

    Background Health care quality is often linked to patient satisfaction. Yet, there is a lack of national studies examining the relationship between patient satisfaction, patient-reported outcomes, and medical expenditure. Objective The aim of this study is to examine the contribution of physical health, mental health, general health, and total health care expenditures to patient satisfaction using a longitudinal, nationally representative sample. Methods Using data from the 2010-2011 Medical Expenditure Panel Survey, analyses were conducted to predict patient satisfaction from patient-reported outcomes and total health care expenditures. The study sample consisted of adult participants (N=10,157), with sampling weights representative of 233.26 million people in the United States. Results The results indicated that patient-reported outcomes and total health care expenditure were associated with patient satisfaction such that higher physical and mental function, higher general health status, and higher total health care expenditure were associated with higher patient satisfaction. Conclusions We found that patient-reported outcomes and total health care expenditure had a significant relationship with patient satisfaction. As more emphasis is placed on health care value and quality, this area of research will become increasingly needed and critical questions should be asked about what we value in health care and whether we can find a balance between patient satisfaction, outcomes, and expenditures. Future research should apply big data analytics to investigate whether there is a differential effect of patient-reported outcomes and medical expenditures on patient satisfaction across different medical specialties. PMID:27227131

  2. Patient-Reported Barriers to the Prekidney Transplant Evaluation in an At-Risk Population in the United States.

    Science.gov (United States)

    Lockwood, Mark B; Saunders, Milda R; Nass, Rachel; McGivern, Claire L; Cunningham, Patrick N; Chon, W James; Josephson, Michelle A; Becker, Yolanda T; Lee, Christopher S

    2017-06-01

    Despite our knowledge of barriers to the early stages of the transplant process, we have limited insight into patient-reported barriers to the prekidney transplant medical evaluation in populations largely at-risk for evaluation failure. One-hundred consecutive adults were enrolled at an urban, Midwestern transplant center. Demographic, clinical, and quality of life data were collected prior to patients visit with a transplant surgeon/nephrologist (evaluation begins). Patient-reported barriers to evaluation completion were collected using the Subjective Barriers Questionnaire 90-days after the initial medical evaluation appointment (evaluation ends), our center targeted goal for transplant work-up completion. At 90 days, 40% of participants had not completed the transplant evaluation. Five barrier categories were created from the 85 responses to the Subjective Barriers Questionnaire. Patient-reported barriers included poor communication, physical health, socioeconomics, psychosocial influences, and access to care. In addition, determinants for successful evaluation completion included being of white race, higher income, free of dialysis, a lower comorbid burden, and reporting higher scores on the Kidney Disease Quality of Life subscale role-emotional. Poor communication between patients and providers, and among providers, was the most prominent patient-reported barrier identified. Barriers were more prominent in marginalized groups such as ethnic minorities and people with low income. Understanding the prevalence of patient-reported barriers may aid in the development of patient-centered interventions to improve completion rates.

  3. Patient-reported non-adherence and immunosuppressant trough levels are associated with rejection after renal transplantation.

    Science.gov (United States)

    Scheel, Jennifer; Reber, Sandra; Stoessel, Lisa; Waldmann, Elisabeth; Jank, Sabine; Eckardt, Kai-Uwe; Grundmann, Franziska; Vitinius, Frank; de Zwaan, Martina; Bertram, Anna; Erim, Yesim

    2017-03-29

    Different measures of non-adherence to immunosuppressant (IS) medication have been found to be associated with rejection episodes after successful transplantation. The aim of the current study was to investigate whether graft rejection after renal transplantation is associated with patient-reported IS medication non-adherence and IS trough level variables (IS trough level variability and percentage of sub-therapeutic IS trough levels). Patient-reported non-adherence, IS trough level variability, percentage of sub-therapeutic IS trough levels, and acute biopsy-proven late allograft rejections were assessed in 267 adult renal transplant recipients who were ≥12 months post-transplantation. The rate of rejection was 13.5%. IS trough level variability, percentage of sub-therapeutic IS trough levels as well as patient-reported non-adherence were all significantly and positively associated with rejection, but not with each other. Logistic regression analyses revealed that only the percentage of sub-therapeutic IS trough levels and age at transplantation remained significantly associated with rejection. Particularly, the percentage of sub-therapeutic IS trough levels is associated with acute rejections after kidney transplantation whereas IS trough level variability and patient-reported non-adherence seem to be of subordinate importance. Patient-reported non-adherence and IS trough level variables were not correlated; thus, non-adherence should always be measured in a multi-methodological approach. Further research concerning the best combination of non-adherence measures is needed.

  4. Patient-Reported Outcomes and Total Health Care Expenditure in Prediction of Patient Satisfaction: Results From a National Study.

    Science.gov (United States)

    Hung, Man; Zhang, Weiping; Chen, Wei; Bounsanga, Jerry; Cheng, Christine; Franklin, Jeremy D; Crum, Anthony B; Voss, Maren W; Hon, Shirley D

    2015-01-01

    Health care quality is often linked to patient satisfaction. Yet, there is a lack of national studies examining the relationship between patient satisfaction, patient-reported outcomes, and medical expenditure. The aim of this study is to examine the contribution of physical health, mental health, general health, and total health care expenditures to patient satisfaction using a longitudinal, nationally representative sample. Using data from the 2010-2011 Medical Expenditure Panel Survey, analyses were conducted to predict patient satisfaction from patient-reported outcomes and total health care expenditures. The study sample consisted of adult participants (N=10,157), with sampling weights representative of 233.26 million people in the United States. The results indicated that patient-reported outcomes and total health care expenditure were associated with patient satisfaction such that higher physical and mental function, higher general health status, and higher total health care expenditure were associated with higher patient satisfaction. We found that patient-reported outcomes and total health care expenditure had a significant relationship with patient satisfaction. As more emphasis is placed on health care value and quality, this area of research will become increasingly needed and critical questions should be asked about what we value in health care and whether we can find a balance between patient satisfaction, outcomes, and expenditures. Future research should apply big data analytics to investigate whether there is a differential effect of patient-reported outcomes and medical expenditures on patient satisfaction across different medical specialties.

  5. Pulse-height response of silicon surface-barrier detectors to high-energy heavy ions

    International Nuclear Information System (INIS)

    Smith, G.D.

    1973-01-01

    The pulse-height defect (PHD) of high-energy heavy ions in silicon surface-barrier detectors can be divided into three components: (1) energy loss in the gold-surface layer, (2) a nuclear-stopping defect, and (3) a defect due to recombination of electron-hole pairs in the plasma created by the heavy ion. The plasma recombination portion of the PHD was the subject of this study using the variation of the PHD with (1) the angle of incidence of incoming heavy ions, and (2) changes in the detector bias. The Tandem Van de Graaff accelerator at Argonne National Laboratory was used to produce scattered beam ions ( 32 S, 35 Cl) and heavy target recoils (Ni, Cu, 98 Mo, Ag, Au) at sufficient energies to produce a significant recombination defect. The results confirm the existence of a recombination zone at the front surface of these detectors and the significance of plasma recombination as a portion of the pulse-height defect. (Diss. Abstr. Int., B)

  6. A novel tissue engineering technique for regeneration of lost interdental papillary height

    Directory of Open Access Journals (Sweden)

    Rutuj Surana

    2010-01-01

    Full Text Available Open interdental spaces caused by papillary gingival recession are one of the most common problems faced in dentistry. Surgical and nonsurgical periodontal treatments for regeneration of lost papillary height have been reported with limited success. The present study reports effectiveness of autologous cultured fibroblast injections, a tissue engineering technique for papillary regeneration. A black triangle caused by Tarnow′s and Nordland′s class I papillary gingival loss was reported in maxillary anterior region of a young male patient. An autologous gingival biopsy was cultured in a biotechnology lab for the growth and expansion of fibroblasts. Cultured fibroblast suspension was injected into the receded papilla twice at an interval of 5 days. Follow-ups were recorded on the 6th day, 15 th day, at 1 month and at 2 months. Complete fill of black triangle was noted at the end of 2 months. No inflammatory or immune reactions were noted at the site of injection. Autologous cultured fibroblast injections are safe, efficacious, and an acceptable treatment option for the regeneration of lost papillary height.

  7. Drugs and hair loss.

    Science.gov (United States)

    Patel, Mansi; Harrison, Shannon; Sinclair, Rodney

    2013-01-01

    Hair loss is a common complaint, both in men and women, and use of prescription medications is widespread. When there is a temporal association between the onset of hair loss and commencement of a medication, the medication is commonly thought to have caused the hair loss. However, hair loss and in particular telogen effluvium may occur in response to a number of triggers including fever, hemorrhage, severe illness, stress, and childbirth, and a thorough exclusion of these potential confounders is necessary before the hair loss can be blamed on the medication. Certain medications are known to cause hair loss by a variety of mechanisms including anagen arrest, telogen effluvium, or accentuation of androgenetic alopecia by androgens. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  8. Handbook on loss reserving

    CERN Document Server

    Schmidt, Klaus; Schnaus, Anja

    2016-01-01

    This handbook presents the basic aspects of actuarial loss reserving. Besides the traditional methods, it also includes a description of more recent ones and a discussion of certain problems occurring in actuarial practice, like inflation, scarce data, large claims, slow loss development, the use of market statistics, the need for simulation techniques and the task of calculating best estimates and ranges of future losses. In property and casualty insurance the provisions for payment obligations from losses that have occurred but have not yet been settled usually constitute the largest item on the liabilities side of an insurer's balance sheet. For this reason, the determination and evaluation of these loss reserves is of considerable economic importance for every property and casualty insurer. Actuarial students, academics as well as practicing actuaries will benefit from this overview of the most important actuarial methods of loss reserving by developing an understanding of the underlying stochastic models...

  9. AMCP Partnership Forum: Improving Quality, Value, and Outcomes with Patient-Reported Outcomes.

    Science.gov (United States)

    2018-03-01

    Patient-reported outcomes (PROs), which provide a direct measure of a patient's health status or treatment preferences, represent a key component of the shift toward patient-centered health care. PROs can measure the state of a patient's disease-specific and overall health throughout the care continuum, enabling them to have a variety of uses for key health care stakeholders. Currently, PROs are used in drug development, aligning patient and clinician goals in care, quality-of-care measures, and coverage and reimbursement decisions. While there have been significant strides by key health care stakeholders to further the development and use of PROs, there are a number of challenges limiting more widespread use. In light of these current challenges and the potential for PROs to improve health care quality and value, on October 19, 2017, the Academy of Managed Care Pharmacy convened a forum of key stakeholders representing patients, payers, providers, government, and pharmaceutical companies to discuss and identify solutions to the current challenges and barriers to further use of PROs. These discussions informed the development of participants' ideal future state in which PROs maximize the goals of all health care stakeholders and the actionable steps required to make the future state a reality. While stakeholders shared unique perspectives throughout the forum, they had consensus on 2 overarching issues: the importance of PROs in defining value, improving patient care, and implementing value-based payment models and the need for strong organizational and operational systems to achieve optimal adoption and use. Participants identified several key challenges in PRO use and adoption: achieving a representative patient population, inclusion of PRO data in medication labels, the necessity for both standardized and customizable PROs, and operational and organizational barriers to collecting and analyzing PROs. To overcome these challenges, participants recommended that

  10. Comparison of reliability and responsiveness of patient-reported clinical outcome measures in knee osteoarthritis rehabilitation.

    Science.gov (United States)

    Williams, Valerie J; Piva, Sara R; Irrgang, James J; Crossley, Chad; Fitzgerald, G Kelley

    2012-08-01

    Secondary analysis, pretreatment-posttreatment observational study. To compare the reliability and responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Knee Outcome Survey activities of daily living subscale (KOS-ADL), and the Lower Extremity Functional Scale (LEFS) in individuals with knee osteoarthritis (OA). The WOMAC is the current standard in patient-reported measures of function in patients with knee OA. The KOS-ADL and LEFS were designed for potential use in patients with knee OA. If the KOS-ADL and LEFS are to be considered viable alternatives to the WOMAC for measuring patient-reported function in individuals with knee OA, they should have measurement properties comparable to the WOMAC. It would also be important to determine whether either of these instruments may be superior to the WOMAC in terms of reliability or responsiveness in this population. Data from 168 subjects with knee OA, who participated in a rehabilitation program, were used in the analyses. Reliability and responsiveness of each outcome measure were estimated at follow-ups of 2, 6, and 12 months. Reliability was estimated by calculating the intraclass correlation coefficient (ICC2,1) for subjects who were unchanged in status from baseline at each follow-up time, based on a global rating of change score. To examine responsiveness, the standard error of the measurement, minimal detectable change, minimal clinically important difference, and the Guyatt responsiveness index were calculated for each outcome measure at each follow-up time. All 3 outcome measures demonstrated reasonable reliability and responsiveness to change. Reliability and responsiveness tended to decrease somewhat with increasing follow-up time. There were no substantial differences between outcome measures for reliability or any of the 3 measures of responsiveness at any follow-up time. The results do not indicate that one outcome measure is more reliable or responsive than

  11. Patient-reported outcomes in European spondyloarthritis patients: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Torre-Alonso JC

    2018-05-01

    Full Text Available Juan Carlos Torre-Alonso,1 Rubén Queiro,2 Marta Comellas,3 Luís Lizán,3,4 Carles Blanch5 1Rheumatology Department, Faculty of Medicine and Health Sciences, University of Oviedo, Hospital Monte Naranco, Oviedo, Spain; 2Rheumatology Division, Hospital Universitario Central de Asturias (HUCA, Oviedo, Spain; 3Outcomes 10, Castellón de la Plana, Spain; 4Medicine Department, Jaime I University, Castellón de la Plana, Spain; 5Health Economics & Market Access, Novartis Pharmaceuticals, Barcelona, Spain Objective: This review aims to summarize the current literature on patient-reported outcomes (PROs in spondyloarthritis (SpA. Patients and methods: We performed a systematic literature review to identify studies (original articles and narrative and systematic reviews regarding PROs (health-related quality of life [HRQoL], satisfaction, preferences, adherence/compliance, and persistence in SpA patients published in the European Union through December 2016. International databases (Medline/PubMed, Cochrane Library, ISI Web of Knowledge, Scopus were searched using keywords in English. The methodological quality of the studies was assessed using the Oxford Centre for Evidence-Based Medicine criteria. Results: A total of 26 publications met the inclusion criteria. Generally, studies indicated that SpA has a negative impact on patients’ HRQoL. In patients with ankylosing spondylitis, physical domains were more affected than emotional ones, whereas for psoriatic arthritis, both physical and psychological factors were strongly affected by the disease. Data indicated that biological agents (BAs greatly contributed to improvement in HRQoL in both ankylosing spondylitis and psoriatic arthritis patients. Findings on compliance with BAs were heterogeneous. However, persistence rates exceeded 50% irrespective of the BA administered. Results on preferences indicated that most SpA patients prefer being involved in decisions regarding their treatment and that

  12. Proxy and patient reports of health-related quality of life in a national cancer survey.

    Science.gov (United States)

    Roydhouse, Jessica K; Gutman, Roee; Keating, Nancy L; Mor, Vincent; Wilson, Ira B

    2018-01-05

    Proxy respondents are frequently used in surveys, including those assessing health-related quality of life (HRQOL). In cancer, most research involving proxies has been undertaken with paired proxy-patient populations, where proxy responses are compared to patient responses for the same individual. In these populations, proxy-patient differences are small and suggest proxy underestimation of patient HRQOL. In practice, however, proxy responses will only be used when patient responses are not available. The difference between proxy and patient reports of patient HRQOL where patients are not able to report for themselves in cancer is not known. The objective of this study was to evaluate the difference between patient and proxy reports of patient HRQOL in a large national cancer survey, and determine if this difference could be mitigated by adjusting for clinical and sociodemographic information about patients. Data were from the Cancer Care Outcomes Research and Surveillance (CanCORS) study. Patients or their proxies were recruited within 3-6 months of diagnosis with lung or colorectal cancer. HRQOL was measured using the SF-12 mental and physical composite scales. Differences of ½ SD (=5 points) were considered clinically significant. The primary independent variable was proxy status. Linear regression models were used to adjust for patient sociodemographic and clinical covariates, including cancer stage, patient age and education, and patient co-morbidities. Of 6471 respondents, 1011 (16%) were proxies. Before adjustment, average proxy-reported scores were lower for both physical (-6.7 points, 95% CI -7.4 to -5.9) and mental (-6 points, 95% CI -6.7 to -5.2) health. Proxy-reported scores remained lower after adjustment (physical: -5.8 points, -6.6 to -5; mental: -5.8 points, -6.6 to 5). Proxy-patient score differences remained clinically and statistically significant, even after adjustment for sociodemographic and clinical variables. Proxy-reported outcome scores

  13. Patient-reported outcome 2 years after lung transplantation: does the underlying diagnosis matter?

    Directory of Open Access Journals (Sweden)

    Ghosh S

    2012-11-01

    Full Text Available Maria Jose Santana,1 David Feeny,2 Sunita Ghosh,3 Dale C Lien41Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada; 2Kaiser Permanente Center for Health Research, Portland, OR, USA; 3Cross Cancer Center, University of Alberta, Edmonton, Alberta, Canada; 4University of Alberta Hospital, Edmonton, Alberta, CanadaPurpose: Transplantation has the potential to produce profound effects on survival and health-related quality of life (HRQL. The inclusion of the patient’s perspective may play an important role in the assessment of the effectiveness of lung transplantation. Patient perspectives are assessed by patient-reported outcome measures, including HRQL measures. We describe how patients’ HRQL among different diagnosis groups can be used by clinicians to monitor and evaluate the outcomes associated with transplantation.Methods: Consecutive lung transplant recipients attending the lung transplant outpatient clinic in a tertiary institution completed the 15-item Health Utilities Index (HUI questionnaire on a touchscreen computer. The results were available to clinicians at every patient visit. The HUI3 covers a range of severity and comorbidities in eight dimensions of health status. Overall HUI3 scores are on a scale in which dead = 0.00 and perfect health = 1.00; disability categories range from no disability = 1 to severe disability <0.70. Single-attribute and overall HUI3 scores were used to compare patients’ HRQL among different diagnosis groups. Random-effect models with time since transplant as a random variable and age, gender, underlying diagnoses, infections, and broncholitis obliterans syndrome as fixed variables were built to identify determinants of health status at 2-years posttransplantation.Results: Two hundred and fourteen lung transplant recipients of whom 61% were male with a mean age of 52 (19–75 years were included in the study. Chronic obstructive pulmonary disease and cystic fibrosis patients displayed

  14. Patient-reported financial barriers to adherence to treatment in neurology

    Directory of Open Access Journals (Sweden)

    Moura LMVR

    2016-11-01

    Full Text Available Lidia MVR Moura,1 Eli L Schwamm,1 Valdery Moura Junior,1 Michael P Seitz,1 Daniel B Hoch,1 John Hsu,2,3 Lee H Schwamm1 1Department of Neurology, 2Mongan Institute for Health Policy, Massachusetts General Hospital, 3Department of Medicine and Department of Health Care Policy, Harvard Medical School, Boston, MA, USA Objective: Many effective medical therapies are available for treating neurological diseases, but these therapies tend to be expensive and adherence is critical to their effectiveness. We used patient-reported data to examine the frequency and determinants of financial barriers to medication adherence among individuals treated for neurological disorders. Patients and methods: Patients completed cross-sectional surveys on iPads as part of routine outpatient care in a neurology clinic. Survey responses from a 3-month period were collected and merged with administrative sources of demographic and clinical information (eg, insurance type. We explored the association between patient characteristics and patient-reported failure to refill prescription medication due to cost in the previous 12 months, termed here as “nonadherence”. Results: The population studied comprised 6075 adults who were presented between July and September 2015 for outpatient neurology appointments. The mean age of participants was 56 (standard deviation: 18 years, and 1613 (54% were females. The patients who participated in the surveys (2992, 49% were comparable to nonparticipants with respect to gender and ethnicity but more often identified English as their preferred language (94% vs 6%, p<0.01. Among respondents, 9.8% (n=265 reported nonadherence that varied by condition. These patients were more frequently Hispanic (16.7% vs 9.8% white, p=0.01, living alone (13.9% vs 8.9% cohabitating, p<0.01, and preferred a language other than English (15.3% vs 9.4%, p=0.02. Conclusion: Overall, the magnitude of financial barriers to medication adherence appears to vary

  15. Development and validation of a patient-reported outcome measure for stroke patients.

    Science.gov (United States)

    Luo, Yanhong; Yang, Jie; Zhang, Yanbo

    2015-05-08

    Family support and patient satisfaction with treatment are crucial for aiding in the recovery from stroke. However, current validated stroke-specific questionnaires may not adequately capture the impact of these two variables on patients undergoing clinical trials of new drugs. Therefore, the aim of this study was to develop and evaluate a new stroke patient-reported outcome measure (Stroke-PROM) instrument for capturing more comprehensive effects of stroke on patients participating in clinical trials of new drugs. A conceptual framework and a pool of items for the preliminary Stroke-PROM were generated by consulting the relevant literature and other questionnaires created in China and other countries, and interviewing 20 patients and 4 experts to ensure that all germane parameters were included. During the first item-selection phase, classical test theory and item response theory were applied to an initial scale completed by 133 patients with stroke. During the item-revaluation phase, classical test theory and item response theory were used again, this time with 475 patients with stroke and 104 healthy participants. During the scale assessment phase, confirmatory factor analysis was applied to the final scale of the Stroke-PROM using the same study population as in the second item-selection phase. Reliability, validity, responsiveness and feasibility of the final scale were tested. The final scale of Stroke-PROM contained 46 items describing four domains (physiology, psychology, society and treatment). These four domains were subdivided into 10 subdomains. Cronbach's α coefficients for the four domains ranged from 0.861 to 0.908. Confirmatory factor analysis supported the validity of the final scale, and the model fit index satisfied the criterion. Differences in the Stroke-PROM mean scores were significant between patients with stroke and healthy participants in nine subdomains (P < 0.001), indicating that the scale showed good responsiveness. The Stroke

  16. Patient-reported outcomes 5 years after laser in situ keratomileusis.

    Science.gov (United States)

    Schallhorn, Steven C; Venter, Jan A; Teenan, David; Hannan, Stephen J; Hettinger, Keith A; Pelouskova, Martina; Schallhorn, Julie M

    2016-06-01

    To assess vision-related, quality-of-life outcomes 5 years after laser in situ keratomileusis (LASIK) and determine factors predictive of patient satisfaction. Optical Express, Glasgow, Scotland. Retrospective case series. Data from patients who had attended a clinical examination 5 years after LASIK were analyzed. All treatments were performed using the Visx Star S4 IR excimer laser. Patient-reported satisfaction, the effect of eyesight on various activities, visual phenomena, and ocular discomfort were evaluated 5 years postoperatively. Multivariate regression analysis was performed to determine factors affecting patient satisfaction. The study comprised 2530 patients (4937 eyes) who had LASIK. The mean age at the time of surgery was 42.4 years ± 12.5 (SD), and the preoperative manifest spherical equivalent ranged from -11.0 diopters (D) to +4.88 D. Five years postoperatively, 79.3% of eyes were within ±0.50 D of emmetropia and 77.7% of eyes achieved monocular uncorrected distance visual acuity (UDVA) and 90.6% of eyes achieved binocular UDVA of 20/20 or better. Of the patients, 91.0% said they were satisfied with their vision and 94.9% did not wear distance correction. Less than 2.0% of patients noticed visual phenomena, even with spectacle correction. Major predictors of patient satisfaction 5 years postoperatively were postoperative binocular UDVA (37.6% variance explained by regression model), visual phenomena (relative contribution of 15.0%), preoperative and postoperative sphere and their interactions (11.6%), and eyesight-related difficulties with various activities such as night driving, outdoor activities, and reading (10.2%). Patient-reported quality-of-life and satisfaction rates remained high 5 years after LASIK. Uncorrected vision was the strongest predictor of satisfaction. Dr. S.C. Schallhorn is a consultant to Abbott Medical Optics, Inc., Zeiss Meditec AG, and Autofocus Inc. and a global medical director for Optical Express. No other

  17. Optimal Height Calculation and Modelling of Noise Barrier

    Directory of Open Access Journals (Sweden)

    Raimondas Grubliauskas

    2011-04-01

    Full Text Available Transport is one of the main sources of noise having a particularly strong negative impact on the environment. In the city, one of the best methods to reduce the spread of noise in residential areas is a noise barrier. The article presents noise reduction barrier adaptation with empirical formulas calculating and modelling noise distribution. The simulation of noise dispersion has been performed applying the CadnaA program that allows modelling the noise levels of various developments under changing conditions. Calculation and simulation is obtained by assessing the level of noise reduction using the same variables. The investigation results are presented as noise distribution isolines. The selection of a different height of noise barriers are the results calculated at the heights of 1, 4 and 15 meters. The level of noise reduction at the maximum overlap of data, calculation and simulation has reached about 10%.Article in Lithuanian

  18. Risk assessment of work at height in construction

    Directory of Open Access Journals (Sweden)

    Letice Dalla Lana

    2014-02-01

    Full Text Available The construction presents alarming statistics when it comes to the risks that these workers are subject. Higher risks still present work at a height where the fall is the biggest causal factor of fatal accidents. Thus the managements of companies who seek to reduce these risks and this has going for technical evaluation of operational risks. Three of these techniques are discussed in this article: PHA, FTA and CIT. The goal is to determine which one is most effective in assessing the risks of working at height in construction. The methodology used was case study of three works on three different construction of Santa Maria, RS. For a better understanding of the phenomenon suggests that the techniques are used together, but the CIT has provided a better quantitative analysis of incidents and the PHA contributes towards already establish the possible effects that each risk may have.

  19. Modelling the development of mixing height in near equatorial region

    Energy Technology Data Exchange (ETDEWEB)

    Samah, A.A. [Univ. of Malaya, Air Pollution Research Unit, Kuala Lumpur (Malaysia)

    1997-10-01

    Most current air pollution models were developed for mid-latitude conditions and as such many of the empirical parameters used were based on observations taken in the mid-latitude boundary layer which is physically different from that of the equatorial boundary layer. In the equatorial boundary layer the Coriolis parameter f is small or zero and moisture plays a more important role in the control of stability and the surface energy balance. Therefore air pollution models such as the OMLMULTI or the ADMS which were basically developed for mid-latitude conditions must be applied with some caution and would need some adaptation to properly simulate the properties of equatorial boundary layer. This work elucidates some of the problems of modelling the evolution of mixing height in the equatorial region. The mixing height estimates were compared with routine observations taken during a severe air pollution episodes in Malaysia. (au)

  20. Development and content validity testing of a patient-reported outcomes questionnaire for the assessment of hereditary angioedema in observational studies.

    Science.gov (United States)

    Bonner, Nicola; Abetz-Webb, Linda; Renault, Lydie; Caballero, Teresa; Longhurst, Hilary; Maurer, Marcus; Christiansen, Sandra; Zuraw, Bruce

    2015-07-01

    Hereditary Angioedema (HAE), a rare genetic disease, manifests as intermittent, painful attacks of angioedema. Attacks vary in frequency and severity and include skin, abdominal and life-threatening laryngeal swellings. This study aimed to develop a patient reported outcome (PRO) tool for the assessment of HAE attacks, including their management and impact on patients' lives, for use in clinical studies, or by physicians in general practice. The results of open-ended face to face concept elicitation interviews with HAE patients in Argentina (n = 10) and the US (n = 33) were used to develop the first draft questionnaire of the HAE patient reported outcomes questionnaire (HAE PRO). Subsequently, in-depth cognitive debriefing interviews were performed with HAE patients in the UK (n = 10), Brazil (n = 10), Germany (n = 11) and France (n = 12). Following input from eight multinational clinical experts further cognitive interviews were conducted in the US (n = 12) and Germany (n = 12). Patients who experienced abdominal, cutaneous or laryngeal attacks of varying severity levels were included in all rounds of interviews. Across the rounds of interviews patients discussed their HAE attack symptoms, impacts and treatments. Cognitive debriefing interviews explored patient understanding and relevance of questionnaire items. All interviews were conducted face to face following a pre-defined semi-structured interview guide in the patient's native language. Patients reported a variety of HAE symptoms, attack triggers, warning signs, attack impacts and treatment options which were used to develop the HAE PRO. The HAE PRO was revised and refined following input from patients and clinical experts. The final 18-item HAE PRO provides an assessment of the HAE attack experience including symptoms, impacts, treatment requirements, healthcare resource use and loss of productivity caused by HAE attacks. Patient and expert input has contributed to the

  1. The Effect of Adolescent Experience on Labor Market Outcomes: The Case of Height.

    Science.gov (United States)

    Persico, Nicola; Postlewaite, Andrew; Silverman, Dan

    2004-01-01

    Taller workers receive a wage premium. Net of differences in family background, the disparity is similar in magnitude to the race and gender gaps. We exploit variation in an individual's height over time to explore how height affects wages. Controlling for teen height essentially eliminates the effect of adult height on wages for white men. The…

  2. A modern Green Revolution gene for reduced height in wheat.

    Science.gov (United States)

    Würschum, Tobias; Langer, Simon M; Longin, C Friedrich H; Tucker, Matthew R; Leiser, Willmar L

    2017-12-01

    Increases in the yield of wheat during the Green Revolution of the late 20 th century were achieved through the introduction of Reduced height (Rht) dwarfing genes. The Rht-B1 and Rht-D1 loci ensured short stature by limiting the response to the growth-promoting hormone gibberellin, and are now widespread through international breeding programs. Despite this advantage, interference with the plant's response to gibberellin also triggers adverse effects for a range of important agronomic traits, and consequently modern Green Revolution genes are urgently required. In this study, we revisited the genetic control of wheat height using an association mapping approach and a large panel of 1110 worldwide winter wheat cultivars. This led to the identification of a major Rht locus on chromosome 6A, Rht24, which substantially reduces plant height alone as well as in combination with Rht-1b alleles. Remarkably, behind Rht-D1, Rht24 was the second most important locus for reduced height, explaining 15.0% of the genotypic variance and exerting an allele substitution effect of -8.8 cm. Unlike the two Rht-1b alleles, plants carrying Rht24 remain sensitive to gibberellic acid treatment. Rht24 appears in breeding programs from all countries of origin investigated, with increased frequency over the last decades, indicating that wheat breeders have actively selected for this locus. Taken together, this study reveals Rht24 as an important Rht gene of commercial relevance in worldwide wheat breeding. © 2017 The Authors The Plant Journal © 2017 John Wiley & Sons Ltd.

  3. Relating Time-Dependent Acceleration and Height Using an Elevator

    Science.gov (United States)

    Kinser, Jason M.

    2015-01-01

    A simple experiment in relating a time-dependent linear acceleration function to height is explored through the use of a smartphone and an elevator. Given acceleration as a function of time, a(t), the velocity function and position functions are determined through integration as in v(t)=? a(t) dt (1) and x(t)=? v(t) dt. Mobile devices such as…

  4. Hypohydration Reduces Vertical Ground Reaction Impulse But Not Jump Height

    Science.gov (United States)

    2010-01-01

    height, provided that muscle contractile function remains normal, because gravitational and inertial resistance to jumping are pro- portional to body...testing, anthropometric and fitness measurements were made to characterize the study population. Peak aerobic power (VO2peak) was determined using an...determinations. All volunteers performed between 3 and 5 practice days of vertical jump testing to reduce training and learning effects. Practice

  5. SOME ASPECTS IN HEIGHT MEASUREMENT BY UAV PHOTOGRAMMETRY

    Directory of Open Access Journals (Sweden)

    R. Matsuoka

    2013-08-01

    Full Text Available We conducted an experiment to investigate the feasibility of the deformation measurement of a large-scale solar power plant on reclaimed land by UAV photogrammetry. Two teams engaged in the experiment at first. One, which is called Team-A, carried out orientation of images following the procedure of conventional aerial photogrammetry. The other, which is called Team-C, executed that in the manner of close range photogrammetry. The RMSE in height measurement by Team-A was 121.5 mm, while that by Team-C was 8.7 mm. This paper reports an analysis conducted in order to investigate the cause of the large difference in height measurement accuracy between Team-A and Team-C. In the analysis the third team, which is called Team-S, conducts supplementary orientation by using the images utilized by Team-A in the same manner as Team-C did. The RMSE in height measurement by Team-S is 19.1 mm. Our investigation focuses on the difference of the arrangement of points utilized in the orientation. Team-A selected pass points and tie points on image automatically by Intergraph’s ImageStation Automatic Triangulation (ISAT software, while Team-C and Team-S selected points to be utilized in orientation manually so that selected points are distributed uniformly in the experiment area. From the results of the analysis we conclude that the sets of tie points along a straight line on a plane that were selected automatically by the ISAT would bring the low accuracy in height measurement by Team-A.

  6. Florovsky at the crossroads: imagining Byzantine Renaissance from Morningside Heights

    OpenAIRE

    Mirkovic, Alexander

    2014-01-01

    Georges Florovsky, an influential theologian, came to New York City in 1948 to be dean of the Russian St Vladimir Theological Seminary. At Morningside Heights, Florovsky taught about what went wrong in Russia in 1917 and what needed to be done about it. His ideas prefigure the critique of European Enlightenment and its Orientalism formulated by Edward Said. Florovsky argued that Russia, imitating Western Europe, gave up its own Hellenic heritage of the Church Fathers, and replaced it with the...

  7. Child Height and Maternal Health Care Knowledge in Mozambique

    DEFF Research Database (Denmark)

    Van Den Broeck, Katleen

    Stunting prevalence rates in Mozambique are very high (41 percent), especially in rural areas (46 percent). Recent research shows that consumption growth alone will not be sufficient to solve the problem of malnutrition. To investigate the role of additional determinants I use a two-stage quantil...... of education and community health care facilities in rural areas and positively affect the height of the most severely stunted children...

  8. Numerical Analysis on Effects of Positioning and Height of the Contoured Endwall on the Three-Dimensional Flow in an Annular Turbine Nozzle Guide Vane Cascade

    International Nuclear Information System (INIS)

    Lee, Wu Sang; Kim, Dae Hyun; Min, Jae Hong; Chung Jin Taek

    2007-01-01

    Endwall losses contribute significantly to the overall losses in modern turbomachinery, especially when aerodynamic airfoil load and pressure ratio are increased. Hence, reducing the extend and intensity of the secondary flow structures helps to enhance overall efficiency. From the large range of viable approaches, a promising combination positioning and height of endwall contouring was chosen. The objective of this study is to document the three-dimensional flow in a turbine cascade in terms of streamwise vorticity, total pressure loss distribution and static pressure distribution on the endwall and blade surface and to propose an appropriate positioning and height of the endwall contouring which show best secondary, overall loss reduction among the simulated endwall. The flow through the gas turbine were numerically analyzed using three dimensional Navier-Stroke equations with a commercial CFD code ANSYS CFX-10. The result shows that the overall loss is reduced near the flat endwall rather than contoured endwall, and the case of contoured endwall installed at 30% from leading edge with height of 25% for span showed best performance

  9. Structural pathology is not related to patient-reported pain and function in patients undergoing meniscal surgery

    DEFF Research Database (Denmark)

    Christensen, Simon Tornbjerg; Nissen, Nis; Englund, Martin

    2017-01-01

    BACKGROUND: The relationship between meniscal tears and other joint pathologies with patient-reported symptoms is not clear. We investigated associations between structural knee pathologies identified at surgery with preoperative knee pain and function in patients undergoing arthroscopic meniscal...... of meniscal tears questionnaire, supplemented with information extracted from surgery reports. Following hypothesis-driven preselection of candidate variables, backward elimination regressions were performed to investigate associations between patient-reported outcomes and structural knee pathologies. RESULTS...... surgery. METHODS: This study included 443 patients from the Knee Arthroscopy Cohort Southern Denmark (KACS), a prospective cohort following patients 18 years or older undergoing arthroscopic meniscal surgery at 4 hospitals between 1 February 2013 and 31 January 2014. Patient-reported outcomes, including...

  10. Shoulder height, body mass and shape of proboscideans

    Directory of Open Access Journals (Sweden)

    Asier Larramendi

    2016-08-01

    Full Text Available In recent decades there has been a growing interest in proboscideans’ body size, given that mass is highly correlated with biological functions. Different allometric equations have been proposed in the recent decades to estimate their body masses, based on a large number of living examples. However, the results obtained by these formulae are not accurate because extinct animals often had different body proportions and some were outside the size range of extant samples. Here the body mass of a large number of extinct proboscideans has been calculated by the Graphic Double Integration volumetric method which is based on technical restorations from graphical reconstructions of fossils employing photos, measurements and comparative anatomy of extant forms. The method has been tested on extant elephants with highly accurate results. The reconstructions necessary to apply this method give important information such as body proportions. On the other hand, equations to calculate the skeletal shoulder height have been developed, with a large number of published shoulder heights being recalculated. From the shoulder heights, several equations were created to find out the body mass of a series of extant and extinct species. A few of the largest proboscideans, namely Mammut borsoni and Palaeoloxodon namadicus, were found out to have reached and surpassed the body size of the largest indricotheres. Bearing this in mind, the largest land mammal that ever existed seems to be within the order of Proboscidea, contrary to previous understanding.

  11. Aerosol layer height from synergistic use of VIIRS and OMPS

    Science.gov (United States)

    Lee, J.; Hsu, N. Y. C.; Sayer, A. M.; Kim, W.; Seftor, C. J.

    2017-12-01

    This study presents an Aerosol Single-scattering albedo and Height Estimation (ASHE) algorithm, which retrieves the height of UV-absorbing aerosols by synergistically using the Visible Infrared Imaging Radiometer Suite (VIIRS) and the Ozone Mapping and Profiler Suite (OMPS). ASHE provides height information over a much broader area than ground-based or spaceborne lidar measurements by benefitting from the wide swaths of the two instruments used. As determination of single-scattering albedo (SSA) of the aerosol layer is the most critical part for the performance and coverage of ASHE, here we demonstrate three different strategies to constrain the SSA. First, ASHE is able to retrieve the SSA of UV-absorbing aerosols when Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) provides vertical profiles of the aerosol layer of interest. Second, Aerosol Robotic Network (AERONET) inversions can directly constrain the SSA of the aerosol layer when collocated with VIIRS or OMPS. Last, a SSA climatology from ASHE, AERONET, or other data sources can be used for large-scale, aged aerosol events, for which climatological SSA is well-known, at the cost of a slight decrease in retrieval accuracy. The same algorithm can be applied to measurements of similar type, such as those made by the Moderate Resolution Imaging Spectroradiometer (MODIS) and Ozone Monitoring Instrument (OMI), for a long-term, consistent data record.

  12. Simple overlay device for determining radial head and neck height

    International Nuclear Information System (INIS)

    Moon, Jun-Gyu; Southgate, Richard D.; Fitzsimmons, James S.; O'Driscoll, Shawn W.

    2010-01-01

    The purpose of this study was to test the hypothesis that a simple overlay device can be used on radiographs to measure radial head and neck height. Thirty anteroposterior elbow radiographs from 30 patients with a clinical diagnosis of lateral epicondylitis were examined to measure radial head and neck height. Three methods using different points along the bicipital tuberosity as a landmark were used. Method 1 used the proximal end of the bicipital tuberosity, method 2 used the most prominent point of the bicipital tuberosity, and method 3 used a simple overlay device (SOD) template that was aligned with anatomic reference points. All measurements were performed three times by three observers to determine interobserver and intraobserver reliability. Intraclass correlation coefficients revealed higher interobserver and intraobserver correlations for the SOD template method than for the other two methods. The 95% limits of agreement between observers were markedly better (-1.8 mm to +1.0 mm) for the SOD template method than for the proximal point method (-3.8 mm to +3.4 mm) or the prominent point method (-5.9 mm to +4.9 mm). We found that the SOD template method was reliable for assessing radial head and neck height. It had less variability than other methods, its 95% limit of agreement being less than 2 mm. This method could be helpful for assessing whether or not the insertion of a radial head prosthesis has resulted in over-lengthening of the radius. (orig.)

  13. Simple overlay device for determining radial head and neck height

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Jun-Gyu; Southgate, Richard D.; Fitzsimmons, James S.; O' Driscoll, Shawn W. [Mayo Clinic, Department of Orthopaedic Surgery, Rochester, MN (United States)

    2010-09-15

    The purpose of this study was to test the hypothesis that a simple overlay device can be used on radiographs to measure radial head and neck height. Thirty anteroposterior elbow radiographs from 30 patients with a clinical diagnosis of lateral epicondylitis were examined to measure radial head and neck height. Three methods using different points along the bicipital tuberosity as a landmark were used. Method 1 used the proximal end of the bicipital tuberosity, method 2 used the most prominent point of the bicipital tuberosity, and method 3 used a simple overlay device (SOD) template that was aligned with anatomic reference points. All measurements were performed three times by three observers to determine interobserver and intraobserver reliability. Intraclass correlation coefficients revealed higher interobserver and intraobserver correlations for the SOD template method than for the other two methods. The 95% limits of agreement between observers were markedly better (-1.8 mm to +1.0 mm) for the SOD template method than for the proximal point method (-3.8 mm to +3.4 mm) or the prominent point method (-5.9 mm to +4.9 mm). We found that the SOD template method was reliable for assessing radial head and neck height. It had less variability than other methods, its 95% limit of agreement being less than 2 mm. This method could be helpful for assessing whether or not the insertion of a radial head prosthesis has resulted in over-lengthening of the radius. (orig.)

  14. Influence of judoka height when using the seoi nage technique

    Directory of Open Access Journals (Sweden)

    Sebastião Iberes Lopes Melo

    2013-06-01

    Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2013v15n5p578 Judo techniques use the assumption of maximum efficiency with minimum energy expenditure, which means to try to use the strength of the opponent against himself, causing an imbalance that, associated with a technique, helps execute a throw. This study is aimed to evaluate the mechanical efficiency of the seoi nage technique applied to judokas (uke of different heights in relation to the thrower (tori. The knee and trunk angular variation of tori was compared with the total throw time, the time to perform each phase of the technique, and the behavior and vertical variation of the trajectory of tori’s center of mass (ΔCM. Ten throws using the seoi nage technique on three uke of shorter, equivalent, and taller statures compared to tori were cinematically analyzed. Theimages were recorded at 180 Hz using the Peak Motus System. The data was analyzed by descriptive statistics, ANOVA, and Tukey’s post-hoc (p < 0.05. The tori’s mechanical efficiency was greater when throwing a uke of a stature taller or of his same height, while the total throw time was shorter for a taller uke. The ΔCM of the tori was greater to throw a uke of a shorter stature. The conclusion is that the seoi nage technique is most effective when applied against opponents of heights equal to or taller than the tori.

  15. Process for preparing schottky diode contacts with predetermined barrier heights

    Science.gov (United States)

    Chang, Y. Austin; Jan, Chia-Hong; Chen, Chia-Ping

    1996-01-01

    A process is provided for producing a Schottky diode having a preselected barrier height .phi..sub.Bn. The substrate is preferably n-GaAs, the metallic contact is derived from a starting alloy of the Formula [.SIGMA.M.sub..delta. ](Al.sub.x Ga.sub.1-x) wherein: .SIGMA.M is a moiety which consists of at least one M, and when more than one M is present, each M is different, M is a Group VIII metal selected from the group consisting of nickel, cobalt, ruthenium, rhodium, indium and platinum, .delta. is a stoichiometric coefficient whose total value in any given .SIGMA.M moiety is 1, and x is a positive number between 0 and 1 (that is, x ranges from greater than 0 to less than 1). Also, the starting alloy is capable of forming with the substrate a two phase equilibrium reciprocal system of the binary alloy mixture [.SIGMA.M.sub..delta. ]Ga-[.SIGMA.M.sub..delta. ]Al-AlAs-GaAs. When members of an alloy subclass within this Formula are each preliminarily correlated with the barrier height .phi..sub.Bn of a contact producable therewith, then Schottky diodes of predetermined barrier heights are producable by sputtering and annealing. Further provided are the product Schottky diodes that are produced according to this process.

  16. Barrier heights, polarization switching, and electrical fatigue in Pb(Zr,Ti)O3 ceramics with different electrodes

    Science.gov (United States)

    Chen, Feng; Schafranek, Robert; Wachau, André; Zhukov, Sergey; Glaum, Julia; Granzow, Torsten; von Seggern, Heinz; Klein, Andreas

    2010-11-01

    The influence of Pt, tin-doped In2O3, and RuO2 electrodes on the electrical fatigue of bulk ceramic Pb(Zr,Ti)O3 (PZT) has been studied. Schottky barrier heights at the ferroelectric/electrode interfaces vary by more than one electronvolt for different electrode materials and do not depend on crystallographic orientation of the interface. Despite different barrier heights, hysteresis loops of polarization, strain, permittivity, and piezoelectric constant and the switching kinetics are identical for all electrodes. A 20% reduction in polarization after 106 bipolar cycles is observed for all the samples. In contrast to PZT thin films, the loss of remanent polarization with bipolar switching cycles does not significantly depend on the electrode material.

  17. Vertical distribution of hydrocarbons in the low troposphere below and above the mixing height: tethered balloon measurements in Milan, Italy.

    Science.gov (United States)

    Sangiorgi, G; Ferrero, L; Perrone, M G; Bolzacchini, E; Duane, M; Larsen, B R

    2011-12-01

    A novel approach for measuring vertical profiles of HCs and particle number concentrations was described and applied in the low troposphere over Milan (Italy) during typical spring and summer days. Particle profiles yielded nearly homogeneous concentrations below the mixing height, with level-to-ground concentration ratios of 92-97%, while HCs showed a more pronounced decrease (74-95%). Vertical mixing and photochemical loss of HCs were demonstrated to cause these gradients. Much lower concentrations were observed for the profiles above the mixing height, where the HC mixtures showed also a different composition, which was partially explained by the horizontal advection of air with HC sources different to those prevailing at the site. The application of pseudo-first order kinetics for reactions between HCs and the hydroxyl radical allowed for the estimation of the vertical mixing time scale in the order of 100 ± 20 min. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Number of patient-reported allergies helps distinguish epilepsy from psychogenic nonepileptic seizures.

    Science.gov (United States)

    Robbins, Nathaniel M; Larimer, Phillip; Bourgeois, James A; Lowenstein, Daniel H

    2016-02-01

    Psychogenic nonepileptic seizures (PNES) are relatively common, accounting for 5-40% of visits to tertiary epilepsy centers. Inpatient video-electroencephalogram (vEEG) monitoring is the gold standard for diagnosis, but additional positive predictive tools are necessary given vEEG's relatively scarce availability. In this study, we investigated if the number of patient-reported allergies distinguishes between PNES and epilepsy. Excessive allergy-reporting, like PNES, may reflect somatization. Using electronic medical records, ICD-9 codes, and text-identification algorithms to search EEG reports, we identified 905 cases of confirmed PNES and 5187 controls with epilepsy but no PNES. Patients with PNES averaged more self-reported allergies than patients with epilepsy alone (1.93 vs. 1.00, pallergies, each additional allergy linearly increased the percentage of patients with PNES by 2.98% (R(2)=0.71) such that with ≥12 allergies, 12/28 patients (42.8%) had PNES compared to 349/3368 (11.6%) of the population with no allergies (odds ratio=6.49). This relationship remained unchanged with logistic regression analysis. We conclude that long allergy lists may help identify patients with PNES. We hypothesize that a tendency to inaccurately self-report allergies reflects a maladaptive externalization of psychologic distress and that a similar mechanism may be responsible for PNES in some patients with somatic symptom disorder. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Interviewing to develop Patient-Reported Outcome (PRO) measures for clinical research: eliciting patients’ experience

    Science.gov (United States)

    2014-01-01

    Patient-reported outcome (PRO) measures must provide evidence that their development followed a rigorous process for ensuring their content validity. To this end, the collection of data is performed through qualitative interviews that allow for the elicitation of in-depth spontaneous reports of the patients’ experiences with their condition and/or its treatment. This paper provides a review of qualitative research applied to PRO measure development. A clear definition of what is a qualitative research interview is given as well as information about the form and content of qualitative interviews required for developing PRO measures. Particular attention is paid to the description of interviewing approaches (e.g., semi-structured and in-depth interviews, individual vs. focus group interviews). Information about how to get prepared for a qualitative interview is provided with the description of how to develop discussion guides for exploratory or cognitive interviews. Interviewing patients to obtain knowledge regarding their illness experience requires interpersonal and communication skills to facilitate patients’ expression. Those skills are described in details, as well as the skills needed to facilitate focus groups and to interview children, adolescents and the elderly. Special attention is also given to quality assurance and interview training. The paper ends on ethical considerations since interviewing for the development of PROs is performed in a context of illness and vulnerability. Therefore, it is all the more important that, in addition to soliciting informed consent, respectful interactions be ensured throughout the interview process. PMID:24499454

  20. Readability Level of Spanish-Language Patient-Reported Outcome Measures in Audiology and Otolaryngology

    Science.gov (United States)

    Coco, Laura; Colina, Sonia; Atcherson, Samuel R.

    2017-01-01

    Purpose The purpose of this study was to examine the readability level of the Spanish versions of several audiology- and otolaryngology-related patient-reported outcome measures (PROMs) and include a readability analysis of 2 translation approaches when available—the published version and a “functionalist” version—using a team-based collaborative approach including community members. Method Readability levels were calculated using the Fry Graph adapted for Spanish, as well as the Fernandez-Huerta and the Spaulding formulae for several commonly used audiology- and otolaryngology-related PROMs. Results Readability calculations agreed with previous studies analyzing audiology-related PROMs in English and demonstrated many Spanish-language PROMs were beyond the 5th grade reading level suggested for health-related materials written for the average population. In addition, the functionalist versions of the PROMs yielded lower grade-level (improved) readability levels than the published versions. Conclusion Our results suggest many of the Spanish-language PROMs evaluated here are beyond the recommended readability levels and may be influenced by the approach to translation. Moreover, improved readability may be possible using a functionalist approach to translation. Future analysis of the suitability of outcome measures and the quality of their translations should move beyond readability and include an evaluation of the individual's comprehension of the written text. PMID:28892821

  1. Use of Diabetes Treatment Satisfaction Questionnaire in Diabetes Care: Importance of Patient-Reported Outcomes

    Directory of Open Access Journals (Sweden)

    Yoshifumi Saisho

    2018-05-01

    Full Text Available The efficacy of diabetes treatment should not be evaluated solely by HbA1c levels as they should also focus on patient-reported outcomes (PROs, such as patient satisfaction, wellbeing and quality of life. The Diabetes Treatment Satisfaction Questionnaire (DTSQ has been developed to assess patient satisfaction with diabetes treatment. DTSQ has been translated into more than 100 languages and is widely used in many countries, since it is relatively easy to answer and is used for both patients with and without medical therapy. Novel therapeutic options, such as insulin analogs, incretin-based therapy and sodium-glucose cotransporter 2 (SGLT2 inhibitors, have been shown to improve patient satisfaction using DTSQ for assessments. DTSQ is not only used for comparisons between different medications or treatment strategies, but also can be used to assess the quality of diabetes care in clinical settings. This is important as an improvement in treatment satisfaction may enhance patients’ self-efficacy and adherence to therapy, leading to the achievement of long-term stable glycemic control and reduced risk of diabetic complications. In this review, we summarize the current topics in DTSQ, introducing our own experience, and discuss the role of PROs in diabetes treatment.

  2. The Influence of Obesity on Patient Reported Outcomes following Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    Vandana Ayyar

    2012-01-01

    Full Text Available This study retrospectively analysed the effects of obesity as described by Body Mass Index (BMI on patient reported outcomes following total knee replacement. Participants (105 females and 66 males who had undergone surgery under the care of a single surgeon were included in the review and were grouped according to their preoperative BMI into nonobese ( kg/m2, ( obese ( kg/m2 (. Oxford Knee Score (OKS and Short Form 12 scores (SF12 were taken preoperatively and 6 and 12 months after surgery to analyse differences between groups in the absolute scores as well as changes from before to after surgery. Preoperatively, the obese group had a significantly poorer OKS compared to non obese (44.7 versus 41.2, . There were no statistically significant group effects on follow-up or change scores of the OKS and SF12. Correlations coefficients between BMI and follow-up and change scores were low (. There were no significant differences in the number of complications and revisions (local wound infection, 6.7% non obese, 11% obese, postoperative systemic complication, 8% non obese, 12% obese, revision, 4% nonobese, 3% obese. In conclusion, our findings indicate similar degrees of benefits from the surgery irrespective of patient BMI.

  3. Systematic collection of patient reported outcome research data: A checklist for clinical research professionals.

    Science.gov (United States)

    Wehrlen, Leslie; Krumlauf, Mike; Ness, Elizabeth; Maloof, Damiana; Bevans, Margaret

    2016-05-01

    Understanding the human experience is no longer an outcome explored strictly by social and behavioral researchers. Increasingly, biomedical researchers are also including patient reported outcomes (PROs) in their clinical research studies not only due to calls for increased patient engagement in research but also healthcare. Collecting PROs in clinical research studies offers a lens into the patient's unique perspective providing important information to industry sponsors and the FDA. Approximately 30% of trials include PROs as primary or secondary endpoints and a quarter of FDA new drug, device and biologic applications include PRO data to support labeling claims. In this paper PRO, represents any information obtained directly from the patient or their proxy, without interpretation by another individual to ascertain their health, evaluate symptoms or conditions and extends the reference of PRO, as defined by the FDA, to include other sources such as patient diaries. Consumers and clinicians consistently report that PRO data are valued, and can aide when deciding between treatment options; therefore an integral part of clinical research. However, little guidance exists for clinical research professionals (CRPs) responsible for collecting PRO data on the best practices to ensure quality data collection so that an accurate assessment of the patient's view is collected. Therefore the purpose of this work was to develop and validate a checklist to guide quality collection of PRO data. The checklist synthesizes best practices from published literature and expert opinions addressing practical and methodological challenges CRPs often encounter when collecting PRO data in research settings. Published by Elsevier Inc.

  4. Analyzing differences between patient and proxy on Patient Reported Outcomes in multiple sclerosis.

    Science.gov (United States)

    Sonder, Judith M; Holman, Rebecca; Knol, Dirk L; Bosma, Libertje V A E; Polman, Chris H; Uitdehaag, Bernard M J

    2013-11-15

    Proxy respondents, partners of multiple sclerosis (MS) patients, can provide valuable information on the MS patients' disease. In an earlier publication we found relatively good agreement on patient reported outcomes (PROs) measuring physical impact and functioning, but we found large differences on (neuro)psychological scales. We aim to identify patient and proxy related variables explaining differences between patients' and proxies' ratings on five PROs. We report on data from 175 MS patients and proxy respondents. Regression analyses were performed, using as dependent variable the mean differences on five scales: Physical and Psychological scale of the Multiple Sclerosis Impact Scale (MSIS-29), the Multiple Sclerosis Walking Scale (MSWS), Guy's Neurological Disability Scale (GNDS) and the Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ). The independent variables were patient, proxy and disease related variables. Caregiver strain was significantly related to differences between patient and proxy scores for all five PROs. A higher level of patient anxiety on the HADS was linked to larger differences on all PROs except the GNDS. In addition, cognitive functioning, proxy depression, walking ability, proxy gender and MS related disability were contributing to the discrepancies. We found several patient and proxy factors that may contribute to discrepancies between patient and proxy scores on MS PROs. The most important factor is caregiver burden. © 2013 Elsevier B.V. All rights reserved.

  5. Collecting, Integrating, and Disseminating Patient-Reported Outcomes for Research in a Learning Healthcare System.

    Science.gov (United States)

    Harle, Christopher A; Lipori, Gloria; Hurley, Robert W

    2016-01-01

    Advances in health policy, research, and information technology have converged to increase the electronic collection and use of patient-reported outcomes (PROs). Therefore, it is important to share lessons learned in implementing PROs in research information systems. The purpose of this case study is to describe a novel information system for electronic PROs and lessons learned in implementing that system to support research in an academic health center. The system incorporates freely available and commercial software and involves clinical and research workflows that support the collection, transformation, and research use of PRO data. The software and processes that comprise the system serve three main functions, (i) collecting electronic PROs in clinical care, (ii) integrating PRO data with non-patient generated clinical data, and (iii) disseminating data to researchers through the institution's research informatics infrastructure, including the i2b2 (Informatics for Integrating Biology and the Bedside) system. Our successful design and implementation was driven by three overarching strategies. First, we selected and implemented multiple interfaced technologies to support PRO collection, management, and research use. Second, we aimed to use standardized approaches to measuring PROs, sending PROs between systems, and disseminating PROs. Finally, we focused on using technologies and processes that aligned with existing clinical research information management strategies within our organization. These experiences and lessons may help future implementers and researchers enhance the scale and sustainable use of systems for research use of PROs.

  6. Toward Ensuring Health Equity: Readability and Cultural Equivalence of OMERACT Patient-reported Outcome Measures.

    Science.gov (United States)

    Petkovic, Jennifer; Epstein, Jonathan; Buchbinder, Rachelle; Welch, Vivian; Rader, Tamara; Lyddiatt, Anne; Clerehan, Rosemary; Christensen, Robin; Boonen, Annelies; Goel, Niti; Maxwell, Lara J; Toupin-April, Karine; De Wit, Maarten; Barton, Jennifer; Flurey, Caroline; Jull, Janet; Barnabe, Cheryl; Sreih, Antoine G; Campbell, Willemina; Pohl, Christoph; Duruöz, Mehmet Tuncay; Singh, Jasvinder A; Tugwell, Peter S; Guillemin, Francis

    2015-12-01

    The goal of the Outcome Measures in Rheumatology (OMERACT) 12 (2014) equity working group was to determine whether and how comprehensibility of patient-reported outcome measures (PROM) should be assessed, to ensure suitability for people with low literacy and differing cultures. The English, Dutch, French, and Turkish Health Assessment Questionnaires and English and French Osteoarthritis Knee and Hip Quality of Life questionnaires were evaluated by applying 3 readability formulas: Flesch Reading Ease, Flesch-Kincaid grade level, and Simple Measure of Gobbledygook; and a new tool, the Evaluative Linguistic Framework for Questionnaires, developed to assess text quality of questionnaires. We also considered a study assessing cross-cultural adaptation with/without back-translation and/or expert committee. The results of this preconference work were presented to the equity working group participants to gain their perspectives on the importance of comprehensibility and cross-cultural adaptation for PROM. Thirty-one OMERACT delegates attended the equity session. Twenty-six participants agreed that PROM should be assessed for comprehensibility and for use of suitable methods (4 abstained, 1 no). Twenty-two participants agreed that cultural equivalency of PROM should be assessed and suitable methods used (7 abstained, 2 no). Special interest group participants identified challenges with cross-cultural adaptation including resources required, and suggested patient involvement for improving translation and adaptation. Future work will include consensus exercises on what methods are required to ensure PROM are appropriate for people with low literacy and different cultures.

  7. An introduction to patient-reported outcome measures (PROMs) in physiotherapy.

    Science.gov (United States)

    Kyte, D G; Calvert, M; van der Wees, P J; ten Hove, R; Tolan, S; Hill, J C

    2015-06-01

    The use of patient-reported outcome measures (PROMs) is set to rise in physiotherapy. PROMs provide additional 'patient-centred' data which is unique in capturing the patient's own opinion on the impact of their disease or disorder, and its treatment, on their life. Thus, PROMs are increasingly used by clinicians to guide routine patient care, or for the purposes of audit, and are already firmly embedded in clinical research. This article seeks to summarise the key aspects of PROM use for physiotherapists, both in routine clinical practice and in the research setting, and highlights recent developments in the field. Generic and condition-specific PROMs are defined and examples of commonly used measures are provided. The selection of appropriate PROMs, and their effective use in the clinical and research settings is discussed. Finally, existing barriers to PROM use in practice are identified and recent physiotherapy PROM initiatives, led by the Royal Dutch Society for Physical Therapy are explored. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. [Outcome Quality in Medical Rehabilitation: Relationship Between "Patient-Reported Outcomes" (PROs) and Social Security Contributions].

    Science.gov (United States)

    Nübling, R; Kaluscha, R; Krischak, G; Kriz, D; Martin, H; Müller, G; Renzland, J; Reuss-Borst, M; Schmidt, J; Kaiser, U; Toepler, E

    2017-02-01

    Aim of the Study The outcome quality of medical rehabilitation is evaluated often by "Patient Reported Outcomes" (PROs). It is examined to what extent these PROs are corresponding with "hard" or "objective" outcomes such as payments of contributions to social insurance. Methods The "rehabilitation QM outcome study" includes self-reports of patients as well as data from the Rehabilitation Statistics Database (RSD) of the German pension insurance Baden-Wurttemberg. The sample for the question posed includes N=2 947 insured who were treated in 2011 in 21 clinics of the "health quality network" and who were either employed or unemployed at the time of the rehabilitation application (e. g. the workforce or labour force group, response rate: 55%). The sample turned out widely representative for the population of the insured persons. Results PROs and payment of contributions to pension insurance clearly correspond. In the year after the rehabilitation improved vs. not improved rehabilitees differed clearly with regard to their payments of contributions. Conclusions The results support the validity of PROs. For a comprehensive depiction of the outcome quality of rehabilitation PROs and payments of contributions should be considered supplementary. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Patient Reported Outcome Measure of Spiritual Care as Delivered by Chaplains.

    Science.gov (United States)

    Snowden, Austyn; Telfer, Iain

    2017-01-01

    Chaplains are employed by health organizations around the world to support patients in recognizing and addressing their spiritual needs. There is currently no generalizable measure of the impact of these interventions and so the clinical and strategic worth of chaplaincy is difficult to articulate. This article introduces the Scottish PROM, an original five-item patient reported outcome measure constructed specifically to address this gap. It describes the validation process from its conceptual grounding in the spiritual care literature through face and content validity cycles. It shows that the Scottish PROM is internally consistent and unidimensional. Responses to the Scottish PROM show strong convergent validity with responses to the Warwick and Edinburgh Mental Well-Being Scale, a generic well-being scale often used as a proxy for spiritual well-being. In summary, the Scottish PROM is fit for purpose. It measures the outcomes of spiritual care as delivered by chaplains in this study. This novel project introduces an essential and original breakthrough; the possibility of generalizable international chaplaincy research.

  10. Patient-reported denials, appeals, and complaints: associations with overall plan ratings.

    Science.gov (United States)

    Quigley, Denise D; Haviland, Amelia M; Dembosky, Jacob W; Klein, David J; Elliott, Marc N

    2018-03-01

    To assess whether Medicare patients' reports of denied care, appeals/complaints, and satisfactory resolution were associated with ratings of their health plan or care. Retrospective analysis of 2010 Medicare Advantage Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data. Multivariate linear regression of data from 154,766 respondents (61.1% response rate) tested the association of beneficiary ratings of plan and care with beneficiary reports of denied care, appeals, complaints, and complaint resolution, adjusting for beneficiary demographics. Beneficiaries who reported being denied needed care rated their plans and care significantly less positively, by 17.2 points (on a 100-point scale) and 9.1 points, respectively. Filing an appeal was not statistically significantly associated with further lower ratings. Beneficiaries who filed a complaint that was satisfactorily resolved gave slightly lower ratings of plans (-3.4 points) and care (-2.5 points) than those not filing a complaint (P plans. Our results suggest that beneficiaries may attribute the actions that lead to complaints or denials to plans more than to the care they received. Successful complaint resolution and utilization management review might eliminate most deficits associated with complaints and denied care, consistent with the service recovery paradox. High rates of complaints and denied care might identify areas that need improved utilization management review, customer service, and quality improvement. Among those reporting being denied care, filing an appeal was not associated with lower patient ratings of plan or care.

  11. An Introduction to Item Response Theory for Patient-Reported Outcome Measurement

    Science.gov (United States)

    Nguyen, Tam H.; Han, Hae-Ra; Kim, Miyong T.

    2015-01-01

    The growing emphasis on patient-centered care has accelerated the demand for high-quality data from patient-reported outcome (PRO) measures. Traditionally, the development and validation of these measures has been guided by classical test theory. However, item response theory (IRT), an alternate measurement framework, offers promise for addressing practical measurement problems found in health-related research that have been difficult to solve through classical methods. This paper introduces foundational concepts in IRT, as well as commonly used models and their assumptions. Existing data on a combined sample (n = 636) of Korean American and Vietnamese American adults who responded to the High Blood Pressure Health Literacy Scale and the Patient Health Questionnaire-9 are used to exemplify typical applications of IRT. These examples illustrate how IRT can be used to improve the development, refinement, and evaluation of PRO measures. Greater use of methods based on this framework can increase the accuracy and efficiency with which PROs are measured. PMID:24403095

  12. Symptoms and side effects in chronic non-cancer pain: patient report vs. systematic assessment.

    Science.gov (United States)

    Jonsson, T; Christrup, L L; Højsted, J; Villesen, H H; Albjerg, T H; Ravn-Nielsen, L V; Sjøgren, P

    2011-01-01

    relieving distressing symptoms and managing the side effects of analgesics are essential in order to improve quality of life and functional capacity in chronic non-cancer pain patients. A quick, reliable and valid tool for assessing symptoms and side effects is needed in order to optimize treatment. We aimed to investigate the symptoms reported by chronic non-cancer pain patients after open-ended questioning vs. a systematic assessment using a list of symptoms, and to assess whether the patients could distinguish between the symptoms and the side effects induced by analgesics. patients treated with either opioids and/or adjuvant analgesics were asked to report their symptoms spontaneously, followed by a 41-item investigator-developed symptom checklist. A control group also filled in the checklist. a total of 62 patients and 64 controls participated in the study. The numbers of symptoms reported by the patients (9.9 ± 5.9) were significantly higher than those reported by the controls (3.2 ± 3.9) (Pside effects due to analgesics was: (1) Dry mouth (42%); (2) Sweating (34%); (3) Weight gain (29%); (4) Memory deficits (24%); (5) Fatigue (19%); and (6) Concentration deficits (19%). the number of symptoms reported using systematic assessment was eightfold higher than those reported voluntarily. Fatigue, cognitive dysfunction, dry mouth, sweating and weight gain were the most frequently reported. The patients reported the side effects of their analgesics to contribute substantially to the reported symptoms. 2010 The Acta Anaesthesiologica Scandinavica Foundation.

  13. Patient-reported speech in noise difficulties and hyperacusis symptoms and correlation with test results.

    Science.gov (United States)

    Spyridakou, Chrysa; Luxon, Linda M; Bamiou, Doris E

    2012-07-01

    To compare self-reported symptoms of difficulty hearing speech in noise and hyperacusis in adults with auditory processing disorders (APDs) and normal controls; and to compare self-reported symptoms to objective test results (speech in babble test, transient evoked otoacoustic emission [TEOAE] suppression test using contralateral noise). A prospective case-control pilot study. Twenty-two participants were recruited in the study: 10 patients with reported hearing difficulty, normal audiometry, and a clinical diagnosis of APD; and 12 normal age-matched controls with no reported hearing difficulty. All participants completed the validated Amsterdam Inventory for Auditory Disability questionnaire, a hyperacusis questionnaire, a speech in babble test, and a TEOAE suppression test using contralateral noise. Patients had significantly worse scores than controls in all domains of the Amsterdam Inventory questionnaire (with the exception of sound detection) and the hyperacusis questionnaire (P reported symptoms of difficulty hearing speech in noise and speech in babble test results in the right ear (ρ = 0.624, P = .002), and between self-reported symptoms of hyperacusis and TEOAE suppression test results in the right ear (ρ = -0.597 P = .003). There was no significant correlation between the two tests. A strong correlation was observed between right ear speech in babble and patient-reported intelligibility of speech in noise, and right ear TEOAE suppression by contralateral noise and hyperacusis questionnaire. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  14. Electronic Patient Reported Outcomes in Paediatric Oncology - Applying Mobile and Near Field Communication Technology.

    Science.gov (United States)

    Duregger, Katharina; Hayn, Dieter; Nitzlnader, Michael; Kropf, Martin; Falgenhauer, Markus; Ladenstein, Ruth; Schreier, Günter

    2016-01-01

    Electronic Patient Reported Outcomes (ePRO) gathered using telemonitoring solutions might be a valuable source of information in rare cancer research. The objective of this paper was to develop a concept and implement a prototype for introducing ePRO into the existing neuroblastoma research network by applying Near Field Communication and mobile technology. For physicians, an application was developed for registering patients within the research network and providing patients with an ID card and a PIN for authentication when transmitting telemonitoring data to the Electronic Data Capture system OpenClinica. For patients, a previously developed telemonitoring system was extended by a Simple Object Access Protocol (SOAP) interface for transmitting nine different health parameters and toxicities. The concept was fully implemented on the front-end side. The developed application for physicians was prototypically implemented and the mobile application of the telemonitoring system was successfully connected to OpenClinica. Future work will focus on the implementation of the back-end features.

  15. The importance of patient-reported outcome measures in reconstructive urology.

    Science.gov (United States)

    Jackson, Matthew J; N'Dow, James; Pickard, Rob

    2010-11-01

    Patient-reported outcome measures (PROMs) are now recognised as the most appropriate instruments to assess the effectiveness of healthcare interventions from the patient's perspective. The purpose of this review was to identify recent publications describing the use of PROMs following reconstructive urological surgery. A wide systematic search identified only three original articles published in the last 2 years that prospectively assessed effectiveness using a patient-completed condition-specific or generic health-related quality of life (HRQoL) instrument. These publications illustrate the need to administer PROMs at a postoperative interval relevant to the anticipated recovery phase of individual procedures. They also highlight the difference in responsiveness of generic HRQoL instruments to symptomatic improvement between straightforward conditions such as pelviureteric junction obstruction and complex multidimensional conditions such as meningomyelocele. PROMs uptake and awareness is increasing in reconstructive urology but more work is required to demonstrate the effectiveness of surgical procedures for patients and healthcare funders alike. Healthcare policy-makers now rely on these measures to determine whether specific treatments are worth financing and to compare outcomes between institutions.

  16. Standards for Clinical Trials in Male and Female Sexual Dysfunction: II. Patient-Reported Outcome Measures.

    Science.gov (United States)

    Fisher, William A; Gruenwald, Ilan; Jannini, Emmanuele A; Lev-Sagie, Ahinoam; Lowenstein, Lior; Pyke, Robert E; Reisman, Yakov; Revicki, Dennis A; Rubio-Aurioles, Eusebio

    2016-12-01

    The second article in this series, Standards for Clinical Trials in Male and Female Sexual Dysfunction, focuses on measurement of patient-reported outcomes (PROs). Together with the design of appropriate phase I to phase IV clinical trials, the development, validation, choice, and implementation of valid PRO measurements-the focus of the present article-form the foundation of research on treatments for male and female sexual dysfunctions. PRO measurements are assessments of any aspect of a patient's health status that come directly from the patient (ie, without the interpretation of the patient's responses by a physician or anyone else). PROs are essential for assessing male and female sexual dysfunction and treatment response, including symptom frequency and severity, personal distress, satisfaction, and other measurements of sexual and general health-related quality of life. Although there are some relatively objective measurements of sexual dysfunction (ie, intravaginal ejaculatory latency time, frequency of sexual activity, etc), these measurements do not comprehensively assess the occurrence and extent of sexual dysfunction or treatment on the patient's symptoms, functioning, and well-being. Data generated by a PRO instrument can provide evidence of a treatment benefit from the patient's perspective. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  17. Added Value of Patient-Reported Outcome Measures in Stroke Clinical Practice.

    Science.gov (United States)

    Katzan, Irene L; Thompson, Nicolas R; Lapin, Brittany; Uchino, Ken

    2017-07-21

    There is uncertainty regarding the clinical utility of the data obtained from patient-reported outcome measures (PROMs) for patient care. We evaluated the incremental information obtained by PROMs compared to the clinician-reported modified Rankin Scale (mRS). This was an observational study of 3283 ischemic stroke patients seen in a cerebrovascular clinic from September 14, 2012 to June 16, 2015 who completed the routinely collected PROMs: Stroke Impact Scale-16 (SIS-16), EQ-5D, Patient Health Questionnaire-9, PROMIS Physical Function, and PROMIS fatigue. The amount of variation in the PROMs explained by mRS was determined using r 2 after adjustment for age and level of stroke impairment. The proportion with meaningful change was calculated for patients with ≥2 visits. Concordance with change in the other scales and the ability to discriminate changes in health state as measured by c-statistic was evaluated for mRS versus SIS-16. Correlation between PROMs and mRS was highest for SIS-16 ( r =-0.64, P measures. PROMs provide additional valuable information compared to the mRS alone in stroke patients seen in the ambulatory setting. SIS-16 may have a better ability to identify change than mRS in health status of relevance to the patient. PROMs may be a useful addition to mRS in the assessment of health status in clinical practice. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  18. Pragmatic characteristics of patient-reported outcome measures are important for use in clinical practice.

    Science.gov (United States)

    Kroenke, Kurt; Monahan, Patrick O; Kean, Jacob

    2015-09-01

    Measures for assessing patient-reported outcomes (PROs) that may have initially been developed for research are increasingly being recommended for use in clinical practice as well. Although psychometric rigor is essential, this article focuses on pragmatic characteristics of PROs that may enhance uptake into clinical practice. Three sources were drawn on in identifying pragmatic criteria for PROs: (1) selected literature review including recommendations by other expert groups; (2) key features of several model public domain PROs; and (3) the authors' experience in developing practical PROs. Eight characteristics of a practical PRO include: (1) actionability (i.e., scores guide diagnostic or therapeutic actions/decision making); (2) appropriateness for the relevant clinical setting; (3) universality (i.e., for screening, severity assessment, and monitoring across multiple conditions); (4) self-administration; (5) item features (number of items and bundling issues); (6) response options (option number and dimensions, uniform vs. varying options, time frame, intervals between options); (7) scoring (simplicity and interpretability); and (8) accessibility (nonproprietary, downloadable, available in different languages and for vulnerable groups, and incorporated into electronic health records). Balancing psychometric and pragmatic factors in the development of PROs is important for accelerating the incorporation of PROs into clinical practice. Published by Elsevier Inc.

  19. Patient-Reported Measures of Narcolepsy: The Need for Better Assessment.

    Science.gov (United States)

    Kallweit, Ulf; Schmidt, Markus; Bassetti, Claudio L

    2017-05-15

    Narcolepsy, a chronic disorder of the central nervous system, is clinically characterized by a symptom pentad that includes excessive daytime sleepiness, cataplexy, sleep paralysis, hypnopompic/hypnagogic hallucinations, and disrupted nighttime sleep. Ideally, screening and diagnosis instruments that assist physicians in evaluating a patient for type 1 or type 2 narcolepsy would be brief, easy for patients to understand and physicians to score, and would identify or rule out the need for electrophysiological testing. A search of the literature was conducted to review patient-reported measures used for the assessment of narcolepsy, mainly in clinical trials, with the goal of summarizing existing scales and identifying areas that may require additional screening questions and clinical practice scales. Of the seven scales reviewed, the Epworth Sleepiness Scale continues to be an important outcome measure to screen adults for excessive daytime sleepiness, which may be associated with narcolepsy. Several narcolepsy-specific scales have demonstrated utility, such as the Ullanlinna Narcolepsy Scale, Swiss Narcolepsy Scale, and Narcolepsy Symptom Assessment Questionnaire, but further validation is required. Although the narcolepsy-specific scales currently in use may identify type 1 narcolepsy, there are no validated questionnaires to identify type 2 narcolepsy. Thus, there remains a need for short, easily understood, and well-validated instruments that can be readily used in clinical practice to distinguish narcolepsy subtypes, as well as other hypersomnias, and for assessing symptoms of these conditions during treatment. © 2017 American Academy of Sleep Medicine

  20. A systematic review of patient reported outcome measures (PROMs) used in child and adolescent burn research.

    Science.gov (United States)

    Griffiths, C; Armstrong-James, L; White, P; Rumsey, N; Pleat, J; Harcourt, D

    2015-03-01

    Patient reported outcome measures (PROMs) can identify important information about patient needs and therapeutic progress. The aim of this review was to identify the PROMs that are being used in child and adolescent burn care and to determine the quality of such scales. Computerised and manual bibliographic searches of Medline, Social Sciences Index, Cinahl, Psychinfo, Psycharticles, AMED, and HAPI, were used to identify English-language articles using English-language PROMs from January 2001 to March 2013. The psychometric quality of the PROMs was assessed. 23 studies met the entry criteria and identified 32 different PROMs (31 generic, 1 burns-specific). Overall, the psychometric quality of the PROMs was low; only two generic scales (the Perceived Stigmatisation Questionnaire and the Social Comfort Scale) and only one burns-specific scale (the Children Burn Outcomes Questionnaire for children aged 5-18) had psychometric evidence relevant to this population. The majority of PROMs did not have psychometric evidence for their use with child or adolescent burn patients. To appropriately identify the needs and treatment progress of child and adolescent burn patients, new burns-specific PROMs need to be developed and validated to reflect issues that are of importance to this population. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.