WorldWideScience

Sample records for proxy reported qol

  1. Quality of Life of Children with Learning Disabilities: A Comparison of Self-Reports and Proxy Reports

    Science.gov (United States)

    Sakiz, Halis; Sart, Zeynep Hande; Börkan, Bengü; Korkmaz, Baris; Babür, Nalan

    2015-01-01

    This study aimed to explore how children with learning disabilities (LD) perceive their quality of life (QoL) and to compare self-reports and proxy reports regarding their QoL. Children with LD, their typically developing peers, their parents and teachers responded to the child, parent, and teacher forms of KINDL® Questionnaire for Measuring…

  2. Munchausen syndrome by proxy: a case report.

    Science.gov (United States)

    Lieder, Holly S; Irving, Sharon Y; Mauricio, Rizalina; Graf, Jeanine M

    2005-01-01

    Munchausen syndrome by proxy is difficult to diagnose unless healthcare providers are astute to its clinical features and management. A case is presented to educate nurses and advanced practice nurses, of the nursing, medical, legal, and social complexities associated with Munchausen syndrome by proxy. This article also provides a brief review of the definition of Munchausen syndrome by proxy, its epidemiology, common features of the perpetrator, implications for healthcare personnel, and the legal and international ramifications of Munchausen syndrome by proxy.

  3. Development of six PROMIS pediatrics proxy-report item banks

    Directory of Open Access Journals (Sweden)

    Irwin Debra E

    2012-02-01

    Full Text Available Abstract Background Pediatric self-report should be considered the standard for measuring patient reported outcomes (PRO among children. However, circumstances exist when the child is too young, cognitively impaired, or too ill to complete a PRO instrument and a proxy-report is needed. This paper describes the development process including the proxy cognitive interviews and large-field-test survey methods and sample characteristics employed to produce item parameters for the Patient Reported Outcomes Measurement Information System (PROMIS pediatric proxy-report item banks. Methods The PROMIS pediatric self-report items were converted into proxy-report items before undergoing cognitive interviews. These items covered six domains (physical function, emotional distress, social peer relationships, fatigue, pain interference, and asthma impact. Caregivers (n = 25 of children ages of 5 and 17 years provided qualitative feedback on proxy-report items to assess any major issues with these items. From May 2008 to March 2009, the large-scale survey enrolled children ages 8-17 years to complete the self-report version and caregivers to complete the proxy-report version of the survey (n = 1548 dyads. Caregivers of children ages 5 to 7 years completed the proxy report survey (n = 432. In addition, caregivers completed other proxy instruments, PedsQL™ 4.0 Generic Core Scales Parent Proxy-Report version, PedsQL™ Asthma Module Parent Proxy-Report version, and KIDSCREEN Parent-Proxy-52. Results Item content was well understood by proxies and did not require item revisions but some proxies clearly noted that determining an answer on behalf of their child was difficult for some items. Dyads and caregivers of children ages 5-17 years old were enrolled in the large-scale testing. The majority were female (85%, married (70%, Caucasian (64% and had at least a high school education (94%. Approximately 50% had children with a chronic health condition, primarily

  4. Application and Network-Cognizant Proxies - Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Antonio Ortega; Daniel C. Lee

    2003-03-24

    OAK B264 Application and Network-Cognizant Proxies - Final Report. Current networks show increasing heterogeneity both in terms of their bandwidths/delays and the applications they are required to support. This is a trend that is likely to intensify in the future, as real-time services, such as video, become more widely available and networking access over wireless links becomes more widespread. For this reason they propose that application-specific proxies, intermediate network nodes that broker the interactions between server and client, will become an increasingly important network element. These proxies will allow adaptation to changes in network characteristics without requiring a direct intervention of either server or client. Moreover, it will be possible to locate these proxies strategically at those points where a mismatch occurs between subdomains (for example, a proxy could be placed so as to act as a bridge between a reliable network domain and an unreliable one). This design philosophy favors scalability in the sense that the basic network infrastructure can remain unchanged while new functionality can be added to proxies, as required by the applications. While proxies can perform numerous generic functions, such as caching or security, they concentrate here on media-specific, and in particular video-specific, tasks. The goal of this project was to demonstrate that application- and network-specific knowledge at a proxy can improve overall performance especially under changing network conditions. They summarize below the work performed to address these issues. Particular effort was spent in studying caching techniques and on video classification to enable DiffServ delivery. other work included analysis of traffic characteristics, optimized media scheduling, coding techniques based on multiple description coding, and use of proxies to reduce computation costs. This work covered much of what was originally proposed but with a necessarily reduced scope.

  5. Measurement equivalence across child self-reports and parent-proxy reports in the Chinese version of the pediatric quality of life inventory version 4.0.

    Science.gov (United States)

    Lin, Chung-Ying; Luh, Wei-Ming; Cheng, Chung-Ping; Yang, Ai-Lun; Su, Chia-Ting; Ma, Hui-Ing

    2013-10-01

    An important assumption for comparing children's quality of life (QoL) between children's and parents' perceptions is that measurement equivalence/invariance (ME/I) exists. The ME/I across the child- and parent-reported Chinese PedsQL was examined, and the latent means between child self-reports and parent-proxy reports were compared. Third-grade to sixth-grade children (n = 519) and their parents (n = 270) respectively completed the child- and parent-reported PedsQL. Seventy-eight parents completed parent-proxy reports twice. Full ME/I across child and parent reports was found in first- and second-order factor loadings. Partial ME/I was supported in item intercepts and item residual variances. The latent means of child self-reports and of parent-proxy reports were not significantly different, which suggested interchangeability between child- and parent-reported PedsQL. The ME/I results support the use of PedsQL scores to compare children's and parents' perceptions of children's QoL.

  6. Reliability of proxy reports of parental smoking by elementary schoolchildren.

    Science.gov (United States)

    Barnett, T; O'Loughlin, J; Paradis, G; Renaud, L

    1997-08-01

    To investigate the reliability of reports of parental smoking by elementary schoolchildren aged 9-13 years, and to identify the correlates of disagreement between student proxy and parent self-reports. As part of the evaluation of a school-based heart health promotion program, data on parental smoking status were collected from 1240 student-mother pairs and 898 student-father pairs. Agreement for parental smoking status was 93.1% among student-mother pairs and 86.4% among student-father pairs. Among student-mother pairs, reports by students aged 9 years were more likely to disagree with mothers' self-reports than those of older children (odds ratio (OR) = 3.1). Among student-father pairs, the only significant correlate of disagreement was living in a single-parent family headed by the mother (OR = 2.6). Children 10-years or older can provide reliable reports of the smoking status of cohabiting parents.

  7. Neuro-QOL

    Science.gov (United States)

    Lai, J.-S.; Nowinski, C.J.; Victorson, D.; Peterman, A.; Miller, D.; Bethoux, F.; Heinemann, A.; Rubin, S.; Cavazos, J.E.; Reder, A.T.; Sufit, R.; Simuni, T.; Holmes, G.L.; Siderowf, A.; Wojna, V.; Bode, R.; McKinney, N.; Podrabsky, T.; Wortman, K.; Choi, S.; Gershon, R.; Rothrock, N.; Moy, C.

    2012-01-01

    Objective: To address the need for brief, reliable, valid, and standardized quality of life (QOL) assessment applicable across neurologic conditions. Methods: Drawing from larger calibrated item banks, we developed short measures (8–9 items each) of 13 different QOL domains across physical, mental, and social health and evaluated their validity and reliability. Three samples were utilized during short form development: general population (Internet-based, n = 2,113); clinical panel (Internet-based, n = 553); and clinical outpatient (clinic-based, n = 581). All short forms are expressed as T scores with a mean of 50 and SD of 10. Results: Internal consistency (Cronbach α) of the 13 short forms ranged from 0.85 to 0.97. Correlations between short form and full-length item bank scores ranged from 0.88 to 0.99 (0.82–0.96 after removing common items from banks). Online respondents were asked whether they had any of 19 different chronic health conditions, and whether or not those reported conditions interfered with ability to function normally. All short forms, across physical, mental, and social health, were able to separate people who reported no health condition from those who reported 1–2 or 3 or more. In addition, scores on all 13 domains were worse for people who acknowledged being limited by the health conditions they reported, compared to those who reported conditions but were not limited by them. Conclusion: These 13 brief measures of self-reported QOL are reliable and show preliminary evidence of concurrent validity inasmuch as they differentiate people based upon number of reported health conditions and whether those reported conditions impede normal function. PMID:22573626

  8. Psychometric evaluation of the pediatric and parent-proxy Patient-Reported Outcomes Measurement Information System and the Neurology and Traumatic Brain Injury Quality of Life measurement item banks in pediatric traumatic brain injury.

    Science.gov (United States)

    Bertisch, Hilary; Rivara, Frederick P; Kisala, Pamela A; Wang, Jin; Yeates, Keith Owen; Durbin, Dennis; Zonfrillo, Mark R; Bell, Michael J; Temkin, Nancy; Tulsky, David S

    2017-07-01

    The primary objective is to provide evidence of convergent and discriminant validity for the pediatric and parent-proxy versions of the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, Depression, Anger, Peer Relations, Mobility, Pain Interference, and Fatigue item banks, the Neurology Quality of Life measurement system (Neuro-QOL) Cognition-General Concerns and Stigma item banks, and the Traumatic Brain Injury Quality of Life (TBI-QOL) Executive Function and Headache item banks in a pediatric traumatic brain injury (TBI) sample. Participants were 134 parent-child (ages 8-18 years) days. Children all sustained TBI and the dyads completed outcome ratings 6 months after injury at one of six medical centers across the United States. Ratings included PROMIS, Neuro-QOL, and TBI-QOL item banks, as well as the Pediatric Quality of Life inventory (PedsQL), the Health Behavior Inventory (HBI), and the Strengths and Difficulties Questionnaire (SDQ) as legacy criterion measures against which these item banks were validated. The PROMIS, Neuro-QOL, and TBI-QOL item banks demonstrated good convergent validity, as evidenced by moderate to strong correlations with comparable scales on the legacy measures. PROMIS, Neuro-QOL, and TBI-QOL item banks showed weaker correlations with ratings of unrelated constructs on legacy measures, providing evidence of discriminant validity. Our results indicate that the constructs measured by the PROMIS, Neuro-QOL, and TBI-QOL item banks are valid in our pediatric TBI sample and that it is appropriate to use these standardized scores for our primary study analyses.

  9. A case report of Factitious Disorder (Munchausen Syndrome by proxy

    Directory of Open Access Journals (Sweden)

    Mehdi Shirzadifar

    2014-09-01

    Full Text Available Background: In Factitious Disorder by proxy, one person (perpetrator induces the disease in another person, thereby seeking emotional needs during the treatment process Diagnosis of this disorder is very difficult and there is not much consensus over it among experts. Lack of timely diagnosis of this disorder may lead to serious harms in patients. Case presentation: We will introduce a 19 year-old boy with mental retardation and history of multiple admissions to psychiatric, internal, urology and surgery wards. He has a 12 year-old sister and a 4 year-old brother, both with history of multiple admissions to pediatrics and internal wards. The father of family was 48 years old with chronic mental disorder, drug dependency and history of multiple admissions to medical, psychiatry and neurology wards. The mother of this family was diagnosed with munchausen syndrome by proxy.

  10. Patient-rated versus proxy-rated cognitive and functional measures in older adults

    Science.gov (United States)

    Howland, Molly; Allan, Kevin C; Carlton, Caitlin E; Tatsuoka, Curtis; Smyth, Kathleen A; Sajatovic, Martha

    2017-01-01

    Objectives Patients with cognitive impairment may have difficulty reporting their functional and cognitive abilities, which are important clinical outcomes. Health care proxies may be able to corroborate patient self-reports. Several studies reported discrepancy between patient and proxy ratings, though the literature is sparse on changes over time of these ratings. Our goals in this 12-month study were to compare patient and proxy reports on functioning, cognition, and everyday executive function, and to further elucidate correlates of patient–proxy discrepancy. Methods This was a prospective cohort study of individuals older than 70 years who ranged from having no cognitive impairment to having moderate dementia who had a proxy available to complete instruments at baseline (N=76). Measurements included Alzheimer’s Disease Cooperative Study–Activities of Daily Living Inventory (ADCS-ADLI), Neuro-QOL Executive Function, PROMIS Applied Cognition (PROMIS-Cog), Mini-Mental State Examination (MMSE), and Geriatric Depression Scale. Results Patient- and proxy-rated ADCS-ADLI were correlated at baseline and at 1-year follow-up. Patient and proxy ratings were discrepant on Neuro-QOL Executive Function and PROMIS-Cog. Greater patient–proxy discrepancy on PROMIS-Cog was associated with younger age and less depression, and greater patient–proxy discrepancy on Neuro-QOL Executive Function was associated with less depression and worse cognitive impairment. Patient–proxy discrepancy increased over time for everyday executive function. Changes in proxy-rated but not patient-rated ADCS-ADLI correlated with MMSE changes. Conclusion Patients and proxies generally agree in reporting on activities of daily living. Patient and proxy reports differ in their respective evaluation of cognitive functioning and everyday executive function. Ratings from both sources may be preferred for these two domains, though studies using gold standard measures are necessary. It is important

  11. The proxy problem anatomized: Child-parent disagreement in health related quality of life reports of chronically ill adolescents

    NARCIS (Netherlands)

    J.N.T. Sattoe (Jane); A.L. van Staa (AnneLoes); H.A. Moll (Henriëtte)

    2012-01-01

    textabstractBackground: Discrepancy between self-reports and parent-proxy reports of adolescent health-related quality of life (HRQoL) has been repeatedly acknowledged in the literature as the proxy problem. However, little is known about the extent and direction of this discrepancy. The purpose of

  12. Parent and Professional Reports of the Quality of Life of Children with Cerebral Palsy and Associated Intellectual Impairment

    Science.gov (United States)

    White-Koning, Melanie; Grandjean, Helene; Colver, Allan; Arnaud, Catherine

    2008-01-01

    To examine parent-professional agreement in proxy-reports of child quality of life (QoL) and the factors associated with low child QoL in children with cerebral palsy (CP) and associated intellectual impairment. Professional (teacher, therapist, or residential carer) and parent reports of QoL for 204 children (127 males, 77 females, mean age 10y…

  13. Self and proxy rating of quality of life in adults with intellectual disabilities: results from the DISQOL study.

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    Schmidt, Silke; Power, Mick; Green, Ann; Lucas-Carrasco, Ramona; Eser, Erhan; Dragomirecka, Eva; Fleck, Marcello

    2010-01-01

    The aim of this study was to analyze the agreement between self and proxy reports of quality of life (QoL) in people with intellectual disabilities and to examine the factors which contribute to these differences. The study was conducted across six international centres in a sample of 614 adults with intellectual disabilities as well as two different samples of proxies (N=874) including both professional carers and relatives. QoL was assessed with the disability version of the WHOQOL-BREF. In both proxy samples results show a significant moderate association between the persons' QoL-assessment and the assessment of their proxies in all of the five QoL domains. There were significant mean differences in most items which varied in their direction. In general, people with disabilities rated their QoL higher than their proxies except for two items from the physical domain. The factors which most significantly contributed to these differences were proxy knowledge of the person as well as the WHODAS-disability score. Cross-cultural differences in the magnitude of concordance were observed. As a conclusion, the study shows a good agreement between the person-proxy QoL-assessments, and that the factors associated with disagreement are limited in this study. Future studies should elaborate the stability of concordance over time. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  14. Validity of proxy-reported height and weight to derive body mass index in adults participating in Special Olympics.

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    Dobranowski, Kristin; Lloyd, Meghann; Côté, Pierre; Balogh, Robert

    2017-02-16

    Overweight and obesity are common in adults with intellectual disabilities, which complicates their health. To meet their health needs, individuals with intellectual disability frequently rely on proxies to answer questions on their behalf. In the general population, the use of proxy-reported height and weight to compute body mass index (BMI) has been validated, but not among adults with intellectual disability. The objective of this study was to determine the accuracy of proxy-reported height, weight and derived BMI among adults with intellectual disability. Proxies were asked to report height and weight on behalf of adults with intellectual disability who participate in Special Olympics Ontario; their answers were compared to measured height and weight. Proxies reported height and weight accurately; the sensitivity of proxy reports for classifying individuals with intellectual disability as overweight and/or obese was 84.6%. Proxy reports may be useful when direct measurements of individuals with intellectual disability are not available. © 2017 John Wiley & Sons Ltd.

  15. Linking Concurrent Self-Reports and Retrospective Proxy Reports About the Last Year of Life: A Prevailing Picture of Life Satisfaction Decline

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    Gerstorf, Denis; Ram, Nilam; Schupp, Jürgen; Sprangers, Mirjam A. G.; Wagner, Gert G.

    2014-01-01

    Objective. We examined the extent to which retrospective proxy reports of well-being mirror participant self-reports at 12–24 months before death and how proxy reports of well-being change over the last year of life. We also explored the role of sociodemographic, cognitive, and health factors of both participants and proxies in moderating such associations. Method. We used retrospective proxy ratings obtained in the German Socio-Economic Panel Study (N = 164; age at death = 19–99 years). Results. Results revealed moderate agreement between self- and proxy reports (r = .42), but proxies, on average, overestimated participants’ life satisfaction by two thirds of a scale point on a 0–10 scale (or 0.4 SD). Discrepancies were particularly pronounced when proxies themselves reported low life satisfaction. Over the last year of life, participants were viewed to have experienced declines in life satisfaction (−0.54 SD). Declines were stronger for ill participants and proxies who reported low life satisfaction. Discussion. Results qualify theoretical expectations and empirical results based on self-report data that are typically available 1 or 2 years before death. We discuss that retrospective proxy reports in panel surveys can be used as a hypothesis-generating tool to gather insights into late life. PMID:23766436

  16. Quality of life (QOL) in women treated for gynecologic malignancies with radiation therapy: a literature review of patient-reported outcomes.

    Science.gov (United States)

    Mirabeau-Beale, Kristina L; Viswanathan, Akila N

    2014-08-01

    To summarize the literature on quality of life for patients treated with definitive radiation for gynecologic cancers, with a specific focus on patient reported outcomes. A literature review was performed to summarize studies about patient-reported outcomes and quality of life in women with gynecologic malignancies who were treated with definitive radiation therapy. Summaries are by disease site, including endometrial, cervical and vulvar cancers. Over 20 different survey instruments have been used to describe patient-reported outcomes for women treated with radiation for gynecologic cancer. Regardless of disease site, all patients describe a degree of compromise in physical and social functioning, as well as sexual dysfunction. Specific symptoms which are most bothersome for patients vary by disease site, such as bowel concerns predominating for endometrial cancer patients, while body image is more concerning for cervical cancer patients. Several quality of life concerns exist for women treated with radiation therapy for gynecologic malignancies. Significant overlap exists in the QOL issues affecting these patients. Whether to combine or separate surveys by diagnosis, treatment type, age, or time point should be explored further. Assessing patients' psychological, emotional, and physical concerns helps to understand long-term adjustment, enabling incorporation of these domains into future trials that will ultimately improve patient well-being. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Parents were accurate proxy reporters of urgent pediatric asthma health services: a retrospective agreement analysis.

    Science.gov (United States)

    Ungar, Wendy J; Davidson-Grimwood, Sara R; Cousins, Martha

    2007-11-01

    To assess agreement between parents' proxy reports of children's respiratory-related health service use and administrative data. A retrospective analysis of statistical agreement between clinical and claims data for reports of physician visits, emergency department (ED) visits, and hospitalizations in 545 asthmatic children recruited from sites in the greater Toronto area was conducted. Health services use data were extracted from the Ontario Health Insurance Plan and Canadian Institute for Health Information databases for each child for the interval coinciding with the proxy report for each health service type. Agreement between administrative data and respondent reports (n=545) was substantial for hospitalizations in the past year (kappa=0.80 [0.74, 0.86]), moderate for ED visits in the past year (kappa=0.60 [0.53, 0.67]), and slight for physician visits (kappa=0.13 [0.00, 0.27]) in the past 6 months. Income, parent's education, and child quality-of-life symptom scores did not affect agreement. Agreement for ED visits was significantly higher (Phealth services utilization.

  18. He said, she said: The gender wage gap according to self and proxy reports in the Current Population Survey.

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    Reynolds, Jeremy; Wenger, Jeffrey B

    2012-03-01

    Roughly half the labor force data in the Current Population Survey (CPS) are provided by proxy respondents, and since 1979, men's reliance on proxies has dropped dramatically while women's reliance on proxies has increased. Few authors, however, have examined how combining these first-hand and second-hand reports may influence our understanding of long-term economic trends. We exploit the outgoing rotation group structure of the CPS by matching individual records one year apart, and we find that self-reported wages are higher than proxy-reported wages even after controlling for all time invariant characteristics. Furthermore, we find that changes in the use of proxy respondents by men and women since 1979 have made current estimates of the gender wage gap larger than they would have been without changes in reporting status. This suggests that the gender wage gap has closed more than previously estimated. We recommend that researchers combine self and proxy responses with great care, especially when analyzing time trends or making gender comparisons. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Performance of the EuroQol in children with imperforate anus

    NARCIS (Netherlands)

    Stolk, E.A; Busschbach, J.J.V.; Vogels, T.

    2000-01-01

    Objective: To investigate the feasibility and validity of a proxy version of the EuroQol in children treated for imperforate anus. Methods: Patients included were between 1 and 51 years of age. Instruments included were the EuroQol, the TACQOL and a disease specific questionnaire, the Langemeijer

  20. Sibling self-report, parental proxies, and quality of life: the importance of multiple informants for siblings of a critically ill child

    NARCIS (Netherlands)

    Houtzager, B. A.; Grootenhuis, M. A.; Caron, H. N.; Last, B. F.

    2005-01-01

    Assessment of quality of life (QoL) has thus far been a neglected approach in describing psychological adaptation in siblings of seriously ill children. The present results concern differences and correspondences between parent- and child-reported QoL in siblings of pediatric cancer patients, at 1

  1. Patient-rated versus proxy-rated cognitive and functional measures in older adults

    Directory of Open Access Journals (Sweden)

    Howland M

    2017-03-01

    Full Text Available Molly Howland,1 Kevin C Allan,1 Caitlin E Carlton,1 Curtis Tatsuoka,2–4 Kathleen A Smyth,3 Martha Sajatovic1,2,4,5 1Case Western Reserve University School of Medicine, 2Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, 3Department of Epidemiology and Biostatistics, 4Department of Neurology, 5Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA Objectives: Patients with cognitive impairment may have difficulty reporting their functional and cognitive abilities, which are important clinical outcomes. Health care proxies may be able to corroborate patient self-reports. Several studies reported discrepancy between patient and proxy ratings, though the literature is sparse on changes over time of these ratings. Our goals in this 12-month study were to compare patient and proxy reports on functioning, cognition, and everyday executive function, and to further elucidate correlates of patient–proxy discrepancy. Methods: This was a prospective cohort study of individuals older than 70 years who ranged from having no cognitive impairment to having moderate dementia who had a proxy available to complete instruments at baseline (N=76. Measurements included Alzheimer’s Disease Cooperative Study–Activities of Daily Living Inventory (ADCS-ADLI, Neuro-QOL Executive Function, PROMIS Applied Cognition (PROMIS-Cog, Mini-Mental State Examination (MMSE, and Geriatric Depression Scale. Results: Patient- and proxy-rated ADCS-ADLI were correlated at baseline and at 1-year follow-up. Patient and proxy ratings were discrepant on Neuro-QOL Executive Function and PROMIS-Cog. Greater patient–proxy discrepancy on PROMIS-Cog was associated with younger age and less depression, and greater patient–proxy discrepancy on Neuro-QOL Executive Function was associated with less depression and worse cognitive impairment. Patient–proxy discrepancy increased over time for everyday executive

  2. 'Munchausen syndrome by proxy' presenting as battered child syndrome: a report of two cases.

    Science.gov (United States)

    Sugandhan, Selvendran; Gupta, Somesh; Khandpur, Sujay; Khanna, Neena; Mehta, Manju; Inna, Prashanth

    2010-06-01

    Child abuse is a major public health crisis and is on the rise. Dermatologists are frequently involved in its evaluation in differentiating abusive injuries from accidental injuries and in excluding pathological conditions that may mimic abuse. Battered child syndrome or physical abuse is not only a common form of child abuse but can also result from a rarer form of child abuse known as Munchausen syndrome by proxy. In this form of abuse, mother, who is the usual perpetrator, induces an illness or abuses the child for her own self-serving psychological needs. We report two cases of battered child syndrome. In both the cases, Psychiatric evaluation was performed on both parents. Observation through one-way mirror was done with the mother and the child alone. Routine hematological and biochemical investigations were done. Diagnosis of Munchausen syndrome by proxy was firmly established in one case and was considered as a possibility in the other. A multidisciplinary team effort is essential in evaluating such cases, and dermatologists should be aware and be well informed about this condition that can be potentially lethal but easily overlooked.

  3. Munchausen by proxy syndrome mimicking systemic autoinflammatory disease: case report and review of the literature.

    Science.gov (United States)

    Wittkowski, Helmut; Hinze, Claas; Häfner-Harms, Sigrid; Oji, Vinzenz; Masjosthusmann, Katja; Monninger, Martina; Grenzebach, Ulrike; Foell, Dirk

    2017-04-05

    Systemic autoinflammatory diseases (SAIDs) represent a growing number of monogenic, polygenic or multifactorial disorders that are often difficult to diagnose. Here we report a patient who was initially erroneously diagnosed and treated for SAID. Symptoms consisted of recurrent fever, erythematous and/or blistering skin lesions, angioedema, susceptibility to bleeding, external ear infections and reversible anisocoria in the absence of laboratory evidence of systemic inflammation. After two and a half years of extensive diagnostic work-up and multiple empirical therapies, a final diagnosis of Munchausen by proxy syndrome (MBPS) was established. The diagnosis of SAID needs to be carefully reassessed if measurable systemic inflammation is missing, and MBPS should be included in the differential diagnosis.

  4. A procedure to correct proxy-reported weight in the National Health Interview Survey, 1976–2002

    Directory of Open Access Journals (Sweden)

    Utz Rebecca L

    2009-01-01

    Full Text Available Abstract Background Data from the National Health Interview Survey (NHIS show a larger-than-expected increase in mean BMI between 1996 and 1997. Proxy-reports of height and weight were discontinued as part of the 1997 NHIS redesign, suggesting that the sharp increase between 1996 and 1997 may be artifactual. Methods We merged NHIS data from 1976–2002 into a single database consisting of approximately 1.7 million adults aged 18 and over. The analysis consisted of two parts: First, we estimated the magnitude of BMI differences by reporting status (i.e., self-reported versus proxy-reported height and weight. Second, we developed a procedure to correct biases in BMI introduced by reporting status. Results Our analyses confirmed that proxy-reports of weight tended to be biased downward, with the degree of bias varying by race, sex, and other characteristics. We developed a correction procedure to minimize BMI underestimation associated with proxy-reporting, substantially reducing the larger-than-expected increase found in NHIS data between 1996 and 1997. Conclusion It is imperative that researchers who use reported estimates of height and weight think carefully about flaws in their data and how existing correction procedures might fail to account for them. The development of this particular correction procedure represents an important step toward improving the quality of BMI estimates in a widely used source of epidemiologic data.

  5. Here be web proxies

    DEFF Research Database (Denmark)

    Weaver, Nicholas; Kreibich, Christian; Dam, Martin

    2014-01-01

    HTTP proxies serve numerous roles, from performance enhancement to access control to network censorship, but often operate stealthily without explicitly indicating their presence to the communicating endpoints. In this paper we present an analysis of the evidence of proxying manifest in executions...... of the ICSI Netalyzr spanning 646,000 distinct IP addresses ("clients"). To identify proxies we employ a range of detectors at the transport and application layer, and report in detail on the extent to which they allow us to fingerprint and map proxies to their likely intended uses. We also analyze 17...

  6. A Case Report of Munchausen Syndrome by Proxy Presenting as Acquired Symptomatic West Syndrome

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    Shridhar Jadhav

    2016-07-01

    Full Text Available Munchausen Syndrome By Proxy (MSBP is an extremely complicated diagnosis because of the difficulty in finding the incriminating evidence of its existence and because of the ethical issue it raises for caregivers. Its implications from a medical, psychological and legal point of view raise difficult questions for any professional confronted to it. We present a case of 8 month female infant who was diagnosed to have Hyperinsulinism causing hypoglycemic brain injury and later developing intractable convulsion with head drops, where EEG was suggestive of West Syndrome, was actually a case of Munchausen syndrome by proxy to start with.

  7. The proxy problem: Child report versus parent report in health-related quality of life research

    NARCIS (Netherlands)

    Theunissen, N.C.M.; Vogels, T.G.C.; Koopman, H.M.; Verrips, G.H.W.; Zwinderman, K.A.H.; Verloove-Vanhorick, S.P.; Wit, J.M.

    1998-01-01

    This study evaluates the agreement between child and parent reports on children's health-related quality of life (HRQoL) in a representative sample of 1,105 Dutch children (age 8-11 years old). Both children and their parents completed a 56 item questionnaire (TACQOL). The questionnaire contains

  8. Comparison of self and proxy ratings for voice handicap index and motor-related quality-of-life of individuals with Parkinson's disease.

    Science.gov (United States)

    Parveen, Sabiha; Goberman, Alexander M

    2017-04-01

    Quality-of-life (QoL) consists of health, psychological well-being and communication-related domains. Due to the heterogeneous nature of Parkinson disease (PD), it is important to examine effects of different domains including motor and cognitive performance or motor and speech performance among the same set of individuals. Existing studies indicate mixed findings due to use of different QoL measures and lack of general consensus regarding QoL components. The present study examined self and proxy ratings for 20 individuals with PD on Voice Handicap Index (VHI) and PDQ-39 mobility to determine effects on speech and motor-related QoL, respectively. There was good level of agreement between self and proxy ratings for PDQ-39 mobility ratings alone. In addition, no overall group differences were found for self and proxy ratings of VHI and PDQ-39 mobility ratings, thus indicating similar perceptions by individuals with PD and their communication partners for speech and motor-related changes associated with PD. Further, no significant correlations between speech and motor-related QoL were found, thereby suggesting these domains to be independent of each other. The present study indicates the need to consider both self and proxy reports to understand the impact of PD on a person's overall functioning.

  9. Proxy-rated quality of life in Alzheimer's disease

    DEFF Research Database (Denmark)

    Vogel, Asmus; Bhattacharya, Suvosree; Waldorff, Frans Boch

    2012-01-01

    The study investigated the change in proxy rated quality of life (QoL) of a large cohort of home living patients with Alzheimer's disease (AD) over a period of 36 months.......The study investigated the change in proxy rated quality of life (QoL) of a large cohort of home living patients with Alzheimer's disease (AD) over a period of 36 months....

  10. Effects of radiotherapy for brain metastases on quality of life (QoL). Prospective pilot study of the DEGRO QoL working party

    Energy Technology Data Exchange (ETDEWEB)

    Steinmann, Diana; Bruns, Frank [Medical School, Hannover (Germany). Radiation Oncology; Schaefer, Christof; Hipp, Matthias [Regensburg Univ. (Germany). Radiation Oncology; Oorschot, Birgitt van [Wuerzburg Univ. (Germany). Radiation Oncology; Wypior, Hans-Joachim [Hospital Landshut (Germany). Radiation Oncology; Boelling, Tobias [Muenster Univ. (Germany). Radiation Oncology; Sehlen, Susanne [Ludwig Maximilians Univ., Muenchen (Germany). Radiation Oncology; Hagg, Juliane [Ulm Univ. (Germany). Radiation Oncology; Bayerl, Anja [Hospital Krems (Austria). Radiation Oncology; Geinitz, Hans [Technical Univ. Muenchen (Germany). Radiation Oncology; Vordermark, Dirk [Halle-Wittenberg Univ., Halle (Germany). Radiation Oncology

    2009-03-15

    Background: Prospective data on quality-of-life (QoL) effects of radiotherapy for brain metastases are currently lacking, but would be of great interest to guide therapeutic decisions. Patients and Methods: From 01/2007 to 08/2007, 46 patients with previously untreated brain metastases were recruited at eight centers. QoL was measured at start of treatment (T{sub 0}) and at 3 months ({sub T3mo}). In the pilot study, two combinations of QoL instruments could be used at the discretion of the centers (A: EORTC QLQ-C30 and B: EORTC QLQ-C15-PAL both with brain module BN20, assessment by proxies with A: Palliative Care Outcome Scale, B: self-constructed brain-specific instrument). Results: All patients received whole-brain radiotherapy, four with an additional boost irradiation. At T{sub 3mo}, 26/46 patients (56.5%) had died. 17/20 survivors (85%) completed the questionnaires. In 3-month survivors, QoL deteriorated in most domains, significant in drowsiness, hair loss and weakness of legs. The scores for headaches and seizures were slightly better after 3 months. Assessment by proxies also suggested worsening of QoL. Initial QoL at T{sub 0} was better in those alive than in those deceased at T{sub 3mo}, significant for physical function and for the symptom scales of fatigue and pain, motor dysfunction, communication deficit and weakness of legs. Conclusion: Practicability and compliance appeared better with the (shorter) version B. This version is now used in the ongoing main phase of the study with additional centers. First results indicate a moderate worsening of QoL during the first 3 months after start of palliative radiotherapy for brain metastases. QoL at initiation of radiotherapy may be prognostic for survival. (orig.)

  11. Alimemazine poisoning as evidence of Munchausen syndrome by proxy: A pediatric case report.

    Science.gov (United States)

    Gomila, Isabel; López-Corominas, Victoria; Pellegrini, Manuela; Quesada, Loreto; Miravet, Elena; Pichini, Simona; Barceló, Bernardino

    2016-09-01

    Munchausen syndrome by proxy (MSBP), also known as fabricated or induced illness in a child by a caretaker, is a form of abuse where a caregiver deliberately produces or feigns illness in a person under his or her care, so that the proxy will receive medical care that gratifies the caregiver. The affected children are often hospitalized for long periods and endure repetitive, painful and expensive diagnostic attempts. We present an analytically confirmed case of MSBP by alimemazine. A 3-year-old boy was brought repetitively to a Pediatric Emergency Department by his mother because he presented limb tremors, dysarthria, obnubilation, and ataxia and generalized tonic-clonic seizures coinciding with intermittent fever. Neither the rest of the physical examination nor the complementary tests showed any significant alterations. MSBP was suspected and a routine systematic toxicological analysis in urine and blood was requested. Alimemazine was detected in all biological samples. The administration of this drug was never mentioned by the mother and the subsequent interview with her corroborated the suspicion of MSBP. Clinically, after separation from the mother, the child's neurological symptoms gradually improved until the complete disappearance of the cerebellar symptoms. Alimemazine was quantified in serum, urine, gastric content and cerebrospinal fluid samples by gas chromatography-mass spectrometry (maximum serum level was 0.42μg/ml). Hair quantification of alimemazine was performed by ultra-performance liquid chromatography-tandem mass spectrometry in different segments of hair. The results confirmed regular substance use during the at least eight last months (8.8, 14.7, 19.7 and 4.6ng/mg hair starting from most proximal segment). This patient represents the first case published with analytical data of alimemazine in blood, urine, gastric content, cerebrospinal fluid and hair, which allowed us to prove an acute and repetitive poisoning with alimemazine as evidence

  12. The level of agreement between child self-reports and parent proxy-reports of health-related quality of life in boys with Duchenne muscular dystrophy.

    Science.gov (United States)

    Lim, Yoonjeong; Velozo, Craig; Bendixen, Roxanna M

    2014-09-01

    To investigate the level of agreement between child self-reports and parent proxy-reports of the health-related quality of life (HRQoL) in boys with Duchenne muscular dystrophy (DMD) using both classical test theory (CTT) and Rasch analysis. A total of 63 boys with DMD and their parents completed the pediatric quality of life inventory version 4.0 child self-report and parent proxy-report of HRQoL, respectively. The data were analyzed using both the CTT (scale-score level) and Rasch analysis (item-level). The intraclass correlation coefficient (ICC, scale-score level) between children and parents showed good to moderate agreement, although parents consistently underestimated their child HRQoL. In Rasch analysis (item-level), 1 out of 8 items was significantly different between children and parents in the physical health scale. Also, 3 out of 15 items were significantly different between those two groups in the psychosocial health scale. By applying both scale-score and item-level analyses, our study seeks to broaden the understanding of the discrepancy of the ratings between child self-reports and parent proxy-reports. The findings could provide further information about the decision-making process when selecting therapy and care programs.

  13. Using carer biographical narratives to explore factors involved in proxy reporting of quality of life in people with dementia.

    Science.gov (United States)

    Robertson, Jane M

    2017-04-01

    Quality of life is an important focus of research on dementia, with interest in direct reports of people with dementia and proxy reports of their carers. By exploring the subjective perspectives of unpaid family carers and paid care workers, this study aims to understand how carers construct meaning in narratives about quality of life with dementia. A case-centred approach involved biographical narrative interviews with 10 carers to explore what was important for people with dementia to have a good quality of life. Detailed narrative analysis attended to the linguistic and structural features of accounts to consider how dementia is conceptualised by carers in the framing of quality of life. An individual's perception of how dementia impacts on awareness and behaviour was central to their understanding of quality of life. Carers who constructed dementia as a loss of skills and abilities were able to represent quality of life in positive terms despite the challenges of dementia. Carers who constructed dementia as eroding identity represented quality of life less positively and centred on their own means of coping with a challenging care situation. Findings highlight the importance of helping carers develop positive constructions of quality of life that are associated with understanding dementia as a loss of skills and abilities, rather than as a loss of self. Engaging with subjectivity in carers' biographical narrative accounts is important in the development of quality of life assessment to understand the meanings and emotions that underlie proxy perspectives.

  14. Do proxies reflect patients' health concerns about urinary incontinence and gait problems?

    Science.gov (United States)

    Higashi, Takahiro; Hays, Ron D; Brown, Julie A; Kamberg, Caren J; Pham, Chau; Reuben, David B; Shekelle, Paul G; Solomon, David H; Young, Roy T; Roth, Carol P; Chang, John T; MacLean, Catherine H; Wenger, Neil S

    2005-01-01

    Background While falls and urinary incontinence are prevalent among older patients, who sometimes rely on proxies to provide their health information, the validity of proxy reports of concern about falls and urinary incontinence remains unknown. Methods Telephone interviews with 43 consecutive patients with falls or fear of falling and/or bothersome urinary incontinence and their proxies chosen by patients as most knowledgeable about their health. The questionnaire included items derived from the Medical Outcomes Study Short Form 12 (SF-12), a scale assessing concerns about urinary incontinence (UI), and a measure of fear of falling, the Falls Efficacy Scale (FES). Scores were estimated using items asking the proxy perspective (6 items from the SF-12, 10 items from a UI scale, and all 10 FES items). Proxy and patient scores were compared using intraclass correlation coefficients (ICC, one-way model). Variables associated with absolute agreement between patients and proxies were explored. Results Patients had a mean age of 81 years (range 75–93) and 67% were female while proxies had a mean age of 70 (range 42–87) and 49% were female. ICCs were 0.63 for the SF-12, 0.52 for the UI scale, and 0.29 for the FES. Proxies tended to understate patients' general health and incontinence concern, but overstate patients' concern about falling. Proxies who lived with patients and those who more often see patients more closely reflected patient FES scores compared to those who lived apart or those who saw patients less often. Internal consistency reliability of proxy responses was 0.62 for the SF-12, 0.86 for the I-QOL, and 0.93 for the FES. In addition, construct validity of the proxy FES scale was supported by greater proxy-perceived fear of falling for patients who received medical care after a fall during the past 12 months (p < .05). Conclusion Caution should be exercised when using proxies as a source of information about older patients' health perceptions. Questions

  15. Do proxies reflect patients' health concerns about urinary incontinence and gait problems?

    Directory of Open Access Journals (Sweden)

    Solomon David H

    2005-11-01

    Full Text Available Abstract Background While falls and urinary incontinence are prevalent among older patients, who sometimes rely on proxies to provide their health information, the validity of proxy reports of concern about falls and urinary incontinence remains unknown. Methods Telephone interviews with 43 consecutive patients with falls or fear of falling and/or bothersome urinary incontinence and their proxies chosen by patients as most knowledgeable about their health. The questionnaire included items derived from the Medical Outcomes Study Short Form 12 (SF-12, a scale assessing concerns about urinary incontinence (UI, and a measure of fear of falling, the Falls Efficacy Scale (FES. Scores were estimated using items asking the proxy perspective (6 items from the SF-12, 10 items from a UI scale, and all 10 FES items. Proxy and patient scores were compared using intraclass correlation coefficients (ICC, one-way model. Variables associated with absolute agreement between patients and proxies were explored. Results Patients had a mean age of 81 years (range 75–93 and 67% were female while proxies had a mean age of 70 (range 42–87 and 49% were female. ICCs were 0.63 for the SF-12, 0.52 for the UI scale, and 0.29 for the FES. Proxies tended to understate patients' general health and incontinence concern, but overstate patients' concern about falling. Proxies who lived with patients and those who more often see patients more closely reflected patient FES scores compared to those who lived apart or those who saw patients less often. Internal consistency reliability of proxy responses was 0.62 for the SF-12, 0.86 for the I-QOL, and 0.93 for the FES. In addition, construct validity of the proxy FES scale was supported by greater proxy-perceived fear of falling for patients who received medical care after a fall during the past 12 months (p Conclusion Caution should be exercised when using proxies as a source of information about older patients' health perceptions

  16. Complex tibial fractures are associated with lower social classes and predict early exit from employment and worse patient-reported QOL

    DEFF Research Database (Denmark)

    Elsoe, Rasmus; Larsen, Peter; Petruskevicius, Juozas

    2017-01-01

    removal in patients with a complex tibial fracture. Secondary objectives included a review of the socio-economic characteristics of the patient group and the rate of return to work in the study period. A prospective follow-up study was conducted of 60 patients with complex fractures of the tibia treated...... with ring external fixation. Patient-reported outcomes, radiological outcomes and socio-economic status including employment status of the patients were obtained 12 months after frame removal. Forty-six patients completed the assessment 12 months after frame removal (77%). The mean age of the patient...... at the time of fracture was 54.6 years (range 31-86). There were 19 males and 27 females. At 12 months after frame removal, the mean EQ5D-5L index was 0.66 (CI 0.60-0.72). The mean EQ5D-5L VAS was 69 (CI 61-76). When this was compared to the established reference population from Denmark, the study population...

  17. A pilot study among older adults of the concordance between their self-reports to a health survey and spousal proxy reports on their behalf.

    Science.gov (United States)

    Wolinsky, Fredric D; Ayres, Lioness; Jones, Michael P; Lou, Yiyue; Wehby, George L; Ullrich, Fred A

    2016-09-09

    Proxy respondents are frequently used in health surveys, and the proxy is most often the spouse. Longstanding concerns linger, however, about the validity of using spousal proxies, especially for older adults. The purpose of this pilot study was to evaluate the concordance between self-reports and spousal proxy reports to a standard health survey in a small convenience sample of older married couples. We used the Seniors Together in Aging Research (STAR) volunteer registry at the University of Iowa to identify and consent a cross-sectional, convenience sample of 28 married husband and wife couples. Private, personal interviews with each member of the married couple using a detailed health survey based on the 2012 Health and Retirement Study (HRS) instrument were conducted using computer assisted personal interviewing software. Within couples, each wife completed the health survey first for herself and then for her husband, and each husband completed the health survey first for himself and then for his wife. The health survey topics included health ratings, health conditions, mobility, instrumental activities of daily living (IADLs), health services use, and preventative services. Percent of agreement and prevalence and bias adjusted kappa statistics (PABAKs) were used to evaluate concordance. PABAK coefficients indicated moderate to excellent concordance (PABAKs >0.60) for most of the IADL, health condition, hospitalization, surgery, preventative service, and mobility questions, but only slight to fair concordance (PABAKs = -0.21 to 0.60) for health ratings, and physician and dental visits. These results do not allay longstanding concerns about the validity of routinely using spousal proxies in health surveys to obtain health ratings or the number of physician and dental visits among older adults. Further research is needed in a nationally representative sample of older couples in which each wife completes the health survey first for herself and then for her

  18. 75 FR 66621 - Reporting of Proxy Votes on Executive Compensation and Other Matters

    Science.gov (United States)

    2010-10-28

    ... Comments Use the Commission's Internet comment form ( http://www.sec.gov/rules/proposed.shtml ); Send an e... all comments on the Commission's Internet Web site ( http://www.sec.gov/rules/proposed.shtml... Reported 2. Voting Power 3. Securities With Respect to Which Votes Are Required To Be Reported C. Time of...

  19. Validity of the SS-QOL in Germany and in survivors of hemorrhagic or ischemic stroke.

    Science.gov (United States)

    Ewert, Thomas; Stucki, Gerold

    2007-01-01

    The Stroke-Specific Quality of Life Scale (SS-QOL) is a recently developed measure to assess health-related quality of life in stroke patients. The objective of this study was to translate the American version of the SS-QOL and examine the validity of the German proxy version, in both ischemic and hemorrhagic stroke survivors. The translation was conducted according to published guidelines. The validation was performed in consecutive adult stroke survivors. Data were obtained 1 year after discharge. To examine the dimensionality of the SS-QOL, factor analyses were conducted. The validity was examined by the associations of the subscales with the Functional Independence Measure and Short Form 36. The literal translation revealed no major changes between the American and the German versions of the SS-QOL. Three hundred seven stroke survivors were included in the study. Unlike the 1st validation study, most of the variance could be explained by 8 instead of 12 factors; therefore, the 8-factor solution was further examined. The validity of the SS-QOL total score and "observable" scales such as "activities" was shown. For the German proxy version of the SS-QOL, an 8-factor solution was found to be the most appropriate. The psychometric properties of these 8 subscales were good or excellent with respect to internal consistency. The validity of the total score was shown, but some subscales (energy, mood, and thinking) failed the hypothesized associations. Therefore, the SS-QOL needs to be further explored in other settings and populations.

  20. Proxy reporting in after-death interviews: the use of proxy respondents in retrospective assessment of chronic diseases and symptom burden in the terminal phase of life

    NARCIS (Netherlands)

    Klinkenberg, M.; Smit, J. H.; Deeg, D. J. H.; Willems, D. L.; Onwuteaka-Philipsen, B. D.; van der Wal, G.

    2003-01-01

    This study evaluates the quality of data obtained from after-death interviews with significant others of deceased older persons regarding the prevalence of chronic diseases and symptoms in the terminal phase of life. These data are compared with reports from physicians and earlier self-reports from

  1. Proxy reporting in after death interviews: the use of proxy respondents in retrospective assessment of chronic diseases and symptom burden in the terminal phase of life

    NARCIS (Netherlands)

    Klinkenberg, M.; Smit, J.H.; Deeg, D.J.H.; Willems, D.L.; Philipsen, B.D.; van der Wal, G.

    2003-01-01

    This study evaluates the quality of data obtained from after-death interviews with significant others of deceased older persons regarding the prevalence of chronic diseases and symptoms in the terminal phase of life. These data are compared with reports from physicians and earlier self-reports from

  2. Parent and professional reports of the quality of life of children with cerebral palsy and associated intellectual impairment.

    Science.gov (United States)

    White-Koning, Melanie; Grandjean, Hélène; Colver, Allan; Arnaud, Catherine

    2008-08-01

    To examine parent-professional agreement in proxy-reports of child quality of life (QoL) and the factors associated with low child QoL in children with cerebral palsy (CP) and associated intellectual impairment. Professional (teacher, therapist, or residential carer) and parent reports of QoL for 204 children (127 males, 77 females, mean age 10 y 4 mo [SD 1y 6mo]; range 8-12 y) with CP and IQParent-professional agreement was studied using correlation and mean differences; multilevel logistic regression was used to determine factors influencing QoL reports and agreement. The mean parent-reported scores of child QoL were significantly higher than the professional reports in the Psychological well-being domain and significantly lower for Social support. The average frequency of disagreement (parent-professional difference >0.5SD of scores) over all domains was 62%. High levels of stress in parenting negatively influenced parent reports of child QoL compared with professional reports, while child pain was associated with professionals rating lower than parents. Proxies do not always agree when reporting the QoL of children with severe disabilities. Parental well-being and child pain should be taken into account in the interpretation of QoL reports in such children.

  3. Is there a difference between child self-ratings and parent proxy-ratings of the quality of life of children with a diagnosis of attention-deficit hyperactivity disorder (ADHD)? A systematic review of the literature.

    Science.gov (United States)

    Galloway, Helen; Newman, Emily

    2017-03-01

    There are contemporary indicators that parent proxy-ratings and child self-ratings of a child's quality of life (QoL) are not interchangeable. This review examines dual informant studies to assess parent-child agreement on the QoL of children with attention-deficit/hyperactivity disorder. A systematic search of four major databases (PsycINFO, MEDLINE, EMBASE and Cochrane databases) was completed, and related peer-reviewed journals were hand-searched. Studies which reported quantitative QoL ratings for matched parent and child dyads were screened in accordance with relevant inclusion and exclusion criteria. Key findings were extracted from thirteen relevant studies, which were rated for conformity to the recommendations of an adapted version of the STROBE statement guidelines for observational studies. In the majority of studies reviewed, children rated their QoL more highly than their parents. There was some evidence for greater agreement on the physical health domain than psychosocial domains.

  4. Screening for psychological well-being in childhood cancer survivors: a preliminary assessment of the feasibility of the strength and difficulties questionnaire as a parent-proxy report.

    Science.gov (United States)

    Williams, Lauren K; Drew, Sarah; Deluca, Cinzia R; McCarthy, Maria C

    2013-01-01

    This article describes the feasibility of utilizing the Strengths and Difficulties Questionnaire (SDQ) as a brief psychosocial screener among survivors of pediatric cancer. Participants were parents of a child/adolescent diagnosed with cancer who were off treatment (n = 35) and a subset of adolescents (n = 14). Parent-proxy report using the SDQ was significantly associated with the Child Health Questionnaire. Parents who self-reported long-term uncertainty about their child's illness were more likely to report child psychosocial difficulties. A trend for concordance between patient and parent-proxy report of the SDQ was observed. These preliminary results highlight the potential utility of the SDQ as a screening tool for detection of child/adolescent psychosocial well-being. Further research, with larger samples, is needed to support these results.

  5. Factors Associated with Subjective Quality of Life of Adults with Autism Spectrum Disorder: Self-Report versus Maternal Reports

    Science.gov (United States)

    Hong, Jinkuk; Bishop-Fitzpatrick, Lauren; Smith, Leann E.; Greenberg, Jan S.; Mailick, Marsha R.

    2016-01-01

    We examined factors related to subjective quality of life (QoL) of adults with autism spectrum disorder (ASD) aged 25-55 (n = 60), using the World Health Organization Quality of Life measure (WHOQOL-BREF). We used three different assessment methods: adult self-report, maternal proxy-report, and maternal report. Reliability analysis showed that…

  6. Proxy-Reported Quality of Life and Family Impact for Children Followed Longitudinally by a Pediatric Palliative Care Team.

    Science.gov (United States)

    Weaver, Meaghann; Wichman, Christopher; Darnall, Cheryl; Bace, Sue; Vail, Catherine; MacFadyen, Andrew

    2018-02-01

    One goal of pediatric palliative care is to maintain quality of life for children and their families. Quality-of-life investigations may be enhanced by considering clinically important metrics in addition to statistical significance. The purpose of this study was to longitudinally evaluate the effect of time on quality of life and family impact for pediatric palliative care patients across all diagnoses and ages. This prospective quality-of-life study included administration of a 23-item PedsQL™ Measurement Model to evaluate for physical, emotional, social, and cognitive dimensions of the child's quality of life and a 36-item PedsQL Family Impact Module to assess for the familial impact at time of initial palliative care consultation, Month 6, and Month 12. All pediatric patients who received a palliative care consultation in our Midwestern free-standing children's hospital over a five-year period were included in the longitudinal study (n = 87). Repeated measures ANOVA was used to investigate how proxy-reported quality of life and family impact changed with time with attentiveness to also follow trends in minimal clinically important difference (MCID) metrics. The emotional domain showed a statistically significant positive trend over the first six months of palliative care involvement (p = 0.049), while the physical domain (p = 0.028) and daily activity (p = 0.039) showed a positive improvement for the full year. In using a standard of MCID, the physical, emotional, and cognitive domains improved in the quality-of-life scale and the communication, worry, and daily activity domains improved in the family impact scale over 12 months. In considering quality-of-life analyses for pediatric palliative care programmatic improvements, providers may consider analyzing not only for statistical significance in collective data sets but also for clinically important difference over time.

  7. Quality of Life in Survivors of Pediatric Cancer and Their Siblings: The Consensus Between Parent-Proxy and Self-Reports.

    Science.gov (United States)

    Schulte, Fiona; Wurz, Amanda; Reynolds, Kathleen; Strother, Douglas; Dewey, Deborah

    2016-04-01

    To examine the discrepancy between survivor-parent and sibling-parent reports of health-related quality of life (HRQL) and the level of agreement (i.e., correlation) between child reports (i.e., survivor and sibling) and parent-proxy reports of HRQL. Fifty-one families participated. Pediatric cancer survivors (49% male; 6-18 years of age) and one sibling (47% male; 9-18 years of age) completed a measure of their HRQL. As well, one parent (14% male; 27-65 years of age) from each family completed a proxy report of their children's (i.e., survivor and sibling) HRQL. Consensus was determined through discrepancy and agreement scores, between parent-proxy and children's (i.e., survivors and siblings) self-reports of total HRQL, and physical, emotional, social, and school functioning subscales. Repeated-measures analysis of variance (ANOVA) revealed significant group differences for total HRQL (F = 6.79, P ≤ 0.01). Repeated-measure ANOVAs of subscale discrepancy scores revealed significant group differences for physical functioning scores (F = 6.39, P cancer on siblings should be further investigated. © 2016 Wiley Periodicals, Inc.

  8. Meta-analysis of quality of life in children and adolescents with ADHD: By both parent proxy-report and child self-report using PedsQL™.

    Science.gov (United States)

    Lee, Yi-chen; Yang, Hao-Jan; Chen, Vincent Chin-Hung; Lee, Wan-Ting; Teng, Ming-Jen; Lin, Chung-Hui; Gossop, Michael

    2016-01-01

    Attention deficit hyperactivity disorder (ADHD) is a prevalent developmental disorder that seriously and negatively impacts a child's health-related quality of life (HRQOL). However, no meta-analysis has been conducted to examine the magnitude of impact, domains affected and factors moderating the impact. This review included nine studies that compared HRQOL of children or adolescents with ADHD with those with typical development using both child self-reports and parent proxy-reports. Seven among nine studies were meta-analytically synthesized to examine the degree of impact of ADHD on children and adolescents, parent-child discrepancy, and the moderators. The results indicate that ADHD impact a child's or adolescent's HRQOL negatively with a moderate effect in physical and a severe effect in psychosocial (i.e., emotional, social, and school) domains. Parental ratings of overall HRQOL in children or adolescents with ADHD were not significantly different from child's ratings when compared with typically developing children and adolescents. Age was negatively associated with all domains of HRQOL in children and adolescents with ADHD both by parent- and child-ratings, and the strongest effect was found in parental ratings of child's emotional HRQOL, with a moderate correlation. This meta-analysis suggests that HRQOL may be assessed in children and adolescents with ADHD both by parent proxy- and child self-reports, and that interventions may be planned accordingly. Future meta-analysis may explore how measures of HRQOL and other factors including child, parental, familiar and school characteristics influence the impact of ADHD and the parent-child agreement in children and adolescents. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. GO-QOL--disease-specific quality of life questionnaire in Graves' orbitopathy.

    Science.gov (United States)

    Sawicka-Gutaj, Nadia; Bednarczuk, Tomasz; Daroszewski, Jacek; Waligórska-Stachura, Joanna; Miśkiewicz, Piotr; Sowiński, Jerzy; Bolanowski, Marek; Ruchała, Marek

    2015-01-01

    The main goal of therapy for Graves' orbitopathy (GO) is to restore visual function and to improve quality of life (QOL); therefore, the idea of self-assessment of eye changes by the patient has been developed. We developed a validated Polish version of the GO-QOL questionnaire (GO-QOLpl). As an original version we used the English version of GO-QOL, which consists of 15 questions summarised in two subscales. GO-QOLpl was translated and validated in accordance with standard principles for translation of patient-reported outcomes (PRO). GO-QOLpl is a linguistically validated version of the original GO-QOL questionnaire, which is recommended by the European Group of Graves' Orbitopathy (EUGOGO). We strongly support the use of GO-QOLpl for the assessment of QOL among Polish patients with GO in clinical practice.

  10. Development and psychometric validation of the Diabetes Therapy-Related QOL (DTR-QOL) questionnaire.

    Science.gov (United States)

    Ishii, Hitoshi

    2012-01-01

    We developed and evaluated the psychometric properties of the Diabetes Therapy-Related QOL (DTR-QOL) as a disease-specific, self-administered questionnaire to assess the influence of diabetes treatment on patient QOL, regardless of treatment method. This new questionnaire was developed and validated in a standardized manner: Item development, pilot-testing and psychometric validation. A survey was conducted using the provisional version of the questionnaire, and reliability and validity were evaluated with psychometric testing. The provisional version of the questionnaire was generated with 29 items through literature review and pilot testing. For psychometric assessment, analyses were performed on the responses of 284 adult Japanese patients with diabetes. Factor analysis by the principal factor method with promax rotation revealed 4 factors; "burden on social activities and daily activities" (13 items), "anxiety and dissatisfaction with treatment" (8 items), "hypoglycemia" (4 items), and "satisfaction with treatment" (4 items). For reliability, the intraclass correlation was 0.92, and Cronbach's alpha coefficient was 0.94, indicating adequate test-retest reliability and internal consistency. For known-group validity, there were significant differences in scores for following variables: age, diabetes type, HbA1c, treatment method, glycemic control, hypoglycemia, nocturnal hypoglycemia, concern about weight gain, health status (patient assessment), and degree of communication with physician. The DTR-QOL, with good reliability and validity, can assess the influence of diabetes treatment on patient QOL. The DTR-QOL can be used regardless of treatment method that patients receive, and this characteristic enables to detect a difference on patients QOL between treatment methods before and after a switch of treatment. Limitations of this study include representativeness of the patient sample. The relatively small number of patients with type 1 diabetes should be noted

  11. Measurement equivalence of the KINDL questionnaire across child self-reports and parent proxy-reports: a comparison between item response theory and ordinal logistic regression.

    Science.gov (United States)

    Jafari, Peyman; Sharafi, Zahra; Bagheri, Zahra; Shalileh, Sara

    2014-06-01

    Measurement equivalence is a necessary assumption for meaningful comparison of pediatric quality of life rated by children and parents. In this study, differential item functioning (DIF) analysis is used to examine whether children and their parents respond consistently to the items in the KINDer Lebensqualitätsfragebogen (KINDL; in German, Children Quality of Life Questionnaire). Two DIF detection methods, graded response model (GRM) and ordinal logistic regression (OLR), were applied for comparability. The KINDL was completed by 1,086 school children and 1,061 of their parents. While the GRM revealed that 12 out of the 24 items were flagged with DIF, the OLR identified 14 out of the 24 items with DIF. Seven items with DIF and five items without DIF were common across the two methods, yielding a total agreement rate of 50 %. This study revealed that parent proxy-reports cannot be used as a substitute for a child's ratings in the KINDL.

  12. Adolescent self-report and parent proxy-report of health-related quality of life: an analysis of validity and reliability of PedsQL 4.0 among a sample of Malaysian adolescents and their parents.

    Science.gov (United States)

    Kaartina, Sanker; Chin, Yit Siew; Fara Wahida, Rezali; Woon, Fui Chee; Hiew, Chu Chien; Zalilah, Mohd Shariff; Mohd Nasir, Mohd Taib

    2015-04-08

    The Pediatric Quality of Life Inventory Generic Core Scales (PedsQL) 4.0 is a generalized assessment of health-related quality of life (HRQoL) based on adolescent self-report and parent proxy-report. This study aims to determine the construct validity and reliability of PedsQL 4.0 among a sample of Malaysian adolescents and parents. A cross-sectional study was carried out at three selected public schools in the state of Selangor. A total of 379 Malaysian adolescents completed the PedsQL 4.0 adolescent self-report and 218 (55.9%) parents completed the PedsQL 4.0 parent proxy-report. Weight and height of adolescents were measured and BMI-for-age by sex was used to determine their body weight status. There were 50.8% male and 49.2% female adolescents who participated in this study (14.25 ± 1.23 years). The prevalence of overweight and obesity (25.8%) was four times higher than the prevalence of severe thinness and thinness (6.1%). Construct validity was analyzed using Confirmatory Factor Analysis (CFA). Based on CFA, adolescent self-report and parent proxy-report met the criteria of convergent validity (factor loading > 0.5, Average Variance Extracted (AVE) > 0.5, Construct Reliability > 0.7) and showed good fit to the data. The adolescent self-report and parent proxy-report exhibited discriminant validity as the AVE values were larger than the R(2) values. Cronbach's alpha coefficients of the adolescent self-report (α = 0.862) and parent proxy-report (α = 0.922) showed these instruments are reliable. Parents perceived the HRQoL of adolescents was poorer compared to the perception of the adolescent themselves (t = 5.92, p 0.05). Parent proxy-report was negatively associated with the adolescents' BMI-for-age (r = -0.152, p 0.05). Adolescent self-report and parent proxy-report of the PedsQL 4.0 are valid and reliable to assess HRQoL of Malaysian adolescents. Future studies are recommended to use both adolescent self-report and parent-proxy report of HRQoL as

  13. Munchausen syndrome by proxy

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001555.htm Munchausen syndrome by proxy To use the sharing features on this page, please enable JavaScript. Munchausen syndrome by proxy is a mental illness and ...

  14. Munchausen syndrome by proxy

    Directory of Open Access Journals (Sweden)

    Jovanović Aleksandar A.

    2005-01-01

    Full Text Available This review deals with bibliography on Munchausen syndrome by proxy (MSbP. The name of this disorder was introduced by English psychiatrist Roy Meadow who pointed to diagnostic difficulties as well as to serious medical and legal connotations of MSbP. MSbP was classified in DSM-IV among criteria sets provided for further study as "factitious disorder by proxy", while in ICD-10, though not explicitly cited, MSbP might be classified as "factitious disorders" F68.1. MSbP is a special form of abuse where the perpetrator induces somatic or mental symptoms of illness in the victim under his/her care and then persistently presents the victims for medical examinations and care. The victim is usually a preschool child and the perpetrator is the child's mother. Motivation for such pathological behavior of perpetrator is considered to be unconscious need to assume sick role by proxy while external incentives such as economic gain are absent. Conceptualization of MSbP development is still in the domain of psychodynamic speculation, its course is chronic and the prognosis is poor considering lack of consistent, efficient and specific treatment. The authors also present the case report of thirty-three year-old mother who had been abusing her nine year-old son both emotionally and physically over the last several years forcing him to, together with her, report to the police, medical and educational institutions that he had been the victim of rape, poisoning and beating by various individuals, especially teaching and medical staff. Mother manifested psychosis and her child presented with impaired cognitive development, emotional problems and conduct disorder.

  15. Discrepancy between self- and proxy-rated pain in Alzheimer's disease: results from the danish Alzheimer intervention study

    DEFF Research Database (Denmark)

    Jensen-Dahm, C.; Vogel, A.; Waldorff, F.B.

    2012-01-01

    OBJECTIVES: To investigate the prevalence of self- and proxy-reported pain in a cohort with Alzheimer's disease (AD) and to identify characteristics of individuals with AD reporting pain. DESIGN: Data were collected at the baseline visit of the Danish Alzheimer Intervention Study. SETTING......: Community. PARTICIPANTS: Three hundred twenty-one community-living individuals with AD (MMSE >/= 20) and their primary caregivers. MEASUREMENTS: Pain was assessed as part of the EuroQol EQ-5D (caregiver- and self-rated). The Cornell Scale for Depression in Dementia, Quality of Life in Alzheimer's Disease...

  16. Metabolic syndrome and quality of life (QOL) using generalised and obesity-specific QOL scales.

    Science.gov (United States)

    Han, J H; Park, H S; Shin, C I; Chang, H M; Yun, K E; Cho, S H; Choi, E Y; Lee, S Y; Kim, J H; Sung, H N; Kim, J H; Choi, S I; Yoon, Y S; Lee, E S; Song, H R; Bae, S C

    2009-05-01

    We investigated the association between metabolic syndrome (MS) and health-related quality of life (HRQOL) assessed using generalised and obesity-specific QOL instruments. We recruited 456 outpatients [age: 19-81 years, body mass index (BMI): 16.3-36.7 kg/m2] in the primary care division from 12 general hospitals in Korea. HRQOL was measured using EuroQol comprising the health states descriptive system (EQ-5D) and visual analogue scale (EQ-VAS) as a general instrument. The Korean Obesity-related QOL scale (KOQOL) composed of six domains was used as a disease-specific QOL instrument. MS was defined on the basis of International Diabetes Federation (IDF) criteria with Korean-specific waist circumference cutoffs (men: 90 cm, women: 85 cm). Subjects with MS displayed significantly higher impairment of EQ-5D and KOQOL. Binary logistic regression analysis of MS patients with controls for age, gender, smoking, alcohol, exercise, education, income, marital status and medication history disclosed odds ratio (OR) values of 2.13 (1.33-3.41) for impaired total KOQOL, 2.07 (1.31-3.27) for impaired physical health, 1.63 (1.03-2.60) for impaired work-related health, 2.42 (1.45-4.04) for impaired routine life, 2.08 (1.27-3.40) for impaired sexual life and 2.56 (1.59-4.11) for diet distress. Among the EQ-5D dimensions, only pain/discomfort displayed a significantly increased OR of 1.60 (1.01-2.56) in MS group. Subjects with MS displayed a significantly impaired HRQOL compared with those without MS. MS and HRQOL were more strongly associated in obesity-specific QOL than in generalised QOL.

  17. Decreased QOL and muscle strength are persistent 1 year after intramedullary nailing of a tibial shaft fracture

    DEFF Research Database (Denmark)

    Larsen, Peter; Elsoe, Rasmus; Laessoe, Uffe

    2016-01-01

    INTRODUCTION:To evaluate the development in patient-reported quality of life (QOL) and muscle strength in the period from surgery to 12 months postoperatively after intramedullary nailing of a tibial shaft fracture. MATERIALS AND METHODS:The design was a prospective, follow-up cohort study. QOL w...

  18. Jemen - the Proxy War

    Directory of Open Access Journals (Sweden)

    Magdalena El Ghamari

    2015-12-01

    Full Text Available The military operation in Yemen is significant departure from Saudi Arabia's foreign policy tradition and customs. Riyadh has always relied on three strategies to pursue its interests abroad: wealth, establish a global network and muslim education and diplomacy and meadiation. The term "proxy war" has experienced a new popularity in stories on the Middle East. A proxy war is two opposing countries avoiding direct war, and instead supporting combatants that serve their interests. In some occasions, one country is a direct combatant whilst the other supporting its enemy. Various news sources began using the term to describe the conflict in Yemen immediately, as if on cue, after Saudi Arabia launched its bombing campaign against Houthi targets in Yemen on 25 March 2015. This is the reason, why author try to answer for following questions: Is the Yemen Conflict Devolves into Proxy War? and Who's fighting whom in Yemen's proxy war?" Research area includes the problem of proxy war in the Middle East. For sure, the real problem of proxy war must begin with the fact that the United States and its NATO allies opened the floodgates for regional proxy wars by the two major wars for regime change: in Iraq and Libya. Those two destabilising wars provided opportunities and motives for Sunni states across the Middle East to pursue their own sectarian and political power objectives through "proxy war".

  19. Using caregivers-as-proxies to retrospectively assess and measure quality of dying of palliative care clients.

    Science.gov (United States)

    Bridge, Marie; Roughton, D I; Lewis, Susan; Barelds, Janine; Brenton, Sava; Cotter, Sherree; Hagebols, Mary-lou; Woolman, Kirsty; Annells, Merilyn; Koch, Tina

    2002-01-01

    This study evaluated two quality-of-life assessment and measurement tools, the Client Generated Index and the McGill Quality of Life questionnaire, within palliative care nursing. Primarily tested was the feasibility of the tools to assess clients' QOL at admission and, if necessary, when their condition altered. The reliability of the tools has previously been ascertained Additionally, quality of dying during the last two days of life for 14 participants who died during the study was assessed and measured retrospectively by these tools, using the client's nominated caregiver as proxy for the client. It is this second focus that we report on here. The reasons why proxy assessment and measurement of client QOD was not useful or feasible are discussed.

  20. A High-Sensitivity Lanthanide Nanoparticle Reporter for Mass Cytometry: Tests on Microgels as a Proxy for Cells

    Science.gov (United States)

    2015-01-01

    This paper addresses the question of whether one can use lanthanide nanoparticles (e.g., NaHoF4) to detect surface biomarkers expressed at low levels by mass cytometry. To avoid many of the complications of experiments on live or fixed cells, we carried out proof-of-concept experiments using aqueous microgels with a diameter on the order of 700 nm as a proxy for cells. These microgels were used to test whether nanoparticle (NP) reagents would allow the detection of as few as 100 proteins per “cell” in cell-by-cell assays. Streptavidin (SAv), which served as the model biomarker, was attached to the microgel in two different ways. Covalent coupling to surface carboxyls of the microgel led to large numbers (>104) of proteins per microgel, whereas biotinylation of the microgel followed by exposure to SAv led to much smaller numbers of SAv per microgel. Using mass cytometry, we compared two biotin-containing reagents, which recognized and bound to the SAvs on the microgel. One was a metal chelating polymer (MCP), a biotin end-capped polyaspartamide containing 50 Tb3+ ions per probe. The other was a biotinylated NaHoF4 NP containing 15 000 Ho atoms per probe. Nonspecific binding was determined with bovine serum albumin (BSA) conjugated microgels. The MCP was effective at detecting and quantifying SAvs on the microgel with covalently bound SAv (20 000 SAvs per microgel) but was unable to give a meaningful signal above that of the BSA-coated microgel for the samples with low levels of SAv. Here the NP reagent gave a signal 2 orders of magnitude stronger than that of the MCP and allowed detection of NPs ranging from 100 to 500 per microgel. Sensitivity was limited by the level of nonspecific adsorption. This proof of concept experiment demonstrates the enhanced sensitivity possible with NP reagents in cell-by-cell assays by mass cytometry. PMID:24617504

  1. The Quality of Life Scale (QOLS: Reliability, Validity, and Utilization

    Directory of Open Access Journals (Sweden)

    Anderson Kathryn L

    2003-10-01

    Full Text Available Abstract The Quality of Life Scale (QOLS, created originally by American psychologist John Flanagan in the 1970's, has been adapted for use in chronic illness groups. This paper reviews the development and psychometric testing of the QOLS. A descriptive review of the published literature was undertaken and findings summarized in the frequently asked questions format. Reliability, content and construct validity testing has been performed on the QOLS and a number of translations have been made. The QOLS has low to moderate correlations with physical health status and disease measures. However, content validity analysis indicates that the instrument measures domains that diverse patient groups with chronic illness define as quality of life. The QOLS is a valid instrument for measuring quality of life across patient groups and cultures and is conceptually distinct from health status or other causal indicators of quality of life.

  2. Jemen - the Proxy War

    OpenAIRE

    Magdalena El Ghamari

    2015-01-01

    The military operation in Yemen is significant departure from Saudi Arabia's foreign policy tradition and customs. Riyadh has always relied on three strategies to pursue its interests abroad: wealth, establish a global network and muslim education and diplomacy and meadiation. The term "proxy war" has experienced a new popularity in stories on the Middle East. A proxy war is two opposing countries avoiding direct war, and instead supporting combatants that serve their interests. In some occas...

  3. Quality of Life (QOL among the Elderly in Rural Dehradun

    Directory of Open Access Journals (Sweden)

    . Kritika

    2017-03-01

    Full Text Available Background: The assessment of quality of life (QOL is a particularly important public health tool for the elderly in an era when life expectancy is increasing. Aims & Objectives: To measure Quality of Life among the elderly and identify its determinants. Material & Methods: This cross-sectional study was conducted on 220 elderly residing in rural areas of Dehradun district after taking written informed consent. Multistage random sampling was done, WHOQOL-OLD questionnaire was used to assess the QOL and data were analyzed by SPSS-22. Results: 55.5% subjects were females and the rest were males. Maximum percentage of respondents were in the age group of 66-75 years (46.4%. The mean (±SD of transformed total QOL score (TTS was 57.76 (±10.97. The mean score of facet V (death and dying was the highest (82.58 and the lowest mean score was observed in facet VI, intimacy (44.83. Overall QOL scores were found to be associated with education and financial dependency. Variation was observed between the determinants of QOL facet scores. Conclusion: Quality of life is a multidimensional concept. Education and financial dependency were found to be the possible determinants of QOL. More extensive studies are recommended to identify other factors affecting QOL.

  4. Validation of the Stroke Specific Quality of Life Scale (SS-QOL): test of reliability and validity of the Danish version (SS-QOL-DK).

    Science.gov (United States)

    Muus, Ingrid; Williams, Linda S; Ringsberg, Karin C

    2007-07-01

    To test the reliability and validity of the Danish version of the Stroke Specific Quality of Life Scale version 2.0 (SS-QOL-DK), an instrument for evaluation of health-related quality of life. A correlational study. A stroke unit that provides acute care and rehabilitation for stroke patients in Frederiksborg County, Denmark. One hundred and fifty-two stroke survivors participated; 24 of these performed test-retest. Questionnaires were sent out and returned by mail. A subsequent telephone interview assessed functional level and missing items. Test-retest was measured using Spearman's r, internal consistency was estimated using Cronbach's alpha, and evaluation of floor and ceiling values in proportion of minimum and maximum scores. Construct validity was assessed by comparing patients' scores on the SS-QOL-DK with those obtained by other test methods: Beck's Depression Index, the General Health Survey Short Form 36 (SF-36), the Barthel Index and the National Institutes of Health Stroke Scale, evaluating shared variance using coefficient of determination, r2. Comparing groups with known scores assessed known-group validity. Convergent and discriminant validity were assessed. Test-retest of SS-QOL-DK showed excellent stability, Spearman's r = 0.65-0.99. Internal consistency for all domains showed Cronbach's alpha = 0.81-0.94. Missing items rate was 1.0%. Most SS-QOL-DK domains showed moderately shared variance with similar domains of other test methods, r2 = 0.03-0.62. Groups with known differences showed statistically significant difference in scores. Item-to-scale correlation coefficients of 0.37-0.88 supported convergent validity. SS-QOL-DK is a reliable and valid instrument for measuring self-reported health-related quality of life on group level among people with mild to moderate stroke.

  5. Molecular proxies for paleoclimatology

    Science.gov (United States)

    Eglinton, Timothy I.; Eglinton, Geoffrey

    2008-10-01

    We summarize the applications of molecular proxies in paleoclimatology. Marine molecular records especially are proving to be of value but certain environmentally persistent compounds can also be measured in lake sediments, loess deposits and ice cores. The fundamentals of this approach are the molecular parameters, the compound abundances and carbon, hydrogen, nitrogen and oxygen isotopic contents which can be derived by the analysis of sediment extracts. These afford proxy measures which can be interpreted in terms of the conditions which control climate and also reflect its operation. We discuss two types of proxy; those of terrigenous and those of aquatic origin, and exemplify their application in the study of marine sediments through the medium of ten case studies based in the Atlantic, Mediterranean and Pacific Oceans, and in Antarctica. The studies are mainly for periods in the present, the Holocene and particularly the last glacial/interglacial, but they also include one study from the Cretaceous. The terrigenous proxies, which are measures of continental vegetation, are based on higher plant leaf wax compounds, i.e. long-chain (circa C 30) hydrocarbons, alcohols and acids. They register the relative contributions of C 3 vs. C 4 type plants to the vegetation in the source areas. The two marine proxies are measures of sea surface temperatures (SST). The longer established one, (U 37K') is based on the relative abundances of C 37 alkenones photosynthesized by unicellular algae, members of the Haptophyta. The newest proxy (TEX 86) is based on C 86 glycerol tetraethers (GDGTs) synthesized in the water column by some of the archaeal microbiota, the Crenarchaeota.

  6. Munchausen Syndrome by Proxy: A Clinical Vignette

    Science.gov (United States)

    Zylstra, Robert G.; Miller, Karl E.; Stephens, Walter E.

    2000-01-01

    Munchausen syndrome by proxy is the act of one person fabricating or inducing an illness in another to meet his or her own emotional needs through the treatment process. The diagnosis is poorly understood and controversial. We report here the case of a 6-year-old boy who presented with possible pneumonia, nausea, vomiting, and diarrhea and whose mother was suspected of Munchausen syndrome by proxy. PMID:15014581

  7. Measurement of Health-Related QOL in Diabetes Mellitus

    OpenAIRE

    Ken Watkins; Connell, Cathleen M

    2004-01-01

    A number of health-related QOL (HR-QOL) measures specifically designed for people with diabetes mellitus have appeared in the literature. This article provides a selective review of 12 measures that address this important construct. For each included study, a description of the measure and its development phase is provided, followed by discussion of sampling, reliability, validity and appropriateness for selected populations. Measures designed to investigate broad and specific conceptualisati...

  8. A comparison between self-reported and GIS-based proxies of residential exposure to environmental pollution in a case-control study on lung cancer.

    Science.gov (United States)

    Cordioli, M; Ranzi, A; Freni Sterrantino, A; Erspamer, L; Razzini, G; Ferrari, U; Gatti, M G; Bonora, K; Artioli, F; Goldoni, C A; Lauriola, P

    2014-06-01

    In epidemiological studies both questionnaire results and GIS modeling have been used to assess exposure to environmental risk factors. Nevertheless, few studies have used both these techniques to evaluate the degree of agreement between different exposure assessment methodologies. As part of a case-control study on lung cancer, we present a comparison between self-reported and GIS-derived proxies of residential exposure to environmental pollution. 649 subjects were asked to fill out a questionnaire and give information about residential history and perceived exposure. Using GIS, for each residence we evaluated land use patterns, proximity to major roads and exposure to industrial pollution. We then compared the GIS exposure-index values among groups created on the basis of questionnaire responses. Our results showed a relatively high agreement between the two methods. Although none of these methods is the "exposure gold standard", understanding similarities, weaknesses and strengths of each method is essential to strengthen epidemiological evidence. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. The Association between Short or Long Sleep Times and Quality of Life (QOL): Results of the Korea National Health and Nutrition Examination Survey (KNHANES IV-V).

    Science.gov (United States)

    Kim, Jae-Hyun; Park, Eun-Cheol; Yoo, Ki-Bong; Park, Sohee

    2015-06-15

    Sleep can affect quality of life (QOL). We examined the association between self-reported sleep time and QOL independent of perceived health status and depressive disorder using the EuroQol-5 Dimension (EQ-5D) and a visual analog scale (VAS). We used the nationwide cross-sectional survey data of 28,178 subjects from the Korea National Health and Nutrition Examination Survey (KNHANES) IV-V. Self-reported sleep time was assessed by average hours of sleep per day. QOL was measured using the EQ-5D and VAS. A generalized additive model and multiple linear regression analysis were used to estimate the effect of sleep time on the QOL while adjusting for potential confounding variables. We found a significant inverted U-shaped relationship between sleep time and QOL using both the EQ-5D and VAS indices. Compared with subjects who slept 7 h/day, Korean men whose sleep time was very short (≤ 4 h/ day) or very long (≥ 10 h/day) had substantially worse QOL (-3.125 in EQ-5D, p sleep time and QOL in Korean women. Inappropriate sleep time (either short or long) in both men and women was significantly associated with lower QOL. In particular, such an association was more apparent among persons whose perceived health status was poor. © 2015 American Academy of Sleep Medicine.

  10. Could we use parent report as a valid proxy of child report on anxiety, depression, and distress? A systematic investigation of father-mother-child triads in children successfully treated for leukemia.

    Science.gov (United States)

    Abate, Cybelle; Lippé, Sarah; Bertout, Laurence; Drouin, Simon; Krajinovic, Maja; Rondeau, Émélie; Sinnett, Daniel; Laverdière, Caroline; Sultan, Serge

    2018-02-01

    Systematic assessment of emotional distress is recommended in after care. Yet, it is unclear if parent report may be used as a proxy of child report. The aim of this study was to assess agreements and differences and explore possible moderators of disagreement between child and parent ratings. Sixty-two young survivors treated for acute lymphoblastic leukemia (9-18 years) and both parents responded to the Beck Youth Inventory (anxiety and depression) and the distress rating scale on the child's status. Parents completed the Brief Symptom Inventory-18 on their own psychological status. Systematic analyses of agreement and differences were performed. Mother-child and father-child agreements were fair on anxiety, depression, and distress (median intraclass correlation coefficient = 0.37). Differences between parents and children were medium sized (median d = 0.55) with parents giving higher scores than their children on anxiety, depression, and distress. Mothers reported distress more frequently than fathers (39 vs. 17%) when children reported none. The child being female and lower parental income were associated with lower agreement in fathers when rating child distress. Higher levels of parental psychological symptoms were consistently associated with lower agreement. Parent-child differences when rating adolescent survivors' difficulties may be more important than previously thought. Parent report probably cannot be considered as a valid proxy of older child report on such internalized domains as anxiety, depression, or distress in the after-care clinic. Parents' report is also likely to be influenced by their own mood, a factor that should be corrected for when using their report. © 2017 Wiley Periodicals, Inc.

  11. Proxy Smart Card Systems

    OpenAIRE

    Cattaneo, Giuseppe; Faruolo, Pompeo; Palazzo, Vincenzo; Visconti, Ivan

    2010-01-01

    International audience; The established legal value of digital signatures and the growing availability of identity-based digital services are progressively extending the use of smart cards to all citizens, opening new challenging scenarios. Among them, motivated by concrete applications, secure and practical delegation of digital signatures is becoming more and more critical. Unfortunately, secure delegation systems proposed so far (e.g., proxy signatures) include various drawbacks for any pr...

  12. The responsiveness of the uterine fibroid symptom and health-related quality of life questionnaire (UFS-QOL)

    Science.gov (United States)

    Harding, Gale; Coyne, Karin S; Thompson, Christine L; Spies, James B

    2008-01-01

    Background A number of noninvasive alternatives to hysterectomy have become available as treatments for uterine fibroids. These alternative therapies, however, may not relieve all symptoms. Consequently, the need for patient-reported outcomes to assess symptom reduction of uterine fibroids has become increasingly important to evaluate the clinical success of patients who choose these alternative therapies. The purpose of the study was to examine the responsiveness of the Uterine Fibroid Symptom and Health-Related Quality of Life Questionnaire (UFS-QOL) with treatment of uterine fibroids. Methods The responsiveness of the UFS-QOL was assessed as a post-hoc analysis of patients treated with MRI-guided focused ultrasound thermal ablation (MRgFUS) for uterine fibroids. The UFS-QOL and SF-36 were completed at baseline and months 1, 3, and 6. Patient perceived overall treatment effect (OTE) was assessed at month 3, while satisfaction with treatment was collected at month 6. The responsiveness of the UFS-QOL was examined using effect sizes and change scores by patient-reported overall treatment effect and satisfaction. Results A total of 102 women with complete UFS-QOL data were included in the analysis; the mean age was 45 years and 79% were Caucasian. From baseline to 6 months, significant improvements were observed in UFS-QOL Symptom Severity and all Health-Related Quality of Life (HRQL) subscale scores (p fibroids and is a useful outcome measure for uterine-sparing uterine fibroid treatments. PMID:19014505

  13. [Rasch analysis on stroke-specific quality of life (SS-QOL) scale of acupuncture intervention on stroke].

    Science.gov (United States)

    Hui, Jian-Rong; Pei, Jian; Wang, Yuan-Chun; Hui, Jian-Ping; Fu, Qin-Hui; Song, Yi; Li, Hai-Yan; Liu, Zhi-Dan

    2013-04-01

    To optimize the evaluation level of active motor threshold and the functional domain of upper limbs of stroke-specific quality of life (SS-QOL) scale with Rasch analysis. Sixty patients with acute ischemic stroke that were in accord with research criterid were randomly divided into a test group (30 cases) and a control group (30 cases). Acupuncture treatment and routine western medicine were applied on the test group, and single treatment of routine western medicine was applied on the control group. Selected acupoints were MS 5, Fengchi (GB 20), Hegu (LI 4), etc. Active motor threshold and the functional domain of upper limbs of SS-QOL were self-tested by patients after one treating course. The characteristics of the above mentioned items were tested with Rasch model. The statistical result on fitness of active motor threshold and the functional domain of upper limbs of SS-QOL showed that every reference of samples and items wosin accord with the Rasch model and has well inner reliability and validity. The Infit and Outfit MnSq values of active motor threshold and the functional domain of upper limbs of SS-QOL are basically between 0.5 and 1.5. The application of Rasch analysis on the assessment of patient reported outcome (PRO) has optimized the PRO scale (the activity and upper limb function domain of SS-QOL scale) and enhanced evaluation level of active motor threshold and the functional domain of upper limbs of SS-QOL scale.

  14. Validating the Cerebral Palsy Quality of Life for Children (CP QOL-Child) questionnaire for use in Chinese populations.

    Science.gov (United States)

    Wang, H-Y; Cheng, C-C; Hung, J-W; Ju, Y-H; Lin, J-H; Lo, S-K

    2010-12-01

    The purpose of this study was to examine the psychometric properties of the Chinese version of Cerebral Palsy Quality of Life for Children (CP QOL-Child) questionnaire. We performed forward (into Chinese) and backward translation of the CP QOL-Child for: (1) the primary caregiver form (for parents of children with CP aged 4-12 years); and (2) the child self-report form (for children with cerebral palsy aged 9-12 years). Psychometric properties assessed included test-retest reliability, internal consistency, item discrimination, construct validity, and concordance between the forms of questionnaire. The Chinese CP QOL-Child was completed by 145 caregivers and 44 children. Excellent test-retest reliability and internal consistency were obtained. Item discrimination analysis revealed a majority of the items have moderate to good discriminating power. Confirmatory factor analysis demonstrated distinguishable domain structure as on the original English version. Significant associations were found between lower QOL and more severe motor disability. Consistent with the English version, the highest correlation between the primary caregiver and child forms on QOL was in the domain of functioning. Results of this study indicate that the Chinese CP QOL-Child appears to be valid for use in Mandarin-Chinese speaking children with cerebral palsy.

  15. Concordance of parent proxy report and child self-report of posttraumatic stress in children with cancer and healthy children: Influence of parental posttraumatic stress

    Science.gov (United States)

    Clawson, Ashley H.; Jurbergs, Niki; Lindwall, Jennifer; Phipps, Sean

    2013-01-01

    Objective This study examined the relationships between parental posttraumatic stress symptoms (PTSS), child PTSS, and parent-child concordance for child PTSS. Method Participants were children with cancer (n = 199) and healthy children (n = 108) and their parents. Children self-reported on PTSS and parents completed measures of child and parent PTSS. Results In the cancer group, child and parent report of child PTSS were significantly correlated with no mean differences between reporters. In contrast, correlations were non-significant in the control group, and parents reported significantly lower levels of child PTSS than children. Increased parental PTSS was associated with better concordance in the cancer group, but not in the control group. In fact, in the cancer group, parent-child concordance was strongest at the highest level of parental PTSS. Conclusions Parents of children with cancer were found to be accurate reporters of their children’s distress, even with high levels of reported personal distress. In contrast, parents of healthy children appear primarily influenced by personal distress when reporting child PTSS. Although multiple informant assessments are always desirable, it appears that utilization of a single informant may be reasonable in the cancer setting when access to informants is limited. PMID:23723147

  16. Concordance of parent proxy report and child self-report of posttraumatic stress in children with cancer and healthy children: influence of parental posttraumatic stress.

    Science.gov (United States)

    Clawson, Ashley H; Jurbergs, Niki; Lindwall, Jennifer; Phipps, Sean

    2013-11-01

    This study examined the relationships between parental posttraumatic stress symptoms (PTSS), child PTSS, and parent-child concordance for child PTSS. Participants were children with cancer (n = 199), and healthy children (n = 108) and their parents. Children self-reported on PTSS and parents completed measures of child and parent PTSS. In the cancer group, child and parent reports of child PTSS were significantly correlated with no mean differences between reporters. In contrast, correlations were non-significant in the control group, and parents reported significantly lower levels of child PTSS than children. Increased parental PTSS was associated with better concordance in the cancer group but not in the control group. In fact, in the cancer group, parent-child concordance was strongest at the highest level of parental PTSS. Parents of children with cancer were found to be accurate reporters of their children's distress, even with high levels of reported personal distress. In contrast, parents of healthy children appear primarily influenced by personal distress when reporting child PTSS. Although multiple informant assessments are always desirable, it appears that utilization of a single informant may be reasonable in the cancer setting when access to informants is limited. Copyright © 2013 John Wiley & Sons, Ltd.

  17. Alendronate improves QOL of postmenopausal women with osteoporosis

    Directory of Open Access Journals (Sweden)

    Hisaya Kawate

    2010-04-01

    Full Text Available Hisaya Kawate1, Keizo Ohnaka2, Masahiro Adachi1, Suminori Kono3, Hideyuki Ikematsu4, Hisashi Matsuo5, Kazumi Higuchi6, Takehiko Takayama7, Ryoichi Takayanagi11Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; 2Department of Geriatric Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; 3Department of Preventive Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; 4Internal Medicine, Haradoi Hospital, Fukuoka, Japan; 5Matsuo Naika Hospital, Fukuoka, Japan; 6Fukuoka Teishin Hospital, Fukuoka, Japan; 7Takayama Icho-ka and Naika Clinic, Fukuoka, JapanPurpose: Postmenopausal osteoporosis causes bone fracture as well as pain, physical, psychological and socially adverse effects, which affects a patient’s quality of life (QOL. The effect of alendronate on QOL was investigated compared with that of alfacalcidol in postmenopausal osteoporotic women.Patients and methods: A total of 44 postmenopausal osteoporotic women (mean age 69.8 years with back or joint pain, although capable of walking, were randomly assigned to two groups; group A (n = 25 received 5 mg/day of alendronate, and group B (n = 19 received 0.5 μg/day of alfacalcidol, for the first 4 months. For the following 2 months, the group A received 0.5 μg/day of alfacalcidol and the group B received 5 mg/day of alendronate in a crossover design. The patient’s QOL was evaluated by score of Japanese Osteoporosis Quality of Life Questionnaire (JOQOL, and pain intensity using a visual analog scale (VAS. Bone metabolism was measured by bone mineral density (BMD and a biomarker for bone resorption, urinary crosslinked N-terminal telopeptide of type I collagen (NTX.Results: With 4-month treatment, alendronate, but not alfacalcidol, improved pain-related QOL, reduced joint pain by VAS, and increased bone mineral density. Both treatments significantly reduced bone resorption, the

  18. Munchausen Syndrome by Proxy: Evaluation and Treatment.

    Science.gov (United States)

    Parnell, Teresa F.; Day, Deborah O.

    Munchausen Syndrome by Proxy (MSBP) is characterized by a significant caretaker, usually a mother, deliberately inducing and/or falsely reporting illness in a child. The potentially fatal outcome of undetected MSBP makes the understanding of this syndrome gravely important. Early detection and effective intervention can be accomplished through the…

  19. Munchausen Syndrome by Proxy: A Family Affair.

    Science.gov (United States)

    Mehl, Albert L.; And Others

    1990-01-01

    The article reports on a case of Munchausen syndrome by proxy in which chronic illicit insulin was administered to a one-year-old child by her mother. Factitious illnesses continued despite psychiatric intervention. Retrospective review of medical records suggested 30 previous episodes of factitious illness within the family. (DB)

  20. [Munchausen by proxy syndrome].

    Science.gov (United States)

    Depauw, A; Loas, G; Delhaye, M

    2015-01-01

    The Munchausen syndrome by proxy (MSBP) was first described in 1977 by the English paediatrician Roy Meadow. The MSBP is an extremely complicated diagnosis because of the difficulty in finding the incriminating evidence of its existence and because of the ethical issue it raises for caregivers. Its implications from a medical, psychological and legal point of view raise difficult questions for any professional confronted to it. In this article we will first present the case of a 16-year-old teenager who had been bedridden in hospital for a year, before an atypical form of MSBP was finally diagnosed, after a stay in a child and adolescent psychiatry unit. We will then discuss this case in light of a literature review on the MSBP.

  1. Development and psychometric characteristics of the SCI-QOL Pressure Ulcers scale and short form.

    Science.gov (United States)

    Kisala, Pamela A; Tulsky, David S; Choi, Seung W; Kirshblum, Steven C

    2015-05-01

    To develop a self-reported measure of the subjective impact of pressure ulcers on health-related quality of life (HRQOL) in individuals with spinal cord injury (SCI) as part of the SCI quality of life (SCI-QOL) measurement system. Grounded-theory based qualitative item development methods, large-scale item calibration testing, confirmatory factor analysis (CFA), and item response theory-based psychometric analysis. Five SCI Model System centers and one Department of Veterans Affairs medical center in the United States. Adults with traumatic SCI. SCI-QOL Pressure Ulcers scale. 189 individuals with traumatic SCI who experienced a pressure ulcer within the past 7 days completed 30 items related to pressure ulcers. CFA confirmed a unidimensional pool of items. IRT analyses were conducted. A constrained Graded Response Model with a constant slope parameter was used to estimate item thresholds for the 12 retained items. The 12-item SCI-QOL Pressure Ulcers scale is unique in that it is specifically targeted to individuals with spinal cord injury and at every stage of development has included input from individuals with SCI. Furthermore, use of CFA and IRT methods provide flexibility and precision of measurement. The scale may be administered in its entirety or as a 7-item "short form" and is available for both research and clinical practice.

  2. Quality of life (QOL), supportive care, and spirituality in hematopoietic stem cell transplant (HSCT) patients.

    Science.gov (United States)

    Sirilla, Janet; Overcash, Janine

    2013-04-01

    For many patients, a hematopoietic stem cell transplant (HSCT) can be challenging to physical and emotional health. Supportive care needs can be overwhelming for many patients and families. The purpose of this study was to evaluate the effect of quality of life (QOL), spiritual well-being, and supportive care resources post-HSCT. This descriptive, repeated-measures study included people over the age of 18 years undergoing HSCT for any cancer diagnosis. The Functional Assessment in Cancer Therapy--Bone Marrow Transplant scale, the Functional Assessment of Chronic Illness Therapy--Spiritual--12 scale, and a resource questionnaire were administered prior to HSCT and following HSCT at 30, 60, 90, and 180 days. Three groups of HSCT patients were examined: allogeneic, autologous, and overall. Data analysis included descriptive statistics and correlations. In the sample (n = 159), the autologous HSCT group reported the highest QOL scores. Spirituality scores increased for the autologous HSCT group at 90 days, but decreased for the overall and allogeneic groups. The type of supportive care resources most used were information from the physician and nurse, the Leukemia and Lymphoma Society Support as the most used form of support group, and Faith, Prayer and Spiritual Healing. QOL and spiritual well-being scores correlated best at 180 days (6 months) for autologous and allogeneic patients.

  3. Psychometric properties and validation of the Polish CP QOL-Child questionnaire: a pilot study.

    Science.gov (United States)

    Dmitruk, Elżbieta; Mirska, Anna; Kułak, Wojciech; Kalinowska, Anna K; Okulczyk, Kamila; Wojtkowski, Janusz

    2014-12-01

    Translate, determine the psychometric properties and validate the Polish CP QOL-Child questionnaire. A double translation of the questionnaire from English into Polish and back was executed. The questionnaire was distributed to 55 parents/legal guardians of children with cerebral palsy aged 4-12 years. The psychometric properties of the questionnaire were determined on the basis of its internal consistency and the internal consistency of each of the investigated aspects, as well as on the assessment of the relationship between quality of life and such data as child's age, parent's age, place of residence and GMFCS level. The results showed high levels of internal consistency of the Polish version of the CP QOL-Child questionnaire - Cronbach's α was between 0.77 and 0.82, which is comparable to the original scale, where it was 0.74-0.92. In addition, we found no relationship between child's age and parent's age and the child's quality of life. Whereas we determined dependencies between the child's GMFCS level and quality of life in areas such as emotional state (p = 0.025), pain and the effects of disability (p = 0.033), and to a lesser extent participation in social life (p = 0.045). However, Spearman test presented that only domain pain and impact of disability reported positive correlation r = 0.43. Studies showed that English language the CP QOL-Child questionnaire was successful translated into Polish which is confirmed by the results of the assessment of the psychometric properties and validation of the Polish language questionnaire. The results of our study indicate that the Polish language version of the CP QOL-Child questionnaire is an appropriate tool to assess the quality of life of Polish-speaking children with cerebral palsy aged 4-12 years. © 2013 Nordic College of Caring Science.

  4. Proxy consent: moral authority misconceived.

    Science.gov (United States)

    Wrigley, A

    2007-09-01

    The Mental Capacity Act 2005 has provided unified scope in the British medical system for proxy consent with regard to medical decisions, in the form of a lasting power of attorney. While the intentions are to increase the autonomous decision making powers of those unable to consent, the author of this paper argues that the whole notion of proxy consent collapses into a paternalistic judgement regarding the other person's best interests and that the new legislation introduces only an advisor, not a proxy with the moral authority to make treatment decisions on behalf of another. The criticism is threefold. First, there is good empirical evidence that people are poor proxy decision makers as regards accurately representing other people's desires and wishes, and this is therefore a pragmatically inadequate method of gaining consent. Second, philosophical theory explaining how we represent other people's thought processes indicates that we are unlikely ever to achieve accurate simulations of others' wishes in making a proxy decision. Third, even if we could accurately simulate other people's beliefs and wishes, the current construction of proxy consent in the Mental Capacity Act means that it has no significant ethical authority to match that of autonomous decision making. Instead, it is governed by a professional, paternalistic, best-interests judgement that undermines the intended role of a proxy decision maker. The author argues in favour of clearly adopting the paternalistic best-interests option and viewing the proxy as solely an advisor to the professional medical team in helping make best-interests judgements.

  5. Private Computing with Untrustworthy Proxies

    NARCIS (Netherlands)

    Gedrojc, B.

    2011-01-01

    The objective of this thesis is to preserve privacy for the user while untrustworthy proxies are involved in the communication and computation i.e. private computing. A basic example of private computing is an access control system (proxy) which grants access (or not) to users based on fingerprints.

  6. Prediction of specific depressive symptom clusters in youth with epilepsy: The NDDI-E-Y versus Neuro-QOL SF.

    Science.gov (United States)

    Kellermann, Tanja S; Mueller, Martina; Carter, Emma G; Brooks, Byron; Smith, Gigi; Kopp, Olivia J; Wagner, Janelle L

    2017-08-01

    Proper assessment and early identification of depressive symptoms are essential to initiate treatment and minimize the risk for poor outcomes in youth with epilepsy (YWE). The current study examined the predictive utility of the Neurological Disorders Depression Inventory-Epilepsy for Youth (NDDI-E-Y) and the Neuro-QOL Depression Short Form (Neuro-QOL SF) in explaining variance in overall depressive symptoms and specific symptom clusters on the gold standard Children's Depression Inventory-2 (CDI-2). Cross-sectional study examining 99 YWE (female 68, mean age 14.7 years) during a routine epilepsy visit, who completed self-report measures of depressive symptoms, including the NDDI-E-Y, CDI-2, and the Neuro-QOL SF. Caregivers completed a measure of seizure severity. All sociodemographic and medical information was evaluated through electronic medical record review. After accounting for seizure and demographic variables, the NDDI-E-Y accounted for 45% of the variance in the CDI-2 Total score and the CDI-2 Ineffectiveness subscale. Furthermore, the NDDI-E-Y predicted CDI-2 Total scores and subscales similarly, with the exception of explaining significantly more variance in the CDI-2 Ineffectiveness subscale compared to the Negative Mood subscale. The NDDI-E-Y explained greater variance compared to Neuro-QOL SF across the Total (48% vs. 37%) and all CDI-2 subscale scores; however, the NDDI-E-Y emerged as a stronger predictor of only CDI-2 Ineffectiveness. Both the NDDI-E-Y and Neuro-QOL SF accounted for the lowest amount of variance in CDI-2 Negative Mood. Sensitivity was poor for the Neuro-QOL SF in predicting high versus low CDI-2 scores. The NDDI-E-Y has strong psychometrics and can be easily integrated into routine epilepsy care for quick, brief screening of depressive symptoms in YWE. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  7. Validity, reliability, and factor analysis of Persian version of quality of life questionnaire for irritable bowel syndrome (IBS-QOL-34

    Directory of Open Access Journals (Sweden)

    Nasrine Masaeli

    2013-01-01

    Full Text Available Background: Quality of life (QOL improvement is the main objective of treating patients with irritable bowel syndrome (IBS. This study aimed to assess the validity, reliability, and factor analysis of IBS-QOL-34 questionnaire as a common transcultural instrument for Iranian IBS patients. Materials and Methods: Two hundred and forty patients with IBS (based on gastroenterologists′ diagnosis according to ROM III criteria were referred to Digestive Health Clinic in Psychosomatic Research Center have been selected in this study. Aside with IBS-QOL-34, MOS 36-item short-form health survey (SF-36 and IBS severity index (IBSSI questionnaires were completed by the cases for determination of correlation coefficients; the data were analyzed using descriptive statistics, factor analysis, Cronbach′s alpha, Pearson correlation coefficient by Statistical Package for Social Sciences (SPSS software, version 18. Results: Total reliability of the questionnaire was reported by using Cronbach′s alpha as 0.95, ranging from 0.65 to 0.90. Correlation coefficients of concurrent implementation of IBS-QOL with SF-36 and IBSSI resulted in −0.61 and 0.64, respectively. Exploratory factor analysis using varimax rotation identified eight principle components, which will determine QOL at 67% variance. Conclusion: According to the results, IBS-QOL-34 questionnaire has good psychometric properties in the research community and can be safely used as a valid tool to assess QOL of patients with IBS for healthcare and therapeutic purposes.

  8. Child- and parent-reported quality of life trajectories in children with epilepsy: A prospective cohort study.

    Science.gov (United States)

    Ferro, Mark A; Avery, Lisa; Fayed, Nora; Streiner, David L; Cunningham, Charles E; Boyle, Michael H; Lach, Lucyna; Glidden, Gina; Rosenbaum, Peter L; Ronen, Gabriel M

    2017-07-01

    To describe the developmental trajectories of quality of life (QoL) in a large cohort of children with epilepsy, and to assess the relative contribution of clinical, psychosocial, and sociodemographic variables on QoL trajectories. Five assessments during a 28-month prospective cohort study were used to model trajectories of QoL. Participants were recruited with their parents from six Canadian tertiary centers. A convenience sample of 506 children aged 8-14 years with epilepsy and without intellectual disability or autism spectrum disorder were enrolled. A total of 894 children were eligible and 330 refused participation. Participating children were, on average, 11.4 years of age, and 49% were female. Nearly one third (32%) had partial seizures. At baseline, 479 and 503 child- and parent-reported questionnaires were completed. In total, 354 children (74%) and 366 parents (73%) completed the 28-month follow-up. QoL was measured using the child- and parent-reported version of the Childhood Epilepsy QoL scale (CHEQOL-25). Child-reported QoL was fitted best by a six-class model and parent-reported QoL by a five-class model. In both models, trajectories remained either stable or improved over 28 months. Of these children, 62% rated their QoL as high or moderately high, defined as at least one standard deviation above the average CHEQOL-25 score. Greater family, classmate, and peer social support, fewer symptoms of child and parent depression, and higher receptive vocabulary were identified as the most robust predictors of better QoL (all p < 0.001). Most children with epilepsy and their parents reported relatively good QoL in this first joint self- and proxy-reported trajectory study. Findings confirm the heterogeneous QoL outcomes for children with epilepsy and the primary importance of psychosocial factors rather than seizure and AED-specific factors in influencing QoL. These predictors that are potentially amenable to change should now be the focus of specific

  9. Robotic Vehicle Proxy Simulation Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Energid Technologies proposes the development of a digital simulation that can replace robotic vehicles in field studies. This proxy simulation will model the...

  10. Munchausen Syndrome by Proxy: Unusual Manifestations and Disturbing Sequelae.

    Science.gov (United States)

    Porter, Gerald E.; And Others

    1994-01-01

    This study documents previously unreported findings in cases of Munchausen Syndrome by Proxy (in which a mother fabricates an illness in her child). In the reported case, esophageal perforation, retrograde intussusception, tooth loss, and bradycardia were found. (Author/DB)

  11. Validation of the prolapse quality-of-life questionnaire (P-QOL): An ...

    African Journals Online (AJOL)

    Background. The prolapse quality-of-life questionnaire (P-QOL) has been validated and translated into eight languages. The lack of an Afrikaans version of the P-QOL limits studies in Afrikaans-speaking patients with pelvic organ prolapse (POP). Objective. To validate an Afrikaans version of the P-QOL in a South African ...

  12. Development of a head and neck companion module for the quality of life-radiation therapy instrument (QOL-RTI)

    Science.gov (United States)

    Trotti, A; Johnson, D J; Gwede, C; Casey, L; Sauder, B; Cantor, A; Pearlman, J

    1998-09-01

    A review of available head and neck quality of life (QOL) instruments reveals them to inadequately address important radiation related side effects, or to be too cumbersome for routine use. The purpose of this study was to develop a head and neck disease specific module as a companion to the previously developed quality of life - radiation therapy instrument (QOL-RTI). The goal was to create a more complete, yet concise, head and neck site-specific module geared toward patients receiving radiation therapy for head and neck cancer. This exploratory study included 34 consecutive patients undergoing definitive radiotherapy over a 6-7 week course (60-79.8 Gy). We developed and administered a 14-item questionnaire to all eligible patients treated with radiotherapy for head and neck cancer who were not already registered in another research study assessing quality of life (e.g., RTOG). During the treatment period, the QOL-RTI general tool and the head and neck (H&N) module were administered as follows: at baseline, at week four (for test-retest), and at the end of the treatment period. For validation purposes the QOL-RTI/H&N was compared to the functional assessment cancer tool head and neck (FACT-H&N) questionnaire. The FACT-H&N was administered one time at week 4, on the same day as the QOL-RTI/H&N. This report includes the treatment phase of the study (during the course of radiation). Mean age was 62 years (range 40-75). Internal consistency of the module was satisfactory (Chronbach's alpha = 0.85). Test-retest yielded a correlation coefficient of 0.90 (p neck module, the difference in the mean baseline (7.17) and end of treatment scores (4.20) was 2.94, or 42% change (p bread and liquids), changes in mucous and saliva, changes in taste, difficulty chewing, trouble with coughing, and speech difficulties. Items that were not significant were pain in the mouth, and appearance. These initial results suggest that the H&N companion module to the QOL-RTI is a valid and

  13. Violent crime rates as a proxy for the social determinants of sexually transmissible infection rates: the consistent state-level correlation between violent crime and reported sexually transmissible infections in the United States, 1981-2010.

    Science.gov (United States)

    Chesson, Harrell W; Owusu-Edusei, Kwame; Leichliter, Jami S; Aral, Sevgi O

    2013-11-01

    Numerous social determinants of health are associated with violent crime rates and sexually transmissible infection (STI) rates. This report aims to illustrate the potential usefulness of violent crime rates as a proxy for the social determinants of STI rates. For each year from 1981 to 2010, we assessed the strength of the association between the violent crime rate and the gonorrhoea (Neisseria gonorrhoeae) rate (number of total reported cases per 100?000) at the state level. Specifically, for each year, we calculated Pearson correlation coefficients (and P-values) between two variables (the violent crime rate and the natural log of the gonorrhoea rate) for all 50 states and Washington, DC. For comparison, we also examined the correlation between gonorrhoea rates, and rates of poverty and unemployment. We repeated the analysis using overall syphilis rates instead of overall gonorrhoea rates. The correlation between gonorrhoea and violent crime was significant at the Pcrime rates. In contrast, the P-value for the correlation coefficient exceeded 0.05 in 9 of the 30 years for the association between gonorrhoea and poverty, and in 17 of the 30 years for that between gonorrhoea and unemployment. Because violent crime is associated with many social determinants of STIs and because it is consistently associated with STI rates, violent crime rates can be a useful proxy for the social determinants of health in statistical analyses of STI rates.

  14. Munchausen by Proxy Syndrome

    Science.gov (United States)

    ... to Talk to Your Child About the News Gun Safety Too Late for the Flu Vaccine? Eating ... is suspected, health care providers are required by law to report their concerns. However, after a parent ...

  15. Qualitative and Quantitative Sentiment Proxies

    DEFF Research Database (Denmark)

    Zhao, Zeyan; Ahmad, Khurshid

    2015-01-01

    Sentiment analysis is a content-analytic investigative framework for researchers, traders and the general public involved in financial markets. This analysis is based on carefully sourced and elaborately constructed proxies for market sentiment and has emerged as a basis for analysing movements...... and trading volumes. The case study we use is a small market index (Danish Stock Exchange Index, OMXC 20, together with prevailing sentiment in Denmark, to evaluate the impact of sentiment on OMXC 20. Furthermore, we introduce a rather novel and quantitative sentiment proxy, that is the use of the index...

  16. [Analysis on the correlation between SF-36 and QOL-35 in patients and coronary artery disease].

    Science.gov (United States)

    Lu, Yi-Hua; Yan, Jian-Hua; Sun, Li-Xian; Li, Quan; Wang, Yan-Jie; Zhuang, Xun; Zhang, Ze-Feng; Fan, Zhong-Jie

    2010-11-01

    To analyze the correlation between SF-36 and QOL-35 and the consistency of the two kinds of life-quality questionnaires when evaluating the quality of life in patients with coronary heart disease. 781 in-hospital-patients, who underwent coronary angiography from June 2008 to April 2009, were included in this study. Quality of life was measured by the Chinese versions of SF-36 and QOL-35. Demographic and clinical information were collected. Correlation Analysis was done between SF-36 and QOL-35 in the patients with coronary artery disease. The total score of SF-36 was 62.63 ± 12.47 and the QOL-35 total score was 62.70 ± 9.69. Data from the simple correlation analysis showed that SF-36 and QOL-35 total scores (r = 0.725, P SF-36 physical functioning and QOL-35 independent living capacity (r = 0.933, P SF-36 mental health and QOL-35 mental health(r = 0.132, P SF-36 social function and QOL-35 social function score (r = 0.215, P SF-36 and QOL-35 (r = 0.946, P SF-36 and QOL-35 were consistent in the evaluation on the quality of life, at the overall level.

  17. Female sexual dysfunction (FSD): Prevalence and impact on quality of life (QoL).

    Science.gov (United States)

    Nappi, Rossella E; Cucinella, Laura; Martella, Silvia; Rossi, Margherita; Tiranini, Lara; Martini, Ellis

    2016-12-01

    Female sexual dysfunction (FSD) and quality of life (QOL) are both multidimensional and have a bidirectional relationship across the reproductive life span and beyond. Methodological difficulties exist in estimating the real prevalence of FSD because it is hard to determine the level of distress associated with sexual symptoms in a large-scale survey. Approximately 40-50% of all women report at least one sexual symptom, and some conditions associated with hormonal changes at menopause, such as vulvovaginal atrophy (VVA) and hypoactive sexual desire disorder (HSDD), have a significant impact on sexual function and QOL. Sexual distress peaks at midlife, declines with age and is strongly partner-related. Many postmenopausal women are still sexually active, especially if they are in a stable partnership. Even though sexual functioning is impaired, a variety of psychosocial factors may maintain sexual satisfaction. That being so, health care providers (HCPs) should proactively address sexual symptoms at midlife and in older women, from a balanced perspective. Adequate counselling should be offered. Women with distressing symptoms may benefit from tailored hormonal and non-hormonal therapies, whereas women without distress related to their sexual experiences should not receive any specific treatment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Surgery for two cases with markedly impaired QOL(Quality of Life) of radiation enterocolitis

    Energy Technology Data Exchange (ETDEWEB)

    Shiba, Tadaaki; Tanishima, Satoru; Sato, Masahiko; Yanagisawa, Terumasa; Yoshino, Masaaki; Takatsuka, Jun [Toho Univ., Tokyo (Japan). School of Medicine

    1996-10-01

    Two cases of radiation enterocolitis with markedly impaired QOL for a long period were reported. Case 1: A 61 years old female. She received 60 Gy irradiation post hysterectomy and ovariectomy due to uterine cancer at the age of 39 y. She suffered from fecal incontinence and anal pain at 58 y, was diagnosed to have radiation colitis. She was hospitalized due to neurosis, anal pain and hypertension at 59 y. She received nephrostomy due to hydronephrosis and ureterostenosis at 60 y, and colostomy and ileal conduit formation due to anal pain and dyschezia. Case 2: A 70 years old female who received 60 Gy irradiation post surgery similar to case 1 at the age of 61 y. She suffered from ileus, intestinal retention and hydronephrosis thereafter. She was hospitalized due to metastasis of the cancer to sacred bone, and received further 40 Gy radiation therapy at the age of 65 y. Up to the present, she received several operations such as ileostomy, nephrostomy and hemorrhoids excision. It is important for surgeons to understand the actual QOL of patients with radiation enterocolitis. (K.H.)

  19. Examining the Relationship between Psychosocial and Behavioral Proxies for Future Consumption Behavior: Self-Reported Impact and Bidding Behavior in an Experimental Auction Study on Cigarette Labeling

    Science.gov (United States)

    Rousu, Matthew C.; Thrasher, James F.

    2014-01-01

    Experimental and observational research often involves asking consumers to self-report the impact of some proposed option. Because self-reported responses involve no consequence to the respondent for falsely revealing how he or she feels about an issue, self-reports may be subject to social desirability and other influences that bias responses in…

  20. Importance Is Not Unimportant: The Role of Importance Weighting in QOL Measures

    Science.gov (United States)

    Hsieh, Chang-Ming

    2012-01-01

    The effect of relative domain importance as a weighting mechanism in quality of life (QoL) measures has been a topic of debate for decades. Studies investigating the role of domain importance in QoL measures have produced mixed results. The mixed results may very well be the consequences of a limited choice of global satisfaction or QoL measures,…

  1. Applicability of a cognitive questionnaire in the elderly and proxy

    Directory of Open Access Journals (Sweden)

    Renata Areza Fegyveres

    Full Text Available Abstract The Informant Questionnaire on Cognitive Decline in the Elderly with the Proxy (IQCODE was developed as a screening tool for cognition alterations. Objectives: 1 To verify the applicability of IQCODE in the elderly with limited schooling, 2 To verify the reliability of the responses supplied by the aged and their proxies. Methods: Individuals of a Community Group were evaluated using the Mini-Mental State Examination (MMSE, IQCODE and Geriatric Depression Scale (GDS. The IQCODE was applied to informants and proxies. Results: We analyzed 44 individuals, aged between 58-82 years (M=66.8, SD=5.97 with mean elderly-schooling level of 3.75, SD=2.82 and 44 proxies aged 44.5 (SD=13.3, with mean schooling level of 8.25 (SD=4.3. The mean GDS was 8.22, SD=4.90 and 13 participants presented a score suggestive of depressive symptoms. The mean elderly IQCODE score was 3.26, SD=0.69 and 3.21, SD=0.65, for proxy responses. There was no statistical difference between these means. On the MMSE, the mean score was 24.20, SD=4.14 and 18 participants presented scores below the cut-off. The IQCODE answers by the elderly in this latter group were more congruent with MMSE than the answers of proxies. Conclusions: The applicability of the IQCODE in a population with little schooling was verified in that the proxy-report was similar to the elderly report. We can affirm that the elderly answers were more accurate than the proxies, as they were closer to MMSE score. The inclusion of a greater number of participants from community-dwelling settings is necessary to confirm the results obtained in this study.

  2. Morinda citrifolia L. (noni Improves the Quality of Life (QoL in Adults with Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Martin S. Lipsky

    2011-02-01

    Full Text Available Background: Morinda citrifolia Linn (noni, as a “pain killer”, has been used as a traditional medicine by Polynesians for over 2000 years. It was reported to have a broad range of therapeutic effects including analgesic and anti-inflammation. The in-vitro and in vivo antiinflammatory and analgesic properties of noni juice (NJ suggest that NJ may be a useful adjunctive treatment for osteoarthritis (OA. In this pilot study we explored whether NJimproves the symptoms and Quality of Life (QoL for adults with OA. We also sought toevaluate the tolerability and safety of NJ for patients with OA in a primary care setting. Methods: This was an open label three-month intervention pilot study. Data were collected by pre/post intervention survey and laboratory testing. Inclusion criteria were: adults of both sexes aged 40 to 75, with a diagnosis of OA on the hip or knee by x-ray examination provided by theirprimary care physician, not on prescription medicine for OA, and who were willing to drink 3 oz of NJ a day for 90 days. Results: Of the 64 questions measuring different aspects of QoL asked on the pre/post survey, 49 (77% had significant pre/post mean scale differences as measured by independent t-test. The OA patients reported being significantly more satisfied with their current health conditions including mobility, walking and bending, hand, finger, and arm functions, household tasks, social activity, arthritis pain, work ability, level of tension, and mood. The study participantswere also more positive about their future health and reported taking less over-the-counter (OTC pain relievers. Pre/post laboratory testing including: lipid panel, liver and kidney functions were in the normal ranges. High Sensitive C Reactive Protein (hsCRP, an inflammatory biomarker, was reduced by 10% after the intervention. Conclusion: As a nutritional supplement, NJ demonstrated a potential therapeutic effect and improved the symptoms and the QoL for adults with OA

  3. Perceptions of QOL among caregivers of Mexican ancestry of adults with advanced cancer.

    Science.gov (United States)

    Juarez, Gloria; Branin, Joan J; Rosales, Monica

    2015-07-01

    There is a substantial gap in the literature about the perceptions of QOL of caregivers of Mexican ancestry. This qualitative study explores the role of culture on the perceptions of QOL of this understudied population. Twenty caregivers providing care to adults with advanced cancer were interviewed. Thematic analysis identified several themes for each domain of QOL, including physical, psychological, social, and spiritual domains and the role of culture. Cultural background influenced all of the QOL domains. There was a tremendous synergy across domains of physical, psychological, social, and spiritual well-being. Extended family and religious beliefs, life experiences, and culture were important components of QOL for these caregivers. Cultural expectations influenced role functioning and caregiver burden. This study informs our understanding of the role of culture on perceptions of QOL. Future investigations should be conducted with other Latino subgroups to describe QOL and to determine the role of culture on perceived QOL. Interventions should be specifically designed to improve caregivers' QOL and to reduce the burden of cancer in this underserved population.

  4. Quality of Life of High-Functioning Children and Youth with Autism Spectrum Disorder and Typically Developing Peers: Self- and Proxy-Reports

    Science.gov (United States)

    Egilson, Snaefrídur T.; Ólafsdóttir, Linda B.; Leósdóttir, Thóra; Saemundsen, Evald

    2017-01-01

    Studies have shown parents to report lower quality of life for their children with autism spectrum disorder than children's self-report scores and the same applies for data on typically developing children. Our objectives were to: (1) explore how high-functioning children with autism spectrum disorder rate their quality of life compared with…

  5. Shareholder Activism Through the Proxy Process

    NARCIS (Netherlands)

    Renneboog, L.D.R.; Szilagyi, P.G.

    2009-01-01

    This paper provides evidence on the corporate governance role of shareholder-initiated proxy proposals. Previous studies debate over whether activists use proxy proposals to discipline firms or to simply advance their self-serving agendas, and whether proxy proposals are effective at all in

  6. Shareholder Activism through the Proxy Process

    NARCIS (Netherlands)

    Renneboog, L.D.R.; Szilagyi, P.G.

    2009-01-01

    This paper provides evidence on the corporate governance role of shareholderinitiated proxy proposals. Previous studies debate over whether activists use proxy proposals to discipline firms or to simply advance their self-serving agendas, and whether proxy proposals are effective at all in

  7. The Cerebral Palsy Quality of Life for Children (CP QOL-Child): Evidence of Construct Validity

    Science.gov (United States)

    Chen, Kuan-Lin; Wang, Hui-Yi; Tseng, Mei-Hui; Shieh, Jeng-Yi; Lu, Lu; Yao, Kai-Ping Grace; Huang, Chien-Yu

    2013-01-01

    The Cerebral Palsy Quality of Life for Children (CP QOL-Child) is the first health condition-specific questionnaire designed for measuring QOL in children with cerebral palsy (CP). However, its construct validity has not yet been confirmed by confirmatory factor analysis (CFA). Hence, this study assessed the construct validity of the caregiver…

  8. Neuro-QOL: brief measures of health-related quality of life for clinical research in neurology.

    Science.gov (United States)

    Cella, D; Lai, J-S; Nowinski, C J; Victorson, D; Peterman, A; Miller, D; Bethoux, F; Heinemann, A; Rubin, S; Cavazos, J E; Reder, A T; Sufit, R; Simuni, T; Holmes, G L; Siderowf, A; Wojna, V; Bode, R; McKinney, N; Podrabsky, T; Wortman, K; Choi, S; Gershon, R; Rothrock, N; Moy, C

    2012-06-05

    To address the need for brief, reliable, valid, and standardized quality of life (QOL) assessment applicable across neurologic conditions. Drawing from larger calibrated item banks, we developed short measures (8-9 items each) of 13 different QOL domains across physical, mental, and social health and evaluated their validity and reliability. Three samples were utilized during short form development: general population (Internet-based, n = 2,113); clinical panel (Internet-based, n = 553); and clinical outpatient (clinic-based, n = 581). All short forms are expressed as T scores with a mean of 50 and SD of 10. Internal consistency (Cronbach α) of the 13 short forms ranged from 0.85 to 0.97. Correlations between short form and full-length item bank scores ranged from 0.88 to 0.99 (0.82-0.96 after removing common items from banks). Online respondents were asked whether they had any of 19 different chronic health conditions, and whether or not those reported conditions interfered with ability to function normally. All short forms, across physical, mental, and social health, were able to separate people who reported no health condition from those who reported 1-2 or 3 or more. In addition, scores on all 13 domains were worse for people who acknowledged being limited by the health conditions they reported, compared to those who reported conditions but were not limited by them. These 13 brief measures of self-reported QOL are reliable and show preliminary evidence of concurrent validity inasmuch as they differentiate people based upon number of reported health conditions and whether those reported conditions impede normal function.

  9. The impact of having natural teeth on the QoL of frail dentulous older people. A qualitative study

    Directory of Open Access Journals (Sweden)

    Niesten Dominique

    2012-10-01

    Full Text Available Abstract Background In order to adapt oral care and treatment to the demands of the growing group of frail dentulous older people, it is important to understand how and to which extent having natural teeth contributes to the quality of life (QoL of frail older people and how frailty influences their perspective. Methods A qualitative approach was used. Interviews with 38 Dutch frail older dentulous people were tape-recorded, transcribed, coded for content and analyzed. Additional information was collected which included age, gender, living situation, use of dental prostheses, self-reported oral health status, chronic disorders, and an index for frailty. Results Seven themes were identified in the relationship between natural teeth and the QoL of the participants: pride and achievement; intactness; sense of control; oral function; appearance; comfort; along with coping and adapting to disabilities. Having natural teeth generally had a positive effect on QoL. Positive effects through pride and achievement, intactness, and sense of control were most apparent for the most severely frail. They compared themselves with peers who are more often edentate, and valued the good state of their teeth against the background of their declining health, especially those with disabilities causing severe chronic pain or impaired fine-motor skills. The effect of coping with and adaptation to tooth loss was also most apparent for the most severely frail. There was a gender effect in that the men generally cared less about having natural teeth than women, regardless of their level of frailty. Conclusions QoL of frail older people is positively influenced by natural teeth, and this effect seems to increase with increasing frailty. Preservation of teeth contributes to a positive body image and self-worth. Oral care for frail people should aim to preserve natural teeth if possible.

  10. Measuring SIP proxy server performance

    CERN Document Server

    Subramanian, Sureshkumar V

    2013-01-01

    Internet Protocol (IP) telephony is an alternative to the traditional Public Switched Telephone Networks (PSTN), and the Session Initiation Protocol (SIP) is quickly becoming a popular signaling protocol for VoIP-based applications. SIP is a peer-to-peer multimedia signaling protocol standardized by the Internet Engineering Task Force (IETF), and it plays a vital role in providing IP telephony services through its use of the SIP Proxy Server (SPS), a software application that provides call routing services by parsing and forwarding all the incoming SIP packets in an IP telephony network.SIP Pr

  11. Comparison of a generic and a rhinitis-specific quality-of-life (QOL) instrument in patients with house dust mite allergy: relationship between the SF-36 and Rhinitis QOL Questionnaire : relationship between the SF-36 and Rhinitis QOL Questionnaire

    NARCIS (Netherlands)

    Terreehorst, I.; Duivenvoorden, H.J.; Tempels-Pavlica, Z.; Oosting, A.J.; de Monchy, J.G.R.; Bruijnzeel-Koomen, C.A.F.M.; van Wijk, R. G.

    2004-01-01

    Background Generic and disease-specific quality-of-life (QOL) questionnaires are commonly used in subjects with allergic rhinitis (AR). AR, however, is closely associated with other disorders such as bronchial asthma and atopic dermatitis (AD). These co-morbid associations may have an effect on the

  12. Validation of the VEINES-QOL quality of life instrument in venous leg ulcers: repeatability and validity study embedded in a randomised clinical trial.

    Science.gov (United States)

    Bland, J Martin; Dumville, Jo C; Ashby, Rebecca L; Gabe, Rhian; Stubbs, Nikki; Adderley, Una; Kang'ombe, Arthur R; Cullum, Nicky A

    2015-08-11

    VEINES-QOL/Sym is a disease-specific quality of life instrument for use in venous diseases of the leg. Its relative scoring system precludes comparisons between studies. There were very few venous leg ulcer patients in the validation samples. We report a validation study for venous leg ulcers and develop a scoring system which enables comparison between studies. Four hundred fifty-one participants in the VenUS IV trial of the management of venous leg ulcers were asked to complete a VEINES-QOL questionnaire at recruitment, along with SF-12, pain, and other aspects of quality of life. VEINES-QOL was repeated after two weeks and after 4 months. Healing of ulcers was confirmed by blind assessment of digital photographs. Three scoring systems for VEINES-QOL were compared. No floor or ceiling effects were observed for VEINES-QOL items, item-item correlations were weak to moderate, item-score correlations were moderate. Internal reliability was good. The VEINES-Sym subscale was confirmed by factor analysis. Test-retest reliability was satisfactory for the scale scores; individual items showed moderate to good agreement. Relationships with SF-12, pain, and the quality items confirmed construct validity. Participants whose ulcers had healed showed greater mean increase in scores than did those yet to heal, though they continued to report leg problems. An intrinsic scoring method appeared superior to the original relative method. VEINES-QOL was suitable for use in the study of venous leg ulcers. The intrinsic scoring method should be adopted, to facilitate comparisons between studies. VenUS IV is registered with the ISRCTN register, number ISRCTN49373072 .

  13. Electronics Industry Study Report: Semiconductors as Proxy

    Science.gov (United States)

    2002-01-01

    Petropolis, Brazil Radio Victoria Fueguina S.A., Buenos Aires, Argentina Raytheon Brasil Sistemas de Integração Ltda., Rio de Janeiro, Brazil Siemens, São... pension plans. They also add that very few people working for Internet 22 companies become millionaires. Indeed, about 75% of all Internet companies

  14. Munchausen Syndrome by Proxy: A Study of Psychopathology.

    Science.gov (United States)

    Bools, Christopher; And Others

    1994-01-01

    This study evaluated 100 mothers with Munchausen Syndrome by Proxy (the fabrication of illness by a mother in her child). Approximately half of the mothers had either smothered or poisoned their child as part of their fabrications. Lifetime psychiatric histories were reported for 47 of the mothers. The most notable psychopathology was personality…

  15. Munchausen Syndrome by Proxy: Mother Fabricates Infant's Hearing Impairment.

    Science.gov (United States)

    Kahn, Gerri; Goldman, Ellen

    1991-01-01

    Case study reports a case of Munchausen Syndrome by Proxy, a form of child abuse in which the mother presents a child for treatment for a condition she herself has invented or created. This case study describes the ways in which a mother obtained a diagnosis of sensorineural hearing loss as well as amplification for her normally hearing infant.…

  16. Anxiety and worry when coping with cancer treatment: agreement between patient and proxy responses.

    Science.gov (United States)

    Hermont, Ana Paula; Scarpelli, Ana Carolina; Paiva, Saul M; Auad, Sheyla M; Pordeus, Isabela A

    2015-06-01

    Assess agreement between proxy respondents (caregivers) and children/adolescents related to the impact of cancer on children's/adolescents' health-related quality of life, with respect to anxiety and worry issues. A cross-sectional study was conducted among 83 Brazilian children/adolescents, of both genders, diagnosed with cancer, aged 5-18 years and their proxy respondents. Anxiety and worry were assessed through items of the instrument Pediatric Quality of Life Inventory™ Cancer Module Scale. Participants were recruited from the pediatric hematology/oncology centers at two public hospitals. All individuals were receiving medical care. Descriptive statistics were performed as well as a weighted kappa coefficient, Spearman's correlation coefficient, Wilcoxon signed-rank test and Bland-Altman plots. The magnitude of the difference between the mean scores obtained from children/adolescents and that of their proxy respondents was evaluated through effect size. The proxy respondents underestimated the feelings of worry among children (8-12 years) (p anxiety (p children/adolescents to report increasing feelings of worry as they got older. In the 'treatment anxiety' subscale, there was a tendency for proxy respondents to present higher mean scores, revealing that proxy respondents believed the children's/adolescents' treatment anxiety decreased as they aged. Discrepancies between the reports of children/adolescents and their proxy respondents were observed. Children's/adolescents' reports should not be ignored nor replaced by proxy reports; both reports should be analyzed together.

  17. Navy Quality of Life (QOL) Program Contributions to Readiness and Career Intentions. Volume 2. Pilot Study Results

    National Research Council Canada - National Science Library

    Schwerin, Michael

    2002-01-01

    Quality of Life (QOL) decision-makers need complete and accurate information that will help them determine if funded QOL programs are actually contributing to positive perceptions of Navy life, and which of them have the greatest impact...

  18. Novel Quantum Proxy Signature without Entanglement

    Science.gov (United States)

    Xu, Guang-bao

    2015-08-01

    Proxy signature is an important research topic in classic cryptography since it has many application occasions in our real life. But only a few quantum proxy signature schemes have been proposed up to now. In this paper, we propose a quantum proxy signature scheme, which is designed based on quantum one-time pad. Our scheme can be realized easily since it only uses single-particle states. Security analysis shows that it is secure and meets all the properties of a proxy signature, such as verifiability, distinguishability, unforgeability and undeniability.

  19. A Comprehensive Review of Quality of Life (QOL Research in Hong Kong

    Directory of Open Access Journals (Sweden)

    Daniel T. L. Shek

    2007-01-01

    Full Text Available Published quality of life (QOL studies in Hong Kong indexed in the major databases were reviewed. Several observations are highlighted from this review. First, most of the published studies were empirical studies involving data collection. Second, there are more micro studies utilizing individual QOL indices than macro studies using societal indicators. Third, most studies addressed personal well-being, followed by studies on family well-being and societal well-being. Fourth, the studies were predominantly quantitative in nature. Fifth, most of the studies were based on adults and comparatively fewer studies were based on children and adolescents. Sixth, most studies were based on populations with special needs, followed by studies based on the general population, helping professionals, and caregivers. Seventh, most studies used measures of QOL rather than developed QOL measures. Finally, QOL data in Hong Kong were seldom compared with those in other places. The gaps on QOL studies in Hong Kong and future research directions are discussed.

  20. Decreased QOL and muscle strength are persistent 1 year after intramedullary nailing of a tibial shaft fracture: a prospective 1-year follow-up cohort study.

    Science.gov (United States)

    Larsen, Peter; Elsoe, Rasmus; Laessoe, Uffe; Graven-Nielsen, Thomas; Eriksen, Christian Berre; Rasmussen, Sten

    2016-10-01

    To evaluate the development in patient-reported quality of life (QOL) and muscle strength in the period from surgery to 12 months postoperatively after intramedullary nailing of a tibial shaft fracture. The design was a prospective, follow-up cohort study. QOL was measured with the questionnaire Eq5D-5L and compared to norm data from a reference population. Recordings of pain and contralateral muscle strength (isometric maximal voluntary contraction (MVC) for knee flexion and extension were collected at 6 weeks, 3, 6, and 12 months postoperatively. Ipsilateral MVCs were recorded at 6 and 12 months. Forty-nine patients were included. The mean age at the time of fracture was 43.1 years (18-79 years). Twelve months postoperatively, the mean Eq5D-5L index was 0.792 (95 % CI 0.747-0.837). Throughout the 12 months postoperatively, patients reported worse QOL compared to the reference population. Six and 12 months after surgery patients demonstrated decreased muscle strength in the injured leg compared to the non-injured leg for knee extension and flexion (P muscle strength during knee extension show a fair correlation to worse QOL (R = 0.541, P Muscle strength in the non-injured leg improved over time and was higher after 6 and 12 months compared with the injured leg.

  1. Munchausen Syndrome by Proxy: Identification and Intervention

    Science.gov (United States)

    Walk, Alexandra; Davies, Susan C.

    2010-01-01

    This article discusses the Munchausen syndrome by proxy (MSBP), also known as "factitious disorder by proxy" (FDBP) and fabricated and/or induced illness, which is a mental illness in which a person lies about the physical or mental well-being of a person he/she is responsible for. Most often the dynamic transpires between a mother and her child.…

  2. Quality of life outcome measures following partial glossectomy: Assessment using the UW-QOL scale

    Directory of Open Access Journals (Sweden)

    Kazi R

    2008-01-01

    Full Text Available Background: The consequences of a diagnosis of head and neck cancer and the impact of treatment have a clear and direct influence on well-being and associated quality of life (QOL in these patients. Aims: To determine the QOL in head and neck cancer patients following a partial glossectomy operation. Design and Setting: Cross-sectional cohort study; Head and Neck Oncology Unit, tertiary referral center. Materials and Methods: 38 patients with partial glossectomy were assessed with the University of Washington head and neck quality of life (UW-QOL scale, version 4. Statistical Analysis: Statistical analysis was performed using the Statistical Package for Social Sciences 10.0 (SPSS Inc, Chicago version III. Information from the scale was correlated using the Mann Whitney test. A P value less than/equal to 0.05 was considered as significant. Results: The mean (sd composite score of the QOL in our series was 73.6 (16.1. The majority (71.8% quoted their QOL as good or very good. Swallowing (n = 16, 47.1%, speech (n = 15, 44.1% and saliva (n = 15, 44.1% were most commonly cited issues over the last 7 days. On the other hand, the groups with reconstruction, neck dissection, complications and radiotherapy demonstrated a significant reduction of quality of life scores (Mann Whitney test, P < 0.05. Conclusion: The composite score and overall QOL as assessed using the UW-QOL scale (version 4 were modestly high in our series of partial glossectomy patients. Swallowing, speech, and saliva are regarded as the most important issues. Stage of the disease, neck dissection, reconstruction, complications, radiotherapy and time since operation were seen to significantly affect domain scores.

  3. Assessment of quality of life (QoL) of burn patients in India using BSHS-RBA scale.

    Science.gov (United States)

    Ahuja, Rajeev B; Mulay, Amit M; Ahuja, Aarti

    2016-05-01

    The Burn Specific Health Scale-Brief (BSHS-B) is a popular instrument to measure quality of life (QoL) in burn patients. The current study aims at identifying the prognostic variables for our burn population using the BSHS-RBA (revised, brief and adapted) scale. The study was conducted on 60 post-burn patients using the BSHS-RBA scale. The questionnaire was administered by an interview as majority of patients were illiterate. The socio-demographic and clinical variables were analyzed against domain scores and total scores of the scale, using Mann-Whitney test and Kruskal Wallis test. The median age of the sample was 28 years, of which 60% were females. Their median TBSA burn was 30%. The median time since burn at the time of interview was 10 months. Higher scores were noted in the domains of simple abilities and mobility, hand function and interpersonal relationship, while poorer scores were recorded in domains of skin sensitivity and body image. The mean score in our study was 2.36, which is quite less as compared to reports from high income countries (range: 2.58-3.36). This study provides an insight on an aspect of burn care outcome, which can be reasonably expected in low income countries with the available standard of care. Being a female, presence of hand and face burn, requirement of corrective surgeries and inability to resume work were factors associated with poor QoL. Strategies to improve QoL of burn patients should target psychological aspects, work rehabilitation (early release of contractures) and skin hypersensitivity (including itching) to derive maximum benefit. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  4. RC-QOL score for rotator cuff pathology: adaptation to Italian.

    Science.gov (United States)

    Papalia, Rocco; Osti, Leonardo; Leonardi, Francesco; Denaro, Vincenzo; Maffulli, Nicola

    2010-10-01

    We translated and adapted the English RC-QOL (rotator cuff quality of life) questionnaire into Italian and performed reliability and validity evaluations of the Italian RC-QOL version in patients with rotator cuff tears. The RC-QOL English version was translated into Italian by a bilingual orthopaedic surgeon. The back translation of the Italian version into English was performed by another bilingual orthopaedic surgeon. The original version was compared with the back translation. The RC-QOL questionnaire was then administered to 22 subjects (range 45-74 years) with a diagnosis of rotator cuff tears. For test-retest evaluation, the 22 patients were asked to complete the questionnaire at first examination, and 30 min following the end of this examination. The intraclass correlation coefficient for the 22 patients was 0.94 (95% CI = 0.85-0.98), indicating a high reliability. There were no significant differences between the scores immediately after the consultation and 30 min later. The Italian and the English versions of the RC-QOL questionnaire evaluate the same aspects of clinical severity in patients with rotator cuff tears.

  5. Munchausen syndrome by adult proxy: a review of the literature.

    Science.gov (United States)

    Burton, M Caroline; Warren, Mark B; Lapid, Maria I; Bostwick, J Michael

    2015-01-01

    Munchausen syndrome by proxy (MSBP), more formally known as factitious disorder imposed on another, is a form of abuse in which a caregiver deliberately produces or feigns illness in a person under his or her care so that the proxy will receive medical care that gratifies the caregiver. Although well documented in the pediatric literature, few cases of MSBP with adult proxies (MSB-AP) have been reported. This study reviews existing literature on MSB-AP to provide a framework for clinicians to recognize this disorder. We searched Ovid MEDLINE, Ovid EMBASE, PubMed, Web of Knowledge, and PsychINFO, supplemented by bibliographic examination. We identified 13 cases of MSB-AP. Perpetrators were caregivers, most (62%) were women, and many worked in healthcare. The age range of the victims was 21 to 82 years. Most were unaware of the abuse, although in 2 cases the victim may have colluded with the perpetrator. Disease fabrication most often resulted from poisoning. MSB-AP should be included in the differential diagnosis of patients presenting with a complex constellation of symptoms without a unifying etiology and an overly involved caregiver with suspected psychological gain. Early identification is necessary so that healthcare providers do not unknowingly perpetuate harm through treatments that satisfy the perpetrator's psychological needs at the proxy's expense. © 2014 Society of Hospital Medicine.

  6. Proxies of quality of life in metastatic colorectal cancer: analyses in the RECOURSE trial

    Science.gov (United States)

    Van Cutsem, Eric; Falcone, Alfredo; Garcia-Carbonero, Rocio; Komatsu, Yoshito; Pastorino, Alessandro; Peeters, Marc; Shimada, Yasuhiro; Yamazaki, Kentaro; Yoshino, Takayuki; Zaniboni, Alberto; Amellal, Nadia; Kanehisa, Akira; Winkler, Robert; Makris, Lukas; Mayer, Robert J; Ohtsu, Atsushi; Tabernero, Josep

    2017-01-01

    Background In the pivotal phase III, randomised, double-blind, placebo-controlled RECOURSE study, treatment with trifluridine/tipiracil was well tolerated and associated with prolonged progression-free and overall survival in patients with metastatic colorectal cancer (mCRC). There was no formal analysis of quality of life (QoL) in RECOURSE. The aim of the present analysis was to assess proxies of QoL during the RECOURSE treatment period, in terms of adverse events (AEs) likely to affect QoL and Eastern Cooperative Oncology Group performance status (ECOG PS). Patients and methods Enrolled patients had documented, previously treated (≥2 prior chemotherapy lines) mCRC and an ECOG PS of 0 or 1. Patients received best supportive care plus trifluridine/tipiracil 35 mg/m2 twice daily (n=534) or placebo (n=266) in a 28-day cycle. AEs analysed included nausea, vomiting, diarrhoea, dysgeusia and fatigue/asthenia. ECOG PS was determined at baseline, on day 1 of each treatment cycle, at treatment end and 30 days post-treatment discontinuation. Results AEs that affect QoL were more frequent in patients treated with trifluridine/tipiracil than placebo. Median treatment duration for patients experiencing at least one of these AEs was longer than that observed for the overall RECOURSE population (trifluridine/tipiracil: 12 vs 7 weeks; placebo: 10 vs 6 weeks). Versus placebo, the duration of most AEs was longer in trifluridine/tipiracil recipients; however, all AEs except nausea and vomiting occupied a lower proportion of the total treatment period. Of the patients who had their PS recorded at discontinuation, PS was maintained in 67% and 63% of trifluridine/tipiracil and placebo recipients, and 84% and 81% of the trifluridine/tipiracil and placebo patients remained at a PS of 0 or 1 at discontinuation. Conclusions Analysis of ECOG PS and AEs thought to affect QoL in the RECOURSE patient population suggests that trifluridine/tipiracil treatment does not result in a

  7. Health-related quality of life after stroke: reliability of proxy responses

    DEFF Research Database (Denmark)

    Muus, Ingrid; Petzold, Max; Ringsberg, Karin C

    2009-01-01

    A Danish version of the Stroke-Specific Quality of Life Scale (SSQOL-DK) has been developed for self-reporting; it contains 12 physical and psychosocial domains. The purpose of this study was (a) to assess the reliability of the proxy version of the SSQOL-DK and (b) to evaluate the influence...... of frequency of proxy contact on agreement. In all, 143 patients completed the SSQOL-DK 1 to 5 years post-stroke. A patient chosen proxy completed a proxy version of the same questionnaire. The proxy version showed satisfactory internal consistency (Cronbach's alpha = .85-.95). Agreement was generally high...... of the SSQOL-DK appears to be reliable for use with stroke patients up to a few years following a stroke....

  8. New proxy replacement algorithm for multimedia streaming

    Science.gov (United States)

    Wong, Hau Ling; Lo, Kwok-Tung

    2001-11-01

    Proxy servers play an important role in between servers and clients in various multimedia systems on the Internet. Since proxy servers do not have an infinite-capacity cache for keeping all the continuous media data, the challenge for the replacement policy is to determine which streams should be cached or removed from the proxy server. In this paper, a new proxy replacement algorithm, named the Least Popular Used (LPU) caching algorithm, is proposed for layered encoded multimedia streams in the Internet. The LPU method takes both the short-term and long-term popularity of the video into account in determining the replacement policy. Simulation evaluation shows that our proposed scheme achieves better results than some existing methods in term of the cache efficiency and replacement frequency under both static and dynamic access environments.

  9. 78 FR 70987 - Proxy Advisory Firm Roundtable

    Science.gov (United States)

    2013-11-27

    ... of proxy advisory firm use by investment advisers and institutional investors and potential changes... Special Counsel, Division of Investment Management, at 202-551-6700, or Raymond Be, Special Counsel...

  10. A serial Munchausen syndrome by proxy

    National Research Council Canada - National Science Library

    Esra Unal; Volkan Unal; Ali Gul; Mustafa Celtek; Behzat Diken; Ibrahim Balcioglu

    2017-01-01

    Munchausen syndrome by proxy (MSBP) is a form of child abuse that describes children whose parents or caregivers invent illness stories and substantiate the stories by fabricating false physical signs...

  11. Seizures and Munchausen Syndrome by Proxy

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-05-01

    Full Text Available The prevalence, morbidity and mortality, diagnosis and management of cases of fabricated seizures and child abuse (Munchausen syndrome by proxy (MSbp are assessed by pediatricians at the University of Wales College of Medicine, Cardiff, UK.

  12. PENGELOLAAN JARINGAN INTERNET DENGAN PROXY WINGATE

    Directory of Open Access Journals (Sweden)

    Titin Winarti

    2005-01-01

    Full Text Available Proxy adalah bagian dari protokol yang berfungsi sebagai link untuk host tunggal atau sebagai link untuk beberapa host antarajaringan dan jaringan lain. Proxy wingate adalah software yang digunakan untuk berbagi koneksi internet melalui satu alamat IPyang terintegrasi ke internet.

  13. A new test of the construct validity of the CarerQol instrument: measuring the impact of informal care giving.

    Science.gov (United States)

    Hoefman, Renske J; van Exel, N Job A; Looren de Jong, Sandra; Redekop, W Ken; Brouwer, Werner B F

    2011-08-01

    Most economic evaluations of health care programmes do not consider the effects of informal care, while this could lead to suboptimal policy decisions. This study investigates the construct validity of the CarerQol instrument, which measures and values carer effects, in a new population of informal caregivers. A questionnaire was distributed by mail (n = 1,100, net response rate = 21%) to regional informal care support centers throughout the Netherlands. Two types of construct validity, i.e., convergent and clinical validity, have been analyzed. Convergent validity was assessed with Spearman's correlation coefficients and multivariate correlation between the burden dimensions (CarerQol-7D) and the valuation component (CarerQol-VAS) of the CarerQol. Additionally, convergent validity was analyzed with Spearman's correlation coefficients between the CarerQol and other measures of subjective caregiver burden (SRB, PU). Clinical validity was evaluated with multivariate correlation between CarerQol-VAS and CarerQol-7D, characteristics of caregivers, care recipients and care situation among the whole sample of caregivers and subgroups. The positive (negative) dimensions of CarerQol-7D were positively (negatively) related to CarerQol-VAS, and almost all had moderate strength of convergent validity. CarerQol-VAS was positively associated with PU and negatively with SRB. The CarerQol-VAS reflects differences in important background characteristics of informal care: type of relationship, age of the care recipient and duration of care giving were associated with higher CarerQol-VAS scores. These results confirmed earlier tests of the construct validity of the CarerQol. Furthermore, the dimensions of CarerQol-7D significantly explained differences in CarerQol-VAS scores among subgroups of carers. Notwithstanding the limitations of our study, such as the low response rate, this study shows that the CarerQol provides a valid means to measure carer effects for use in economic

  14. Web proxy auto discovery for the WLCG

    CERN Document Server

    Dykstra, D; Blumenfeld, B; De Salvo, A; Dewhurst, A; Verguilov, V

    2017-01-01

    All four of the LHC experiments depend on web proxies (that is, squids) at each grid site to support software distribution by the CernVM FileSystem (CVMFS). CMS and ATLAS also use web proxies for conditions data distributed through the Frontier Distributed Database caching system. ATLAS & CMS each have their own methods for their grid jobs to find out which web proxies to use for Frontier at each site, and CVMFS has a third method. Those diverse methods limit usability and flexibility, particularly for opportunistic use cases, where an experiment’s jobs are run at sites that do not primarily support that experiment. This paper describes a new Worldwide LHC Computing Grid (WLCG) system for discovering the addresses of web proxies. The system is based on an internet standard called Web Proxy Auto Discovery (WPAD). WPAD is in turn based on another standard called Proxy Auto Configuration (PAC). Both the Frontier and CVMFS clients support this standard. The input into the WLCG system comes from squids regis...

  15. SINOMA - a better tool for proxy based reconstructions?

    Science.gov (United States)

    Buras, Allan; Thees, Barnim; Czymzik, Markus; Dräger, Nadine; Kienel, Ulrike; Neugebauer, Ina; Ott, Florian; Scharnweber, Tobias; Simard, Sonia; Slowinski, Michal; Slowinski, Sandra; Tecklenburg, Christina; Zawiska, Izabela; Wilmking, Martin

    2014-05-01

    than on its mathematical background which we intend to present in another contribution to this EGU session (Thees at al., 2014). On average, SINOMA performs better than or, under specific error noise conditions, equal to the traditional modeling techniques. However, some of the investigated data reveal constraints of SINOMA, which have to be considered in 'real-world' applications. Nevertheless, our results indicate that SINOMA likely is a more reliable tool for estimating regression parameters if compared to traditional techniques. Based on the generally noisy characteristics of proxies used typically, applications of SINOMA to already existing reconstructions will probably result in different model parameter estimates, most likely leading to differing amplitudes of reconstructed past environmental conditions. Therefore, SINOMA has the potential to reframe our picture of the past. References: Kutzbach L, Thees B, and Wilmking M (2011): Identification of linear relationships from noisy data using errors-in-variables models -relevance for reconstruction of past climate from tree-ring and other proxy information, Climatic Change, 105, 155-177. Thees B, Kutzbach L, Wilmking M, and Zorita E (2009): Ein Bewertungsmaß für die amplitudentreue regressive Abbildung von verrauschten Daten im Rahmen einer iterativen "Errors in Variables"- Modellierung (EVM), GKSS-report 2009/8. Thees B, Buras A, Jetschke G, Zorita E, Wilmking M, and Kutzbach L: The Sequential Iterative Noise Matching Algorithm: A new statistical approach for the unbiased estimation of linear relationships between noisy serial data streams and their respective error variances. Submitted. Thees B, Buras A, Jetschke G, Kutzbach L, Zorita, E, and Wilmking, M, 2014: SINOMA - A new iterative statistical approach for the identification of linear relationships between noisy time series. Abstract submitted to EGU-session CL 6.1.

  16. Clinimetric properties of the EuroQol-5D in patients with chronic low back pain

    NARCIS (Netherlands)

    Soer, R.; Reneman, M.F.; Speijer, B.L.; Coppes, M.H.; Vroomen, P.C.

    2012-01-01

    BACKGROUND CONTEXT: Clinimetric properties of the EuroQol-5D (EQ-5D) in patients with nonspecific chronic low back pain (CLBP) are largely unknown. PURPOSE: To study the criterion validity, responsiveness, and minimal clinically important change (MCIC) of EQ-5D in patients with CLBP. STUDY DESIGN:

  17. Romanian Translation and Cross-Cultural Adaptation of the SarQol Questionnaire

    Directory of Open Access Journals (Sweden)

    Ildiko Gasparik Andrea

    2016-09-01

    Full Text Available Sarcopenia, or age-related muscle loss is emerging as a major public health concern. A reduced quality of life (QoL due to impaired physical performance associated with this disease has been evidenced in these individuals. Generic instruments, such as Short Form 36 questionnaire (SF-36, do not accurately assess the impact of sarcopenia on QoL. SarQol (Sarcopenia Quality of Life questionnaire, was the first disease-specific questionnaire addressing quality of life in patients with sarcopenia and has been recently designed for providing a global picture on quality of life in community-dwelling elderly subjects aged 65 years and older. Our aim was the translation and cultural adaptation of the original SarQol, to finally obtain a highly reliable instrument for the assessment of the quality of life of Romanian patients, affected by sarcopenia. We followed the recommended process, the international protocol of translation. The pretest process involved 20 subjects (10 sarcopenic and 10 non sarcopenic with different educational and socioeconomic backgrounds who were asked to complete the questionnaire. Feedbacks were requested from all subjects regarding the clearness of questions, difficulties in completing the test or understanding the meaning of questions. Using the recommended best practice protocol for translation, the pre-final version is comparable with the original instrument in terms of content and accuracy. After the validation of psychometric properties, it should be a useful tool to assess Quality of Life and sarcopenia among elderly romanian patients.

  18. Psychometric Properties of the Portuguese Version of the Quality of Life Questionnaire (QOL-Q)

    Science.gov (United States)

    Albuquerque, Cristina P.

    2012-01-01

    Background: This study analyzes the psychometric properties of the Portuguese version of the Quality of Life Questionnaire (QOL-Q; Quality of Life Questionnaire Manual--1993 Manual and 2004 Revision. 2004, IDS Publishing Company, Worthington, OH; Schalock & Keith 2004). Method: The analysis of the factorial structure was carried out on a sample of…

  19. Should We Give up Domain Importance Weighting in QoL Measures?

    Science.gov (United States)

    Hsieh, Chang-ming

    2012-01-01

    The purpose of this article is to examine the recent claims calling for abolishing domain importance weighting in quality of life (QoL) measures by considering the evidence conceptually and empirically. Based on a close review of evidence presented to date, it is suggested that using the range-of-affect hypothesis as a possible explanation of the…

  20. Effects of radiation and surgery on function and quality of life (QOL) in rectal cancer patients.

    Science.gov (United States)

    Wang, Linda; Wang, Xiaodong; Lo, Ada; Raval, Manoj; Brown, Carl; Karimuddin, Ahmer; Phang, P Terry

    2018-01-31

    Pre-operative radiotherapy (PRT) and total mesorectal excision surgery (TME) for rectal cancer yield the lowest risk for local recurrence. However, both treatments negatively impact quality of life (QOL). To understand individual treatment effects, we ask whether PRT affects function and quality of life before TME. Function and QOL were prospectively assessed in 26 patients using EORTC QLQ-C30/-CR38, and Wexner scale at three time points: before PRT, 6 weeks after PRT and before TME, and one year after stoma closure. Wexner score did not change post-PRT but did increase post-TME (p < .01). Micturition score did not change with PRT or TME (p = .29). Sexual function score improved post-PRT (p = .03) but did not change post-TME. Global health status did not change post-treatments (p = .45). Future perspective improved post-surgery (p = .04). PRT did not affect micturition, bowel function, or QOL. Future perspective improved despite increased bowel problems and fecal incontinence. QOL was maintained after curative rectal cancer treatments, radiation and TME surgery. This information may help patients and physicians better understand effects of PRT and TME treatments for rectal cancer. Copyright © 2018 Elsevier Inc. All rights reserved.

  1. The Quality-of-Life (QOL) Research Movement: Past, Present, and Future

    Science.gov (United States)

    Sirgy, M. Joseph; Michalos, Alex C.; Ferriss, Abbott L.; Easterlin, Richard A.; Pavot, William; Patrick, Donald

    2006-01-01

    The purpose of this paper is to trace the history of the social indicators or quality-of-life (QOL) research movement up to today, forecast future developments, and pave the way for future growth. Broadly speaking, we tried to review historical antecedents from the point of view of different disciplines, with specialists in each discipline…

  2. Validation of the prolapse quality-of-life questionnaire (P-QOL): An ...

    African Journals Online (AJOL)

    Pelvic organ prolapse (POP) occurs in 46 - 73% of women in South. Africa (SA) and may also be associated with other pelvic floor dysfunctions.[1] The assessment of quality of life (QOL) is becoming increasingly important in determining the outcome of pelvic floor reconstructive surgery, as well as other pelvic floor disorders ...

  3. Exploring the quality of life (QOL) in the Indian software industry: a public health viewpoint.

    Science.gov (United States)

    Jha, Ayan; Sadhukhan, Sanjoy Kumar; Velusamy, Saravanan; Banerjee, Gargi; Banerjee, Arpita; Saha, Amitava; Talukdar, Sumit

    2012-04-01

    Our objectives were to describe the QOL and its determinants among software professionals of Kolkata, and to compare the same according to information technology (IT) and IT-enabled services (ITeS) sub-sectors. An institution-based cross-sectional study was conducted among software professionals of Kolkata applying a two-stage stratified random sampling technique. The WHO QOL BREF questionnaire was administered along with a list of pertinent variables. Overall, the analysis for 338 software professionals (177 IT and 161 ITeS) clearly demonstrated significant differences between mean scores of these two sectors for each of the six outcome domains of WHO QOL BREF. Multilevel multivariate analysis outlined 13 significant predictors of QOL-four positive (age, regular fitness regimes, foreign placements and changing companies frequently) and the rest of the nine, negative (multiple sex partners, multiple addictions, extended working hours, night-shift duties, income, expenditure, carrying office work home, current illness and ITeS company type). Our study helps in obtaining a clear understanding of the multifaceted risk factors prevailing in this sector, the majority of which can be effectively addressed by specific health promotional interventions. A dedicated health policy is mandated at both government and company levels.

  4. The QOL-DASS Model to Estimate Overall Quality of Life and General Health

    Directory of Open Access Journals (Sweden)

    Mehrdad Mazaheri

    2011-01-01

    Full Text Available "n Objective: In order to find how rating the WHOQOL-BREF and DASS scales are combined to produce an overall measure of quality of life and satisfaction with health rating, a QOL-DASS model was designed ; and the strength of this hypothesized model was examined using the structural equation modeling "n "nMethod: Participants included a sample of 103 voluntary males who were divided into two groups of unhealthy (N=55 and healthy (N=48. To assess satisfaction and negative  emotions of depression, anxiety and stress among the participants, they were asked to fill out the WHOQOLBREF and The Depression Anxiety Stress Scale (DASS-42. "nResults: Our findings on running the hypothesized model of QOL-DASS indicated that the proposed model of QOL-DASS fitted the data well for the both healthy and unhealthy groups "nConclusion: Our findings with CFA to evaluate the hypothesized model of QOL-DASS indicated that the different satisfaction domain ratings and the negative emotions of depression, anxiety and stress as the observed variables can represent the underlying constructs of general health and quality of life on both healthy and unhealthy groups.

  5. A brief intervention for preparing ICU families to be proxies: A phase I study.

    Science.gov (United States)

    Turnbull, Alison E; Chessare, Caroline M; Coffin, Rachel K; Needham, Dale M

    2017-01-01

    Family members of critically ill patients report high levels of conflict with clinicians, have poor understanding of prognosis, struggle to make decisions, and experience substantial symptoms of anxiety, depression, and post-traumatic stress regardless of patient survival status. Efficient interventions are needed to prepare these families to act as patient proxies. To assess a brief "patient activation" intervention designed to set expectations and prepare families of adult intensive care unit (ICU) patients to communicate effectively with the clinical team. Phase I study of acceptability and immediate side effects. 122 healthcare proxies of 111 consecutive patients with a stay of ≥24 hours in the Johns Hopkins Hospital Medical ICU (MICU), in Baltimore, Maryland. Reading aloud to proxies from a booklet (Flesch-Kincard reading grade level 3.8) designed with multidisciplinary input including from former MICU proxies. Enrolled proxies had a median age of 51 years old with 83 (68%) female, and 55 (45%) African-American. MICU mortality was 18%, and 37 patients (33%) died in hospital or were discharged to hospice. Among proxies 98% (95% CI: 94% - 100%) agreed or strongly agreed that the intervention was appropriate, 98% (95% CI: 92% - 99%) agreed or strongly agreed that it is important for families to know the information in the booklet, and 54 (44%, 95% CI 35%- 54%) agreed or strongly agreed that parts of the booklet are upsetting. Upset vs. non-upset proxies were not statistically or substantially different in terms of age, sex, education level, race, relation to the patient, or perceived decision-making authority. This patient activation intervention was acceptable and important to nearly all proxies. Frequently, the intervention was simultaneously rated as both acceptable/important and upsetting. Proxies who rated the intervention as upsetting were not identifiable based on readily available proxy or patient characteristics.

  6. A brief intervention for preparing ICU families to be proxies: A phase I study.

    Directory of Open Access Journals (Sweden)

    Alison E Turnbull

    Full Text Available Family members of critically ill patients report high levels of conflict with clinicians, have poor understanding of prognosis, struggle to make decisions, and experience substantial symptoms of anxiety, depression, and post-traumatic stress regardless of patient survival status. Efficient interventions are needed to prepare these families to act as patient proxies.To assess a brief "patient activation" intervention designed to set expectations and prepare families of adult intensive care unit (ICU patients to communicate effectively with the clinical team.Phase I study of acceptability and immediate side effects.122 healthcare proxies of 111 consecutive patients with a stay of ≥24 hours in the Johns Hopkins Hospital Medical ICU (MICU, in Baltimore, Maryland.Reading aloud to proxies from a booklet (Flesch-Kincard reading grade level 3.8 designed with multidisciplinary input including from former MICU proxies.Enrolled proxies had a median age of 51 years old with 83 (68% female, and 55 (45% African-American. MICU mortality was 18%, and 37 patients (33% died in hospital or were discharged to hospice. Among proxies 98% (95% CI: 94% - 100% agreed or strongly agreed that the intervention was appropriate, 98% (95% CI: 92% - 99% agreed or strongly agreed that it is important for families to know the information in the booklet, and 54 (44%, 95% CI 35%- 54% agreed or strongly agreed that parts of the booklet are upsetting. Upset vs. non-upset proxies were not statistically or substantially different in terms of age, sex, education level, race, relation to the patient, or perceived decision-making authority.This patient activation intervention was acceptable and important to nearly all proxies. Frequently, the intervention was simultaneously rated as both acceptable/important and upsetting. Proxies who rated the intervention as upsetting were not identifiable based on readily available proxy or patient characteristics.

  7. Implementation of a mobile inpatient quality of life (QoL) assessment for oncology nursing.

    Science.gov (United States)

    Schuler, Markus K; Trautmann, Freya; Radloff, Mirko; Schmädig, Roman; Hentschel, Leopold; Eberlein-Gonska, Maria; Petzold, Thomas; Vetter, Heike; Oberlack, Sebastian; Ehninger, Gerhard; Schmitt, Jochen

    2016-08-01

    Cancer patients suffer from a variety of symptoms, but little is known about changes during hospitalization and symptom burden at discharge. We implemented an electronic quality of life (QoL) assessment used by the nursing team in routine inpatient care. Feasibility, acceptance, and the course of QoL were investigated. A self-administered electronic questionnaire based on the EQ-5D and the EORTC QLQ-C30 was applied in clinical routine. Cancer patients were approached by the nursing staff to complete the QoL assessment twice, at admission and at the day of discharge. Both the feedback of the nursing staff as well as characteristics of participants were used to evaluate the electronic assessment. Out of 210 patients from an oncologic ward, 85 patients (40 %) were invited to participate, 95 % of whom (n = 81) agreed to participate. Participation rate depended on the day of admission, the presence of the coordinating nurse, the overall morbidity assessed by patient clinical complexity level, and the patient age. Forty-six patients (56 %) asked for assistance in completing the questionnaire. Patients older than 53 years and male patients were more likely to need assistance. Twenty-two percent of the nursing staff (n = 5) use the information assessed for individual patient care. Fifty-two percent (n = 12) rated the additional workload as very little or little and 68 % (n = 15) agreed that handling for the patient was easy. Global QoL improved during the stay. Most severe symptoms at admission included fatigue, pain, appetite loss, and insomnia. The results of this study indicate that it is feasible to implement and use an electronic QoL assessment by the nursing staff in routine inpatient cancer care. Obstacles and worries of staff members have to be considered when further developing this program.

  8. QOL and sociodemographic factors among first-time parents in Japan: a multilevel analysis.

    Science.gov (United States)

    Yoshitake, Naomi; Sun, Yi; Sugawara, Masumi; Matsumoto, Satoko; Sakai, Atsushi; Takaoka, Junko; Goto, Noriko

    2016-12-01

    The present study aimed to examine the relationship between sociodemographic factors and domains of quality of life (QOL) among married adults in Japan who were either rearing or expecting their first child. Our research focus was on whether different sociodemographic variables interacted with each other in predicting the first-time parents' QOL. In total, 4374 (mean age = 34.9 years, SD = 8.4, range 18-71) community-based married couples pooled from two surveys provided their sociodemographic information (i.e., age, years of education, and annual income) and responded to the brief version of the QOL instrument developed by the World Health Organization (WHOQOL-BREF in Psychological Medicine 28(3):551-555, 1998). Series of multilevel regression analyses revealed that household annual income and education were associated with all domains of QOL, and other sociodemographic variables worked in a domain-specific manner. In addition, the effect of educational attainment on psychological domain was significant for mothers only, whereas the effects of household income on psychological and environmental domains were stronger for the younger (below age 26) than the older (over 43) couples. The effects of sociodemographic factors at couple as well as individual levels on the first-time parents' QOL were examined for the first time in Japan using couple data. In addition to corroborating previous findings on the main effects concerning these variables, the present study demonstrated the complex patterns of interaction across different levels. These findings provide evidence for the need for financial and health measures targeted at specific parent populations.

  9. Inferring climate variability from skewed proxy records

    Science.gov (United States)

    Emile-Geay, J.; Tingley, M.

    2013-12-01

    Many paleoclimate analyses assume a linear relationship between the proxy and the target climate variable, and that both the climate quantity and the errors follow normal distributions. An ever-increasing number of proxy records, however, are better modeled using distributions that are heavy-tailed, skewed, or otherwise non-normal, on account of the proxies reflecting non-normally distributed climate variables, or having non-linear relationships with a normally distributed climate variable. The analysis of such proxies requires a different set of tools, and this work serves as a cautionary tale on the danger of making conclusions about the underlying climate from applications of classic statistical procedures to heavily skewed proxy records. Inspired by runoff proxies, we consider an idealized proxy characterized by a nonlinear, thresholded relationship with climate, and describe three approaches to using such a record to infer past climate: (i) applying standard methods commonly used in the paleoclimate literature, without considering the non-linearities inherent to the proxy record; (ii) applying a power transform prior to using these standard methods; (iii) constructing a Bayesian model to invert the mechanistic relationship between the climate and the proxy. We find that neglecting the skewness in the proxy leads to erroneous conclusions and often exaggerates changes in climate variability between different time intervals. In contrast, an explicit treatment of the skewness, using either power transforms or a Bayesian inversion of the mechanistic model for the proxy, yields significantly better estimates of past climate variations. We apply these insights in two paleoclimate settings: (1) a classical sedimentary record from Laguna Pallcacocha, Ecuador (Moy et al., 2002). Our results agree with the qualitative aspects of previous analyses of this record, but quantitative departures are evident and hold implications for how such records are interpreted, and

  10. Quality of Life in Thalassemia Major Patients: Reliability and Validity of Indonesian Version of TranQol Questionnaire

    Directory of Open Access Journals (Sweden)

    Billy Ng Setiawan Rachmat Poengoet

    2017-09-01

    Full Text Available Objective: To determine the validity and reliability of TranQol questionnaire that has been translated into Indonesian to be used in Indonesian thalassemia major patients. The quality of life problems among these patients can be detected earlier because TranQol is more precise compared to the Pediatric Quality of Life Inventory (PedsQLTM, World Health Organization Quality of Life Instruments (WHOQOL, and SF-36 Questionaire. Methods: This study was conducted in Bandung, Indonesia from October 2015 to March 2016 and used a standard “forward-backward” translation procedure. It involved 60 adults and 73 children who are thalassemia major patients, and 71 parents of patients in Dr. Hasan Sadikin General Hospital. TranQol was processed through forward and backward translation approach and evaluation was conducted by the TranQol author. After the translation process, a cognitive debriefing was performed and the translated TranQol was tested to all subjects. Results: Cronbach’s alpha >0.7 was used for all TranQol categories. Front validity and content validity testing was performed. The internal validity results showed that some questions were not valid. Conclusions: TranQol reliability in Indonesian language for every category is good. Validity for TranQol in Indonesian language shows that the translated TranQol is not quite suitable that it still cannot be used.

  11. False allegations of abuse and Munchausen syndrome by proxy.

    Science.gov (United States)

    Meadow, R

    1993-01-01

    Fourteen children from seven families are reported for whom false allegations of abuse were made by the mother. Twelve children were alleged to have incurred sexual abuse, one both sexual and physical abuse, and one physical abuse alone. Thirteen of the children had incurred, or were currently victims of, factitious illness abuse invented by the mother. The one child with no history of factitious illness abuse had a sibling who had incurred definite factitious illness abuse. The false allegations of abuse did not occur in the context of parental separation, divorce, or custody disputes concerning the children. They occurred in the context of Munchausen syndrome by proxy abuse. The age of the children, 3 to 9 years, was older than the usual age for Munchausen syndrome by proxy abuse. The mother was the source of the false allegations and was the person who encouraged or taught six of the children to substantiate allegations of sexual abuse. PMID:8503664

  12. Munchausen syndrome by proxy: an alarming face of child abuse.

    Science.gov (United States)

    Gehlawat, Pratibha; Gehlawat, Virender Kumar; Singh, Priti; Gupta, Rajiv

    2015-01-01

    Munchausen syndrome by proxy (MSBP) is emerging as a serious form of child abuse. It is an intentional production of illness in another, usually children by mothers, to assume sick role by proxy. It is poorly understood and a controversial diagnosis. Treatment is very difficult. We present a case of 9-year-old boy brought to Pt. B. D. Sharma, PGIMS, Rohtak, a tertiary care hospital in northern India by his father and paternal uncle with complaints of hematemesis since July 2012. He underwent many invasive procedures until the diagnosis of MSBP was finally considered. The examination of the blood sample confirmed the diagnosis. The child was placed under custody of his mother. The case was reported to social services, which incorporated whole family in the management.

  13. Cooperative Proxy Caching for Wireless Base Stations

    Directory of Open Access Journals (Sweden)

    James Z. Wang

    2007-01-01

    Full Text Available This paper proposes a mobile cache model to facilitate the cooperative proxy caching in wireless base stations. This mobile cache model uses a network cache line to record the caching state information about a web document for effective data search and cache space management. Based on the proposed mobile cache model, a P2P cooperative proxy caching scheme is proposed to use a self-configured and self-managed virtual proxy graph (VPG, independent of the underlying wireless network structure and adaptive to the network and geographic environment changes, to achieve efficient data search, data cache and date replication. Based on demand, the aggregate effect of data caching, searching and replicating actions by individual proxy servers automatically migrates the cached web documents closer to the interested clients. In addition, a cache line migration (CLM strategy is proposed to flow and replicate the heads of network cache lines of web documents associated with a moving mobile host to the new base station during the mobile host handoff. These replicated cache line heads provide direct links to the cached web documents accessed by the moving mobile hosts in the previous base station, thus improving the mobile web caching performance. Performance studies have shown that the proposed P2P cooperative proxy caching schemes significantly outperform existing caching schemes.

  14. Determinants of quality of life (QoL) in elderly stroke patients: a short-term follow-up study.

    Science.gov (United States)

    Gunaydin, Rezzan; Karatepe, Altinay Goksel; Kaya, Taciser; Ulutas, Ozgur

    2011-01-01

    The aim of this study was to determine the quality of life (QoL) at the third month after stroke and to identify the factors related with and determinants of QoL in geriatric stroke patients. Eighty of 122 patients who were assessed within the first week after stroke were reevaluated at the third month. Patients were divided into two groups as those of ≥65 years old (geriatric group) and those of geriatric group). The stroke severity, functional status, and ambulation level were assessed by the Canadian neurological scale (CNS), the functional independence measure (FIM), and the functional ambulation classification scale (FACS) within the first week of stroke, respectively. Depression and QoL levels were also determined at the third month using the Zung self-rating depression scale (ZDS) and both the Short Form-36 (SF-36) survey and the stroke-specific quality of life (SSQoL) scale, respectively. The QoL of 80 patients according to the SF-36 were lower than those of general population. No significant difference was found in stroke severity, functional status at baseline and third month, depression and QoL between geriatric and non-geriatric patients (p>0.05). The most influenced subscale of QoL was work/productivity in geriatric patients, and the main determinant of QoL was the functional status during the assessment. Stroke patients had an impaired QoL, and geriatric patients did not demonstrate a difference in terms of QoL compared to non-geriatric patients. The fact that the main determinant of QoL was functional status has been suggested that improving of physical function may be helpful to provide a better QoL for stroke patients. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  15. Development of the US English version of the phenylketonuria - quality of life (PKU-QOL) questionnaire.

    Science.gov (United States)

    Jurecki, Elaina; Cunningham, Amy; Birardi, Vanessa; Gagol, Grégory; Acquadro, Catherine

    2017-03-09

    Phenylketonuria (PKU) is a rare genetic disorder caused by a defect in the metabolism of phenylalanine (PHE) resulting in elevated blood and brain PHE levels, and leading to cognitive, emotional, and psychosocial problems. The phenylketonuria - quality of life (PKU-QOL) questionnaire was the first self-administered disease-specific instrument developed to assess the impact of PKU and its treatment on the health-related quality of life (HRQL) of patients and their caregivers. Available in four versions (child, adolescent, adult and parent), the PKU-QOL was simultaneously developed and validated in seven countries [i.e., France, Germany, Italy, The Netherlands, Spain, Turkey and the United Kingdom (UK)]. The objectives of our study were to develop and linguistically validate the PKU-QOL questionnaire for use in the United States (US). The UK versions served as a basis for the development of the US English PKU-QOL questionnaire. The linguistic validation process consisted of 4 steps: 1) adaptation of the UK versions into US English by a translator native of US English and living in the US; 2) a clinician review; 3) cognitive interviews with patients and caregivers to test the appropriateness, understandability and clarity of the US translations; and 4) two proof-readings. The adaptation from UK to US English revealed the usual syntactic and idiomatic differences between the two languages, such as differences in: 1) Spelling, e.g., "dietician" (UK) vs. "dietitian" (US), or "mum" (UK) vs. "mom" (US); 2) Syntax or punctuation; and 3) Words/expressions use, e.g., "holidays" (UK) vs. "vacation" (US), or "biscuits" (UK) vs. "crackers" (US). The major issue was cultural, and consisted of using a different terminology to describe PKU treatment throughout the questionnaires. The clinician, with the patients and the caregivers, during the interviews suggested to replace "supplement and amino-acid mixture" or "supplements" with "medical formula." This wording was later changed

  16. A statistical proxy for sulphuric acid concentration

    Directory of Open Access Journals (Sweden)

    S. Mikkonen

    2011-11-01

    Full Text Available Gaseous sulphuric acid is a key precursor for new particle formation in the atmosphere. Previous experimental studies have confirmed a strong correlation between the number concentrations of freshly formed particles and the ambient concentrations of sulphuric acid. This study evaluates a body of experimental gas phase sulphuric acid concentrations, as measured by Chemical Ionization Mass Spectrometry (CIMS during six intensive measurement campaigns and one long-term observational period. The campaign datasets were measured in Hyytiälä, Finland, in 2003 and 2007, in San Pietro Capofiume, Italy, in 2009, in Melpitz, Germany, in 2008, in Atlanta, Georgia, USA, in 2002, and in Niwot Ridge, Colorado, USA, in 2007. The long term data were obtained in Hohenpeissenberg, Germany, during 1998 to 2000. The measured time series were used to construct proximity measures ("proxies" for sulphuric acid concentration by using statistical analysis methods. The objective of this study is to find a proxy for sulfuric acid that is valid in as many different atmospheric environments as possible. Our most accurate and universal formulation of the sulphuric acid concentration proxy uses global solar radiation, SO2 concentration, condensation sink and relative humidity as predictor variables, yielding a correlation measure (R of 0.87 between observed concentration and the proxy predictions. Interestingly, the role of the condensation sink in the proxy was only minor, since similarly accurate proxies could be constructed with global solar radiation and SO2 concentration alone. This could be attributed to SO2 being an indicator for anthropogenic pollution, including particulate and gaseous emissions which represent sinks for the OH radical that, in turn, is needed for the formation of sulphuric acid.

  17. Web Proxy Auto Discovery for the WLCG

    Science.gov (United States)

    Dykstra, D.; Blomer, J.; Blumenfeld, B.; De Salvo, A.; Dewhurst, A.; Verguilov, V.

    2017-10-01

    All four of the LHC experiments depend on web proxies (that is, squids) at each grid site to support software distribution by the CernVM FileSystem (CVMFS). CMS and ATLAS also use web proxies for conditions data distributed through the Frontier Distributed Database caching system. ATLAS & CMS each have their own methods for their grid jobs to find out which web proxies to use for Frontier at each site, and CVMFS has a third method. Those diverse methods limit usability and flexibility, particularly for opportunistic use cases, where an experiment’s jobs are run at sites that do not primarily support that experiment. This paper describes a new Worldwide LHC Computing Grid (WLCG) system for discovering the addresses of web proxies. The system is based on an internet standard called Web Proxy Auto Discovery (WPAD). WPAD is in turn based on another standard called Proxy Auto Configuration (PAC). Both the Frontier and CVMFS clients support this standard. The input into the WLCG system comes from squids registered in the ATLAS Grid Information System (AGIS) and CMS SITECONF files, cross-checked with squids registered by sites in the Grid Configuration Database (GOCDB) and the OSG Information Management (OIM) system, and combined with some exceptions manually configured by people from ATLAS and CMS who operate WLCG Squid monitoring. WPAD servers at CERN respond to http requests from grid nodes all over the world with a PAC file that lists available web proxies, based on IP addresses matched from a database that contains the IP address ranges registered to organizations. Large grid sites are encouraged to supply their own WPAD web servers for more flexibility, to avoid being affected by short term long distance network outages, and to offload the WLCG WPAD servers at CERN. The CERN WPAD servers additionally support requests from jobs running at non-grid sites (particularly for LHC@Home) which they direct to the nearest publicly accessible web proxy servers. The responses

  18. Relationship Between Student QoL With Irritable Bowel Syndrome and Related Factors at Ahvaz Jundishapur University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Asadi

    2015-01-01

    Full Text Available Background Irritable bowel syndrome (IBS is one of the most common functional disorders of the lower gastrointestinal tract characterized by abdominal pain and changes in bowel habits. This disorder changes the QoL (QoL for patients. Objectives This study examines the relationship between QoL for nursing students with other associated factors. Patients and Methods These descriptive-analytic studies indicate a census for 57 senior nursing students of the School of Nursing-Midwifery, Ahvaz in 2013–2014. The data from the demographic questionnaire and QoL questionnaire (QOL-34 was collected. Data using ANOVA and t-tests with significance level of P 0.05.While for QoL and academic Grade Point Average (P = 0.048, ethnicity (P = 0.006, disease duration (P = 0.049, and disease severity (P = 0.030 were significantly related . Conclusions It seems important to pay attention to health problems and to apply interventions that will influence QoL. Lifestyle changes and staying away from activities that are associated with tension stress can help to eliminate the symptoms and disease severity and improve the QoL for student.

  19. Description and Psychometric Properties of the CP QOL-Teen: A Quality of Life Questionnaire for Adolescents with Cerebral Palsy

    Science.gov (United States)

    Davis, Elise; Mackinnon, Andrew; Davern, Melanie; Boyd, Roslyn; Bohanna, India; Waters, Elizabeth; Graham, H. Kerr; Reid, Susan; Reddihough, Dinah

    2013-01-01

    To assess the measurement properties of a new QOL instrument, the Cerebral Palsy Quality of Life Questionnaire-Teen (CP QOL-Teen), in adolescents with cerebral palsy (CP) aged 13-18 years, examining domain structure, reliability, validity and adolescent-caregiver concordance. Based on age, 695 eligible families were invited to participate by mail.…

  20. MUNCHAUSEN SYNDROME BY PROXY IN PEDIATRIC DENTISTRY: MYTH OR REALITY?

    Directory of Open Access Journals (Sweden)

    Veronica PINTILICIUC-ŞERBAN

    2017-06-01

    Full Text Available Background and aims: Munchausen syndrome by proxy is a condition traditionally comprising physical and mental abuse and medical neglect as a form of psychogenic maltreatment of the child, secondary to fabrication of a pediatric illness by the parent or guardian. The aim of our paper is to assess whether such condition occurs in current pediatric dental practice and to evidence certain situations in which the pediatric dentist should suspect this form of child abuse. Problem statement: Munchausen syndrome by proxy in pediatric dentistry may lead to serious chronic disabilities of the abused or neglected child, being one of the causes of treatment failure. Discussion: Prompt detection of such condition should be regarded as one of the duties of the practitioner who should be trained to report the suspected cases to the governmental child protective agencies. This should be regarded as a form of child abuse and neglect, and the responsible caregiver could be held liable when such wrongful actions cause harm or endanger child’s welfare. Conclusion: Munchausen syndrome by proxy should be regarded as a reality in current pediatric dental practice and dental teams should be trained to properly recognize, assess and manage such complex situations.

  1. Caring for a child with autism spectrum disorder and parents' quality of life: application of the CarerQol.

    Science.gov (United States)

    Hoefman, Renske; Payakachat, Nalin; van Exel, Job; Kuhlthau, Karen; Kovacs, Erica; Pyne, Jeffrey; Tilford, J Mick

    2014-08-01

    This study describes the impact of caregiving on parents of children with autism spectrum disorders (ASDs). Secondly, we investigate construct validation of the care-related quality of life instrument (CarerQol) measuring impact of caregiving. Primary caregivers of children with ASDs were included. Many parents experienced considerable problems combining daily activities with care, had financial problems or suffered from depressive mood. Validity tests showed that a higher impact of caring on the CarerQol was positively associated with higher subjective burden and lower family quality of life. Most of the associations between CarerQol scores and background characteristics confirmed previous research. The CarerQol validly measures the impact of caregiving for children with ASDs on caregivers in our sample. The CarerQol may therefore be useful for including parent outcomes in research on ASDs.

  2. [ASSESSMENT OF QOL BY URTICARIA ACTIVITY SCORE IN PEDIATRIC PATIENTS WITH CHRONIC URTICARIA].

    Science.gov (United States)

    Asaumi, Tomoyuki; Iikura, Katsuhito; Yanagida, Noriyuki; Sato, Sakura; Ebisawa, Motohiro

    2016-02-01

    There is no standard for assessing pediatric chronic urticaria in Japan. UAS7, weekly total values of the Urticaria Activity Score (UAS), has correlation with Dermatology Life Quality Index (DLQI) which assesses Quality of Life (QOL). The current European Academy of Allergy and Clinical Immunology (EAACI) guidelines recommend assessing disease activity in chronic urticaria by using UAS. We translated UAS into Japanese version, and evaluated usefulness of UAS by comparing with QOL score. Subjects were 42 patients who had received treatments in our clinic from February to September in 2014. They wrote UAS at home. They wrote Children's Dermatology Life Quality Index (CDLQI) when they visited hospital. We assessed correlation UAS7 with CDLQI. Male/Female ratio was 1:1. Median age was 7.5 years old. Duration of chronic urticaria was 5.5 months. Anti-histamine was used in 75%. UAS7 values reflected chronic urticaria patients' quality of life impairment. Change in UAS7 values reflected change in chronic urticaria patients' quality of life impairment. UAS may be a useful tool for assessing QOL in pediatric patients with chronic urticaria.

  3. French validation of the NOSE and RhinoQOL questionnaires in the management of nasal obstruction.

    Science.gov (United States)

    Marro, Magali; Mondina, Michel; Stoll, Dominique; de Gabory, Ludovic

    2011-06-01

    Until now, there has been no validated and specific questionnaire in French allowing the assessment of nasal obstruction and its consequences on quality of life. The aim of this study was to validate the French translation and sociocultural adaptation of the Nasal Obstruction Symptom Evaluation (NOSE) and Rhinosinusitis Quality of Life Survey (RhinoQOL) self-questionnaires. Prospective instrument validation study. French tertiary referral center. The questionnaires were translated into French and then translated back into English. The final version was administered twice to an asymptomatic control population (n = 50) and once to a population with symptomatic septal deviation (n = 50). The psychometric properties (reliability, reproducibility, validity, responsiveness) were assessed by test-retest procedure, internal consistency, correlation intra- and interscores, and response sensitivity between both populations. There was no statistical difference in both responses obtained from the control population after the test-retest procedure. Internal consistency was 0.86 for the NOSE and 0.57, 0.67, and 0.83 for the scores of the RhinoQOL (frequency, bothersomeness, and impact, respectively). There was always a strong correlation between all NOSE variables and RhinoQOL scores (r > 0.40; P < 10(-3)). Effect size showed a high sensitivity to change. The French versions of both questionnaires appear to be as reliable, valid, and sensitive to change as the English versions. Their association was strong, allowing assessment of nasal obstruction in all its dimensions.

  4. Assessment of Quality of Life (QOL) in Obsessive Compulsive Disorder (OCD) and Dysthymic Disorder (DD): A Comparative Study.

    Science.gov (United States)

    Vasudev, Roopesh Gopal Nariyandada; Yallappa, Sudarshan Chikkanayakanahalli; Saya, Ganesh Kumar

    2015-05-01

    There is paucity of data on Quality of Life (QOL) in non-psychotic mental disorders. To assess the Quality of Life (QOL) in Obsessive Compulsive Disorder (OCD) and compare it with Dysthymic Disorder (DD). This hospital based cross-sectional study was conducted in 30 patients each diagnosed to have OCD and DD during October 2009 to September 2011 in a medical institution in Davanagere, Karnataka, India. DSM-IV-TR (Diagnostic statistical manual-IV-Text Revised) criteria was used for diagnosis of OCD and DD. Yale Brown Obsessive Compulsive Scale (Y-BOCS) and WHO QOL BREF (brief form) scales were used. Data was analysed by independent sample t-test. Overall QOL score was 51.07(SD=11.47) and 50.91(SD=7.41) in OCD and DD groups respectively. QOL score was comparatively low in psychological domain with score of 44.12(SD=14.14) and 45.10(12.35) in OCD and DD respectively. There was no significant difference in the QOL score of the two groups with respect to socio demographic variables in OCD group, but it was different with respect to place of residence in DD group (p0.05). Overall QOL score was average and there was no significant difference of QOL score between the OCD and DD groups implying that both these non-psychotic mental disorders may have same influence or effect on QOL of the subjects. Further analytical studies will explore the associated factors of QOL in OCD and DD.

  5. Development and validation of the positive affect and well-being scale for the neurology quality of life (Neuro-QOL) measurement system.

    Science.gov (United States)

    Salsman, John M; Victorson, David; Choi, Seung W; Peterman, Amy H; Heinemann, Allen W; Nowinski, Cindy; Cella, David

    2013-11-01

    To develop and validate an item-response theory-based patient-reported outcomes assessment tool of positive affect and well-being (PAW). This is part of a larger NINDS-funded study to develop a health-related quality of life measurement system across major neurological disorders, called Neuro-QOL. Informed by a literature review and qualitative input from clinicians and patients, item pools were created to assess PAW concepts. Items were administered to a general population sample (N = 513) and a group of individuals with a variety of neurologic conditions (N = 581) for calibration and validation purposes, respectively. A 23-item calibrated bank and a 9-item short form of PAW was developed, reflecting components of positive affect, life satisfaction, or an overall sense of purpose and meaning. The Neuro-QOL PAW measure demonstrated sufficient unidimensionality and displayed good internal consistency, test-retest reliability, model fit, convergent and discriminant validity, and responsiveness. The Neuro-QOL PAW measure was designed to aid clinicians and researchers to better evaluate and understand the potential role of positive health processes for individuals with chronic neurological conditions. Further psychometric testing within and between neurological conditions, as well as testing in non-neurologic chronic diseases, will help evaluate the generalizability of this new tool.

  6. The Impact of Hyposalivation on Quality of Life (QoL) and Oral Health in the Aging Population of Al Madinah Al Munawarrah.

    Science.gov (United States)

    Ahmad, Mohammad S; Bhayat, Ahmed; Zafar, Muhammad Sohail; Al-Samadani, Khalid H

    2017-04-20

    Hyposalivation (HS) affects aging individuals by causing pain and discomfort in the oral cavity. The aim here was to determine the impact of hyposalivation and the saliva pH on the quality of life and caries status of geriatrics population. A total of 138 male outpatients attending the Taibah University College of Dentistry (TUCoD) dental clinic were included in the study. The saliva flow, pH, Quality of Life (QoL), and caries status were recorded. The QoL was measured using the Arabic version of the Oral Health Impact Profile-14 (OHIP-14), and the caries status was recorded using the Decayed, Missed, Filled Teeth (DMFT) index. The mean age was 67.5 years and 64% were classified as having hyposalivation. The older respondents tended to have a lower saliva flow and pH compared to their younger counterparts. There was a significant inverse association ( p = 0.02) between the caries status and mean saliva flow rate. There was also a significant ( p hyposalivation was relatively high and there was an inverse relationship between the age, the saliva flow, and pH. Those with more caries reported significantly poor QoL.

  7. The Impact of Hyposalivation on Quality of Life (QoL and Oral Health in the Aging Population of Al Madinah Al Munawarrah

    Directory of Open Access Journals (Sweden)

    Mohammad S. Ahmad

    2017-04-01

    Full Text Available Hyposalivation (HS affects aging individuals by causing pain and discomfort in the oral cavity. The aim here was to determine the impact of hyposalivation and the saliva pH on the quality of life and caries status of geriatrics population. A total of 138 male outpatients attending the Taibah University College of Dentistry (TUCoD dental clinic were included in the study. The saliva flow, pH, Quality of Life (QoL, and caries status were recorded. The QoL was measured using the Arabic version of the Oral Health Impact Profile-14 (OHIP-14, and the caries status was recorded using the Decayed, Missed, Filled Teeth (DMFT index. The mean age was 67.5 years and 64% were classified as having hyposalivation. The older respondents tended to have a lower saliva flow and pH compared to their younger counterparts. There was a significant inverse association (p = 0.02 between the caries status and mean saliva flow rate. There was also a significant (p < 0.001 positive correlation between caries and the OHIP-14 scores (Spearman’s ρ = 0.293. The prevalence of hyposalivation was relatively high and there was an inverse relationship between the age, the saliva flow, and pH. Those with more caries reported significantly poor QoL.

  8. Munchausen Syndrome by Proxy: Medical Diagnostic Criteria.

    Science.gov (United States)

    Rosenberg, Donna Andrea

    2003-01-01

    Medical diagnostic criteria for Munchausen Syndrome by Proxy (a persistent fabrication by one individual of illness in another) are presented. Since the strength of the known facts may vary from case to case, diagnostic criteria are given for a definitive diagnosis, a possible diagnosis, an inconclusive determination, and the definitely excluded…

  9. Munchausen Syndrome by Proxy: Social Work's Role.

    Science.gov (United States)

    Mercer, Susan O.; Perdue, Jeanette D.

    1993-01-01

    Describes Munchausen syndrome by proxy, diagnosis used to describe variation of child abuse whereby parent or adult caregiver fabricates medical history or induces symptoms in child, or both, resulting in unnecessary examinations, treatments, hospitalizations, and even death. Reviews assessment procedures, provides case studies, and describes…

  10. The Syndrome of Munchausen by Proxy.

    Science.gov (United States)

    Jones, David P. H.

    1994-01-01

    This editorial introduces two articles on Munchausen by Proxy syndrome (the induction of an appearance or state of physical ill health in a child, by the caretaker, and the child's subsequent presentation to health professionals for diagnosis and/or treatment). The severity of the caretaker's psychological disturbance and the serious effects on…

  11. Improving Internet Archive Service through Proxy Cache.

    Science.gov (United States)

    Yu, Hsiang-Fu; Chen, Yi-Ming; Wang, Shih-Yong; Tseng, Li-Ming

    2003-01-01

    Discusses file transfer protocol (FTP) servers for downloading archives (files with particular file extensions), and the change to HTTP (Hypertext transfer protocol) with increased Web use. Topics include the Archie server; proxy cache servers; and how to improve the hit rate of archives by a combination of caching and better searching mechanisms.…

  12. A cross-sectional study of QOL of diabetic patients at tertiary care hospitals in Delhi

    Directory of Open Access Journals (Sweden)

    Gautam Yogesh

    2009-01-01

    Full Text Available Background: According to WHO estimates India will be the global capital of diabetes by 2025, accounting for 57.2 million diabetics. Worsening the situation is the fact that diabetes affects the economically productive age-group (45-65 years in developing countries. Objective : To measure quality of life (QOL and study the clinical profiles and associated sociodemographic factors affecting diabetic patients aged 20 years and above. Materials and Methods: We conducted a hospital-based cross-sectional study using a generic instrument, Short-Form 36 (SF-36 of the Medical Outcome Study Group to measure QOL of diabetic subjects aged ≥20 years. Two hundred and sixty diabetics, including 91 males and 169 females, were selected from the clinics of SSK Hospital and Dr RML Hospital of New Delhi. Data was analysed using SPSS for Windows, version 12. Results: The mean age of the respondents was 49.7 years, with 80% of respondents being in the age-group of 40-69 years. The majority (52.1% of female respondents were illiterate and 91.1% were economically dependent. Of the male respondents, 65.9% were skilled workers. Substance abuse was present among 41.8% male subjects. Type 2 diabetes was the commonest, with 94.6% of the subjects having this form. The mean duration of diabetes was 6.96 ± 6.08 years. Oral hypoglycemic agents were being taken by 70.77% of the respondents. Among the diabetics the most common comorbidity was hypertension (30.8% and the commonest complication was neuropathy (26.2%. We calculated the body mass index (BMI of all subjects and found that, 46.2% of the male and 59.8% of the female respondents were either overweight or obese. As predicted by the waist/hip ratio (WHR, 53.8% of the male and 66.9% of the female respondents had high risk for CHD. Regular physical activity was undertaken by less than half of the subjects (46.5%. Out of eight domains of QOL in the SF-36, the two most affected were ′General Health′ and

  13. Nursing interventions in Münchausen syndrome by proxy.

    Science.gov (United States)

    Volz, A G

    1995-09-01

    1. Münchausen syndrome by proxy is a rare but serious and potentially lethal form of child abuse in which a primary care giver induces or reports factitious symptoms in a child. 2. The child suffers from the caregiver's actions and health care providers unknowingly become accomplices when they provide unnecessary testing and therapies. 3. The child's physical and psychological welfare can be protected through the efforts of the forensic nurse specialist coordinating a multidisciplinary health care team's work to detect the syndrome and intervene early on.

  14. The Use of COVD-QOL Questionnaire in School Vision Screening

    Directory of Open Access Journals (Sweden)

    Nurul Farhana Abu Bakar

    2011-05-01

    Full Text Available Purpose: To evaluate the application of College of Optometrist in Vision Development (COVD Quality of Life (QOL questionnaire in vision screening for normal school children and children with learning disabilities (LD and to determine appropriate referral-score for different target population. Methods: A total of 90 children (Normal: 45, LD: 45 who attended government primary schools aged between 6 to 12 years old were recruited. An interview session with normal children and parents or teachers in children with LD was made to determine visual symptoms using shorter version of COVD-QOL questionnaire. A comprehensive eye examination was performed after completion of the questionnaire. The evaluation was made base on the sensitivity and specificity for detection of refractive error, amblyopia, strabismus, vergence and accommodative disorders. Results: The mean score for normal children and children with LD were 22.47±10.75 and 12.24±8.72 respectively. Rapidity of the test in normal children and children with LD were 177.27±9.52 seconds and 162.16±16.58 seconds respectively. In normal children referral score of =20 showed highest sensitivity (66.7% and specificity (95.8% for detection of amblyopia. Sensitivity and specificity for referral-score of =20, =10 and =4 for detection of overall vision problems in children with LD were (20.4%, 100.0%, (54.5%, 100.0% and (81.8%, 100.0% respectively. Conclusion: COVD-QOL questionnaire was recommended as an easy, rapid and cost-effective tool for school vision screening. Different referral-score was suggested for different target population.

  15. Quality of life (QoL) and neurotoxicity in germ-cell cancer survivors (GCCS)

    DEFF Research Database (Denmark)

    Lauritsen, J.; Bandak, Mikkel; Mortensen, M. S.

    2016-01-01

    , divided into 4 subscales (neuropathy, ototoxicity, motor impairment, and dysfunction). Patients were divided into treatment groups; surveillance only (reference), n = 1092, radiotherapy (RT), n = 299, BEP chemotherapy (CT), n = 790, and more than one line of treatment (MTOL), n = 82. Outcomes were......L and treatment disappeared except dyspnea and impaired social function in the MTOL-group. Neurotoxicity was associated with all EORTC-subscales (p BEP and MTOL were associated with several QoL subscales in GCCS. However, when adjusting for neurotoxicity the associations...

  16. An analysis of determinants of QOL for the elderly people participating in local sport activities : The relationship of QOL between the elderly and their members in connection with participation and non-participation in sport

    OpenAIRE

    金子, 勝司; 石川, 旦; Shouji, Kaneko; Noboru, Ishikawa; 仙台大学; Graduate School of Sport Science, Sendai College

    2000-01-01

    This research was conducted in order to clarify the factors regulating the effects of local sport participation on the QOL for the elderly and its relationship with the QOL of their family members. Subjects were a group of the elderly who lived in Sennan District of Miyagi Prefecture and who were affiliated with their local senior citizen's clubs. After having explained about the survery, two types of questionnaires were distributed to and collected later from the group of elderly and each of...

  17. Legal requirements governing proxy voting in Denmark

    DEFF Research Database (Denmark)

    Werlauff, Erik

    2008-01-01

    The requirements in Danish company law concerning proxy voting in companies whose shares have been accepted for listing on a regulated market have been successively tightened in recent years, and corporate governance principles have also led to the introduction of several requirements concerning...... proxy holders. A thorough knowledge of these requirements is important not only for the listed companies but also for their advisers and investors in Denmark and abroad. This article considers these requirements as well as the additional requirements which will derive from Directive 2007....../36 on the exercise of shareholders' rights in listed companies, which must be implemented by 3 August 2009. It is pointed out that companies may provide with advantage in their articles of association for both the existing and the forthcoming requirements at this early stage....

  18. Observable Proxies For 26 Al Enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Fryer, Christopher L [Los Alamos National Laboratory; Young, Patrick A [Los Alamos National Laboratory; Ellinger, Carola I [ASU; Arnett, William D [UNIV ARIZONA

    2008-01-01

    We consider the cospatial production of elements in supernova explosions to find observationally detectable proxies for enhancement of {sup 26}Al in supernova ejecta and stellar systems. Using four progenitors we explore a range of 1D explosions at different energies and an asymmetric 3D explosion. We find that the most reliable indicator of the presence of {sup 26}Al in unmixed ejecta is a very low S/Si ratio ({approx} 0.05). Production of N in O/S/Si-rich regions is also indicative. The biologically important element P is produced at its highest abundance in the same regions. Proxies should be detectable in supernova ejecta with high spatial resolution multi wavelength observations, but the small absolute abundance of material injected into a proto-planetary disk makes detection unlikely in existing or forming stellar/planetary systems.

  19. Non-destructive foraminiferal paleoclimatic proxies: A brief insight

    Digital Repository Service at National Institute of Oceanography (India)

    Saraswat, R.

    Non-Destructive Foraminiferal Paleoclimatic Proxies: A Brief Insight The knowledge of past climate can help us to understand imminent climatic changes. Oceans are the vast archives of past climate. Various indirect techniques termed as proxies...

  20. Simulation of Wake Vortex Radiometric Detection via Jet Exhaust Proxy

    Science.gov (United States)

    Daniels, Taumi S.

    2015-01-01

    This paper describes an analysis of the potential of an airborne hyperspectral imaging IR instrument to infer wake vortices via turbine jet exhaust as a proxy. The goal was to determine the requirements for an imaging spectrometer or radiometer to effectively detect the exhaust plume, and by inference, the location of the wake vortices. The effort examines the gas spectroscopy of the various major constituents of turbine jet exhaust and their contributions to the modeled detectable radiance. Initially, a theoretical analysis of wake vortex proxy detection by thermal radiation was realized in a series of simulations. The first stage used the SLAB plume model to simulate turbine jet exhaust plume characteristics, including exhaust gas transport dynamics and concentrations. The second stage used these plume characteristics as input to the Line By Line Radiative Transfer Model (LBLRTM) to simulate responses from both an imaging IR hyperspectral spectrometer or radiometer. These numerical simulations generated thermal imagery that was compared with previously reported wake vortex temperature data. This research is a continuation of an effort to specify the requirements for an imaging IR spectrometer or radiometer to make wake vortex measurements. Results of the two-stage simulation will be reported, including instrument specifications for wake vortex thermal detection. These results will be compared with previously reported results for IR imaging spectrometer performance.

  1. Implementasi Proxy Server Dengan Linux Clear OS 5.2

    OpenAIRE

    Setiadi, Aprian

    2013-01-01

    Tugas Akhir ini membahas mengenai cara untuk membangun sebuah proxy server dalam jaringan LAN. Jaringan LAN yang dibangun menggunakan arsitektur topologi star dengan menjadikan komputer server sebagai Gateway Server dan Proxy Server, sehingga tidak membutuhkan perangkat tambahan Router yang berfungsi sebagai Gateway Server. Proxy Server yang yang dibangun menggunakan metode Transparent Mode, sehingga pada komputer klien tidak perlu mengkonfigurasi port proxy server pada Web Browser. Hasil ya...

  2. Estimation of EuroQol 5-Dimensions health status utility values in hereditary angioedema

    Directory of Open Access Journals (Sweden)

    Aygören-Pürsün E

    2016-09-01

    Full Text Available Emel Aygören-Pürsün,1 Anette Bygum,2 Kathleen Beusterien,3 Emily Hautamaki,4 Zlatko Sisic,5 Henrik B Boysen,6 Teresa Caballero7 1Angioedema Centre, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany; 2Hereditary Angioedema Centre Denmark, Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark; 3Outcomes Research Strategies in Health, Washington, DC, 4Patient Reported Outcomes, Oxford Outcomes Inc., an ICON plc company, Bethesda, MD, USA; 5ViroPharma Incorporated, Chatsworth House, Maidenhead, UK; 6HAEi – Hereditary Angioedema International Patient Organization for C1 Inhibitor Deficiencies, Skanderborg, Denmark; 7Allergy Department, Hospital La Paz Institute for Health Research (IdiPaz, Biomedical Research Network on Rare Diseases U754 (CIBERER, University Hospital La Paz, Madrid, Spain Objective: To estimate health status utility (preference weights for hereditary angioedema (HAE during an attack and between attacks using data from the Hereditary Angioedema Burden of Illness Study in Europe (HAE-BOIS-Europe survey. Utility measures quantitatively describe the net impact of a condition on a patient’s life; a score of 0.0 reflects death and 1.0 reflects full health.Study design and methods: The HAE-BOIS-Europe was a cross-sectional survey conducted in Spain, Germany, and Denmark to assess the real-world experience of HAE from the patient perspective. Survey items that overlapped conceptually with the EuroQol 5-Dimensions (EQ-5D domains (pain/discomfort, mobility, self-care, usual activities, and anxiety/depression were manually crosswalked to the corresponding UK population-based EQ-5D utility weights. EQ-5D utilities were computed for each respondent in the HAE-BOIS-Europe survey for acute attacks and between attacks.Results: Overall, a total of 111 HAE-BOIS-Europe participants completed all selected survey items and thus allowed for computation

  3. 12 CFR 7.2002 - Director or attorney as proxy.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Director or attorney as proxy. 7.2002 Section 7... OPERATIONS Corporate Practices § 7.2002 Director or attorney as proxy. Any person or group of persons, except the bank's officers, clerks, tellers, or bookkeepers, may be designated to act as proxy. The bank's...

  4. Physicians' Involvement with the New York State Health Care Proxy

    Science.gov (United States)

    Heyman, Janna C.; Sealy, Yvette M.

    2011-01-01

    This study examined physicians' attitude, involvement, and perceived barriers with the health care proxy. A cross sectional, correlational design was used to survey practicing physicians (N = 70). Physicians had positive attitudes toward the health care proxy and indicated that the most significant barriers to health care proxy completion were…

  5. Impact of Clinical Pharmacy Services on KAP and QOL in Cancer Patients: A Single-Center Experience

    Directory of Open Access Journals (Sweden)

    Yan Wang

    2015-01-01

    Full Text Available This study was to evaluate the efficacy of pharmaceutical intervention (PI on chemotherapy knowledge-attitude-practice (KAP and quality of life (QOL in cancer patients. A prospective, randomized, controlled study was carried out at Oncology Ward in a tertiary hospital affiliated to Southern Medical University, China. Eligible patient was randomly assigned to pharmaceutical intervention (PI group or control group. Each patient in PI group was given information booklets and was given 30 min face-to-face medication education and psychological counseling by clinical pharmacists, 2 sessions per week for 2 months. Patients in control group only received conventional treatment. All participants were asked to complete a structured Chemotherapy KAP Questionnaire and QOL Questionnaire at pre- and poststudy time. A total of 149 cancer patients (77 in PI group and 72 in control group completed the study. The baseline scores of KAP and QOL in 2 groups were similar. At the end of study, only knowledge score was significantly increased; meanwhile no difference existed for attitude, practice, and QOL scores in control group; both KAP scores and QOL score were significantly increased in PI group. As for the between-group comparison, both KAP scores and QOL score in PI group were significantly higher than those in control group. In conclusion, pharmaceutical intervention has a positive role in increasing chemotherapy-related knowledge, improving patients’ positive emotions, dealing with chemotherapy adverse reactions, and improving the quality of life of patients.

  6. Proxy Graph: Visual Quality Metrics of Big Graph Sampling.

    Science.gov (United States)

    Nguyen, Quan Hoang; Hong, Seok-Hee; Eades, Peter; Meidiana, Amyra

    2017-06-01

    Data sampling has been extensively studied for large scale graph mining. Many analyses and tasks become more efficient when performed on graph samples of much smaller size. The use of proxy objects is common in software engineering for analysis and interaction with heavy objects or systems. In this paper, we coin the term 'proxy graph' and empirically investigate how well a proxy graph visualization can represent a big graph. Our investigation focuses on proxy graphs obtained by sampling; this is one of the most common proxy approaches. Despite the plethora of data sampling studies, this is the first evaluation of sampling in the context of graph visualization. For an objective evaluation, we propose a new family of quality metrics for visual quality of proxy graphs. Our experiments cover popular sampling techniques. Our experimental results lead to guidelines for using sampling-based proxy graphs in visualization.

  7. Adaptability in CORBA: The Mobile Proxy Approach

    DEFF Research Database (Denmark)

    Aziz, B.; Jensen, Christian D.

    2000-01-01

    are inherently open, heterogeneous, and dynamic environments integrating a wide range of platforms, operating systems and applications from a number of different sources. In this paper, we propose to use mobile proxies to provide adaptability in distributed applications integrated using the CORBA technology......Adaptability is one of the most important challenges in modern distributed systems. It may be defined as the ease with which a software application satisfies the different system constraints and the requirements of users and other applications. Adaptability is needed because distributed systems...

  8. Construct and criterion validity of the Euro Qol-5D in patients with systemic lupus erythematosus.

    Directory of Open Access Journals (Sweden)

    Su-li Wang

    Full Text Available OBJECTIVE: To investigate the construct and criterion validity of the Euro Qol-5D (EQ-5D, which allows quality-adjusted life-years to be calculated, in patients with systemic lupus erythematosus (SLE. METHODS: Consecutive SLE patients who had been followed at the Renji Hospital, School of Medicine, Shanghai Jiao Tong University were recruited. Cross-sectional correlations of the EQ-5D with equivalent domains in disease-specific health-related quality of life (HRQoL, LupusQol, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI measures, the Systemic Lupus International Collaborating Clinics Damage Index (SDI, and patient characteristics were tested. Discriminant validity to assess the ability to distinguish between patients of different disease severity was assessed. There also were evaluations of ceiling and floor effects. RESULTS: 240 patients were recruited in total. The EQ-5D correlated moderately to strongly with all domains of the LupusQoL (r: 0.44-0.7 apart from intimate relationships (r = 0.25 and body image (r = 0.18. There was moderate negative correlation between EQ-5D and clinical assessment of disease, SLEDAI (r = -0.589 and SDI (r = -0.509. When compared with equivalent domains on LupusQoL, there was good construct validity in EQ-5D (r: 0.631-0.812. EQ-5D could also discriminate patients with varied disease severity (according SLEDAI and SDI. There was no floor effect in EQ-5D but the ceiling effect remains strong (34%. CONCLUSION: Our results provide sufficient evidence that the EQ-5D displays construct and criterion validity for use in SLE patients. Disease-specific measures of HRQoL used alongside may be a better choice.

  9. Construct and criterion validity of the Euro Qol-5D in patients with systemic lupus erythematosus.

    Science.gov (United States)

    Wang, Su-li; Wu, Bin; Zhu, Li-an; Leng, Lin; Bucala, Richard; Lu, Liang-jing

    2014-01-01

    To investigate the construct and criterion validity of the Euro Qol-5D (EQ-5D), which allows quality-adjusted life-years to be calculated, in patients with systemic lupus erythematosus (SLE). Consecutive SLE patients who had been followed at the Renji Hospital, School of Medicine, Shanghai Jiao Tong University were recruited. Cross-sectional correlations of the EQ-5D with equivalent domains in disease-specific health-related quality of life (HRQoL), LupusQol, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) measures, the Systemic Lupus International Collaborating Clinics Damage Index (SDI), and patient characteristics were tested. Discriminant validity to assess the ability to distinguish between patients of different disease severity was assessed. There also were evaluations of ceiling and floor effects. 240 patients were recruited in total. The EQ-5D correlated moderately to strongly with all domains of the LupusQoL (r: 0.44-0.7) apart from intimate relationships (r = 0.25) and body image (r = 0.18). There was moderate negative correlation between EQ-5D and clinical assessment of disease, SLEDAI (r = -0.589) and SDI (r = -0.509). When compared with equivalent domains on LupusQoL, there was good construct validity in EQ-5D (r: 0.631-0.812). EQ-5D could also discriminate patients with varied disease severity (according SLEDAI and SDI). There was no floor effect in EQ-5D but the ceiling effect remains strong (34%). Our results provide sufficient evidence that the EQ-5D displays construct and criterion validity for use in SLE patients. Disease-specific measures of HRQoL used alongside may be a better choice.

  10. [Validation of quality of life questionnaire ConQol for Chilean children with congenital heart diseases].

    Science.gov (United States)

    Toledo, María Isabel G; Alarcón, Ana María M; Bustos, Luis M; Molina, Juan P; Heusser, Felipe R; Garay, Francisco G; Castillo, María Elisa N; Oliva, Pamela N

    2012-12-01

    ConQoL questionnaire assesses health related quality of life among children with congenital heart diseases. It has a version for children aged 8 to 11 years and another for children aged 12 to 16 years. To validate ConQol questionnaire for Chilean children with a congenital heart disease. Using a multicentric cross sectional design, 334 children from four hospitals (54% males), were surveyed. Among them 45% were aged 8 to 11 years and 55%, 12 to 16 years. The study involved three stages: cross cultural adjustment of the original questionnaire, pre-test study, and estimation of its psychometric properties. Content, construct and criterion validity and internal consistency with Cronbach's alpha, were assessed. The version for children aged 8 to 11 years and comprised by three domains (symptoms, activity and relationships), obtained and α ≥ 0.60. In the questionnaire for children aged 12 to 16 years, there is one more domain called coping, which obtained an α of 0.53, that was different to the other three domains that obtained an α > 0.70. The correlation between Health Quality of Life and Perception of Health Quality of Life was statistically significant for both groups. The association between Health Quality of Life and health capability was only significant among children aged 12 to 16 years (p < 0.01). The adapted ConQol questionnaire matched properly with the original one. The adapted questionnaire is valid and reliable to assess Health Quality of Life among Chilean children with congenital heart diseases.

  11. Early intervention influences positively quality of life as reported by prematurely born children at age nine and their parents; a randomized clinical trial.

    Science.gov (United States)

    Landsem, Inger Pauline; Handegård, Bjørn Helge; Ulvund, Stein Erik; Kaaresen, Per Ivar; Rønning, John A

    2015-02-22

    The Tromsø Intervention Study on Preterms evaluates an early, sensitizing intervention given to parents of prematurely born children (birth-weight intervention on children's self-reported and parental proxy-reported quality of life (QoL) at children's age of nine. Participants were randomized to either intervention (PI, n = 72) or preterm control (PC, n = 74) in the neonatal care unit, while healthy term-born infants were recruited to a term reference group (TR, n = 75). The intervention was a modified version of the Mother-Infant Transaction Program, and comprised eight one-hour sessions during the last week before discharge and four home visits at 1, 2, 4 and 12 weeks post-discharge. The two control groups received care in accordance with written guidelines drawn up at the hospital. Participants and parents reported QoL independently on the Kinder Lebensqualität Fragebogen (KINDL) questionnaire. Differences between groups were analyzed by SPSS; Linear Mixed Models and parent-child agreement were analyzed and compared by intra-class correlations within each group. On average, children in all groups reported high levels of well-being. The PI children reported better physical well-being than the PC children (p = 0.002). In all other aspects of QoL both the PI and the PC children reported at similar levels as the term reference group. PI parents reported better emotional wellbeing (p = 0.05) and a higher level of contentment in school (p = 0.003) compared with PC parents. Parent-child agreement was significantly weaker in the PI group than in the PC group on dimensions such as emotional well-being and relationships with friends (p parents reported QoL similar to parents of terms on all aspects except the subscale self-esteem, while PC parents generally reported moderately lower QoL than TR parents. This early intervention appears to have generated long-lasting positive effects, improving perceived physical well-being among prematurely

  12. The development and validation of a quality-of-life questionnaire for head and neck cancer patients with enteral feeding tubes: the QOL-EF.

    Science.gov (United States)

    Stevens, Christiaan Seimeon Michael; Lemon, Betty; Lockwood, Gina A; Waldron, John N; Bezjak, Andrea; Ringash, Jolie

    2011-08-01

    To develop a questionnaire that measures the impact of enteral feeding tubes (EFTs) on the quality of life (QOL) of head and neck cancer (HNC) patients The development of the questionnaire (QOL-EF) was done in four phases. Phase 1-3 included: (1) literature review and consultation with an expert focus group (item generation), (2) pilot-testing in 12 patients and, (3) judgmental item reduction. In phase 4, the QOL-EF, FACT-H&N, and UW-QOL were administered to a cross-sectional group of HNC patients on active EFT feeding to test the reliability and validity of the QOL-EF. A 20-item QOL-EF was developed. In phase 4, 72 patients were accrued over 2.5 years, 31 of which were part of the test-retest subgroup. Cronbach's α for the QOL-EF was 0.73, and test-retest reliability was 0.83. Moderate correlations were observed between scores for the QOL-EF and both the FACT-H&N (-0.58) and the UW-QOL (-0.42). The QOL-EF is a treatment-specific QOL instrument developed and validated for use in HNC patients with EFTs. It may become an important tool in evaluating treatment outcomes and complications in these patients.

  13. A prospective examination of perceived stress as a mediator of the relationship between life-events and QOL following breast cancer.

    Science.gov (United States)

    Beatty, Lisa; Lee, Christina; Wade, Tracey D

    2009-11-01

    This study prospectively investigated the relationship between life-events, perceived stress, and quality of life (QOL) following breast cancer diagnosis, using the bio-behavioural model of cancer stress as a framework. A longitudinal, self-report design was used. Three waves of data from 10,543 mid-aged Australian women (aged 45-50 at Survey 1) were collected over 5 years as part of a population-based survey. From this group a subsample (N=140) were identified who did not have breast cancer at Survey 1, but who subsequently developed breast cancer. Random regression growth curve analyses were used to investigate whether perceived stress mediated the relationship between initial life-events and change in QOL functioning overtime. Prospective evidence was generated for each of the three criteria for testing mediation. As the number of life-events before breast cancer increased, women were significantly more likely to experience corresponding increases in perceived stress over the 5-year period. As the level of perceived stress before breast cancer increased, women were more likely to experience deteriorations overtime in role emotional, role physical, vitality, bodily pain, physical functioning, and social functioning. As the number of life-events before breast cancer increased, women were at significant risk of experiencing deteriorations overtime in bodily pain, social functioning, role emotional, and vitality. Mediational analyses revealed that perceived stress fully mediated the relationship between initial life-events and two QOL domains; role-emotional and social functioning. Results partially supported the bio-behavioural model of cancer stress, but the model does not appear to fit the data as well as predicted, and may require revision.

  14. Munchausen syndrome by proxy: ongoing clinical challenges.

    Science.gov (United States)

    Squires, Janet E; Squires, Robert H

    2010-09-01

    In 1977, Roy Meadow, a pediatric nephrologist, first described a condition he subsequently coined Munchausen syndrome by proxy. The classic form involves a parent or other caregiver who inflicts injury or induces illness in a child, deceive the treating physician with fictitious or exaggerated information, and perpetrate the trick for months or years. A related form of pathology is more insidious and more common but also damaging. It involves parents who fabricate or exaggerate symptoms of illness in children, causing overly aggressive medical evaluations and interventions. The common thread is that the treating physician plays a role in inflicting the abuse upon the child. Failure to recognize the problem is common because the condition is often not included in the differential diagnosis of challenging or confusing clinical problems. We believe that a heightened "self-awareness" of the physician's role in Munchausen syndrome by proxy will prevent or reduce the morbidity and mortality associated with this diagnosis. In addition, we believe contemporary developments within the modern health care system likely facilitate this condition.

  15. Toxicological evaluation of two children diagnosed as Munchausen syndrome by proxy.

    Science.gov (United States)

    Türkmen, Zeynep; Ziyalar, Neylan; Tari, Itir; Mercan, Selda; Kayiran, Sinan Mahir; Sener, Dicle; Cengiz, Salih; Akçakaya, Necla

    2012-01-01

    Munchausen syndrome by proxy is a kind of child abuse in which affected children are often hospitalized for long periods and endure repetitive, painful and expensive diagnostic attempts. We present herein two toxicologically confirmed cases of Munchausen syndrome by proxy. Case 1 is a 16-month-old male who had fever, peripheral cyanosis, tremor, and reported cardiac arrest. Symptoms recurred in the hospital when the mother administered fluids. Toxicology detected 3.5 ng/ml mercury (Hg) in the fluid and 9.4 microg Hg/g creatinine in the urine. Case 2 is a 14-year-old female who had irregular blood findings and multiple hospitalizations. Serum analysis detected warfarin. Both mothers were transferred to psychiatric care. Munchausen syndrome by proxy should be suspected when clinical/laboratory findings are negative, illness descriptions are inconsistent, and frequent hospitalization yields no diagnosis. Psychiatric evaluation and toxicological analysis are recommended.

  16. Effects of Art Therapy on Distress Levels of Adults with Cancer: A Proxy Pretest Study

    Science.gov (United States)

    Glinzak, Leara

    2016-01-01

    This study identified decreased distress after art therapy in a proxy pretest study with a convenience sample of 73 patients being treated for cancer. Art therapy outcomes from 4 settings (oncology unit, infusion clinic, individual sessions, and open studio) were measured via the self-report Distress Thermometer, which was collected as part of an…

  17. Parent and Athlete Perceptions of Special Olympics Participation: Utility and Danger of Proxy Responding

    Science.gov (United States)

    Glidden, Laraine Masters; Bamberger, Katharine T.; Draheim, Angela R.; Kersh, Joanne

    2011-01-01

    Participation in athletics has benefits for persons with intellectual disabilities and their parents. Our purposes here were to confirm these benefits and to determine whether reports from athletes and parents were comparable (i.e., to test the validity of proxy responding). We conducted interviews with 34 Special Olympics sailing/kayaking…

  18. Improvement of Quality of Life (QOL in Osteoporotic Patients by Elcatonin Treatment: A Trial Taking the Participants’ Preference into Account

    Directory of Open Access Journals (Sweden)

    K. Yoh

    2012-01-01

    Full Text Available Osteoporosis is associated with compromised quality of life (QOL, to which pain has the most important contribution. Elcatonin, a derivative of calcitonin, is widely used in the treatment of osteoporosis in two ways. One is as the inhibitor of osteoclastic bone resorption. The other is for osteoporosis-related pain based on the unique analgesic effects of elcatonin. Since pain is subjective in nature, and QOL is the only clinical outcome representing the patients’ subjective perception of health status, pain associated with osteoporosis would be best evaluated based on QOL assessment. Evidence based medicine gives the highest remarks to the double-blinded, randomized controlled trial, which, however, cannot be free from methodological problems on some occasions. For example, it is practically impossible to remain blinded in the trial of a potent analgesia, which in turn causes biases. Thus, the significance of taking the patients’ preference into account is increasingly acknowledged. In this study, 45 osteoporotic patients were given brochures describing the pros and cons on the three treatment choices; calcium and alfacalcidol, additional use of elcatonin, and additional use of bisphosphonate. Those who favored elcatonin were older, had more vertebral fractures, and lower QOL scores. QOL was evaluated before and three months after the treatment using SF-8; the most widely used generic questionnaire, and RDQ; a lumbago-specific measure. Elcatonin treatment improved physical function, general health, and vitality of SF-8, and RDQ score. Although this is a preliminary study, our results suggest that patients with vertebral fracture(s have impaired QOL and more likely to favor elcatonin treatment expecting analgesia.

  19. Workflows for intelligent monitoring using proxy services.

    Science.gov (United States)

    Rüping, Stefan; Wegener, Dennis; Sfakianakis, Stelios; Sengstag, Thierry

    2009-01-01

    Grid technologies have proven to be very successful in the area of eScience, and in particular in healthcare applications. But while the applicability of workflow enacting tools for biomedical research has long since been proven, the practical adoption into regular clinical research has some additional challenges in grid context. In this paper, we investigate the case of data monitoring, and how to seamlessly implement the step between a one-time proof-of-concept workflow and high-performance on-line monitoring of data streams, as exemplified by the case of long-running clinical trials. We will present an approach based on proxy services that allows executing single-run workflows repeatedly with little overhead.

  20. Salmon: Robust Proxy Distribution for Censorship Circumvention

    Directory of Open Access Journals (Sweden)

    Douglas Frederick

    2016-10-01

    Full Text Available Many governments block their citizens’ access to much of the Internet. Simple workarounds are unreliable; censors quickly discover and patch them. Previously proposed robust approaches either have non-trivial obstacles to deployment, or rely on low-performance covert channels that cannot support typical Internet usage such as streaming video. We present Salmon, an incrementally deployable system designed to resist a censor with the resources of the “Great Firewall” of China. Salmon relies on a network of volunteers in uncensored countries to run proxy servers. Although any member of the public can become a user, Salmon protects the bulk of its servers from being discovered and blocked by the censor via an algorithm for quickly identifying malicious users. The algorithm entails identifying some users as especially trustworthy or suspicious, based on their actions. We impede Sybil attacks by requiring either an unobtrusive check of a social network account, or a referral from a trustworthy user.

  1. Obesity as a Presentation of Munchausen Syndrome by Proxy.

    Science.gov (United States)

    Nogueira-de-Almeida, Carlos Alberto; de Almeida, Carla Cristina J N; Pereira, Natália Inocêncio; de Souza Filho, Nilton Antonio; de Oliveira, Valmir Aparecido

    2017-04-17

    To describe a case of an obese child whose weight gain was related to the Munchausen Syndrome by proxy (MSP). This is a case report including information regarding the child's clinical history and the mother's behavior. The common features of the syndrome are confronted with the description of the case, seeking to demonstrate the similarities. The description ratifies the diagnosis based on the signs and symptoms presented by the child (<5 years old, frequent contacts with health system, symptoms witnessed only by the mother, confusing findings, not helped by treatments, emotionally distant father) and the attitude of the mother (concerned, interested in procedures, comfortable in the medical setting, higher medical knowledge, hostile when thwarted). The case presented points to a new etiology, the MSP, to be considered within the set of factors currently known to cause and maintain obesity in childhood.

  2. Translation and validation of a Japanese version of the irritable bowel syndrome-quality of life measure (IBS-QOL-J

    Directory of Open Access Journals (Sweden)

    Hongo Michio

    2007-03-01

    Full Text Available Abstract Aims To compare quality of life (QOL for patients with irritable bowel syndrome (IBS between the U.S. and Japan, it is indispensable to develop common instruments. The IBS-QOL, which is widely used in Western countries, was translated into Japanese as there has been a lack of Japanese disease-specific QOL measures for IBS. Methods The original 34 items of the IBS-QOL were translated from English into Japanese through two independent forward translations, resolution, back translation, and resolution of differences. Forty nine patients who had GI symptoms but did not have any organic diseases (including 30 IBS patients diagnosed by Rome II criteria were recruited from Tohoku University Hospital in Sendai, Japan and completed a Japanese version of the IBS-QOL (IBS-QOL-J concomitant with a Japanese version of the IBS severity index (IBSSI-J twice within 7–14 days. Results The IBS-QOL-J demonstrated high internal consistency (Cronbach's alpha; 0.96 and high reproducibility (intraclass correlation coefficient; 0.92, p Conclusion The IBS-QOL-J is a reliable instrument to assess the disease-specific QOL for IBS. Considering cross-cultural comparison, this measure is likely to be a valuable tool to investigate the QOL in Japanese patients with IBS.

  3. The English Version of the Gilles de la Tourette Syndrome-Quality of Life Scale for Children and Adolescents (C&A-GTS-QOL).

    Science.gov (United States)

    Su, Merina T; McFarlane, Fiona; Cavanna, Andrea E; Termine, Cristiano; Murray, Imogen; Heidemeyer, Larissa; Heyman, Isobel; Murphy, Tara

    2017-01-01

    Gilles de la Tourette syndrome is a chronic neuropsychiatric disorder that can have a detrimental impact on the health-related quality of life of children with the condition. To date no patient-reported health-related quality of life measures have been developed for children and adolescents in the English language. This study validated the first disease-specific scale for the quantitative assessment of health-related quality of life in 118 children and adolescents with Gilles de la Tourette syndrome (C&A-GTS-QOL) following language adaptation from Italian to English in the United Kingdom. Standard statistical methods were used to test the psychometric properties of the rating scale. Principal component factor analyses led to the identification of six health-related quality of life domains (cognitive, copro-phenomena, psychological, physical, obsessive-compulsive, and activities of daily living), explaining 66.7% of the overall variance. The C&A-GTS-QOL demonstrated satisfactory scaling assumptions and acceptability; validity was supported by interscale correlations (range 0.2-0.7), confirmatory factor analysis, and correlation patterns with other rating scales and clinical variables.

  4. Deprescribing Using the Guidelines for Medical Treatment and Its Safety in the Elderly and Changes in Patient QOL and Activities of Daily Living.

    Science.gov (United States)

    Ohshima, Shigeru; Hara, Ayaka; Abe, Takumi; Akimoto, Hayato; Ohara, Kousuke; Negishi, Akio; Okita, Mitsuyoshi; Oshima, Shinji; Inoue, Naoko; Numajiri, Sachihiko; Ogawa, Etsushi; Saiki, Minoru; Kobayashi, Daisuke

    2017-01-01

    Pharmacists applied deprescribing, which is a process for the rational use of drugs, for 13 at-home patients. The standard used for the rational use of drugs was the "Guidelines for Medical Treatment and Its Safety in the Elderly" (the Guidelines). The results of the deprescribing were discussed with physicians to determine prescriptions. After the prescription change, activities of daily living (ADL) and QOL were assessed using the Barthel Index and SF-36v2, respectively. Potentially inappropriate medications (PIMs) were detected in 10 of the 13 patients (76.9%). This detection rate is higher than previous PIM detection rates of 48.4% and 40.4% reported in prescriptions for home-care patients in Japan under the Beers and STOPP/START criteria. The Guidelines appeared useful as a decision support tool for deprescribing. The patients continuing the changed prescriptions showed no decrease in ADL or QOL after deprescribing, suggesting its rationality. The 10 measurement items of the Barthel Index were all suitable for evaluating the physical conditions of the patients. Meanwhile, SF-36v2 includes many items, but few indexes were directly applicable.

  5. Validity of proxy data obtained by different psychological autopsy information reconstruction techniques.

    Science.gov (United States)

    Fang, L; Zhang, J

    2010-01-01

    Two informants were interviewed for each of 416 living controls (individuals sampled from the normal population) interviewed in a Chinese case-control psychological autopsy study. The validity of proxy data, obtained using seven psychological autopsy information reconstruction techniques (types 1, 2 and A - E), was evaluated, with living controls' self reports used as the gold-standard. Proxy data for reconstruction technique types 1, 2 and D on the Impulsivity Inventory Scale (total impulsivity score) were no different from the living controls' self report gold standard, whereas data for types A and E were smaller than data from living controls. On the 'acceptance or resignation' sub-scale of the avoidance coping dimension of the Moos Coping Response Inventory, information obtained by reconstruction technique types 1 and D was not significantly different from the living controls' self reports, whereas proxy data from types 2, A and E were smaller than those from the living controls. No statistically significant differences were identified for other proxy data obtained by reconstruction technique types 1, 2, A, D and E. These results indicate that using a second informant does not significantly enhance information reconstruction for the target.

  6. Proxy-produced ethnographic work: what are the problems, issues, and dilemmas arising from proxy ethnography?

    DEFF Research Database (Denmark)

    Martinussen, Marie Louise; Højbjerg, Karin; Tamborg, Andreas Lindenskov

    2018-01-01

    and positions arising from such a setup between the teacher/researcher and the proxy ethnographer/student are found to have implications for the ethnographies produced. This article’s main focus is to show how these relations and positions have not distorted the ethnographic work and the ethnographies but......This article addresses the implications of research-student cooperation in the production of empirical material. For the student to replace the experienced researcher and work under the researcher’s supervision, we call such work proxy-produced ethnographic work. The specific relations...... the research process. These ethnographic distortions will be generated and described within a framework drawn primarily on the work of sociologist Pierre Bourdieu....

  7. Mapping PROMIS Global Health Items to EuroQol (EQ-5D) Utility Scores Using Linear and Equipercentile Equating.

    Science.gov (United States)

    Thompson, Nicolas R; Lapin, Brittany R; Katzan, Irene L

    2017-11-01

    Mapping Patient-Reported Outcomes Measurement Information System-Global Health (PROMIS-GH) to EuroQol 5-dimension, three-level version (EQ-5D-3L) provides a utility score for use in quality-of-life and cost-effectiveness analyses. In 2009, Revicki et al. mapped the PROMIS-GH items to EQ-5D-3L utilities using linear regression (REVReg). More recently, regression was shown to be ill-suited for mapping to preference-based measures due to regression to the mean. Linear and equipercentile equating are alternative mapping methods that avoid the issue of regression to the mean. Another limitation of the prior models is that ordinal predictors were treated as continuous. Using data collected from the PROMIS Wave 1 sample, we refit REVReg, treating the PROMIS-GH items as categorical variables (CATReg). We applied linear and equipercentile equating to the REVReg model (REVLE, REVequip) and the CATReg model (CATLE, CATequip). We validated and compared the predictive accuracy of these models in a large sample of neurological patients at a single tertiary-care hospital. In the neurological disease patient sample, CATLE produced the strongest correlations between estimated and observed EQ-5D-3L scores and had the lowest mean squared error. The CATequip model had the lowest mean absolute error and had estimated scores that best matched the overall distribution of observed scores. Using linear and equipercentile equating, we created new models mapping PROMIS-GH items to EQ-5D-3L utility scores. EQ-5D-3L utility scores can be more accurately estimated using our models for use in cost-effectiveness studies or studies examining overall health-related quality of life.

  8. Psychometric properties of the EuroQol Five Dimensional Questionnaire (EQ-5D-3L) in caregivers of autistic children.

    Science.gov (United States)

    Khanna, Rahul; Jariwala, Krutika; Bentley, John P

    2013-12-01

    This study aimed to ascertain the psychometric properties of EuroQol Five Dimensional Questionnaire (EQ-5D-3L) in primary caregivers of children with autism. The convergent validity, discriminant validity, known-groups validity, internal consistency reliability, and floor and ceiling effects of EQ-5D-3L were analyzed. A cross-sectional design was used for study purposes. Through an online survey, relevant study information was collected from 316 primary caregivers of children with autism. Study participants were from families of children with autism living in the United States who were registered with the Interactive Autism Network. Convergent validity of the EQ-5D-3L was assessed through its correlation with other measures of similar constructs. Discriminant validity was assessed by observing the correlation of EQ-5D-3L domains with theoretically unrelated constructs. Known-groups validity was tested by comparing EQ-5D-3L index and visual analog scale (VAS) scores across levels of autism severity among the care recipients. Internal consistency reliability of EQ-5D-3L was tested. Lastly, floor and ceiling effects of EQ-5D-3L were assessed. More than 60 % of participants reported problems of 'anxiety/depression.' Convergent and discriminant validity of the EQ-5D-3L was good. Significant correlation (convergent validity) was observed among EQ-5D-3L index and VAS and (SF-12v2) physical component summary and mental component summary scores. Caregivers' EQ-5D-3L index and VAS scores varied by levels of autism severity among care recipients, providing evidence of known-groups validity. Reliability assessed through Cronbach's alpha was less than satisfactory; however, corrected item-total correlations were adequate. The EQ-5D-3L is a psychometrically sound tool to elicit health state preferences among caregivers of children with autism.

  9. Does hypoglycaemia affect the improvement in QoL after the transition to insulin in people with type 2 diabetes?

    NARCIS (Netherlands)

    Wieringa, T. H.; de Wit, M.; Twisk, J. W. R.; Snoek, F. J.

    2018-01-01

    Quality of Life (QoL) of insulin-naïve people with type 2 diabetes mellitus (T2DM) improves after transition to insulin. Little is known about the role of hypoglycaemia in this context. Secondary analyses of the Study of the Psychological Impact in Real care of Initiating insulin glargine Treatment

  10. Pre-diagnosis quality of life (QoL) in patients with hematuria : Comparison of bladder cancer with other causes

    NARCIS (Netherlands)

    Goossens-Laan, C.A.; Kil, P.J.M.; Bosch, J.L.; de Vries, J.

    2013-01-01

    Purpose To examine quality of life (QoL), health status, sexual function, and anxiety in patients with primary hematuria who later appear to have bladder cancer (BC) and patients with other diagnoses. Methods From July 2007 to July 2010, 598 patients with primary hematuria were enrolled in this

  11. A new test of the construct validity of the CarerQol instrument: Measuring the impact of informal care giving

    NARCIS (Netherlands)

    R.J. Hoefman (Renske); N.J.A. van Exel (Job); S. Looren De Jong (Sandra); E. Orlewska (William Ken); W.B.F. Brouwer (Werner)

    2011-01-01

    textabstractPurpose: Most economic evaluations of health care programmes do not consider the effects of informal care, while this could lead to suboptimal policy decisions. This study investigates the construct validity of the CarerQol instrument, which measures and values carer effects, in a new

  12. Compassion Satisfaction, Compassion Fatigue, and Burnout in Spain and Brazil: ProQOL Validation and Cross-cultural Diagnosis.

    Science.gov (United States)

    Galiana, Laura; Arena, Fernanda; Oliver, Amparo; Sansó, Noemí; Benito, Enric

    2017-03-01

    Palliative care professionals' quality of life has emerged as a growing issue of interest in health care literature, centered on concerns about professionals' compassion within a context of work characterized by pain and death. The aim of this study was threefold: 1) to study the psychometric properties of both the Spanish and the Portuguese versions of the ProQOL scale, by means of confirmatory factor analyses; 2) to offer a diagnosis of compassion satisfaction and compassion fatigue levels of Spanish and Brazilian palliative care professionals; and 3) to compare levels in ProQOL between countries. Two surveys with a cross-sectional design were carried out; 161 Brazilian palliative care professionals and 385 Spanish participated in this study. Confirmatory factor analysis for both the Spanish and the Portuguese versions showed an adequate fit. Reliability estimates were also adequate, with problems with the burnout dimension. Spanish and Brazilian palliative care professionals showed high levels of compassion satisfaction (specially, for the Brazilian samples), medium levels of secondary traumatic stress, and low levels of burnout. Finally, statistically significant differences in Spanish and Brazilian levels of compassion satisfaction and secondary traumatic stress were found, but not in burnout. The ProQOL shows psychometric goodness in its Spanish and Portuguese versions, although some items should be revised. The ProQOL is also useful for diagnosis and is sensitive enough to distinguish nuances as that found between Brazilian and Spanish professionals. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  13. rTMS in fibromyalgia: a randomized trial evaluating QoL and its brain metabolic substrate

    NARCIS (Netherlands)

    Boyer, L.; Dousset, A.; Roussel, P.; Dossetto, N.; Cammilleri, S.; Piano, V.M.M.; Khalfa, S.; Mundler, O.; Donnet, A.; Guedj, E.

    2014-01-01

    OBJECTIVE: This double-blind, randomized, placebo-controlled study investigated the impact of repetitive transcranial magnetic stimulation (rTMS) on quality of life (QoL) of patients with fibromyalgia, and its possible brain metabolic substrate. METHODS: Thirty-eight patients were randomly assigned

  14. Development of a disease specific quality of life questionnaire for patients with Graves' ophthalmopathy: the GO-QOL

    NARCIS (Netherlands)

    Terwee, C. B.; Gerding, M. N.; Dekker, F. W.; Prummel, M. F.; Wiersinga, W. M.

    1998-01-01

    To develop a reliable and valid disease specific quality of life questionnaire (the GO-QOL) for patients with Graves' ophthalmopathy (GO), that can be used to describe the health related quality of life and changes in health related quality of life over time as a consequence of disease and

  15. Caring for a Child with Autism Spectrum Disorder and Parents' Quality of Life: Application of the CarerQol

    NARCIS (Netherlands)

    R.J. Hoefman (Renske); N. Payakachat (Nalin); N.J.A. van Exel (Job); K.A. Kuhlthau (Karen); E.M. Kovacs (Erica); J.M. Pyne (Jeffrey); J.M. Tilford (John Mick)

    2014-01-01

    textabstractThis study describes the impact of caregiving on parents of children with autism spectrum disorders (ASDs). Secondly, we investigate construct validation of the care-related quality of life instrument (CarerQol) measuring impact of caregiving. Primary caregivers of children with ASDs

  16. Attacks on One Designated Verifier Proxy Signature Scheme

    Directory of Open Access Journals (Sweden)

    Baoyuan Kang

    2012-01-01

    Full Text Available In a designated verifier proxy signature scheme, there are three participants, namely, the original signer, the proxy signer, and the designated verifier. The original signer delegates his or her signing right to the proxy signer, then the proxy signer can generate valid signature on behalf of the original signer. But only the designated verifier can verify the proxy signature. Several designated verifier proxy signature schemes have been proposed. However, most of them were proven secure in the random oracle model, which has received a lot of criticism since the security proofs in the random oracle model are not sound with respect to the standard model. Recently, by employing Water's hashing technique, Yu et al. proposed a new construction of designated verifier proxy signature. They claimed that the new construction is the first designated verifier proxy signature, whose security does not rely on the random oracles. But, in this paper, we will show some attacks on Yu et al.'s scheme. So, their scheme is not secure.

  17. Factitious Disorder by Proxy in Educational Settings: A Review

    Science.gov (United States)

    Frye, Ellen M.; Feldman, Marc D.

    2012-01-01

    Factitious disorder by proxy (FDP), historically known as Munchausen syndrome by proxy, is a diagnosis applied to parents and other caregivers who intentionally feign, exaggerate, and/or induce illness or injury in a child to get attention from health professionals and others. A review of the recent literature and our experience as consultants…

  18. Perbandingan proxy pada linux dan windows untuk mempercepat browsing website

    Directory of Open Access Journals (Sweden)

    Dafwen Toresa

    2017-05-01

    Full Text Available AbstrakPada saat ini sangat banyak organisasi, baik pendidikan, pemerintahan,  maupun perusahaan swasta berusaha membatasi akses para pengguna ke internet dengan alasan bandwidth yang dimiliki mulai terasa lambat ketika para penggunanya mulai banyak yang melakukan browsing ke internet. Mempercepat akses browsing menjadi perhatian utama dengan memanfaatkan teknologi Proxy server. Penggunaan proxy server perlu mempertimbangkan sistem operasi pada server dan tool yang digunakan belum diketahui performansi terbaiknya pada sistem operasi apa.  Untuk itu dirasa perlu untuk menganalisis performan Proxy server pada sistem operasi berbeda yaitu Sistem Operasi Linux dengan tools Squid  dan Sistem Operasi Windows dengan tool Winroute. Kajian ini dilakukan untuk mengetahui perbandingan kecepatan browsing dari komputer pengguna (client. Browser yang digunakan di komputer pengguna adalah Mozilla Firefox. Penelitian ini menggunakan 2 komputer klien dengan pengujian masing-masingnya 5 kali pengujian pengaksesan/browsing web yang dituju melalui proxy server. Dari hasil pengujian yang dilakukan, diperoleh kesimpulan bahwa penerapan proxy server di sistem operasi linux dengan tools squid lebih cepat browsing dari klien menggunakan web browser yang sama dan komputer klien yang berbeda dari pada proxy server sistem operasi windows dengan tools winroute.  Kata kunci: Proxy, Bandwidth, Browsing, Squid, Winroute AbstractAt this time very many organizations, both education, government, and private companies try to limit the access of users to the internet on the grounds that the bandwidth owned began to feel slow when the users began to do a lot of browsing to the internet. Speed up browsing access is a major concern by utilizing Proxy server technology. The use of proxy servers need to consider the operating system on the server and the tool used is not yet known the best performance on what operating system. For that it is necessary to analyze Performance Proxy

  19. Proxy SDN Controller for Wireless Networks

    Directory of Open Access Journals (Sweden)

    Won-Suk Kim

    2016-01-01

    Full Text Available Management of wireless networks as well as wired networks by using software-defined networking (SDN has been highlighted continually. However, control features of a wireless network differ from those of a wired network in several aspects. In this study, we identify the various inefficient points when controlling and managing wireless networks by using SDN and propose SDN-based control architecture called Proxcon to resolve these problems. Proxcon introduces the concept of a proxy SDN controller (PSC for the wireless network control, and the PSC entrusted with the role of a main controller performs control operations and provides the latest network state for a network administrator. To address the control inefficiency, Proxcon supports offloaded SDN operations for controlling wireless networks by utilizing the PSC, such as local control by each PSC, hybrid control utilizing the PSC and the main controller, and locally cooperative control utilizing the PSCs. The proposed architecture and the newly supported control operations can enhance scalability and response time when the logically centralized control plane responds to the various wireless network events. Through actual experiments, we verified that the proposed architecture could address the various control issues such as scalability, response time, and control overhead.

  20. Lithium in Brachiopods - proxy for seawater evolution?

    Science.gov (United States)

    Gaspers, Natalie; Magna, Tomas; Tomasovych, Adam; Henkel, Daniela

    2017-04-01

    Marine biogenic carbonates have the potential to serve as a proxy for evolution of seawater chemistry. In order to compile a record of the past and recent δ7Li in the oceans, foraminifera shells, scleractinian corals and belemnites have been used. However, only a foraminifera-based record appears to more accurately reflect the Li isotope composition of ocean water. At present, this record is available for the Cenozoic with implications for major events during this period of time, including K/T event [1]. A record for the entire Phanerozoic has not yet been obtained. In order to extend this record to the more distant past, Li elemental/isotope systematics of brachiopods were investigated because these marine animals were already present in Early Cambrian oceans and because they are less sensitive to diagenesis-induced modifications due to their shell mineralogy (low-Mg calcite). The preliminary data indicates a species-, temperature- and salinity-independent behavior of Li isotopes in brachiopod shells. Also, no vital effects have been observed for different shell parts. The consistent offset of -4‰ relative to modern seawater is in accordance with experimental data [2]. Further data are now being collected for Cenozoic specimens to more rigorously test brachiopods as possible archives of past seawater in comparison to the existing foraminiferal records. [1] Misra & Froelich (2012) Science 335, 818-823 [2] Marriott et al. (2004) Chem Geol 212, 5-15

  1. Deciphering dynamical proxy responses from lake sediments

    Science.gov (United States)

    Ramisch, Arne; Tjallingii, Rik; Hartmann, Kai; Brauer, Achim; Diekmann, Bernhard; Haberzettl, Torsten; Kasper, Thomas; Ahlborn, Marieke

    2017-04-01

    Lakes form a reliable archive of paleoenvironmental change in the terrestrial realm. Non-destructive XRF scans provide high-resolution records of element concentrations that are commonly related to past environmental change. However, XRF records of lake sediments enclose paleoenvironmental information that originates from multiple lake external and internal forcing. The variety of environmental forcing factors can complicate a direct identification of single mechanisms like climatic change from XRF or other proxy records. Here we present XRF records from several Asian lake archives, which indicate asynchronous variations of similar geochemical records since the late glacial/early Holocene. All XRF time series are characterized by damped harmonic oscillations of relative element concentrations through time. The asynchronous variations can be expressed by the frequency and the rate of damping of theses oscillations that differ between the lakes. We argue that the oscillatory behavior is a result of a feedback between the physical removal and dissolution of mineral phases in catchment soils and their subsequent enrichment and deposition within the lake. We present a numerical model, which accurately simulates major Holocene variations in the element concentration of lake records and discuss implications for the reconstruction of environmental signals from lake sediments.

  2. Predictors of parent-reported quality of life of adolescents with cerebral palsy

    DEFF Research Database (Denmark)

    Rapp, Marion; Eisemann, Nora; Arnaud, Catherine

    2017-01-01

    AIM: Parent-reporting is needed to examine Quality of Life (QoL) of children with cerebral palsy (CP) across all severities. This study examines whether QoL changes between childhood and adolescence, and what predicts adolescent QoL. METHOD: SPARCLE is a European cohort study of children with CP...

  3. A New Proxy Measurement Algorithm with Application to the Estimation of Vertical Ground Reaction Forces Using Wearable Sensors

    Directory of Open Access Journals (Sweden)

    Yuzhu Guo

    2017-09-01

    Full Text Available Measurement of the ground reaction forces (GRF during walking is typically limited to laboratory settings, and only short observations using wearable pressure insoles have been reported so far. In this study, a new proxy measurement method is proposed to estimate the vertical component of the GRF (vGRF from wearable accelerometer signals. The accelerations are used as the proxy variable. An orthogonal forward regression algorithm (OFR is employed to identify the dynamic relationships between the proxy variables and the measured vGRF using pressure-sensing insoles. The obtained model, which represents the connection between the proxy variable and the vGRF, is then used to predict the latter. The results have been validated using pressure insoles data collected from nine healthy individuals under two outdoor walking tasks in non-laboratory settings. The results show that the vGRFs can be reconstructed with high accuracy (with an average prediction error of less than 5.0% using only one wearable sensor mounted at the waist (L5, fifth lumbar vertebra. Proxy measures with different sensor positions are also discussed. Results show that the waist acceleration-based proxy measurement is more stable with less inter-task and inter-subject variability than the proxy measures based on forehead level accelerations. The proposed proxy measure provides a promising low-cost method for monitoring ground reaction forces in real-life settings and introduces a novel generic approach for replacing the direct determination of difficult to measure variables in many applications.

  4. Secure Mobile Agent from Leakage-Resilient Proxy Signatures

    Directory of Open Access Journals (Sweden)

    Fei Tang

    2015-01-01

    Full Text Available A mobile agent can sign a message in a remote server on behalf of a customer without exposing its secret key; it can be used not only to search for special products or services, but also to make a contract with a remote server. Hence a mobile agent system can be used for electronic commerce as an important key technology. In order to realize such a system, Lee et al. showed that a secure mobile agent can be constructed using proxy signatures. Intuitively, a proxy signature permits an entity (delegator to delegate its signing right to another entity (proxy to sign some specified messages on behalf of the delegator. However, the proxy signatures are often used in scenarios where the signing is done in an insecure environment, for example, the remote server of a mobile agent system. In such setting, an adversary could launch side-channel attacks to exploit some leakage information about the proxy key or even other secret states. The proxy signatures which are secure in the traditional security models obviously cannot provide such security. Based on this consideration, in this paper, we design a leakage-resilient proxy signature scheme for the secure mobile agent systems.

  5. Proxies and consent discussions for dementia research.

    Science.gov (United States)

    Sugarman, Jeremy; Roter, Debra; Cain, Carole; Wallace, Roberta; Schmechel, Don; Welsh-Bohmer, Kathleen A

    2007-04-01

    To better understand the nature of informed consent encounters for research involving patients with dementia that requires proxy consent. Audiotaping of informed-consent encounters for a study of genetic markers for sporadic Alzheimer's disease. Outpatients at an Alzheimer's disease research center. Patients with dementia and their companions. Audiotapes were analyzed to characterize communication style and coverage of the standard elements of informed consent and, using the Roter Interaction Analysis System, to capture the dynamics of three-way interaction between the patient, their companion, and the physician investigator. Of 26 informed consent encounters, all involved a patient, a companion, and a physician. Patients had a mean Mini-Mental State Examination (MMSE) score of 21.8. For patients, 49% of their interactions involved agreement and approval (positive statements), 16% psychosocial information, 7% biomedical information, 7% asking questions, and 7% expressing emotion. Companion interactions involved 37% positive statements and 19% biomedical information. Physician interactions involved emotional expressiveness (30%) and positive statements (19%). Discussion length was positively related to MMSE score (Spearman rho=0.45; Pinformed consent was fairly comprehensive and had no relationship to patients' MMSE scores. These data should inform policies regarding the ethically appropriate ways of conducting research with cognitively impaired adults. For example, patients in this study were more silent than their companions and the physician, but when patients spoke, they primarily agreed with what was said. Although this might first seem to signal assent, such an interpretation should be made with caution for persons with dementia. In addition, previous work on informed consent has focused on its cognitive aspects, but these data reveal that the emotional and social dimensions warrant attention.

  6. From translation to version management: a history and review of methods for the cultural adaptation of the EuroQol five-dimensional questionnaire.

    Science.gov (United States)

    Rabin, Rosalind; Gudex, Claire; Selai, Caroline; Herdman, Michael

    2014-01-01

    The EuroQol five-dimensional (EQ-5D) questionnaire is used worldwide as a patient-reported outcome (PRO) instrument for the measurement and valuation of health. Several variants of the instrument now exist, including versions with three and five levels of severity and one for respondents aged 8 to 14 years. From the outset, a demand for new language versions of the EQ-5D questionnaire meant that there was a need to implement standardized procedures, which ensured that such versions were produced following international recommendations for the cultural adaptation of patient-reported outcomes. The availability of new variants and formats of the instrument, such as telephone-administered or electronic formats, complicated the task of providing and controlling the quality of cultural adaptations. Although cultural adaptations of the instrument are widely used, the procedures currently used to produce them have not been widely disseminated. The present article therefore describes the evolution of the production of other language versions of the instrument from the earliest days of simultaneous production and translation of the EQ-5D questionnaire to the more recent, broader-based strategy of version management. We describe current adaptation procedures and innovations within those procedures. We also describe how version management is organized within the EuroQol Group, review aspects related to quality control, and provide an overview of the number of currently available language versions for each variant of the EQ-5D questionnaire: three-level, five-level, and youth versions. We conclude by discussing some of the relevant issues related to cultural adaptation for frequently used instruments such as the EQ-5D questionnaire. © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Published by International Society for Pharmacoeconomics and Outcomes Research (ISPOR) All rights reserved.

  7. Validity of the EuroQol-5 dimensions as a measure of recovery after pulmonary resection.

    Science.gov (United States)

    Bejjani, Jimmy; Fiore, Julio F; Lee, Lawrence; Kaneva, Pepa; Mata, Juan; Ncuti, Annie; Sirois, Christian; Mulder, David S; Ferri, Lorenzo E; Feldman, Liane S

    2015-03-01

    Surgical innovations advocated to improve patient recovery are often costly. Economic evaluation requires preference-based measures that reflect the construct of patient recovery. We investigated the responsiveness and construct validity of the EuroQol-5 dimensions (EQ-5D) as a measure of postoperative recovery after planned pulmonary resection for suspected malignant tumors. Patients undergoing pulmonary resection completed the EQ-5D questionnaire and visual analog scales (VAS) for pain and fatigue at baseline (preoperatively) and at 1 and 3 mo postoperatively. Responsiveness and construct validity (discriminant and convergent) were investigated by testing a priori hypotheses. Fifty-five patients were analyzed (45% male, 62 ± 12 y, 29% video-assisted). There was no significant difference between median EQ-5D scores obtained at baseline (0.83 [interquartile range {IQR 0.80-1}]) compared to scores at 1 mo (0.83 [0.80-1], P = 0.86) and 3 mo after surgery (1 [0.83-1]; P = 0.09). At 1 mo after surgery, EQ-5D scores were significantly lower in patients undergoing thoracotomy versus video-assisted surgery (0.82 [IQR 0.77-0.89] versus 1 [0.83-1], P = 0.003), but there were no significant differences between patients ≥ 70-y old versus younger (0.95 [IQR 0.82-1] versus 0.83 [0.77-1], P = 0.09) or between patients with versus without complications (0.82 [IQR 0.79-0.95] versus 0.83 [0.80-1], P = 0.10). There was a low but significant correlation between EQ-5D and VAS scores of pain and fatigue (Rho -0.30 to -0.47, P ≤ 0.01). Despite evidence of convergent validity, the EQ-5D was not sensitive to the hypothesized trajectory of postoperative recovery and showed limited discriminant validity. This study suggests that the EQ-5D may not be appropriate to value recovery after lung resection. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Optimizing TCP Performance over UMTS with Split TCP Proxy

    DEFF Research Database (Denmark)

    Hu, Liang; Dittmann, Lars

    2009-01-01

    Abstract: The TCP performance over UMTS network is challenged by the large delay bandwidth product. Large delay bandwidth product is mainly caused by the latency from the link layer ARQ retransmissions and diversity technique at physical layer which are used to cope with radio transmission errors...... scenario (e.g.64 kbps). Besides, the split TCP proxy brings more performance gain for downloading large files than downloading small ones. To the end, for the configuration of the split proxy, an aggressive initial TCP congestion window size (e.g. 10 MSS) at proxy is particularly useful for radio links...

  9. Cryptanalytic Performance Appraisal of Improved CCH2 Proxy Multisignature Scheme

    Directory of Open Access Journals (Sweden)

    Raman Kumar

    2014-01-01

    Full Text Available Many of the signature schemes are proposed in which the t out of n threshold schemes are deployed, but they still lack the property of security. In this paper, we have discussed implementation of improved CCH1 and improved CCH2 proxy multisignature scheme based on elliptic curve cryptosystem. We have represented time complexity, space complexity, and computational overhead of improved CCH1 and CCH2 proxy multisignature schemes. We have presented cryptanalysis of improved CCH2 proxy multisignature scheme and showed that improved CCH2 scheme suffered from various attacks, that is, forgery attack and framing attack.

  10. Web proxy cache replacement strategies simulation, implementation, and performance evaluation

    CERN Document Server

    ElAarag, Hala; Cobb, Jake

    2013-01-01

    This work presents a study of cache replacement strategies designed for static web content. Proxy servers can improve performance by caching static web content such as cascading style sheets, java script source files, and large files such as images. This topic is particularly important in wireless ad hoc networks, in which mobile devices act as proxy servers for a group of other mobile devices. Opening chapters present an introduction to web requests and the characteristics of web objects, web proxy servers and Squid, and artificial neural networks. This is followed by a comprehensive review o

  11. Munchausen syndrome by proxy mimicking as Gaucher disease.

    Science.gov (United States)

    Al-Owain, Mohammed; Al-Zaidan, Hamad; Al-Hashem, Amal; Kattan, Hoda; Al-Dowaish, Abdullah

    2010-08-01

    Although rare, Munchausen syndrome by proxy (MBP) is a potentially life-threatening form of child abuse. Here, we report a 19-month-old female infant who presented with hepatosplenomegaly, anemia, thrombocytopenia, and recurrent septicemia. She was initially thought to have myelodysplastic syndrome. Further hematological and immunological investigations revealed no cause. beta-Glucosylceramidase enzyme activity on dried blood spot was suggestive of Gaucher disease. However, the enzyme level on cultured skin fibroblast was not consistent with Gaucher disease. The first hint about MBP was the recurrent sepsis with numerous gram negative rods. Furthermore, the mother's behavior and health history raised our suspicion about MBP. The child showed significant improvement after she was separated from the mother for a week. Finally, the mother confessed that she was spitting in local herbs and injecting it into the central line. This is, to our knowledge, the first report of MBP resembling in its presentation Gaucher disease. This case should alert the general and specialized pediatricians about MBP, as it may mimic metabolic diseases like Gaucher disease.

  12. MUNCHAUSEN SYNDROME BY PROXY: REPORT OF A CASE

    Directory of Open Access Journals (Sweden)

    Seyyed Mohammad Rafiei

    1995-07-01

    Full Text Available Abstracf--Trontal cortical dopamine (DA systems may play an inhibitory role inmotor behavior, possibly mediated through the nucleus accumbcns (NAc. Bilateral lesions ofDA terminals in medial prefrontal cortex (MPFC and bilateral electrolytic lesions in NAc both induce hyperactivity in rats. However, unilateral NAc lesions elicit hyperactivity only from the right hemisphere. The purpose of the present experiment was to determine whether unilateral lesions of catcchclamin (CA terminals in MPFC elicit an asymmetrical increase in locomotor activity, and whether this effect is dependent on norepinephrine (NE or DA terminals. Male Sprague-Dawley rats were housed in runningwheel cages for 21 days before and 30 days after receiving intracortical infections of the CA neurotoxin 6-hydroxydopaminc"n(6-0HDA, either with or without pre-treatment with desmcthylimipramine (DMI, a noradrcncrgic uptake blocker (n-? and 5 pair, respectively. Rats were paired according to baseline activity and alternate members of each pair lcsioncd in either the len or right MPFC. Lcsicncd animals not pretreated with OMI were significantly more active than pretreated rats, indicating that NE terminals were relatively more

  13. The effects of virgin coconut oil (VCO) as supplementation on quality of life (QOL) among breast cancer patients.

    Science.gov (United States)

    Law, Kim Sooi; Azman, Nizuwan; Omar, Eshaifol Azam; Musa, Muhammad Yusri; Yusoff, Narazah Mohd; Sulaiman, Siti Amrah; Hussain, Nik Hazlina Nik

    2014-08-27

    Breast cancer is the most common cancer amongst Malaysian women. Both the disease and its treatment can disrupt the lives of the woman and adversely affect all aspects of life and thus can alter a woman's quality of life. The aim of this study was to examine the effect of virgin coconut oil (VCO) on the quality of life (QOL) of patients diagnosed with breast cancer. This was a prospective study of breast cancer patients admitted into the Oncology Unit of Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. The sample consisted of 60 patients with stage III and IV breast cancer allocated to either an intervention group (n = 30) or a control group (n = 30) using a simple random table. QOL was evaluated from the first cycle of chemotherapy to the sixth cycle, and data were collected using a validated Bahasa Malaysia version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Breast Cancer Module (EORTC QLQ-C30) and its breast-specific module (QLQ-BR 23). The mean age of breast cancer patients was 50.2 (SD = 13.5) years. There were significant mean score differences for functioning and global QOL between groups (α sleep difficulties, and loss of appetite compared to the control group. Although there are deteriorations for sexual enjoyment, the intervention group exhibited improvement in breast functioning and symptom scores for body image, sexual function, future perspective, breast symptoms, and systemic therapy side effects. VCO consumption during chemotherapy helped improve the functional status and global QOL of breast cancer patients. In addition, it reduced the symptoms related to side effects of chemotherapy.

  14. A new test of the construct validity of the CarerQol instrument: Measuring the impact of informal care giving

    OpenAIRE

    Hoefman, Renske; van Exel, Job; Looren de Jong, Sandra; Orlewska, William Ken; Brouwer, Werner

    2011-01-01

    textabstractPurpose: Most economic evaluations of health care programmes do not consider the effects of informal care, while this could lead to suboptimal policy decisions. This study investigates the construct validity of the CarerQol instrument, which measures and values carer effects, in a new population of informal caregivers. Methods: A questionnaire was distributed by mail (n = 1,100, net response rate = 21%) to regional informal care support centers throughout the Netherlands. Two type...

  15. Munchausen syndrome by proxy presenting as hearing loss.

    Science.gov (United States)

    Ashraf, N; Thevasagayam, M S

    2014-06-01

    To review the diagnosis of Munchausen syndrome by proxy, a factitious disorder, in which symptoms are induced or feigned, usually in a child, by the caregiver. The involved caregiver seeks to gain attention or sympathy and often has a psychological need to maintain the sick role. We highlight the diagnostic difficulties and factors that may help with diagnosis in an otolaryngology setting. We present the case of Munchausen syndrome by proxy presenting with hearing loss in a five-year old boy, who was diagnosed eight years after his initial presentation. A literature review of Munchausen syndrome by proxy cases presenting with ENT symptoms is provided. Munchausen syndrome by proxy is a diagnosis that otolaryngologists should be aware of, particularly where recurrent or persistent illnesses in children, especially those involving otological symptoms, are refractory to the usual treatments.

  16. Proxy Perspectives about End-of-Life Care for Person’s with Cancer

    Science.gov (United States)

    Bakitas, Marie; Ahles, Tim A.; Skalla, Karen; Brokaw, Frances C.; Byock, Ira; Hanscom, Brett; Lyons, Kathleen Doyle; Hegel, Mark T.

    2013-01-01

    Background Each year more than one-half million people die from cancer in the United States. Despite progress in increasing access to palliative oncology services, end-of-life care still needs improvement. Measuring the quality of the end-of-life experience is difficult due to patient debility and reduced consciousness as death approaches. Family proxies have been proposed as valuable informants regarding the quality of end-of-life care. This paper describes family proxy perspectives on care at the end of life in patients who died from advanced cancer Methods In the context of a novel outpatient palliative care demonstration project, 125 family proxy respondents completed a structured survey by phone 3–6 months following patients’ death from breast, lung, or gastrointestinal cancer. Four key quality of care indicators were measured: decision-making and physician communication, location of death, hospice involvement, and end-of-life symptoms. Results Proxies reported that 80% of patients completed advance directives and about half of them were helpful in guiding care; communication with physicians about end-of-life treatment wishes occurred in 67%, but less than half actually made a plan with the physician to ensure that their wishes were followed; the majority died in their location of choice, most often at home; over half had hospice involvement for an average of 41.8 days prior to death; and during the last week of life the majority of patients experienced troublesome physical and emotional symptoms. Conclusions Measurement of proxy perspectives is feasible and these results provide actionable data for areas of improvement in palliative oncology care. PMID:18306393

  17. Proxy perspectives regarding end-of-life care for persons with cancer.

    Science.gov (United States)

    Bakitas, Marie; Ahles, Tim A; Skalla, Karen; Brokaw, Frances C; Byock, Ira; Hanscom, Brett; Lyons, Kathleen Doyle; Hegel, Mark T

    2008-04-15

    Each year, greater than a half million people die of cancer in the U.S. Despite progress in increasing access to palliative oncology services, end-of-life care still needs improvement. Measuring the quality of the end-of-life experience is difficult because of patient debility and reduced consciousness as death approaches. Family proxies have been proposed as valuable informants regarding the quality of end-of-life care. This article describes family proxy perspectives concerning care at the end of life in patients who died of advanced cancer. In the context of a novel outpatient palliative care demonstration project, 125 family proxy respondents completed a structured survey by telephone 3 months to 6 months after the patient's death from breast, lung, or gastrointestinal cancer. Four key quality of care indicators were measured: decision-making and physician communication, location of death, hospice involvement, and end-of-life symptoms. Proxies reported that 78% to 81% of patients completed at least 1 form of advance directive and approximately half of them were helpful in guiding care. Communication with physicians regarding end-of-life treatment wishes occurred in 67% of cases, but only 57% of the patients actually made a plan with their physician to ensure that their wishes were followed. The majority of patients died in their location of choice, most often at home, and greater than half had hospice involvement for an average of 41.8 days before death. During the last week of life, the majority of patients experienced troublesome physical and emotional symptoms. Measurement of proxy perspectives is feasible as an indicator of the quality of end-of-life care, and the results of the current study provide actionable data for areas of improvement in palliative oncology care.

  18. Creating meaningful cut-scores for Neuro-QOL measures of fatigue, physical functioning, and sleep disturbance using standard setting with patients and providers.

    Science.gov (United States)

    Cook, Karon F; Victorson, David E; Cella, David; Schalet, Benjamin D; Miller, Deborah

    2015-03-01

    To establish clinically relevant classifications of health outcome scores for four Neuro-QOL measures (lower extremity function, upper extremity function, fatigue, and sleep disturbance). We employed a modified educational standard-setting methodology to identify cut-scores for symptom severity. Clinical vignettes were developed to represent graduated levels of symptom severity. A clinician panel and a panel of persons with multiple sclerosis (PwMS) were recruited, and, in separate, 1-day meetings, the panelists identified adjacent vignettes they judged to represent the threshold between two levels of severity for a given domain (e.g., threshold between a vignette that indicated "no problems" with sleep and the adjacent one that represented "mild problems" with sleep). Working independently, each panel (PwMS and clinicians) reached consensus on its recommended thresholds for each of the four targeted measures. Cut-scores were defined as the mean location for each pair of threshold vignettes. PwMS and clinician panels derived identical thresholds for severity levels of lower extremity function and sleep disturbance, but slightly different ones for upper extremity function and fatigue. In every case of divergence, PwMS set higher thresholds for more severe classifications of symptoms (by 0.5 SDs) than did clinicians. The modified bookmarking method is effective for defining thresholds for symptom severity based on self-reported outcome scores and consensus judgments. Derived cut-scores and severity levels provide an interpretative context for Neuro-QOL scores. Future studies should explore whether these findings can be replicated and evaluate the validity of the classifications compared to external criteria.

  19. Acute kidney injury in a child: A case of Munchausen syndrome by proxy.

    Science.gov (United States)

    Mantan, Mukta; Dhingra, Dhulika; Gupta, Aditi; Sethi, Gulshan Rai

    2015-11-01

    Renal and urologic problems in pediatric condition falsification (PCF) or Munchausen by proxy (MSP) can result in serious diagnostic dilemma. Symptoms of hematuria, pyuria and recurrent urinary tract infections have occasionally been described. However, MSP presenting as azotemia has not been previously reported. We describe the case of an unfortunate boy who had to undergo unnecessary hemodialysis for persistent hyperkalemia and azotemia before a final diagnosis of the falsification of investigations by the parents was made.

  20. Acute kidney injury in a child: A case of Munchausen syndrome by proxy

    Directory of Open Access Journals (Sweden)

    Mukta Mantan

    2015-01-01

    Full Text Available Renal and urologic problems in pediatric condition falsification (PCF or Munchausen by proxy (MSP can result in serious diagnostic dilemma. Symptoms of hematuria, pyuria and recurrent urinary tract infections have occasionally been described. However, MSP presenting as azotemia has not been previously reported. We describe the case of an unfortunate boy who had to undergo unnecessary hemodialysis for persistent hyperkalemia and azotemia before a final diagnosis of the falsification of investigations by the parents was made.

  1. [A case of Munchausen Syndrome by proxy in the context of folie a famille].

    Science.gov (United States)

    Foto Özdemir, Dilşad; Gökler, Bahar; Evinç, Ş Gülin; Balseven Odabaşı, Aysun

    2013-01-01

    The occurrence of similar psychotic symptoms in two or more people is called shared paranoid disorder. In this disease, the person who exhibits psychotic symptoms first is the "primary patient". The symptoms are contracted by the other people through persuasion. This disorder is seen among people who share the same house or are emotionally bound. In some cases, shared paranoid disorder may include other diagnoses, such as Munchausen Syndrome. This report discusses the case of a six-year-old, sexually abused boy who, when admitted to the hospital at the age of 10, claimed to have been repeatedly sexually harassed by several different people. His family's frequent changes in hospitals, negative perceptions of and accusations against medical staff, and improper methods of responding to harassment led clinicians to a diagnosis of Munchausen by proxy syndrome. In addition, both parents believed the abuse story, suggesting a potential diagnosis of shared psychotic disorder. In the literature, Munchausen by proxy has rarely been reported with symptoms of sexual abuse. The psychotic symptoms were shared by the family, complicating the case. This report emphasizes that psychodynamic evaluations of Munchausen by proxy and shared psychotic disorder may be helpful in understanding underlying factors.

  2. The added value of quality of life (QoL) for prognosis of overall survival in patients with palliative hepatocellular carcinoma.

    Science.gov (United States)

    Diouf, Momar; Filleron, Thomas; Barbare, Jean-Claude; Fin, Loïc; Picard, Carl; Bouché, Olivier; Dahan, Laetitia; Paoletti, Xavier; Bonnetain, Franck

    2013-03-01

    Several prognostic classifications (PCs) have been developed for use in palliative care in patients with hepatocellular carcinoma (HCC). We have recently suggested that CLIP combined with WHO PS has the greatest discriminative power. We evaluated the prognostic value of quality of life (QoL) data and whether the latter could improve classification of palliative HCC patients. This was a reanalysis from the CHOC trial with an evaluation of the discriminative power for overall survival (OS) of the established CLIP/GRETCH/BCLC/BoBar prognostic systems alone and then in association with each of the following groups of parameters: selected clinical factors, QoL as continuous variables, dichotomized QoL, selected clinical factors and continuous QoL, selected clinical factors and dichotomized QoL. Baseline QoL was assessed using the EORTC QLQ-C30. Discriminative power was evaluated with the Harrell's C-index and net reclassification improvement. Quality of life was available in 79% of the patients (n=271). Univariate analysis revealed that better role functioning (HR=0.991 [0.987-0.995]) and better physical functioning (0.991 [0.984-0.997]) scores were associated with longer survival. In contrast, poorer score for fatigue (1.011 [1.006-1.015]) and diarrhoea (1.008 [1.002-1.013]) were associated with shorter survival. After adjustment for clinical and sociodemographic variables, only better role functioning score (0.993 [0.988-0.998]) was associated with longer survival. Adding oedema, hepatomegaly, fatigue and diarrhoea QoL scales to CLIP resulted in the best performance. Our results confirm that QoL scales are independent prognostic factors of OS in palliative HCC patients. Incorporation of QoL data improved all the studied PCs. Copyright © 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  3. The solar proxy κ1 Cet and the planetary habitability around the young Sun

    Science.gov (United States)

    do Nascimento, J.-D.; Vidotto, A. A.; Petit, P.; Folsom, C.; Porto de Mello, G. F.; Meibom, S.; Abrevaya, X. C.; Ribas, I.; Castro, M.; Marsden, S. C.; Morin, J.; Jeffers, S. V.; Guinan, E.; Bcool Collaboration

    2017-10-01

    Among the solar proxies, κ1 Cet, stands out as potentially having a mass very close to solar and a young age. We report magnetic field measurements and planetary habitability consequences around this star, a proxy of the young Sun when life arose on Earth. Magnetic strength was determined from spectropolarimetric observations and we reconstruct the large-scale surface magnetic field to derive the magnetic environment, stellar winds, and particle flux permeating the interplanetary medium around κ1 Cet. Our results show a closer magnetosphere and mass-loss rate 50 times larger than the current solar wind mass-loss rate when Life arose on Earth, resulting in a larger interaction via space weather disturbances between the stellar wind and a hypothetical young-Earth analogue, potentially affecting the habitability. Interaction of the wind from the young Sun with the planetary ancient magnetic field may have affected the young Earth and its life conditions.

  4. Proxy comparisons for Paleogene sea water temperature reconstructions

    Science.gov (United States)

    de Bar, Marijke; de Nooijer, Lennart; Schouten, Stefan; Ziegler, Martin; Sluijs, Appy; Reichart, Gert-Jan

    2017-04-01

    Several studies have reconstructed Paleogene seawater temperatures, using single- or multi-proxy approaches (e.g. Hollis et al., 2012 and references therein), particularly comparing TEX86 with foraminiferal δ18O and Mg/Ca. Whereas trends often agree relatively well, absolute temperatures can differ significantly between proxies, possibly because they are often applied to (extreme) climate events/transitions (e.g. Sluijs et al., 2011), where certain assumptions underlying the temperature proxies may not hold true. A more general long-term multi-proxy temperature reconstruction, is therefore necessary to validate the different proxies and underlying presumed boundary conditions. Here we apply a multi-proxy approach using foraminiferal calcite and organic proxies to generate a low-resolution, long term (80 Myr) paleotemperature record for the Bass River core (New Jersey, North Atlantic). Oxygen (δ18O), clumped isotopes (Δ47) and Mg/Ca of benthic foraminifera, as well as the organic proxies MBT'-CBT, TEX86H, U37K' index and the LDI were determined on the same sediments. The youngest samples of Miocene age are characterized by a high BIT index (>0.8) and fractional abundance of the C32 1,15-diol (>0.6; de Bar et al., 2016) and the absence of foraminifera, all suggesting high continental input and shallow depths. The older sediment layers (˜30 to 90 Ma) display BIT values and C32 1,15-diol fractional abundances global transition from the Cretaceous to Eocene greenhouse world into the icehouse climate. The TEX86H sea surface temperature (SST) record shows a gradual cooling over time of ˜35 to 20 ˚ C, whereas the δ18O-derived bottom water temperatures (BWTs) decrease from ˜20 to 10 ˚ C, and the Mg/Ca and Δ47-derived BWTs decrease from ˜25 to 15 ˚ C. The absolute temperature difference between the δ18O and Δ47, might be explained by local variations in seawater δ18O composition. Similarly, the difference in Mg/Ca- and δ18O-derived BWTs is likely caused by

  5. Time-and-ID-Based Proxy Reencryption Scheme

    Directory of Open Access Journals (Sweden)

    Kambombo Mtonga

    2014-01-01

    Full Text Available Time- and ID-based proxy reencryption scheme is proposed in this paper in which a type-based proxy reencryption enables the delegator to implement fine-grained policies with one key pair without any additional trust on the proxy. However, in some applications, the time within which the data was sampled or collected is very critical. In such applications, for example, healthcare and criminal investigations, the delegatee may be interested in only some of the messages with some types sampled within some time bound instead of the entire subset. Hence, in order to carter for such situations, in this paper, we propose a time-and-identity-based proxy reencryption scheme that takes into account the time within which the data was collected as a factor to consider when categorizing data in addition to its type. Our scheme is based on Boneh and Boyen identity-based scheme (BB-IBE and Matsuo’s proxy reencryption scheme for identity-based encryption (IBE to IBE. We prove that our scheme is semantically secure in the standard model.

  6. A new way to proxy levels of infrastructure development

    Directory of Open Access Journals (Sweden)

    Steve Pickering

    2017-01-01

    Full Text Available Researchers in many fields have needed to develop a measure of infrastructure, and many proxies have been used toward this end, such as night light data and the Digital Chart of the World. Yet there are issues in using these methods. This paper presents a new way of proxying infrastructure: analysing the file sizes of map images on the Bing, Google, OpenStreetMap and Sina websites. The paper also demonstrates four ways in which this can be achieved. This approach is by no means perfect and does not solve all of the difficulties presented by other methods. Nevertheless, it does provide a simple and functional alternative proxy for level of infrastructure development.

  7. Munchausen Syndrome By Proxy Admitting with Bloody Urine and Stool

    Directory of Open Access Journals (Sweden)

    Tugba Koca

    2014-02-01

    Full Text Available Munchausen syndrome by Proxy is a severe form of child abuse. Disease symptoms and signs are fabricated or imitated by parents or caregivers The child is usually presented to doctors, persistently. A delay in diagnosis may cause severe negative impact on spiritual, physical, mental and social development of the cases and even death. Symptoms usually disappear in the absence of the perpetrators. The diagnosis is extremely difficult. A 21-month-old boy who had applied to many centers due to bleeding from various parts of the body for last six months, and whose symptoms could not be explained with any physical reason after tests were conducted. Finally he was admitted to our center with bloody urine and stools, and diagnosed Munchausen syndrome by proxy. In cases with recurrent hospital admission in whom no apparent disease is diagnosed, Munchausen syndrome by Proxy should be among the differential diagnosis.

  8. Research on implementation of proxy Arp in IP DSLAM

    Science.gov (United States)

    Cheng, Chuanqing; Wang, Li; Huang, Qiugen

    2005-02-01

    While the ethernet is applied more and more in public network environment and xdsl service become the most common access mode ,IP kenel DSLAM undertakes some functions such as service distribution and convergence ,security management and customer management.Facing the contradiction of the need of port isolation and the shortage of ip address,VLAN aggregation technology is applied in DSLAM.How to implement the communicatio between the two vlan but share the same ip subnet,proxy arp does this. This paper introduces how to implement proxy arp in the DSLAM. TCP/IP communication detail procedure betweent two host ,the relation of VLAN and network segment are discussed. The proxy arp model and its implementation in IP DSLAM is also expatiated in this paper and a conformance tesing is given.

  9. Economic valuation of informal care: lessons from the application of the opportunity costs and proxy good methods

    NARCIS (Netherlands)

    van den Berg, Bernard; Brouwer, Werner; van Exel, Job; Koopmanschap, Marc; van den Bos, Geertrudis A. M.; Rutten, Frans

    2006-01-01

    This paper reports the results of the application of the opportunity costs and proxy good methods to determine a monetary value of informal care. We developed a survey in which we asked informal caregivers in The Netherlands to indicate the different types of time forgone (paid work, unpaid work and

  10. Transcultural adaptation and validation of the Celiac Disease Quality of Life (CD-QOL survey, a specific questionnaire to measure quality of life in patients with celiac disease

    Directory of Open Access Journals (Sweden)

    Francesc Casellas

    2013-12-01

    Full Text Available Introduction: celiac disease is a chronic condition that requires continued treatment, with the resultant impact on health-related quality of life (HRQOL of people who suffer it. Most studies in this field have used generic questionnaires to measure HRQOL in celiac patients. It was therefore decided to conduct a study to translate into Spanish and validate a specific questionnaire for celiac disease, the Celiac Disease Quality Of Life Survey (CD-QOL. Objectives: to translate and validate in Spanish the specific celiac disease questionnaire CD-QOL. Methods: a multicenter, prospective, observational study was designed consisting of two phases: In the first phase, the questionnaire was translated and adapted into Spanish using the translation/back translation procedure and an understandability study. In the second phase, internal consistency of the translated questionnaire was analyzed. For this, results of the CD-QOL were compared to those of EuroQol and the Daily Fatigue Impact Scale (D-FIS. Understandability of the translated and adapted questionnaire was tested in six patients, and the validation study was done in 298 celiac patients (201 treated with a gluten-free diet and 97 at diagnosis. Results: in both celiac groups, Cronbach's alpha coefficient was high (0.90, feasibility was excellent (99.2 % of patients completed all questions, and there were no ceiling and floor effects. Spearman correlation to EuroQol and D-FIS was statistically significant (p < 0.05. CD-QOL score was different depending on whether state of health was good, fair, or poor based on the EuroQol score. Conclusion: the Spanish version of the CD-QOL is a valid tool for measuring HRQOL in celiac patients.

  11. Personal goals and factors related to QoL in Dutch homeless people: what is the role of goal-related self-efficacy?

    Science.gov (United States)

    van der Laan, Jorien; Boersma, Sandra N; van Straaten, Barbara; Rodenburg, Gerda; van de Mheen, Dike; Wolf, Judith R L M

    2017-05-01

    Very little is known about the personal goals of homeless people and how these relate to their quality of life (QoL). By using survey data on 407 homeless adults upon entry to the social relief system in 2011, we examined the personal goals of homeless adults and the association between their perceived goal-related self-efficacy and their QoL. A hierarchical regression analysis was used to analyse the association between QoL and goal-related self-efficacy, relative to factors contributing to QoL, such as demographic characteristics, socioeconomic resources, health and service use. Results indicate that the majority of homeless adults had at least one personal goal for the coming 6 months and that most goals concerned housing and daily life (94.3%) and finances (83.6%). The QoL of homeless adults appeared to be lower in comparison with general population samples. General goal-related self-efficacy was positively related to QoL (β = 0.09, P = 0.042), independent of socioeconomic resources (i.e. income and housing), health and service use. The strongest predictors of QoL were psychological distress (β = -0.45, P goals regarding socioeconomic resources and their goal-related self-efficacy is positively related to QoL. It is therefore important to take the personal goals of homeless people as the starting point of integrated service programmes and to promote their goal-related self-efficacy by strength-based interventions. © 2017 John Wiley & Sons Ltd.

  12. Health anxiety by proxy in women with severe health anxiety

    DEFF Research Database (Denmark)

    Thorgaard, Mette Viller; Frostholm, Lisbeth; Walker, Lynn

    2017-01-01

    Health anxiety (HA) refers to excessive worries and anxiety about harbouring serious illness based on misinterpretation of bodily sensations or changes as signs of serious illness. Severe HA is associated with disability and high health care costs. However, the impact of parental HA on excessive...... concern with their children's health (health anxiety by proxy) is scantly investigated. The aim of this study is to investigate HA by proxy in mothers with severe HA. Fifty mothers with severe HA and two control groups were included, i.e. mothers with rheumatoid arthritis (N = 49) and healthy mothers (N...

  13. Home-based walking improves cardiopulmonary function and health-related QOL in community-dwelling adults.

    Science.gov (United States)

    Okamoto, N; Nakatani, T; Morita, N; Saeki, K; Kurumatani, N

    2007-12-01

    The objective of our study was to investigate the effects of a home-based walking program on physical fitness and QOL among community residents. Subjects (n = 200, mean age: 64.2 years, range: 42 - 75 years) who participated in the 32-week trial were randomly allocated to one of two groups: an exercise (E) group and a control (C) group. The E group was instructed to increase the number of steps a day that they walked and to perform aerobic walking at a target heart rate for 20 minutes or more daily, 2 or more days a week. The C group was told to continue their normal level of activity. Outcome measures were the 3-minute shuttle stamina walk test (SSWT), 30-second chair-stand test (CS-30), and SF-36. Increases in SSWT values were significantly greater in the E group than in the C group (men 24.1 m vs. 6.3 m; women 8.8 m vs. 2.4 m), as were increases in CS-30 values (men 5.9 vs. 2.6; women 4.5 vs. - 0.1). On the SF-36, the scores in the E group for vitality and mental health increased significantly. Home-based walking is considered to be an effective and feasible method to improve physical fitness and QOL among community residents.

  14. Simulated airplane headache: a proxy towards identification of underlying mechanisms.

    Science.gov (United States)

    Bui, Sebastian Bao Dinh; Petersen, Torben; Poulsen, Jeppe Nørgaard; Gazerani, Parisa

    2017-12-01

    Airplane Headache (AH) occurs during flights and often appears as an intense, short lasting headache during take-off or landing. Reports are limited on pathological mechanisms underlying the occurrence of this headache. Proper diagnosis and treatments would benefit from identification of potential pathways involved in AH pathogenesis. This study aimed at providing a simulated airplane headache condition as a proxy towards identification of its underlying mechanisms. Fourteen participants including 7 volunteers suffering from AH and 7 healthy matched controls were recruited after meeting the diagnostic and safety criteria based on an approved study protocol. Simulation of AH was achieved by entering a pressure chamber with similar characteristics of an airplane flight. Selected potential biomarkers including salivary prostaglandin E2 (PGE2), cortisol, facial thermo-images, blood pressure, pulse, and saturation pulse oxygen (SPO) were defined and values were collected before, during and after flight simulation in the pressure chamber. Salivary samples were analyzed with ELISA techniques, while data analysis and statistical tests were handled with SPSS version 22.0. All participants in the AH-group experienced a headache attack similar to AH experience during flight. The non-AH-group did not experience any headaches. Our data showed that the values for PGE2, cortisol and SPO were significantly different in the AH-group in comparison with the non-AH-group during the flight simulation in the pressure chamber. The pressure chamber proved useful not only to provoke AH-like attack but also to study potential biomarkers for AH in this study. PGE2, and cortisol levels together with SPO presented dysregulation during the simulated AH-attack in affected individuals compared with healthy controls. Based on these findings we propose to use pressure chamber as a model to induce AH, and thus assess new potential biomarkers for AH in future studies.

  15. [Validation of the Quality of Life in Alzheimer's Disease (QOL-AD) scale in Mexican patients with Alzheimer, vascular and mixed-type dementia].

    Science.gov (United States)

    Rosas-Carrasco, Oscar; Torres-Arreola, Laura del Pilar; Guerra-Silla, M de Guadalupe; Torres-Castro, Sara; Gutierrez-Robledo, Luis Miguel

    2010-07-16

    To adapt the Quality of Life in Alzheimer's Disease (QOL-AD) scale to Spanish, as well as to evaluate its reliability and validity in Mexico. The study involved a sample of 114 patients diagnosed with Alzheimer, vascular and mixed-type dementia, according to the criteria of the National Institute for Neurological and Communicative Disorders/Stroke-Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA), the National Institute of Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) and the Alzheimer's Disease Diagnostic and Treatment Centers (ADDTC), respectively. Their primary caregivers (n = 114) and a control group (n = 30) of persons aged 60 or over without dementia and their closest relatives were also evaluated. The total group with dementia obtained a mean age and a standard deviation of 80.15 +/- 7.13. The Folstein minimental test was 18.55 +/- 4.99. We obtained a Cronbach's alpha of 0.88 for the patient version of the QOL-AD (QOL-ADp) and 0.82 for the caregiver version of the QOL-AD (QOL-ADc). The test-retest yielded an intraclass correlation coefficient of 0.9 (p dementia and the control group. The QOL-AD yielded satisfactory results in terms of internal and external reliability, validity between measurements and between known groups. Thus, we can recommend its use to evaluate the quality of life of patients with dementia.

  16. Biomarker Proxy Calibration Along the AMT Transect: Alkenone Uk37' and δD

    Science.gov (United States)

    Gould, J.; Kienast, M.; Dowd, M.; Schefuß, E.

    2016-12-01

    This study analyzes 60 suspended particulate organic matter (SPOM) samples from an Atlantic Meridional Transect (AMT20), spanning approximately 105° latitude (Southampton to Punta Arenas), for key biomarker proxy signatures: alkenone unsaturation (Uk37') and hydrogen isotopic (δD) composition. The wide range in surface ocean characteristics along the transect offers a unique opportunity to refine our understanding of these proxies. Initial alkenone δD values correlate - to a first order - with water column δD signatures, which in turn parallel salinity values along the AMT20 transect. Other factors that have been shown to influence δD will be discussed as well. The Uk37' data presented are in good agreement with previously published SPOM data, though we offer an alternative regression model to relate Uk37' to sea surface temperatures (SST); the Richards curve (Richards, 1959). This non-linear regression model uniquely accounts for both the fact that the Uk37' index is a proportion, and so must lie between 0 and 1, as well as for an apparent reduction in slope at temperature extremes. The inverse of this relationship allows estimation of SST from a measured Uk37' value with quantitative estimates of uncertainty. Further, we have identified a pronounced seasonal sampling bias in the SPOM dataset analyzed in this and prior studies (e.g. Conte et al. 2006), which may be contributing to a reported offset between surface particulate and core-top Uk37'- SST calibrations for this proxy.

  17. Comparing Sunspot Area and Sunspot Number as Proxies for Long-term Solar Irradiance Variation

    Science.gov (United States)

    Jordan, Stuart D.; Garcia, A. G.; Oegerle, William (Technical Monitor)

    2002-01-01

    Because relevant observations from space began only in 1979 with Nimbus-7, it is impossible to correlate direct measurements of small changes in solar irradiance with terrestrial temperature over a number of solar cycles. Yet there is recent evidence that some feature of solar change over a cycle may have a larger influence on climate than would result from merely introducing the additional amount of heat delivered to Earth's atmosphere at solar minimum. It would be useful to check this possibility over several solar cycles. To do this, we would need a sufficiently reliable proxy for irradiance change that at least survives a test against the space observations. Sunspot area is a fairly straightforward parameter to measure, and is associated with the extent of magnetic activity known to correlate strongly with solar irradiance change. We have tested the use of sunspot area as a long-term proxy for solar irradiance change, using observations made at the Coimbra Solar Observatory, from which we obtain both statistically weighted sunspot numbers and sunspot areas over the period 1980-1992. These are both correlated with solar irradiance values measured from Nimbus-7 spacecraft over the same time period, to see if sunspot area offers affords a strong positive correlation and also a distinct advantage over sunspot number as a useful proxy that can then be compared with terrestrial temperature records. Preliminary results yield a positive correlation of 0.71 for sunspot area, but further tests are being conducted and will be reported.

  18. Slices: A shape-proxy based on planar sections

    KAUST Repository

    McCrae, James

    2011-12-01

    Minimalist object representations or shape-proxies that spark and inspire human perception of shape remain an incompletely understood, yet powerful aspect of visual communication. We explore the use of planar sections, i.e., the contours of intersection of planes with a 3D object, for creating shape abstractions, motivated by their popularity in art and engineering. We first perform a user study to show that humans do define consistent and similar planar section proxies for common objects. Interestingly, we observe a strong correlation between user-defined planes and geometric features of objects. Further we show that the problem of finding the minimum set of planes that capture a set of 3D geometric shape features is both NP-hard and not always the proxy a user would pick. Guided by the principles inferred from our user study, we present an algorithm that progressively selects planes to maximize feature coverage, which in turn influence the selection of subsequent planes. The algorithmic framework easily incorporates various shape features, while their relative importance values are computed and validated from the user study data. We use our algorithm to compute planar slices for various objects, validate their utility towards object abstraction using a second user study, and conclude showing the potential applications of the extracted planar slice shape proxies.

  19. Proxy indicators as measure of local economic dispositions in South ...

    African Journals Online (AJOL)

    Even though South Africa is in a more fortunate position with regard to the availability of such data, it also has data gaps, notably with regard to informal economic activities in the rural areas of the country. This exploratory article engages the use of proxy indicators to provide cues as to the state of a local economy.

  20. Proxy indicators as measure of local economic dispositions in South ...

    African Journals Online (AJOL)

    The growth of spare-part sales mirrors the behaviour of the national economy more accurately than used and new vehicles. BER: Retail Survey. (2005-2010). Used vehicles. 0.53. Spare Parts. 0.80. Banking-related proxy indicators. 13. House bonds. 0.43. Although some similarities exist between the national economy and ...

  1. Identifying and Responding to Munchausen Syndrome by Proxy.

    Science.gov (United States)

    Pearl, Peggy T.

    1995-01-01

    Defines Munchausen Syndrome by Proxy in children up to eight years, in which the mother falsifies illness in her child by simulating or producing illness, bringing about frequent hospitalizations, painful tests, potentially harmful treatment, and in extreme cases, death. Describes symptoms and suggested professional actions. (DR)

  2. Munchausen by Proxy Victims in Adulthood: A First Look.

    Science.gov (United States)

    Libow, Judith A.

    1995-01-01

    Childhood experiences and long-term psychological outcomes were investigated with 10 adults, ages 33 through 71, who were self-identified victims of illness fabrication by a parent (Munchausen by Proxy). During childhood they felt unloved and unsafe and had emotional and physical problems. As adults, problems included insecurity, reality-testing…

  3. Munchausen Syndrome by Proxy (MSBP): An Intergenerational Perspective.

    Science.gov (United States)

    Rappaport, Sol R.; Hochstadt, Neil J.

    1993-01-01

    Presents new information about Munchausen Syndrome by Proxy (MSBP), factitious disorder in which caretaker may induce or exaggerate medical illness in his or her child that may lead to illness and even death. Provides psychosocial history of caregiver using intergenerational model. Presents case of MSBP involving three siblings and information…

  4. Shareholder Activism through Proxy Proposals : The European Perspective

    NARCIS (Netherlands)

    Cziraki, P.; Renneboog, L.D.R.; Szilagyi, P.G.

    2009-01-01

    This paper is the first to investigate the corporate governance role of shareholderinitiated proxy proposals in European firms. While proposals in the US are nonbinding even if they pass the shareholder vote, they are legally binding in the UK and most of Continental Europe. Nonetheless, submissions

  5. A comparison of Solar proxy-magnetometry diagnostics

    NARCIS (Netherlands)

    Leenaarts, J.|info:eu-repo/dai/nl/304837946; Rutten, R.J.|info:eu-repo/dai/nl/074143662; Carlsson, M.; Uitenbroek, H.

    2006-01-01

    Aims. We test various proxy-magnetometry diagnostics, i.e., brightness signatures of small-scale magnetic elements, for studying magnetic field structures in the solar photosphere. Methods. Images are numerically synthesized from a 3D solar magneto-convection simulation for, respectively, the G band

  6. Munchausen by Proxy (MBP) Maltreatment: An International Educational Challenge.

    Science.gov (United States)

    Lasher, Louisa J.

    2003-01-01

    This article is an introduction to a special section on Munchausen Syndrome by Proxy (MSBP) as a form of child maltreatment. In MSBP the perpetrator has deliberately induced, fabricated, or exaggerated a physical and/or psychological-behavioral-mental health problem in another. The article stresses the importance of obtaining an MSBP finding of…

  7. Multi-proxy evidence of long-term changes in ecosystem structure in a Danish marine estuary, linked to increased nutrient loading

    DEFF Research Database (Denmark)

    Ellegaard, Marianne; Clarke, A.L.; Reuss, Nina Steenberg

    2006-01-01

    and prompting debate on the causes. This paper reports a multi-proxy survey of 210Pb-dated sediment cores from the anoxic basin. Analyses of diatoms, dinoflagellates, pigments and geochemical proxies were used to determine changes in ecosystem structure over the past 100 years. The aim was to establish ‘base......-line conditions', for management purposes, of the biological structure prior to 1900, and to examine possible causes of changes observed. Geochemical proxies total nitrogen (TN), total carbon (TC) and biogenic silica (BSi) were consistently high throughout the sediment record. Increased concentrations of pigments...... and natural isotopes (d13C, d15N) suggested increasing production and nutrient loading. The main changes in the biological proxies occurred between 1915 and the 1940s, and indicated that the estuary has been somewhat eutrophic since 1900, but that the eutrophication process increased over the past 100 years...

  8. Sustained informal care: the feasibility, construct validity and test-retest reliability of the CarerQol-instrument to measure the impact of informal care in long-term care.

    Science.gov (United States)

    Hoefman, Renske J; van Exel, N Job A; Foets, Marleen; Brouwer, Werner B F

    2011-11-01

    This study analyses feasibility, construct validity and test-retest reliability of the Care-related Quality of Life (CarerQol)-instrument among informal caregivers of long-term care (LTC) users. The CarerQol measures the impact of informal care by assessing happiness (CarerQol-VAS) and describing burden dimensions (CarerQol-7D). Data was gathered among informal caregivers of patients obtaining day care or living in a LTC facility in the Netherlands with two questionnaires sent with a two-week interval (n test = 108, n retest = 100). Percentages of missing values indicated feasibility of the CarerQol. Construct validity assessed the extent to which differences in background characteristics were reflected in happiness scores (CarerQol-VAS) with univariate and multivariate statistics. Additionally, construct validity was tested with assessing the correlation between the CarerQol and the Self-Rated Burden (SRB) scale. Percentages of complete agreement between CarerQol scores at test and retest, Cohen's kappa coefficients (κ value) and Intraclass Correlation Coefficients (ICCs) were used to assess reliability. In this study, 3.7% was missing on the CarerQol. CarerQol-VAS was positively associated with caregivers' age and health, and negatively with SRB score. The percentage of complete agreement of CarerQol-VAS between the measure moments was 60% and between 76% and 96% for CarerQol-7D. κ value and ICC of CarerQol-VAS were 0.52 and 0.86, and ranged between 0.55 and 0.94 for CarerQol-7D. The CarerQol measures the impact of informal care among carers of LTC users in a feasible, valid and reliable way.

  9. On the use of human mobility proxies for modeling epidemics.

    Directory of Open Access Journals (Sweden)

    Michele Tizzoni

    2014-07-01

    Full Text Available Human mobility is a key component of large-scale spatial-transmission models of infectious diseases. Correctly modeling and quantifying human mobility is critical for improving epidemic control, but may be hindered by data incompleteness or unavailability. Here we explore the opportunity of using proxies for individual mobility to describe commuting flows and predict the diffusion of an influenza-like-illness epidemic. We consider three European countries and the corresponding commuting networks at different resolution scales, obtained from (i official census surveys, (ii proxy mobility data extracted from mobile phone call records, and (iii the radiation model calibrated with census data. Metapopulation models defined on these countries and integrating the different mobility layers are compared in terms of epidemic observables. We show that commuting networks from mobile phone data capture the empirical commuting patterns well, accounting for more than 87% of the total fluxes. The distributions of commuting fluxes per link from mobile phones and census sources are similar and highly correlated, however a systematic overestimation of commuting traffic in the mobile phone data is observed. This leads to epidemics that spread faster than on census commuting networks, once the mobile phone commuting network is considered in the epidemic model, however preserving to a high degree the order of infection of newly affected locations. Proxies' calibration affects the arrival times' agreement across different models, and the observed topological and traffic discrepancies among mobility sources alter the resulting epidemic invasion patterns. Results also suggest that proxies perform differently in approximating commuting patterns for disease spread at different resolution scales, with the radiation model showing higher accuracy than mobile phone data when the seed is central in the network, the opposite being observed for peripheral locations. Proxies

  10. On the use of human mobility proxies for modeling epidemics.

    Science.gov (United States)

    Tizzoni, Michele; Bajardi, Paolo; Decuyper, Adeline; Kon Kam King, Guillaume; Schneider, Christian M; Blondel, Vincent; Smoreda, Zbigniew; González, Marta C; Colizza, Vittoria

    2014-07-01

    Human mobility is a key component of large-scale spatial-transmission models of infectious diseases. Correctly modeling and quantifying human mobility is critical for improving epidemic control, but may be hindered by data incompleteness or unavailability. Here we explore the opportunity of using proxies for individual mobility to describe commuting flows and predict the diffusion of an influenza-like-illness epidemic. We consider three European countries and the corresponding commuting networks at different resolution scales, obtained from (i) official census surveys, (ii) proxy mobility data extracted from mobile phone call records, and (iii) the radiation model calibrated with census data. Metapopulation models defined on these countries and integrating the different mobility layers are compared in terms of epidemic observables. We show that commuting networks from mobile phone data capture the empirical commuting patterns well, accounting for more than 87% of the total fluxes. The distributions of commuting fluxes per link from mobile phones and census sources are similar and highly correlated, however a systematic overestimation of commuting traffic in the mobile phone data is observed. This leads to epidemics that spread faster than on census commuting networks, once the mobile phone commuting network is considered in the epidemic model, however preserving to a high degree the order of infection of newly affected locations. Proxies' calibration affects the arrival times' agreement across different models, and the observed topological and traffic discrepancies among mobility sources alter the resulting epidemic invasion patterns. Results also suggest that proxies perform differently in approximating commuting patterns for disease spread at different resolution scales, with the radiation model showing higher accuracy than mobile phone data when the seed is central in the network, the opposite being observed for peripheral locations. Proxies should therefore be

  11. The effectiveness of integrated care interventions in improving patient quality of life (QoL) for patients with chronic conditions. An overview of the systematic review evidence.

    Science.gov (United States)

    Flanagan, Sarah; Damery, Sarah; Combes, Gill

    2017-09-29

    To determine the effectiveness of integrated care interventions in improving the Quality of Life (QoL) for patients with chronic conditions. A review of the systematic reviews evidence (umbrella review). Medline, Embase, ASSIA, PsychINFO, HMIC, CINAHL, Cochrane Library (including HTA database), DARE, and Cochrane Database of Systematic Reviews), EPPI-Centre, TRIP and Health Economics Evaluations databases. Reference lists of included reviews were searched for additional references not returned by electronic searches. English language systematic reviews or meta-analyses published since 2000 that assessed the effectiveness of interventions in improving the QoL of patients with chronic conditions. Two reviewers independently assessed reviews for eligibility, extracted data, and assessed the quality of included studies. A total of 41 reviews assessed QoL. Twenty one reviews presented quantitative data, 17 reviews were narrative and three were reviews of reviews. The intervention categories included case management, Chronic care model (CCM), discharge management, multidisciplinary teams (MDT), complex interventions, primary vs. secondary care follow-up, and self-management. Taken together, the 41 reviews that assessed QoL provided a mixed picture of the effectiveness of integrated care interventions. Case management interventions showed some positive findings as did CCM interventions, although these interventions were more likely to be effective when they included a greater number of components. Discharge management interventions appeared to be particularly successful for patients with heart failure. MDT and self-management interventions showed a mixed picture. In general terms, interventions were typically more effective in improving condition-specific QoL rather than global QoL. This review provided the first overview of international evidence for the effectiveness of integrated care interventions for improving the QoL for patients with chronic conditions.

  12. Translation and validation of the Uterine Fibroid Symptom and Quality of Life (UFS-QOL questionnaire for the Brazilian Portuguese language

    Directory of Open Access Journals (Sweden)

    Luiz Gustavo Oliveira Brito

    2017-03-01

    Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: Uterine fibroids (UF, also known as leiomyomas, are the most prevalent gynecological tumors. The Uterine Fibroid Symptoms and Quality of Life (UFS-QOL is the only specific questionnaire that assesses symptom intensity and quality-of-life issues for women with symptomatic UF; however, it only exists in the English language. Thus, we aimed to translate and culturally validate the UFS-QOL questionnaire for the Brazilian Portuguese language. DESIGN AND SETTING: Cross-sectional study, Department of Gynecology and Obstetrics, FMRP-USP. METHODS: 113 patients with UF (case group and 55 patients without UF (control group were interviewed using the UFS-QOL questionnaire after translation and cultural adaptation. The Short Form-36 questionnaire was used as a control. Demographic and psychometric variables were analyzed. RESULTS: Women with UF presented higher mean age, body mass index, weight, parity and comorbidities than the control group (P < 0.05. The most prevalent complaints were abnormal uterine bleeding (93.8%, pelvic pain (36.3% and extrinsic compression (10.6% and these presented adequate construct validity regarding UFS-QOL severity (P < 0.05. The UFS-QOL questionnaire presented good internal consistency regarding symptom severity and quality-of-life-related domains (intraclass correlation coefficient, ICC = 0.82/0.88. Structural validity presented correlation coefficients ranging from 0.59 to 0.91. Test-retest comparison did not show differences among the UFS-QOL subscales. After treatment, women with UF presented improvements on all subscales. CONCLUSION: The UFS-QOL questionnaire presented adequate translation to the Brazilian Portuguese language, with good internal consistency, discriminant validity, construct validity, structural validity and responsiveness, along with adequate test-retest results.

  13. SRH and HrQOL: does social position impact differently on their link with health status?

    Directory of Open Access Journals (Sweden)

    Delpierre Cyrille

    2012-01-01

    Full Text Available Abstract Background Self-rated Health (SRH and health-related quality of life (HRQoL are used to evaluate health disparities. Like all subjective measures of health, they are dependent on health expectations that are associated with socioeconomic characteristics. It is thus needed to analyse the influence played by socioeconomic position (SEP on the relationship between these two indicators and health conditions if we aim to use them to study health disparities. Our objective is to assess the influence of SEP on the relationship between physical health status and subjective health status, measured by SRH and HRQoL using the SF-36 scale. Methods We used data from the French National Health Survey. SEP was assessed by years of education and household annual income. Physical health status was measured by functional limitations and chronic low back pain. Results Regardless of their health status, people with lower SEP were more likely than their more socially advantaged counterparts to report poor SRH and poorer HRQoL, using any of the indicators of SEP. The negative impact of chronic low back pain on SRH was relatively greater in people with a high SEP than in those with a low SEP. In contrast, chronic low back pain and functional limitations had less impact on physical and mental component scores of quality of life for socially advantaged men and women. Conclusions Both SRH and HRQoL were lower among those reporting functional limitations or chronic low back pain. However, the change varied according SEP and the measure. In relative term, the negative impact of a given health condition seems to be greater on SRH and lower on HRQoL for people with higher SEP in comparison with people with low SEP. Using SRH could thus decrease socioeconomic differences. In contrast using HRQoL could increase these differences, suggesting being cautious when using these indicators for analyzing health disparities.

  14. HD-PRO-TRIAD™ Validation: a Patient-Reported Instrument for the Symptom Triad of Huntington Disease

    Directory of Open Access Journals (Sweden)

    Noelle E. Carlozzi

    2014-04-01

    Full Text Available Background: Few valid, disease‐specific measures of health‐related quality of life (HRQOL capture the spectrum of symptoms associated with Huntington's disease (HD. The HD‐PRO‐TRIAD™ is a new, HD‐specific, patient‐reported outcome (PRO instrument of the HD symptom triad (cognitive decline, emotional/behavioral dyscontrol, and motor dysfunction designed for clinical research and practice. The objective was to validate the HD‐PRO‐TRIAD™ through a cross‐sectional sample of individuals with HD and caregivers.Methods: Development of the HD‐PRO‐TRIAD™ has been described elsewhere. A total of 132 individuals with HD and 40 HD caregivers, comprising 29 dyads, participated in the cross‐sectional psychometric validation of this instrument. Participants provided responses to the HD‐PRO‐TRIAD™ and other HRQOL and disease severity instruments (EuroQOL 5D, Short Form 12, Neuro‐QOL Item Banks, PROMIS Global Health, and self‐reported Unified Huntington's Disease Rating Scale Total Functional Capacity and Independence Scales. Internal consistency, construct validity, and patient–caregiver proxy consistency were evaluated. Results: Internal consistency of the three domains and overall HD‐PRO‐TRIAD™ instrument was supported by Cronbach's alpha values ≥0.94. Construct validity was supported by significant correlations between HD‐PRO‐TRIAD™ domain scores and other measures of the same domains (e.g., significant positive correlations between HD‐PRO‐TRIAD™ Anxiety with Neuro‐QOL Anxiety, as well as slightly weaker but still strong correlations with other HRQOL instruments (e.g., HD‐PRO‐TRIAD™ Anxiety and UHDRS Independence; all p<0.01. Consistency between patient self‐report and caregiver proxy report was supported by an intra‐class correlation coefficient ≥0.92 for all three domains and the overall instrument.Discussion: These data indicate that HD‐PRO‐TRIAD™ is a reliable and

  15. A case with unexplained bleeding from multiple sites: munchausen syndrome by proxy.

    Science.gov (United States)

    Tüfekçi, Özlem; Gözmen, Salih; Yılmaz, Şebnem; Hilkay Karapınar, Tuba; Çetin, Benhur; Burak Dursun, Onur; Emiroğlu, Neslihan; Ören, Hale; Irken, Gülersu

    2011-08-01

    Munchausen syndrome by proxy (MBP) is an extreme form of child abuse where children were unnecessarily treated or investigated for medical conditions that were falsified by their caregivers. Here the authors report a 16-year-old female with the complaints of bleeding from multiple and unusual sites, including hemoptysis, hematuria, bloody tears, and bloody nipple discharge, all of which are only witnessed by her mother. Extensive investigation revealed no organic etiologies for bleeding. The diagnosis of MBP was put by a multidisciplinary team. The diagnosis of MBP must be kept in mind in conditions where there is no underlying organic pathology in a bleeding patient.

  16. [Fortuitous discovery of intracerebral foreign body leads to the diagnosis of Munchausen syndrome by proxy].

    Science.gov (United States)

    Bouaziz Abed, A; Mustapha, R; Chiha, M

    2011-11-01

    An intracerebral foreign body is a rare situation in childhood. It often occurs accidentally with transorbital or more rarely transnasal penetration. We report the case of a child who had been followed since the age of 2.5 months for chronic vomiting without failure to thrive. The fortuitous discovery at 22 months of age of a 4.5-cm-long sewing needle in his brain probably introduced via the fontanel led us to the diagnosis of Munchausen syndrome by proxy. Copyright © 2011. Published by Elsevier SAS.

  17. Mobile Multicast in Hierarchical Proxy Mobile IPV6

    Science.gov (United States)

    Hafizah Mohd Aman, Azana; Hashim, Aisha Hassan A.; Mustafa, Amin; Abdullah, Khaizuran

    2013-12-01

    Mobile Internet Protocol Version 6 (MIPv6) environments have been developing very rapidly. Many challenges arise with the fast progress of MIPv6 technologies and its environment. Therefore the importance of improving the existing architecture and operations increases. One of the many challenges which need to be addressed is the need for performance improvement to support mobile multicast. Numerous approaches have been proposed to improve mobile multicast performance. This includes Context Transfer Protocol (CXTP), Hierarchical Mobile IPv6 (HMIPv6), Fast Mobile IPv6 (FMIPv6) and Proxy Mobile IPv6 (PMIPv6). This document describes multicast context transfer in hierarchical proxy mobile IPv6 (H-PMIPv6) to provide better multicasting performance in PMIPv6 domain.

  18. How different proxies record precipitation variability over southeastern South America

    Energy Technology Data Exchange (ETDEWEB)

    Chiessi, Cristiano M; Mulitza, Stefan; Paetzold, Juergen; Wefer, Gerold, E-mail: chiessi@uni-bremen.d [MARUM-Center for Marine Environmental Sciences, University of Bremen, Leobener Strasse, 28359 Bremen (Germany)

    2010-03-15

    Detrending natural and anthropogenic components of climate variability is arguably an issue of utmost importance to society. To accomplish this issue, one must rely on a comprehensive understanding of the natural variability of the climate system on a regional level. Here we explore how different proxies (e.g., stalagmite oxygen isotopic composition, pollen percentages, bulk sediment elemental ratios) record Holocene precipitation variability over southeastern South America. We found a general good agreement between the different records both on orbital and centennial time-scales. Dry mid Holocene, and wet late Holocene, Younger Dryas and a period between {approx}9.4 and 8.12 cal kyr BP seem to be pervasive features. Moreover, we show that proxy-specific sensitivity can greatly improve past precipitation reconstructions.

  19. A comparison of proxy performance in coral biodiversity monitoring

    Science.gov (United States)

    Richards, Zoe T.

    2013-03-01

    The productivity and health of coral reef habitat is diminishing worldwide; however, the effect that habitat declines have on coral reef biodiversity is not known. Logistical and financial constraints mean that surveys of hard coral communities rarely collect data at the species level; hence it is important to know if there are proxy metrics that can reliably predict biodiversity. Here, the performances of six proxy metrics are compared using regression analyses on survey data from a location in the northern Great Barrier Reef. Results suggest generic richness is a strong explanatory variable for spatial patterns in species richness (explaining 82 % of the variation when measured on a belt transect). The most commonly used metric of reef health, percentage live coral cover, is not positively or linearly related to hard coral species richness. This result raises doubt as to whether management actions based on such reefscape information will be effective for the conservation of coral biodiversity.

  20. Munchausen syndrome and Munchausen syndrome by proxy in dermatology.

    Science.gov (United States)

    Boyd, Alan S; Ritchie, Coleman; Likhari, Sunaina

    2014-08-01

    Patients with Munchausen syndrome purposefully injure themselves, often with the injection of foreign materials, to gain hospital admission and the attention associated with having a difficult-to-identify condition. Munchausen syndrome by proxy occurs when a child's caregiver, typically the mother, injures the child for the same reasons. Cases of Munchausen syndrome and Munchausen syndrome by proxy with primary cutaneous involvement appear to be rarely described in the literature suggesting either that diagnosis is not made readily or that it is, in fact, an uncommon disorder. At the center of both conditions is significant psychological pathology and treatment is difficult as many patients with Munchausen syndrome when confronted with these diagnostic possibilities simply leave the hospital. Little is known about the long-term outcome or prognosis of these patients. Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  1. Proxy-SU(3) symmetry in heavy deformed nuclei

    Science.gov (United States)

    Bonatsos, Dennis; Assimakis, I. E.; Minkov, N.; Martinou, Andriana; Cakirli, R. B.; Casten, R. F.; Blaum, K.

    2017-06-01

    Background: Microscopic calculations of heavy nuclei face considerable difficulties due to the sizes of the matrices that need to be solved. Various approximation schemes have been invoked, for example by truncating the spaces, imposing seniority limits, or appealing to various symmetry schemes such as pseudo-SU(3). This paper proposes a new symmetry scheme also based on SU(3). This proxy-SU(3) can be applied to well-deformed nuclei, is simple to use, and can yield analytic predictions. Purpose: To present the new scheme and its microscopic motivation, and to test it using a Nilsson model calculation with the original shell model orbits and with the new proxy set. Method: We invoke an approximate, analytic, treatment of the Nilsson model, that allows the above vetting and yet is also transparent in understanding the approximations involved in the new proxy-SU(3). Results: It is found that the new scheme yields a Nilsson diagram for well-deformed nuclei that is very close to the original Nilsson diagram. The specific levels of approximation in the new scheme are also shown, for each major shell. Conclusions: The new proxy-SU(3) scheme is a good approximation to the full set of orbits in a major shell. Being able to replace a complex shell model calculation with a symmetry-based description now opens up the possibility to predict many properties of nuclei analytically and often in a parameter-free way. The new scheme works best for heavier nuclei, precisely where full microscopic calculations are most challenged. Some cases in which the new scheme can be used, often analytically, to make specific predictions, are shown in a subsequent paper.

  2. Law Enforcement Proxies Matter for the Law and Finance Nexus

    OpenAIRE

    Valentin Toci; Iraj Hashi

    2013-01-01

    The paper employs various measures of law enforcement to provide new evidence on the importance of legal institutions for different dimensions of financial development in transition economies. It offers a critical assessment of law enforcement measures employed in recent studies by showing that some proxies for law enforcement in the credit market may not be appropriate. Hence, care should be taken in how the quality of institutions is measured and the context which it represents. An original...

  3. Fingerprinting Reverse Proxies Using Timing Analysis of TCP Flows

    Science.gov (United States)

    2013-09-01

    Address Translation NPS Naval Postgraduate School OTT One-way Transit Time PET Privacy Enhancing Technology PHP Hypertext Preprocessor P2P ] Peer-to...of timing information that can translate into usable intelligence for detecting the use of reverse proxies by a network domain. 1.1 Problem Statement...websites (i.e., Sky News Arabia, Kemalist Gazete, Detroit News), and entertainment industry sites (i.e., HBO GO, LeoVegas Online Casino , FreeRide Games

  4. Marine proxy evidence linking decadal North Pacific and Atlantic climate

    Energy Technology Data Exchange (ETDEWEB)

    Hetzinger, S. [University of Toronto Mississauga, CPS-Department, Mississauga, ON (Canada); Leibniz Institute of Marine Sciences, IFM-GEOMAR, Kiel (Germany); Halfar, J. [University of Toronto Mississauga, CPS-Department, Mississauga, ON (Canada); Mecking, J.V.; Keenlyside, N.S. [Leibniz Institute of Marine Sciences, IFM-GEOMAR, Kiel (Germany); University of Bergen, Geophysical Institute and Bjerknes Centre for Climate Research, Bergen (Norway); Kronz, A. [University of Goettingen, Geowissenschaftliches Zentrum, Goettingen (Germany); Steneck, R.S. [University of Maine, Darling Marine Center, Walpole, ME (United States); Adey, W.H. [Smithsonian Institution, Department of Botany, Washington, DC (United States); Lebednik, P.A. [ARCADIS U.S. Inc., Walnut Creek, CA (United States)

    2012-09-15

    Decadal- to multidecadal variability in the extra-tropical North Pacific is evident in 20th century instrumental records and has significant impacts on Northern Hemisphere climate and marine ecosystems. Several studies have discussed a potential linkage between North Pacific and Atlantic climate on various time scales. On decadal time scales no relationship could be confirmed, potentially due to sparse instrumental observations before 1950. Proxy data are limited and no multi-centennial high-resolution marine geochemical proxy records are available from the subarctic North Pacific. Here we present an annually-resolved record (1818-1967) of Mg/Ca variations from a North Pacific/Bering Sea coralline alga that extends our knowledge in this region beyond available data. It shows for the first time a statistically significant link between decadal fluctuations in sea-level pressure in the North Pacific and North Atlantic. The record is a lagged proxy for decadal-scale variations of the Aleutian Low. It is significantly related to regional sea surface temperature and the North Atlantic Oscillation (NAO) index in late boreal winter on these time scales. Our data show that on decadal time scales a weaker Aleutian Low precedes a negative NAO by several years. This atmospheric link can explain the coherence of decadal North Pacific and Atlantic Multidecadal Variability, as suggested by earlier studies using climate models and limited instrumental data. (orig.)

  5. Short-term indicators. Intensities as a proxy for savings

    Energy Technology Data Exchange (ETDEWEB)

    Boonekamp, P.G.M.; Gerdes, J. [ECN Policy Studies, Petten (Netherlands); Faberi, S. [Institute of Studies for the Integration of Systems ISIS, Rome (Italy)

    2013-12-15

    The ODYSSEE database on energy efficiency indicators (www.odyssee-indicators.org) has been set up to enable the monitoring and evaluation of realised energy efficiency improvements and related energy savings. The database covers the 27 EU countries as well as Norway and Croatia and data are available from 1990 on. This work contributes to the growing need for quantitative monitoring and evaluation of the impacts of energy policies and measures, both at the EU and national level, e.g. due to the Energy Services Directive and the proposed Energy Efficiency Directive. Because the underlying data become available only after some time, the savings figures are not always timely available. This is especially true for the ODEX efficiency indices per sector that rely on a number of indicators. Therefore, there is a need for so-called short-term indicators that become available shortly after the year has passed for which data are needed. The short term indicators do not replace the savings indicators but function as a proxy for the savings in the most recent year. This proxy value is faster available, but will be less accurate than the saving indicators themselves. The short term indicators have to be checked regularly with the ODEX indicators in order to see whether they can function still as a proxy.

  6. A unified proxy for ENSO and PDO variability since 1650

    Directory of Open Access Journals (Sweden)

    S. McGregor

    2010-01-01

    Full Text Available In this manuscript we have attempted to consolidate the common signal in previously defined proxy reconstructions of the El Niño-Southern Oscillation into one individual proxy titled the Unified ENSO Proxy (UEP. While correlating well with the majority of input reconstructions, the UEP provides better representation of observed indices of ENSO, discrete ENSO events and documented historical chronologies of ENSO than any of these input ENSO reconstructions. Further to this, the UEP also provides a means to reconstruct the PDO/IPO multi-decadal variability of the Pacific Ocean as the low-pass filtered UEP displays multi-decadal variability that is consistent with the 20th century variability of the PDO and IPO. The UEP is then used to describe changes in ENSO variability which have occurred since 1650 focusing on changes in ENSOs variance, multi-year ENSO events, PDO-like multi-decadal variability and the effects of volcanic and solar forcing on ENSO. We find that multi-year El Niño events similar to the 1990–1995 event have occurred several times over the last 3 1/2 centuries. Consistent with earlier studies we find that volcanic forcing can induce a statistically significant change in the mean state of ENSO in the year of the eruption and a doubling of the probability of an El Niño (La Niña event occurring in the year of (three years after the eruption.

  7. Evaluating Ground-based Proxies for Solar Irradiance Variation

    Science.gov (United States)

    Oegerle, William (Technical Monitor); Jordan, Stuart

    2003-01-01

    In order to determine what ground-based proxies are best for evaluating solar irradiance variation before the advent of space observations, it is necessary to test these proxies against space observations. We have tested sunspot number, total sunspot area, and sunspot umbral area against the Nimbus-7 measurements of total solar irradiance variation cover the eleven year period 1980-1990. The umbral area yields the best correlation and the total sunspot area yields the poorest. Reasons for expecting the umbral area to yield the best correlation are given, the statistical procedure followed to obtain the results is described, and the value of determining the best proxy is discussed. The latter is based upon the availability of an excellent database from the Greenwich Observatory obtained over the period 1876-1976, which can be used to estimate the total solar irradiance variation before sensitive space observations were available. The ground-based observations used were obtained at the Coimbra Solar Observatory. The analysis was done at Goddard using these data and data from the Nimbus-7 satellite.

  8. Shell architecture: a novel proxy for paleotemperature reconstructions?

    Science.gov (United States)

    Milano, Stefania; Nehrke, Gernot; Wanamaker, Alan D., Jr.; Witbaard, Rob; Schöne, Bernd R.

    2017-04-01

    Mollusk shells are unique high-resolution paleoenvironmental archives. Their geochemical properties, such as oxygen isotope composition (δ18Oshell) and element-to-calcium ratios, are routinely used to estimate past environmental conditions. However, the existing proxies have certain drawbacks that can affect paleoreconstruction robustness. For instance, the estimation of water temperature of brackish and near-shore environments can be biased by the interdependency of δ18Oshell from multiple environmental variables (water temperature and δ18Owater). Likely, the environmental signature can be masked by physiological processes responsible for the incorporation of trace elements into the shell. The present study evaluated the use of shell structural properties as alternative environmental proxies. The sensitivity of shell architecture at µm and nm-scale to the environment was tested. In particular, the relationship between water temperature and microstructure formation was investigated. To enable the detection of potential structural changes, the shells of the marine bivalves Cerastoderma edule and Arctica islandica were analyzed with Scanning Electron Microscopy (SEM), nanoindentation and Confocal Raman Microscopy (CRM). These techniques allow a quantitative approach to the microstructural analysis. Our results show that water temperature induces a clear response in shell microstructure. A significant alteration in the morphometric characteristics and crystallographic orientation of the structural units was observed. Our pilot study suggests that shell architecture records environmental information and it has potential to be used as novel temperature proxy in near-shore and open ocean habitats.

  9. Heinrich event 4 characterized by terrestrial proxies in southwestern Europe

    Directory of Open Access Journals (Sweden)

    J. M. López-García

    2013-05-01

    Full Text Available Heinrich event 4 (H4 is well documented in the North Atlantic Ocean as a cooling event that occurred between 39 and 40 Ka. Deep-sea cores around the Iberian Peninsula coastline have been analysed to characterize the H4 event, but there are no data on the terrestrial response to this event. Here we present for the first time an analysis of terrestrial proxies for characterizing the H4 event, using the small-vertebrate assemblage (comprising small mammals, squamates and amphibians from Terrassa Riera dels Canyars, an archaeo-palaeontological deposit located on the seaboard of the northeastern Iberian Peninsula. This assemblage shows that the H4 event is characterized in northeastern Iberia by harsher and drier terrestrial conditions than today. Our results were compared with other proxies such as pollen, charcoal, phytolith, avifauna and large-mammal data available for this site, as well as with the general H4 event fluctuations and with other sites where H4 and the previous and subsequent Heinrich events (H5 and H3 have been detected in the Mediterranean and Atlantic regions of the Iberian Peninsula. We conclude that the terrestrial proxies follow the same patterns as the climatic and environmental conditions detected by the deep-sea cores at the Iberian margins.

  10. Error characterization for asynchronous computations: Proxy equation approach

    Science.gov (United States)

    Sallai, Gabriella; Mittal, Ankita; Girimaji, Sharath

    2017-11-01

    Numerical techniques for asynchronous fluid flow simulations are currently under development to enable efficient utilization of massively parallel computers. These numerical approaches attempt to accurately solve time evolution of transport equations using spatial information at different time levels. The truncation error of asynchronous methods can be divided into two parts: delay dependent (EA) or asynchronous error and delay independent (ES) or synchronous error. The focus of this study is a specific asynchronous error mitigation technique called proxy-equation approach. The aim of this study is to examine these errors as a function of the characteristic wavelength of the solution. Mitigation of asynchronous effects requires that the asynchronous error be smaller than synchronous truncation error. For a simple convection-diffusion equation, proxy-equation error analysis identifies critical initial wave-number, λc. At smaller wave numbers, synchronous error are larger than asynchronous errors. We examine various approaches to increase the value of λc in order to improve the range of applicability of proxy-equation approach.

  11. Determinants of quality of life (QoL) and quality of university life (QuL) in Malaysian public university students

    Science.gov (United States)

    Haron, Halilah; Osman, Balkish Mohd; Maidinsah, Hamidah; Sari, Maznita Maksari @ Md; Zaki, Nurul Qusna Mohd

    2015-02-01

    Quality of life (QoL) refers to the degree of satisfaction, or the sense of well being, people experience in organizations including universities. The quality of life students experience in a university increases when they believe their needs are aligned with the goals of the university because they perceive that the university is responsive to their needs. Quality of University Life (QuL) refers to the students' ability to stabilize their life regarding social activities, academic performance, health and spiritual. A study was undertaken to investigate the accountability of Universiti Teknologi MARA (UiTM), Malaysia, in terms of teaching and learning. The objective of this paper is to identify and evaluate the determinants of QoL and QuL measurement models. Data from 788 students who responded to a set of questionnaire were collected from nine faculties. Factor analysis performed on the data resulted in six determinants for QuL; friendly, skills, satisfaction, interest, learning and feeling. Only two determinants, environment and quality represented QoL. Results indicated that the measures were highly reliable (in terms of internal consistency) based on Cronbach Alpha values ranging from 0.705 to 0.905 for QuL and 0.826 to 0.888 for QoL. Construct validity was supported by Average Variance Extraction values of more than 0.5 for QuL (0.481 - 0.724) and QoL. (0.503 and 0.519). The construct reliability (CR) values ranging between 0.623 to 0.882 for QuL and 0.731 to 0.815 for QoL suggested good reliability construct.

  12. Efficient Conditional Proxy Re-encryption with Chosen-Ciphertext Security

    NARCIS (Netherlands)

    Weng, Jiang; Yang, Yanjiang; Tang, Qiang; Deng, Robert H.; Bao, Feng

    Recently, a variant of proxy re-encryption, named conditional proxy re-encryption (C-PRE), has been introduced. Compared with traditional proxy re-encryption, C-PRE enables the delegator to implement fine-grained delegation of decryption rights, and thus is more useful in many applications. In this

  13. 17 CFR 240.14a-16 - Internet availability of proxy materials.

    Science.gov (United States)

    2010-04-01

    ... holder to access and review the proxy materials before voting; (3) The Internet Web site address where... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Internet availability of proxy... Under the Securities Exchange Act of 1934 Regulation 14a: Solicitation of Proxies § 240.14a-16 Internet...

  14. Remote Patron Validation: Posting a Proxy Server at the Digital Doorway.

    Science.gov (United States)

    Webster, Peter

    2002-01-01

    Discussion of remote access to library services focuses on proxy servers as a method for remote access, based on experiences at Saint Mary's University (Halifax). Topics include Internet protocol user validation; browser-directed proxies; server software proxies; vendor alternatives for validating remote users; and Internet security issues. (LRW)

  15. A novel salinity proxy based on Na incorporation into foraminiferal calcite

    NARCIS (Netherlands)

    Wit, J.C.; de Nooijer, L.J.; Wolthers, M.; Reichart, G.J.

    2013-01-01

    Salinity and temperature determine seawater density, and differences in both thereby control global thermohaline circulation. Whereas numerous proxies have been calibrated and applied to reconstruct temperature, a direct and independent proxy for salinity is still missing. Ideally, a new proxy for

  16. A Type-and-Identity-based Proxy Re-Encryption Scheme and its Application in Healthcare

    NARCIS (Netherlands)

    Ibraimi, L.; Tang, Qiang; Hartel, Pieter H.; Jonker, Willem

    2008-01-01

    Proxy re-encryption is a cryptographic primitive developed to delegate the decryption right from one party (the delegator) to another (the delegatee). In a proxy re-encryption scheme, the delegator assigns a key to a proxy to re-encrypt all messages encrypted with his public key such that the

  17. Measuring quality of life in opioid-induced constipation: mapping EQ-5D-3 L and PAC-QOL.

    Science.gov (United States)

    Hatswell, Anthony James; Vegter, Stefan

    2016-12-01

    In health economic evaluations, quality of life should be measured with preference-based utilities, such as the EuroQol 5 Dimension 3-level (EQ-5D-3 L). Non-preference-based instruments (often disease-specific questionnaires) are commonly mapped to utilities. We investigated if the relationship observed between the Patient Assessment of Constipation Quality of Life (PAC-QOL) and the EQ-5D-3 L in patients with chronic idiopathic constipation (CIC) also applies in opioid-induced constipation (OIC). EQ-5D-3 L patient-level data from a clinical study of lubiprostone in OIC (n = 439) were scored using the UK tariff. A published mapping between the PAC-QOL and the EQ-5D-3 L was tested using these data. New mapping formulas were analysed, including PAC-QOL total and subscale scores. The root mean square error (RMSE), the adjusted R(2) and predicted/observed plots were used to test the fit. The utility measured with the EQ-5D-3 L was 0.450 ± 0.329, with a distinctly bimodal distribution. This significantly improved if patients responded to treatment (defined as an increase of three spontaneous bowel movements per week, with no rescue medication taken). The published mapping in CIC performed poorly in this OIC population, and the PAC-QOL could not be reliably mapped on to the EQ-5D-3 L even when re-estimating coefficients. This was shown in our two mappings (using PAC-QOL total score, and subscale scores) by a high RMSE (0.317 and 0.314) and a low R(2) (0.068 and 0.080), with high utilities underestimated and low utilities overestimated. Patients with OIC have a low quality of life which does improve with the resolution of symptoms. However the PAC-QOL cannot be used to estimate the EQ-5D-3 L utility - potentially as the PAC-QOL does not capture the all relevant aspects of the patients quality of life (for example the cause of the opioid use).

  18. A method to select an instrument for measurement of HR-QOL for cross-cultural adaptation applied to dermatology.

    Science.gov (United States)

    de Tiedra, A G; Mercadal, J; Badía, X; Mascaró, J M; Lozano, R

    1998-10-01

    The objective of this study was to develop a process to obtain an instrument to measure dermatology specific health-related quality of life (HR-QOL), and to adapt it into another culture, namely the Spanish-speaking community. By consensus, a multi-disciplinary team determined the qualities of an 'ideal' questionnaire as follows: need (absence of any such instrument), utility, multi-dimensionality, psychometric development, simplicity, high degree of standardisation, and accessibility. A bibliographic search was conducted on Medline, EMBASE and IME (Spanish Medical Index), using 'dermatology' and 'quality of life' as the key words, from January 1990 through to September 1997, supplemented by a second level reference search, to identify the instruments already in existence. Rather than develop a questionnaire ex novo, it was decided to make a cultural adaptation of an existing one. The questionnaires identified in the literature search were classified according to their generic or specific scope and it was decided to adapt a dermatology specific instrument. To select and compare the instruments, a model was developed which would provide an Adaptation Index (ADAPT), which includes the degree of development of psychometric properties, the formal design and the degree of standardisation at a given moment in time. Six dermatology specific scales were identified: Impact of Skin Disease Scale (IMPACT), Dermatology Life Quality Index (DLQI), Skindex, Dermatology Quality-of-Life Scales (DQOLS), Dermatology Specific Quality of Life (DSQL) and Qualita di Vita Italiana in Dermatologia (QUAVIDERM). The ADAPT Index for each of the above was determined at the time of the study and the DLQI was chosen for adaptation (ADAPT = 77, October 1997). The study showed the utility of ADAPT Index to assist in the selection process of the questionnaire to adapt. The results of the analysis indicate that in order to introduce and systematically use dermatology specific HR-QOL instruments, the

  19. Measuring quality of life after intensive care using the Arabic version for Morocco of the EuroQol 5 Dimensions

    Directory of Open Access Journals (Sweden)

    Khoudri Ibtissam

    2012-01-01

    Full Text Available Abstract Background Health-related quality of life (HRQL is a relevant outcome measures in intensive care unit (ICU. The aim of this study was to evaluate HRQL of ICU patients 3 months after discharge using the Arabic version for Morocco of the EuroQol-5-Dimension (EQ-5D, and to examine the psychometric properties of the questionnaire. Results The Arabic version for Morocco of the EQ-5D was approved by the EuroQol group. A prospective cohort study was conducted after medical ICU discharge. At 3-month follow up, the EQ-5D (self classifier and EQ-VAS was administered in consultation or by telephone. EQ-VAS varies from 0 (better HRQL to 100 (worst HRQL. An unweighted scoring for EQ5D-index was calculated. EQ5D-index ranges from -0.59 to 1. Test-retest reliability of the EQ-5D was tested using Kappa coefficient and intraclass correlation coefficient (ICC. Criterion validity was assessed by correlating EQ-VAS and EQ5D-index with the Short Form 36 (SF-36. Construct validity was tested using simple and multiple liner regression to assess factors influencing patients'HRQL. 145 survivors answered the EQ-5D. Median EQ5D-index was 0.52 [0.20-1]. Mean EQ-VAS was 62 ± 20. Test-retest reliability was conducted in 83 patients. ICCs of EQ5D-index and EQ-VAS were 0.95 and 0.92 respectively. For EQ-5D self classifier, agreement by kappa was above 0.40. Significant correlations were noted between EQ5D-index, EQ-VAS and SF-36 (p p = 0.017 and higher educational level (β = -0.2; p = 0.001. For EQ-VAS men were associated with better HRQL (β = 6.5; p = 0.048. Conclusions The Arabic version for Morocco of the EQ-5D is reliable and valid. Women, high educational level and longer ICU length of stay were associated with poorer HRQL.

  20. Anemia and neutropenic fever with high dose diazoxide treatment in a case with hyperinsulinism due to Munchausen by proxy.

    Science.gov (United States)

    Ozon, A; Demirbilek, H; Ertugrul, A; Unal, S; Gumruk, F; Kandemir, N

    2010-07-01

    The etiology of hyperinsulinemic hypoglycemia in adolescents is similar to that of adults. Patients resistant to medical treatment may undergo pancreatectomy. Diazoxide is the mainstay of medical treatment. Rarely bone marrow suppression is reported due to diazoxide. An adolescent with severe hyperinsulinemic hypoglycemia was referred for pancreatectomy after she was treated with high doses of diazoxide, octreotide and glucose. She developed anemia and febrile neutropenia in the course of diazoxide treatment that resolved with cessation of medication. The cause of the hyperinsulinemia proved to be classical Munchausen by proxy. This is the first report of bone marrow suppression involving erythroid series by diazoxide. Follow-up of blood count may be considered in patients on high dosages since anemia may be dose dependent. Munchausen by proxy poses a serious threat to children with significant morbidity and mortality. Awareness and a high index of suspicion in clinical settings with unusual causes are the mainstay for the diagnosis.

  1. A high-resolution multi-proxy record of late Cenozoic environment change from central Taklimakan Desert, China

    OpenAIRE

    X Wang; Sun, D. H.; Wang, F; Li, B F; Wu, S.; Guo, F.; Li, Z. J.; Zhang, Y. B.; F. H. Chen

    2013-01-01

    The Taklimakan Desert in the Tarim Basin is the largest desert in Central Asia, and is regarded as one of the main dust sources to the Northern Hemisphere. Late Cenozoic sedimentary sequences with intercalated in-situ aeolian dune sands in this area preserve direct evidence for the Asian desertification. Herein, we report a high-resolution multi-proxy climatic record from the precise magnetostratigraphic dated Hongbaishan section in the central Taklimakan Desert. Our results...

  2. A high-resolution multi-proxy record of late Cenozoic environment change from central Taklimakan Desert, China

    OpenAIRE

    X Wang; Sun, D. H.; Wang, F; Li, B F; Wu, S.; Guo, F.; Li, Z. J.; Zhang, Y. B.; F. H. Chen

    2013-01-01

    The Taklimakan Desert in the Tarim Basin is the largest desert in Central Asia, and is regarded as one of the main dust sources to the Northern Hemisphere. Late Cenozoic sedimentary sequences with intercalated in-situ aeolian dune sands in this area preserve direct evidence for the Asian desertification. Herein, we report a high-resolution multi-proxy climatic record from the precise magnetostratigraphic dated Hongbaishan section in the central Taklimakan Desert. Our results show that ...

  3. Quality-of-Life (QOL) during Screening for Phase 1 Trial Studies in Patients with Advanced Solid Tumors and Its Impact on Risk for Serious Adverse Events

    Science.gov (United States)

    Tan, Wei; Hong, Chi-Chen; Admane, Sonal; Dozier, Askia; Siedlecki, Francine; Whitworth, Amy; DiRaddo, Ann Marie; DePaolo, Dawn; Jacob, Sandra M.; Ma, Wen Wee; Miller, Austin; Adjei, Alex A.; Dy, Grace K.

    2017-01-01

    Background: Serious adverse events (SAEs) and subject replacements occur frequently in phase 1 oncology clinical trials. Whether baseline quality-of-life (QOL) or social support can predict risk for SAEs or subject replacement among these patients is not known. Methods: Between 2011–2013, 92 patients undergoing screening for enrollment into one of 22 phase 1 solid tumor clinical trials at Roswell Park Cancer Institute were included in this study. QOL Questionnaires (EORTC QLQ-C30 and FACT-G), Medical Outcomes Study Social Support Survey (MOSSSS), Charlson comorbidity scores (CCS) and Royal Marsden scores (RMS) were obtained at baseline. Frequency of dose limiting toxicities (DLTs), subject replacement and SAEs that occurred within the first 4 cycles of treatment were recorded. Fisher’s exact test and Mann-Whitney-Wilcoxon test were used to study the association between categorical and continuous variables, respectively. A linear transformation was used to standardize QOL scores. p-value ≤ 0.05 was considered statistically significant. Results: Baseline QOL, MOSSSS, CCS and RMS were not associated with subject replacement nor DLTs. Baseline EORTC QLQ-C30 scores were significantly lower among patients who encountered SAEs within the first 4 cycles (p = 0.04). Conclusions: Lower (worse) EORTC QLQ-C30 score at baseline is associated with SAE occurrence during phase 1 oncology trials. PMID:28672850

  4. Measuring Care-Related Quality of Life of Caregivers for Use in Economic Evaluations: CarerQol Tariffs for Australia, Germany, Sweden, UK, and US

    NARCIS (Netherlands)

    R.J. Hoefman (Renske); N.J.A. van Exel (Job); W.B.F. Brouwer (Werner)

    2017-01-01

    textabstractBackground: Informal care is often not included in economic evaluations in healthcare, while the impact of caregiving can be relevant for cost-effectiveness recommendations from a societal perspective. The impact of informal care can be measured and valued with the CarerQol instrument,

  5. Measuring care-related quality of life of caregivers for use in economic evaluations: CarerQol tariffs for Australia, Germany, Sweden, the UK and the US.

    NARCIS (Netherlands)

    Hoefman, R.J.; Exel, N.J.A. van; Brouwer, W.B.F.

    2017-01-01

    Background: Informal care is often not included in economic evaluations in healthcare, while the impact of caregiving can be relevant for cost-effectiveness recommendations from a societal perspective. The impact of informal care can be measured and valued with the CarerQol instrument, which

  6. Quality-of-Life (QOL) during Screening for Phase 1 Trial Studies in Patients with Advanced Solid Tumors and Its Impact on Risk for Serious Adverse Events.

    Science.gov (United States)

    Anwar, Sidra; Tan, Wei; Hong, Chi-Chen; Admane, Sonal; Dozier, Askia; Siedlecki, Francine; Whitworth, Amy; DiRaddo, Ann Marie; DePaolo, Dawn; Jacob, Sandra M; Ma, Wen Wee; Miller, Austin; Adjei, Alex A; Dy, Grace K

    2017-06-26

    Background: Serious adverse events (SAEs) and subject replacements occur frequently in phase 1 oncology clinical trials. Whether baseline quality-of-life (QOL) or social support can predict risk for SAEs or subject replacement among these patients is not known. Methods: Between 2011-2013, 92 patients undergoing screening for enrollment into one of 22 phase 1 solid tumor clinical trials at Roswell Park Cancer Institute were included in this study. QOL Questionnaires (EORTC QLQ-C30 and FACT-G), Medical Outcomes Study Social Support Survey (MOSSSS), Charlson comorbidity scores (CCS) and Royal Marsden scores (RMS) were obtained at baseline. Frequency of dose limiting toxicities (DLTs), subject replacement and SAEs that occurred within the first 4 cycles of treatment were recorded. Fisher's exact test and Mann-Whitney-Wilcoxon test were used to study the association between categorical and continuous variables, respectively. A linear transformation was used to standardize QOL scores. p-value ≤ 0.05 was considered statistically significant. Results: Baseline QOL, MOSSSS, CCS and RMS were not associated with subject replacement nor DLTs. Baseline EORTC QLQ-C30 scores were significantly lower among patients who encountered SAEs within the first 4 cycles (p = 0.04). Conclusions: Lower (worse) EORTC QLQ-C30 score at baseline is associated with SAE occurrence during phase 1 oncology trials.

  7. Quality-of-Life (QOL during Screening for Phase 1 Trial Studies in Patients with Advanced Solid Tumors and Its Impact on Risk for Serious Adverse Events

    Directory of Open Access Journals (Sweden)

    Sidra Anwar

    2017-06-01

    Full Text Available Background: Serious adverse events (SAEs and subject replacements occur frequently in phase 1 oncology clinical trials. Whether baseline quality-of-life (QOL or social support can predict risk for SAEs or subject replacement among these patients is not known. Methods: Between 2011–2013, 92 patients undergoing screening for enrollment into one of 22 phase 1 solid tumor clinical trials at Roswell Park Cancer Institute were included in this study. QOL Questionnaires (EORTC QLQ-C30 and FACT-G, Medical Outcomes Study Social Support Survey (MOSSSS, Charlson comorbidity scores (CCS and Royal Marsden scores (RMS were obtained at baseline. Frequency of dose limiting toxicities (DLTs, subject replacement and SAEs that occurred within the first 4 cycles of treatment were recorded. Fisher’s exact test and Mann-Whitney-Wilcoxon test were used to study the association between categorical and continuous variables, respectively. A linear transformation was used to standardize QOL scores. p-value ≤ 0.05 was considered statistically significant. Results: Baseline QOL, MOSSSS, CCS and RMS were not associated with subject replacement nor DLTs. Baseline EORTC QLQ-C30 scores were significantly lower among patients who encountered SAEs within the first 4 cycles (p = 0.04. Conclusions: Lower (worse EORTC QLQ-C30 score at baseline is associated with SAE occurrence during phase 1 oncology trials.

  8. Personal goals and factors related to QoL in Dutch homeless people : What is the role of goal-related self-efficacy?

    NARCIS (Netherlands)

    van der Laan, Jorien; Boersma, Sandra N; van Straaten, Barbara; Rodenburg, Gerda; van de Mheen, Dike; Wolf, Judith R L M

    2017-01-01

    Very little is known about the personal goals of homeless people and how these relate to their quality of life (QoL). By using survey data on 407 homeless adults upon entry to the social relief system in 2011, we examined the personal goals of homeless adults and the association between their

  9. The effects of an 8-week computer-based brain training programme on cognitive functioning, QoL and self-efficacy after stroke.

    Science.gov (United States)

    Wentink, M M; Berger, M A M; de Kloet, A J; Meesters, J; Band, G P H; Wolterbeek, R; Goossens, P H; Vliet Vlieland, T P M

    2016-10-01

    Cognitive impairment after stroke has a direct impact on daily functioning and quality of life (QoL) of patients and is associated with higher mortality and healthcare costs. The aim of this study was to determine the effect of a computer-based brain training programme on cognitive functioning, QoL and self-efficacy compared to a control condition in stroke patients. Stroke patients with self-perceived cognitive impairment were randomly allocated to the intervention or control group. The intervention consisted of an 8-week brain training programme (Lumosity Inc.®). The control group received general information about the brain weekly. Assessments consisted of a set of neuropsychological tests and questionnaires. In addition, adherence with trained computer tasks was recorded. No effect of the training was found on cognitive functioning, QoL or self-efficacy when compared to the control condition, except for very limited effects on working memory and speed. This study found very limited effects on neuropsychological tests that were closely related to trained computer tasks, but no transfers to other tests or self-perceived cognitive failures, QoL or self-efficacy. These findings warrant the need for further research into the value of computer-based brain training to improve cognitive functioning in the chronic phase after stroke.

  10. How to combine sparse proxy data and coupled climate models

    Science.gov (United States)

    Paul, André; Schäfer-Neth, Christian

    2005-04-01

    We address the problem of reconstructing a global field from proxy data with sparse spatial sampling such as the MARGO (multi-proxy approach for the reconstruction of the glacial ocean surface) SST (sea-surface temperature) and δ18O c (oxygen-18/oxygen-16 isotope ratio preserved in fossil carbonate shells of planktic foraminifera) data. To this end, we propose to `assimilate' these data into coupled climate models by adjusting some of their parameters and optimizing the fit. In particular, we suggest to combine a forward model and an objective function that quantifies the misfit to the data. Because of their computational efficiency, earth system models of intermediate complexity are particularly well-suited for this purpose. We used one such model (the University of Victoria Earth System Climate Model) and carried out a series of sensitivity experiments by varying a single model parameter through changing the atmospheric CO2 concentration. The unanalyzed World Ocean Atlas SST and the observed sea-ice concentration served as present-day targets. The sparse data coverage as implied by the locations of 756 ocean sediment cores from the MARGO SST database was indeed sufficient to determine the best fit. As anticipated, it turned out to be the 365 ppm experiment. We also found that the 200 ppm experiment came surprisingly close to what is commonly expected for the Last Glacial Maximum ocean circulation. Our strategy has a number of advantages over more traditional mapping methods, e.g., there is no need to force the results of different proxies into a single map, because they can be compared to the model output one at a time, properly taking into account the different seasons of plankton growth or varying depth habitats. It can be extended to more model parameters and even be automated.

  11. Tycho 2: A Proxy Application for Kinetic Transport Sweeps

    Energy Technology Data Exchange (ETDEWEB)

    Garrett, Charles Kristopher [Los Alamos National Lab. (LANL), Los Alamos, NM (United States). Computer, Computational, and Statistical Sciences Division; Warsa, James S. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States). Computer, Computational, and Statistical Sciences Division

    2016-09-14

    Tycho 2 is a proxy application that implements discrete ordinates (SN) kinetic transport sweeps on unstructured, 3D, tetrahedral meshes. It has been designed to be small and require minimal dependencies to make collaboration and experimentation as easy as possible. Tycho 2 has been released as open source software. The software is currently in a beta release with plans for a stable release (version 1.0) before the end of the year. The code is parallelized via MPI across spatial cells and OpenMP across angles. Currently, several parallelization algorithms are implemented.

  12. Compliance with treatment in asthma and Munchausen syndrome by proxy.

    Science.gov (United States)

    Godding, V; Kruth, M

    1991-01-01

    Among 1648 asthmatic patients, 17 families (1%) were identified as having Munchausen syndrome by proxy. Ten families did not treat their children's, attacks or refused medical care, and seven exaggerated the severity of symptoms to obtain invasive investigations and treatment. All the families had disturbed psychosocial backgrounds. The abuse consisted mainly of neglect, in that necessary treatment was not given. In some cases a more direct form of abuse was observed, when useless and sometimes harmful investigations and treatment were given. We conclude that medical control of the compliance of both parents and children is necessary in the management of childhood asthma. PMID:1929492

  13. Investigating genetic loci that encode plant-derived paleoclimate proxies

    Science.gov (United States)

    Bender, A. L. D.; Suess, M.; Chitwood, D. H.; Bradley, A. S.

    2016-12-01

    Long chain (>C25) n-alkanes in sediments predominantly derive from terrestrial plant waxes. Hydrogen isotope ratios (δD) of leaf wax hydrocarbons correlate with δDH2O of precipitation and are commonly used as paleoclimate proxies. However, biological variability in the isotopic fractionations between water and plant materials also affects the n-alkane δD values. Correct interpretation of this paleoclimate proxy requires that we resolve genetic and environmental effects. Genetic variability underlying differences in leaf wax structure and isotopic composition can be quantitatively determined through the use of model organisms. Interfertile Solanum sect. Lycopersicon (tomato) species provide an ideal model species complex for this approach. We used a set of 76 precisely defined near-isogenic lines (introgression lines [ILs]) in which small genomic regions from the wild tomato relative Solanum pennellii have been introduced into the genome of the domestic tomato, S. lycopersicum. By characterizing quantitative traits of these ILs (leaf wax structure and isotopic composition), we can resolve the degree to which each trait is regulated by genetic versus environmental factors. We present data from two growth experiments conducted with all 76 ILs. In this study, we quantify leaf wax traits, including δD values, δ13C values, and structural metrics including the methylation index (a variable that describes the ratio of iso­- and anteiso- to n-alkanes). Among ILs, δD values vary by up to 35‰ and 60‰ for C31 and C33 n-alkanes, respectively. Many ILs have methylation indices that are discernably different from the parent domesticated tomato (p < 0.001), which suggests that methylation is a highly polygenic trait. This pattern is similar to the genetics that control leaf shape, another trait commonly used as a paleoclimate proxy. Based on our preliminary analysis, we propose candidate genes that control aspects of plant physiology that affect these quantitative

  14. Characterization of Proxy Application Performance on Advanced Architectures. UMT2013, MCB, AMG2013

    Energy Technology Data Exchange (ETDEWEB)

    Howell, Louis H. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Gunney, Brian T. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Bhatele, Abhinav [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2015-10-09

    Three codes were tested at LLNL as part of a Tri-Lab effort to make detailed assessments of several proxy applications on various advanced architectures, with the eventual goal of extending these assessments to codes of programmatic interest running more realistic simulations. Teams from Sandia and Los Alamos tested proxy apps of their own. The focus in this report is on the LLNL codes UMT2013, MCB, and AMG2013. We present weak and strong MPI scaling results and studies of OpenMP efficiency on a large BG/Q system at LLNL, with comparison against similar tests on an Intel Sandy Bridge TLCC2 system. The hardware counters on BG/Q provide detailed information on many aspects of on-node performance, while information from the mpiP tool gives insight into the reasons for the differing scaling behavior on these two different architectures. Results from three more speculative tests are also included: one that exploits NVRAM as extended memory, one that studies performance under a power bound, and one that illustrates the effects of changing the torus network mapping on BG/Q.

  15. Pediatric condition falsification (Munchausen syndrome by Proxy) as a continuum of maternal factitious disorder (Munchausen syndrome).

    Science.gov (United States)

    Kucuker, Hudaverdi; Demir, Tevfik; Oral, Resmiye

    2010-12-01

    Pediatric condition falsification (PCF), also known as Munchausen syndrome by Proxy or Medical Child Abuse, is a somewhat rare form of child abuse and neglect. Its association with a history of adult factitious disorder (AFD) or Munchausen syndrome in the perpetrator is also well known. Exogenous insulin injection to cause hypoglycemia both in the context of PCF and AFD has been reported in the literature. However, the coexistence of both conditions via insulin injection in the same family has not been reported in the literature. This paper presents a family, in which the mother was diagnosed with AFD and her three children with PCF perpetrated by their mother via exogenous insulin injection. © 2010 John Wiley & Sons A/S.

  16. Changes in the WOMAC, EuroQol and Japanese lifestyle measurements among patients undergoing total hip arthroplasty.

    Science.gov (United States)

    Fujita, K; Makimoto, K; Higo, T; Shigematsu, M; Hotokebuchi, T

    2009-07-01

    To assess changes in the health outcomes of Japanese patients before and after total hip arthroplasty (THA), and to assess the impact of THA on commonly performed postures or body positions requiring deep flexion of the hip joint such as the use of Japanese squat toilets. Consecutive patients undergoing primary THA between July 2003 and July 2004 were eligible for the study. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the EuroQol 5D (EQ-5D) were administered at the preoperative period and two postoperative periods of 6 weeks and 6 months. The patients were also asked to rate three items regarding common activities of daily living in Japan such as squatting. Changes in scores were examined using effect size and proportion at the floor and ceiling. Four-hundred and fifty-one patients completed both pre- and post-THA surveys. Significant improvements in pain and physical function as measured by WOMAC and EQ-5D were evident within 6 weeks. Changes in WOMAC and EQ-5D subscale scores and scores for each item from the three time periods were highly significant (P=0.000). The effect size was 1.56 for WOMAC pain and 1.38 for physical function at 6 months. In contrast, two items (Japanese toilet and seiza) became significantly worse at the 6-week postoperative period (P=0.000) and returned to preoperative levels by the 6-month postoperative period. These results highlight the importance of evaluating culturally sensitive physical functions in addition to conventional measurements for the health outcomes of THA patients.

  17. Mapping of Multiple Sclerosis Walking Scale (MSWS-12 to five-dimension EuroQol (EQ-5D health outcomes: an independent validation in a randomized control cohort

    Directory of Open Access Journals (Sweden)

    Sidovar MF

    2016-02-01

    Full Text Available Matthew F Sidovar,1 Brendan L Limone,2 Craig I Coleman2 1Clinical Development and Medical Affairs, Acorda Therapeutics, Ardsley, NY, 2Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, CT, USA Background: Mapping of patient-reported outcomes to the five-dimension EuroQol (EQ-5D health index is increasingly being used for understanding the relationship of outcomes to health states and for predicting utilities that have application in economic evaluations. The 12-item Multiple Sclerosis Walking Scale (MSWS-12 is a patient-reported outcome that assesses the impact of walking impairment in people with MS. An equation for mapping the MSWS-12 to the EQ-5D was previously developed and validated using a North American Research Committee on MS (NARCOMS registry cohort. Materials and methods: This analysis retested the validity of the equation mapping the MSWS-12 to the three-level EQ-5D (EQ-5D-3L by using an independent cohort of patients with MS enrolled in a randomized controlled trial. Mapping was evaluated at two separate time points (baseline and week 4 during the clinical trial. The mapping equation’s performance was subsequently assessed with mean absolute error (MAE and root-mean-square error (RMSE by comparing equation-based estimates to values elicited in the trial using the actual EQ-5D-3L questionnaire. Results: The mapping equation predicted EQ-5D-3L values in this external cohort with reasonable precision at both time points (MAE 0.116 and RMSE 0.155 at baseline; MAE 0.105 and RMSE 0.138 at week 4, and was similar to that reported in the original NARCOMS cohort (MAE 0.109 and RMSE 0.145. Also as observed in the original NARCOMS cohort, the mapping equation performed best in patients with EQ-5D-3L values between 0.50 and 0.75, and poorly in patients with values <0.50.Conclusion: The mapping equation performed similarly in this external cohort as in the original derivation cohort, including a poorer

  18. Comfort with proxy consent to research involving decisionally impaired older adults: do type of proxy and risk-benefit profile matter?

    Science.gov (United States)

    Dubois, Marie-France; Bravo, Gina; Graham, Janice; Wildeman, Sheila; Cohen, Carole; Painter, Karen; Bellemare, Suzanne

    2011-11-01

    Dementia research often requires the participation of people with dementia. Obtaining informed consent is problematic when potential participants lack the capacity to provide it. We investigated comfort with proxy consent to research involving older adults deemed incapable of this decision, and examined if comfort varies with the type of proxy and the study's risk-benefit profile. We surveyed random samples of five relevant groups (older adults, informal caregivers, physicians, researchers in aging, and Research Ethics Board members) from four Canadian provinces. Respondents were presented with scenarios involving four types of proxies (non-assigned, designated in a healthcare advance directive with or without instructions specific to research participation, and court-appointed). Given a series of risk-benefit profiles, respondents indicated whether they were comfortable with proxy consent to research for each scenario. Two percent of the respondents felt proxy consent should never be allowed. In all groups, comfort depended far more on the risk-benefit profile associated with the research scenario than with type of proxy. For research involving little or no risk and potential personal benefits, over 90% of the respondents felt comfortable with substitute consent by a designated or court-appointed proxy while 80% were at ease with a non-assigned proxy. For studies involving serious risks with potentially greater personal benefits, older adults and informal caregivers were less comfortable with proxy consent. A large majority of Canadians are comfortable with proxy consent for low-risk research. Further work is needed to establish what kinds of research are considered to be low risk.

  19. Thermodynamic Proxies to Compensate for Biases in Drug Discovery Methods.

    Science.gov (United States)

    Ekins, Sean; Litterman, Nadia K; Lipinski, Christopher A; Bunin, Barry A

    2016-01-01

    We propose a framework with simple proxies to dissect the relative energy contributions responsible for standard drug discovery binding activity. We explore a rule of thumb using hydrogen-bond donors, hydrogen-bond acceptors and rotatable bonds as relative proxies for the thermodynamic terms. We apply this methodology to several datasets (e.g., multiple small molecules profiled against kinases, Mycobacterium tuberculosis (Mtb) high throughput screening (HTS) and structure based drug design (SBDD) derived compounds, and FDA approved drugs). We found that Mtb active compounds developed through SBDD methods had statistically significantly larger PEnthalpy values than HTS derived compounds, suggesting these compounds had relatively more hydrogen bond donor and hydrogen bond acceptors compared to rotatable bonds. In recent FDA approved medicines we found that compounds identified via target-based approaches had a more balanced enthalpic relationship between these descriptors compared to compounds identified via phenotypic screens As it is common to experimentally optimize directly for total binding energy, these computational methods provide alternative calculations and approaches useful for compound optimization alongside other common metrics in available software and databases.

  20. Solar spectral irradiance datasets: analysis and comparison with proxies

    Science.gov (United States)

    Kretzschmar, M.; Schoell, M.; Dudok de Wit, T.

    2013-12-01

    Solar spectral irradiance (SSI) measurements have been acquired in space since the late 1960's. These data are of extreme importance to assess the variability of the Sun in the last decades as well as to understand how its magnetic activity affects its radiative output, and therefore to constrain the solar variability further in time. However, these data sometimes disagree between themselves or with our expectations deduced from well known observed proxies, and it is hard to disentangle instrumental effects from possible solar behavior. In the context of the european project SOLID (First European comprehensive SOlar Irradiance Data Exploitation) project, which aims at building an SSI composite with time dependent error-bars over the space age, we will show our first results towards the construction of a carefully assessed homogeneous solar spectral irradiance datasets, focussing on the ultraviolet wavelength range, for which more data are available. We will first present the data used, together with methods for gap-filling and outlier removal. Then we will show some results obtained by comparing a single dataset at different times of the mission, as well as results obtained from the comparison of simultaneous datasets and proxies. Finally, we will discuss how these analyses can help us to estimate errors on the solar variability at a particular wavelength.

  1. Attribute-based proxy re-encryption with keyword search.

    Directory of Open Access Journals (Sweden)

    Yanfeng Shi

    Full Text Available Keyword search on encrypted data allows one to issue the search token and conduct search operations on encrypted data while still preserving keyword privacy. In the present paper, we consider the keyword search problem further and introduce a novel notion called attribute-based proxy re-encryption with keyword search (ABRKS, which introduces a promising feature: In addition to supporting keyword search on encrypted data, it enables data owners to delegate the keyword search capability to some other data users complying with the specific access control policy. To be specific, ABRKS allows (i the data owner to outsource his encrypted data to the cloud and then ask the cloud to conduct keyword search on outsourced encrypted data with the given search token, and (ii the data owner to delegate other data users keyword search capability in the fine-grained access control manner through allowing the cloud to re-encrypted stored encrypted data with a re-encrypted data (embedding with some form of access control policy. We formalize the syntax and security definitions for ABRKS, and propose two concrete constructions for ABRKS: key-policy ABRKS and ciphertext-policy ABRKS. In the nutshell, our constructions can be treated as the integration of technologies in the fields of attribute-based cryptography and proxy re-encryption cryptography.

  2. Estimation of force of infection based on different epidemiological proxies: 2009/2010 Influenza epidemic in Malta

    Directory of Open Access Journals (Sweden)

    V. Marmara

    2014-12-01

    Full Text Available Information about infectious disease outbreaks is often gathered indirectly, from doctor's reports and health board records. It also typically underestimates the actual number of cases, but the relationship between the observed proxies and the numbers that drive the diseases is complicated, nonlinear and potentially time- and state-dependent. We use a combination of data collection from the 2009–2010 H1N1 outbreak in Malta, compartmental modelling and Bayesian inference to explore the effect of using various sources of information (consultations, doctor's diagnose, swabbing and molecular testing on estimation of the effective basic reproduction ratio, Rt. Different proxies and different sampling rates (daily and weekly lead to similar behaviour of Rt as the epidemic unfolds, although individual parameters (force of infection, length of latent and infectious period vary. We also demonstrate that the relationship between different proxies varies as epidemic progresses, with the first period characterised by high ratio of consultations and influenza diagnoses to actual confirmed cases of H1N1. This has important consequences for modelling that is based on reconstructing influenza cases from doctor's reports.

  3. Iron content of soils as a precipitation proxy

    Science.gov (United States)

    Dzombak, R.; Sheldon, N. D.

    2016-12-01

    Given that different iron phases form under different precipitation and drainage regimes, soil iron content could be used as a proxy for both volume and seasonality of precipitation. Constraining these factors is important for predicting future precipitation trends, especially for a warmer climate that will likely see more frequent extreme weather events. Specifically, using paleoprecipitation data from periods of higher temperatures and atmospheric CO2 concentrations helps inform models of future `greenhouse' climate. Forty-five modern samples from across the continental United States were analyzed, with MAP ranging from 200 to 1200 mm yr-1 and MAT ranging from 5 to 22°C. Soil types included Alfisols (N=15), Inceptisols (N=8), Mollisols (N=15), and Aridisols (N=7), and ranged from seasonally wet to well-drained. Analytical techniques included combustion-elemental analysis and organic carbon isotope analysis, a sequential iron extraction modified with a sodium hypochlorite step for the extraction of organic matter-bound iron, and the extraction of iron sulfides. The sequential extractions yield five different `pools' of iron found in sediment: crystalline iron oxides (e.g., goethite, hematite), magnetite, carbonate-bound, organic matter-bound, and labile/easily reducible iron minerals (e.g., ferrihydrite). Analysis by ICP-OES yielded a strong relationship between magnetite-bound iron and MAP, and fair relationships between the other iron pools and MAP. Individual soil orders tended to show stronger relationships to the iron pools than all soils analyzed together, potentially indicating the need for separate proxy relationships for each soil order. Pyrite concentrations were well below 1% by weight for these soils, suggesting that none of these soils has a long enough wet season to encourage its formation and that the presence vs. absence of pyrite in paleosols may be a useful proxy for soil moisture state. In contrast to some earlier work, no significant

  4. Carbohydrates and phenols as quantitative molecular vegetation proxies in peats

    Science.gov (United States)

    Kaiser, K.; Benner, R. H.

    2012-12-01

    Vegetation in peatlands is intricately linked to local environmental conditions and climate. Here we use chemical analyses of carbohydrates and phenols to reconstruct paleovegetation in peat cores collected from 56.8°N (SIB04), 58.4°N (SIB06), 63.8°N (G137) and 66.5°N (E113) in the Western Siberian Lowland. Lignin phenols (vanillyl and syringyl phenols) were sensitive biomarkers for vascular plant contributions and provided additional information on the relative contributions of angiosperm and gymnosperm plants. Specific neutral sugar compositions allowed identification of sphagnum mosses, sedges (Cyperaceae) and lichens. Hydroxyphenols released by CuO oxidation were useful tracers of sphagnum moss contributions. The three independent molecular proxies were calibrated with a diverse group of peat-forming plants to yield quantitative estimates (%C) of vascular plant, sphagnum moss and lichen contributions in peat core samples. Correlation analysis indicated the three molecular proxies produced fairly similar results for paleovegetation compositions, generally within the error interval of each approach (≤26%). The lignin-based method generally lead to higher estimates of vascular plant vegetation. Several significant deviations were also observed due to different reactivities of carbohydrate and phenolic polymers during peat decomposition. Rapid vegetation changes on timescales of 50-200 years were observed in the southern cores SIB04 and SIB06 over the last 2000 years. Vanillyl and syringyl phenol ratios indicated these vegetation changes were largely due to varying inputs of angiosperm and gymnosperm plants. The northern permafrost cores G137 and E113 showed a more stable development. Lichens briefly replaced sphagnum mosses and vascular plants in both of these cores. Shifts in vegetation did not correlate well with Northern hemisphere climate variability over the last 2000 years. This suggested that direct climate forcing of peatland dynamics was overridden

  5. Analysis of Forgery Attack on One-Time Proxy Signature and the Improvement

    Science.gov (United States)

    Wang, Tian-Yin; Wei, Zong-Li

    2016-02-01

    In a recent paper, Yang et al. (Quant. Inf. Process. 13(9), 2007-2016, 2014) analyzed the security of one-time proxy signature scheme Wang and Wei (Quant. Inf. Process. 11(2), 455-463, 2012) and pointed out that it cannot satisfy the security requirements of unforgeability and undeniability because an eavesdropper Eve can forge a valid proxy signature on a message chosen by herself. However, we find that the so-called proxy message-signature pair forged by Eve is issued by the proxy signer in fact, and anybody can obtain it as a requester, which means that the forgery attack is not considered as a successful attack. Therefore, the conclusion that this scheme cannot satisfy the security requirements of proxy signature against forging and denying is not appropriate in this sense. Finally, we study the reason for the misunderstanding and clarify the security requirements for proxy signatures.

  6. Law Enforcement Proxies Matter for the Law and Finance Nexus

    Directory of Open Access Journals (Sweden)

    Valentin Toci

    2013-07-01

    Full Text Available The paper employs various measures of law enforcement to provide new evidence on the importance of legal institutions for different dimensions of financial development in transition economies. It offers a critical assessment of law enforcement measures employed in recent studies by showing that some proxies for law enforcement in the credit market may not be appropriate. Hence, care should be taken in how the quality of institutions is measured and the context which it represents. An original approach to measuring law enforcement in the credit market is developed by embodying the legal theory of dispute resolution and assessing this approach by collecting primary data for Kosovo. The findings suggest that Kosovo compares well with countries in the region and other transition economies in terms of the enforcement of creditor rights.

  7. Munchausen Syndrome by proxy: Definition, context, and psychological factors involved

    Directory of Open Access Journals (Sweden)

    Thomas Gomes Gonçalves

    2014-07-01

    Full Text Available The Munchausen syndrome by proxy refers to a pathology characterized by physical and emotional abuse in which the simulation or production of symptoms is directed towards a child, which involves taking him or her to health treatments and unnecessary surgeries. The difficulties in the diagnosis of this form of abuse and the emotional aspects involved highlight the destructive effects in the infancy subjectivity due to the lack of loving capacity protecting and prioritizing the child demands. Psychoanalysis offers a differentiated view, comprehending that the mother attempts to elaborate her own psychic conflicts by the repetition of traumatic experience. There is a necessity of comprehension of the instinct destructivity presented in the maternal unconscious dynamics revealed in the modality of caring which is reflected in violence.

  8. Interactive images: Cuboid proxies for smart image manipulation

    KAUST Repository

    Zheng, Youyi

    2012-07-01

    Images are static and lack important depth information about the underlying 3D scenes. We introduce interactive images in the context of man-made environments wherein objects are simple and regular, share various non-local relations (e.g., coplanarity, parallelism, etc.), and are often repeated. Our interactive framework creates partial scene reconstructions based on cuboid-proxies with minimal user interaction. It subsequently allows a range of intuitive image edits mimicking real-world behavior, which are otherwise difficult to achieve. Effectively, the user simply provides high-level semantic hints, while our system ensures plausible operations by conforming to the extracted non-local relations. We demonstrate our system on a range of real-world images and validate the plausibility of the results using a user study. © 2012 ACM 0730-0301/2012/08-ART99.

  9. STRONTIUM DISTRIBUTION IN UPPER DEVONIAN CONODONT ELEMENTS: A PALAEOBIOLOGICAL PROXY

    Directory of Open Access Journals (Sweden)

    ANDREY V. ZHURAVLEV

    2017-04-01

    Full Text Available Conodonts are an extinct group of marine animals possessing debated affinities. The conodont elements are composed of calcium phosphate [apatite (CaF] and collagen-like proteins. Distribution of Sr in the bioapatite of albid, lamellar and paralamellar tissues of some Upper Devonian conodont element crowns from NW Russia was studied by microprobe. The calcium phosphate of the lamellar and paralamellar tissues demonstrates periodical oscillation of Sr contents across the lamellae (0.4-0.5 wt% in the outer part of lamella, and 0.2 wt% in the inner part. The albid tissue contains Sr of less than 0.4 wt%. It is suggested that oscillations of Sr concentrations reflect the periodic growth of the lamellae, and the average Ca/Sr ratio can be a proxy of the growth rate.

  10. The investigation of life-threatening child abuse and Munchausen syndrome by proxy.

    Science.gov (United States)

    Evans, D

    1995-01-01

    The use of covert video surveillance in the investigation of suspected life-threatening child abuse and Munchausen syndrome by proxy raises important ethical questions. That the recently reported provision of this facility in North Staffordshire was not presented to a Local Research Ethics Committee (LREC) for approval as a research exercise raises important questions about the ethical review of research and practice. The case made for avoiding such review is first set out and then examined. The three main premisses which form the basis of the view that LREC approval is not required are identified and tested in turn. The conclusion is that there is an undeniable element of research involved in the procedure and that the welfare of all those subjected to the surveillance would be best protected by the submission of the protocol to an independent committee for ethical assessment. PMID:7776355

  11. One thousand years of fires: Integrating proxy and model data

    Directory of Open Access Journals (Sweden)

    Natalie Marie Kehrwald

    2016-04-01

    Full Text Available The current fires raging across Indonesia are emitting more carbon than the annual fossil fuel emissions of Germany or Japan, and the fires are still consuming vast tracts of rainforest and peatlands. The National Interagency Fire Center (www.nifc.gov notes that 2015 is one worst fire years on record in the U.S., where more than 9 million acres burned -- equivalent to the combined size of Massachusetts and New Jersey. The U.S. and Indonesian fires have already displaced tens of thousands of people, and their impacts on ecosystems are still unclear. In the case of Indonesia, the burning peat is destroying much of the existing soil, with unknown implications for the type of vegetation regrowth. Such large fires result from a combination of fire management practices, increasing anthropogenic land use, and a changing climate. The expected increase in fire activity in the upcoming decades has led to a surge in research trying to understand their causes, the factors that may have influenced similar times of fire activity in the past, and the implications of such fire activity in the future. Multiple types of complementary data provide information on the impacts of current fires and the extent of past fires. The wide array of data encompasses different spatial and temporal resolutions (Figure 1 and includes fire proxy information such as charcoal and tree ring fire scars, observational records, satellite products, modern emissions data, fire models within global land cover and vegetation models, and sociodemographic data for modeling past human land use and ignition frequency. Any single data type is more powerful when combined with another source of information. Merging model and proxy data enables analyses of how fire activity modifies vegetation distribution, air and water quality, and proximity to cities; these analyses in turn support land management decisions relating to conservation and development.

  12. Assessing paleo-biodiversity using low proxy influx.

    Directory of Open Access Journals (Sweden)

    Olivier Blarquez

    Full Text Available We developed an algorithm to improve richness assessment based on paleoecological series, considering sample features such as their temporal resolutions or their volumes. Our new method can be applied to both high- and low-count size proxies, i.e. pollen and plant macroremain records, respectively. While pollen generally abounds in sediments, plant macroremains are generally rare, thus leading to difficulties to compute paleo-biodiversity indices. Our approach uses resampled macroremain influxes that enable the computation of the rarefaction index for the low influx records. The raw counts are resampled to a constant resolution and sample volume by interpolating initial sample ages at a constant time interval using the age∼depth model. Then, the contribution of initial counts and volume to each interpolated sample is determined by calculating a proportion matrix that is in turn used to obtain regularly spaced time series of pollen and macroremain influx. We applied this algorithm to sedimentary data from a subalpine lake situated in the European Alps. The reconstructed total floristic richness at the study site increased gradually when both pollen and macroremain records indicated a decrease in relative abundances of shrubs and an increase in trees from 11,000 to 7,000 cal BP. This points to an ecosystem change that favored trees against shrubs, whereas herb abundance remained stable. Since 6,000 cal BP, local richness decreased based on plant macroremains, while pollen-based richness was stable. The reconstructed richness and evenness are interrelated confirming the difficulty to distinguish these two aspects for the studies in paleo-biodiversity. The present study shows that low-influx bio-proxy records (here macroremains can be used to reconstruct stand diversity and address ecological issues. These developments on macroremain and pollen records may contribute to bridge the gap between paleoecology and biodiversity studies.

  13. Assessing paleo-biodiversity using low proxy influx.

    Science.gov (United States)

    Blarquez, Olivier; Finsinger, Walter; Carcaillet, Christopher

    2013-01-01

    We developed an algorithm to improve richness assessment based on paleoecological series, considering sample features such as their temporal resolutions or their volumes. Our new method can be applied to both high- and low-count size proxies, i.e. pollen and plant macroremain records, respectively. While pollen generally abounds in sediments, plant macroremains are generally rare, thus leading to difficulties to compute paleo-biodiversity indices. Our approach uses resampled macroremain influxes that enable the computation of the rarefaction index for the low influx records. The raw counts are resampled to a constant resolution and sample volume by interpolating initial sample ages at a constant time interval using the age∼depth model. Then, the contribution of initial counts and volume to each interpolated sample is determined by calculating a proportion matrix that is in turn used to obtain regularly spaced time series of pollen and macroremain influx. We applied this algorithm to sedimentary data from a subalpine lake situated in the European Alps. The reconstructed total floristic richness at the study site increased gradually when both pollen and macroremain records indicated a decrease in relative abundances of shrubs and an increase in trees from 11,000 to 7,000 cal BP. This points to an ecosystem change that favored trees against shrubs, whereas herb abundance remained stable. Since 6,000 cal BP, local richness decreased based on plant macroremains, while pollen-based richness was stable. The reconstructed richness and evenness are interrelated confirming the difficulty to distinguish these two aspects for the studies in paleo-biodiversity. The present study shows that low-influx bio-proxy records (here macroremains) can be used to reconstruct stand diversity and address ecological issues. These developments on macroremain and pollen records may contribute to bridge the gap between paleoecology and biodiversity studies.

  14. Intensity modulated neutron radiotherapy optimization by photon proxy.

    Science.gov (United States)

    Snyder, Michael; Hammoud, Ahmad; Bossenberger, Todd; Spink, Robyn; Burmeister, Jay

    2012-08-01

    Introducing intensity modulation into neutron radiotherapy (IMNRT) planning has the potential to mitigate some normal tissue complications seen in past neutron trials. While the hardware to deliver IMNRT plans has been in use for several years, until recently the IMNRT planning process has been cumbersome and of lower fidelity than conventional photon plans. Our in-house planning system used to calculate neutron therapy plans allows beam weight optimization of forward planned segments, but does not provide inverse optimization capabilities. Commercial treatment planning systems provide inverse optimization capabilities, but currently cannot model our neutron beam. We have developed a methodology and software suite to make use of the robust optimization in our commercial planning system while still using our in-house planning system to calculate final neutron dose distributions. Optimized multileaf collimator (MLC) leaf positions for segments designed in the commercial system using a 4 MV photon proxy beam are translated into static neutron ports that can be represented within our in-house treatment planning system. The true neutron dose distribution is calculated in the in-house system and then exported back through the MATLAB software into the commercial treatment planning system for evaluation. The planning process produces optimized IMNRT plans that reduce dose to normal tissue structures as compared to 3D conformal plans using static MLC apertures. The process involves standard planning techniques using a commercially available treatment planning system, and is not significantly more complex than conventional IMRT planning. Using a photon proxy in a commercial optimization algorithm produces IMNRT plans that are more conformal than those previously designed at our center and take much less time to create. The planning process presented here allows for the optimization of IMNRT plans by a commercial treatment planning optimization algorithm, potentially allowing

  15. Proxy-assisted multicasting of video streams over mobile wireless networks

    Science.gov (United States)

    Nguyen, Maggie; Pezeshkmehr, Layla; Moh, Melody

    2005-03-01

    This work addresses the challenge of providing seamless multimedia services to mobile users by proposing a proxy-assisted multicast architecture for delivery of video streams. We propose a hybrid system of streaming proxies, interconnected by an application-layer multicast tree, where each proxy acts as a cluster head to stream out content to its stationary and mobile users. The architecture is based on our previously proposed Enhanced-NICE protocol, which uses an application-layer multicast tree to deliver layered video streams to multiple heterogeneous receivers. We targeted the study on placements of streaming proxies to enable efficient delivery of live and on-demand video, supporting both stationary and mobile users. The simulation results are evaluated and compared with two other baseline scenarios: one with a centralized proxy system serving the entire population and one with mini-proxies each to serve its local users. The simulations are implemented using the J-SIM simulator. The results show that even though proxies in the hybrid scenario experienced a slightly longer delay, they had the lowest drop rate of video content. This finding illustrates the significance of task sharing in multiple proxies. The resulted load balancing among proxies has provided a better video quality delivered to a larger audience.

  16. Analisis Perbandingan Respons Time Squid Proxy Pada Windows Server dan Linux Server

    OpenAIRE

    Sirait, Parulian

    2016-01-01

    In the development of information technology, information is obtained quickly through technology computer network known as the Internet. The use bandwidth for Internet access can be maximized by using a proxy server. One of the proxy server is squid. The use squid as the proxy server need to consider the operating system on the server and have not known its best performance on any operating system yet. For that it is necessary to analyze the performance of squid proxy server on a different op...

  17. Three-year follow-up study of health related QOL and lifestyle indicators for Japanese patients after total hip arthroplasty.

    Science.gov (United States)

    Fujita, Kimie; Makimoto, Kiyoko; Mawatari, Masaaki

    2016-03-01

    In non-Western countries including Japan, activities requiring deep flexion of the hip joint, such as seiza (kneeling with calves tucked under the thighs and buttocks resting on the heels) and using squat toilets are commonly practiced. The purpose of this study was to assess longitudinal changes in traditional health-related quality of life measures and measures of physical functions associated with lifestyle for Japanese patients pre-surgery and after total hip arthroplasty. Consecutive primary total hip arthroplasty patients between July 2003 and November 2006 were eligible. Patients were measured preoperatively and at 6 weeks, 1 year and 3 years postoperatively. Patients completed the EuroQol 5D, the Western Ontario and McMaster Universities Osteoarthritis Index and items related to Japanese lifestyle activities such as squatting. Changes in these scale scores across the four time points were tested, and we examined predictive factors of EuroQol 5D score at 3-year follow-up using multiple linear regression. Of 1103 eligible patients, 576 completed questionnaires at all four time points. By 6 weeks post-surgery, reductions in pain and improvements in physical function and stiffness became highly significant, and improvements continued to 3 years postoperative. In contrast, improvements were far more limited for items related to Japanese lifestyle functions such as seiza and use of a Japanese squat toilet, even 3 years after surgery. Predictive factors of EQ5D at 3-year post THA were WOMAC pain and physical function, seiza, age and comorbidity measured at 3-year post THA. The rate of improvement in QOL requiring deep flexion of the hip joint was much slower than that in QOL related to Western lifestyle. Our study suggests a need for lifestyle modification for THA patients in the other countries where kneeling and squatting are commonly performed. Copyright © 2015 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  18. Estimating a minimal clinically important difference for the EuroQol 5-dimension health status index in persons with multiple sclerosis

    Science.gov (United States)

    2014-01-01

    Background Limited data define what constitutes a minimal clinically important difference (MCID) on the EuroQol 5-Dimension (EQ-5D) health status index in persons with multiple sclerosis (PwMS). We sought to estimate the MCID for the EQ-5D health index in North American PwMS. Methods PwMS completing the Patient Determined Disease Steps (PDDS) scale, 12-Item Multiple Sclerosis Walking Scale (MSWS-12) and EQ-5D as part of the North American Research Committee on Multiple Sclerosis (NARCOMS) registry’s spring 2011 update and supplemental survey were included in this retrospective, cross-sectional study. Distribution-based (standard error of measurement [SEM], 0.50 standard deviation [SD] and 0.33 SD unit) approaches were used to estimate a range of MCIDs for the EQ-5D based upon disease severity groups determined by the PDDS and MSWS-12 tertiles. Results A total of 3,044 participants were included. Moderately strong correlations between the EQ-5D and the PDDS and MSWS-12 were observed (Spearman’s r = -0.56 and -0.59, respectively, p MCID estimates based on PDDS score categories ranged from 0.065-0.158 (SEMs), 0.059-0.142 (0.50 SDs) and 0.039-0.095 (0.33 SDs). MCID estimates as measured by MSWS-12 tertile categories ranged from 0.068-0.098 (SEMs), 0.061-0.088 (0.50 SDs), and 0.041-0.059 (0.33 SDs). Across both the PDDS and tertiles of MSWS-12, MCID estimates tended to be larger as disease severity worsened. Mean weighted MCID estimates ranged from 0.05-0.084 for both the PDDS and MSWS-12 tertiles. Conclusion MCID estimates for the EQ-5D in PwMS were within the range of estimates seen for other disease states and appeared to be larger in those reporting more severe disease. PMID:24886430

  19. Correlating pharmaceutical data with a national health survey as a proxy for estimating rural population health

    Directory of Open Access Journals (Sweden)

    Cossman Ronald E

    2010-09-01

    Full Text Available Abstract Background Chronic disease accounts for nearly three-quarters of US deaths, yet prevalence rates are not consistently reported at the state level and are not available at the sub-state level. This makes it difficult to assess trends in prevalence and impossible to measure sub-state differences. Such county-level differences could inform and direct the delivery of health services to those with the greatest need. Methods We used a database of prescription drugs filled in the US as a proxy for nationwide, county-level prevalence of three top causes of death: heart disease, stroke, and diabetes. We tested whether prescription data are statistically valid proxy measures for prevalence, using the correlation between prescriptions filled at the state level and comparable Behavioral Risk Factor Surveillance System (BRFSS data. We further tested for statistically significant national geographic patterns. Results Fourteen correlations were tested for years in which the BRFSS questions were asked (1999-2003, and all were statistically significant. The correlations at the state level ranged from a low of 0.41 (stroke, 1999 to a high of 0.73 (heart disease, 2003. We also mapped self-reported chronic illnesses along with prescription rates associated with those illnesses. Conclusions County prescription drug rates were shown to be valid measures of sub-state estimates of diagnosed prevalence and could be used to target health resources to counties in need. This methodology could be particularly helpful to rural areas whose prevalence rates cannot be estimated using national surveys. While there are no spatial statistically significant patterns nationally, there are significant variations within states that suggest unmet health needs.

  20. Translation and validation of the Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaire for the Brazilian Portuguese language.

    Science.gov (United States)

    Oliveira Brito, Luiz Gustavo; Malzone-Lott, Daniela Alves; Sandoval Fagundes, Mayra Fernanda; Magnani, Pedro Sérgio; Fernandes Arouca, Mariana Alves; Poli-Neto, Omero Benedicto; Nogueira, Antônio Alberto

    2017-01-01

    Uterine fibroids (UF), also known as leiomyomas, are the most prevalent gynecological tumors. The Uterine Fibroid Symptoms and Quality of Life (UFS-QOL) is the only specific questionnaire that assesses symptom intensity and quality-of-life issues for women with symptomatic UF; however, it only exists in the English language. Thus, we aimed to translate and culturally validate the UFS-QOL questionnaire for the Brazilian Portuguese language. Cross-sectional study, Department of Gynecology and Obstetrics, FMRP-USP. 113 patients with UF (case group) and 55 patients without UF (control group) were interviewed using the UFS-QOL questionnaire after translation and cultural adaptation. The Short Form-36 questionnaire was used as a control. Demographic and psychometric variables were analyzed. Women with UF presented higher mean age, body mass index, weight, parity and comorbidities than the control group (P translation to the Brazilian Portuguese language, with good internal consistency, discriminant validity, construct validity, structural validity and responsiveness, along with adequate test-retest results.

  1. Quality of Life Assessment Using EuroQOL EQ-5D Questionnaire in Patients with Deep Infiltrating Endometriosis: The Relation with Symptoms and Locations

    Science.gov (United States)

    Touboul, C.; Amate, P.; Ballester, M.; Bazot, M.; Fauconnier, A.; Daraï, E.

    2013-01-01

    The objective of this study was to evaluate the quality of life (QOL) of patients with deep infiltrating endometriosis (DIE) using EuroQOL (EQ-5D) and its correlation with symptoms and locations of endometriotic lesions. One hundred and fifty-nine patients referred for DIE from January 2011 to April 2011 were prospectively invited to complete questionnaires evaluating symptoms associated with endometriosis as well as the EQ-5D questionnaire and health state. Patients also had locations of DIE evaluated by clinical examination and magnetic resonance imaging (MRI). All 159 patients completed the questionnaires. Item response rate was 91.1%. The most intense symptoms were dysmenorrhea (7.1/10), painful defecation (6.3/10), and fatigue (6.0/10). Mean (SD) scores were 77 (14) for the EQ-5D questionnaire and 63.4 (21) for the health state. A relation was observed between the EQ-5D questionnaire and the presence of dysmenorrhea, dyspareunia, cyclic pelvic pain, painful defecation, and diarrhea or constipation. Vaginal and rectal infiltrations were significantly associated with altered EQ-5D and health state scores. The EQ-5D questionnaire is easy to complete and well related to symptoms of DIE. Rectal and vaginal infiltrations were found to be determinant factors of altered QOL by the EQ-5D questionnaire and health state. PMID:26464845

  2. Conceptual Structure of Health-Related Quality of Life for Persons With Traumatic Brain Injury: Confirmatory Factor Analysis of the TBI-QOL.

    Science.gov (United States)

    Sherer, Mark; Poritz, Julia M P; Tulsky, David; Kisala, Pamela; Leon-Novelo, Luis; Ngan, Esther

    2017-05-18

    To determine the factor structure of the Traumatic Brain Injury-Quality of Life (TBI-QOL) measurement system. Observational. 3 TBI Model Systems rehabilitation centers. Twenty TBI-QOL item banks were administered to a sample of community-dwelling adults with TBI (N=504) as part of a study of TBI classification. A subsample of participants (n=200) was randomly selected for exploratory factor analyses, while data from the remaining participants (n=304) were used for the confirmatory factor analysis. To examine a wide range of conceptual models, confirmatory factor analyses were conducted on a total of 16 models, ranging from 1 to 7 factors. Not applicable. Not applicable. Initial exploratory factor analysis yielded support for a 5-factor model (negative emotion, cognitive impairment, functioning and participation, positive emotion, pain). Confirmatory factor analysis results, however, indicated a 7-factor model including physical function, physical symptoms, cognition, negative emotion, positive emotion, sense of self, and social participation (model 16; robust fit statistics root mean square error of approximation =.063, standardized root mean square residual =.035, comparative fit index =.955, Tucker-Lewis Index =.943, Bayes Information Criterion =40059.44). The complex 7-factor model of the TBI-QOL provides a more nuanced framework for understanding health-related quality of life for persons with TBI than the commonly used 3-factor model including physical health, mental health, and social health. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  3. Lifestyle at 3 years of age and quality of life (QOL) in first-year junior high school students in Japan: results of the Toyama Birth Cohort Study.

    Science.gov (United States)

    Wang, Hongbing; Sekine, Michikazu; Chen, Xiaoli; Yamagami, Takashi; Kagamimori, Sadanobu

    2008-03-01

    The aim of this study was to determine whether some effects of childhood lifestyles at 3 years of age are associated with quality of life (QOL) in first-year junior high school students (JHSS). Lifestyles including sleep, physical activity and dietary habits of 9,674 3-year-old children were obtained by questionnaire between 1992 and 1994. Assessments were undertaken with the Dartmouth Primary Care Co-operative Project charts in 9,574 first-year JHSS in 2002. Logistic regression analyses were used to explore the relationship between lifestyle in early childhood and QOL in first-year JHSS for the follow-up subjects. After adjusting for demographic and familial factors at baseline, the results showed that later bedtime [odds ratio (OR) = 1.17, P = 0.043], later waking time (OR = 1.19, P = 0.039), short sleep duration (OR = 1.15, P = 0.061), physical inactivity (OR = 1.48, P = 0.022), skipping breakfast (OR = 1.56, P = 0.003), irregular snacks (OR = 1.43, P lifestyle factors, especially dietary habits, at 3 years of age have significant effects on QOL in first-year JHSS. This suggests that interventions as early as 3 years of age should be considered.

  4. Appraising timing response of paleoenvironmental proxies to the Bond cycle in the western Mediterranean over the last 20 kyr

    Science.gov (United States)

    Rodrigo-Gámiz, Marta; Martínez-Ruiz, Francisca; Rodríguez-Tovar, Francisco J.; Pardo-Igúzquiza, Eulogio; Ortega-Huertas, Miguel

    2017-07-01

    The timing of climate responses to the Bond cycle is investigated in the western Mediterranean. Periodicities had been previously reported in a marine sediment record from this region spanning the last 20 kyr, and registered by diverse paleoenvironmental proxies, in particular those associated with terrigenous input, redox conditions, productivity, sea surface temperature (SST) and salinity. Further cross-spectral analyses on these time series reveal leads-lags in the 1400 year climate cycle. Considering as reference a terrigenous input proxy (the K/Al ratio), all the paleoenvironmental proxies displayed time shifts varying from ca. 700 year to ca. 350 year. SST and salinity variations show a first leaded response with the inflow of cold and less salty Atlantic waters. Followed by a time lead of 525 year, progresively arid conditions with an increase of eolian dust transport to the area, given by the Zr/Al signal, are observed. The intensification of dust transport could have triggered a latest biological response, lead by 350 year, with an increase of productivity, as suggested by the Ba/Al ratio. Lastly changes in the Mediterranean thermohaline circulation, indicated by a selected redox proxy (the U/Th ratio), are observed. These results support that the oceanic response triggered the atmospheric response to the Bond cycle in the western Mediterranean. Changes in the North Atlantic Oscillation mode and in the Inter-Tropical Convergence Zone migrations with variations in the monsoon activity or Saharan winds system, are considered as main forcing mechanisms, with a complex relationship of the involved phenomena.

  5. Sources and proxy potential of long chain alkyl diols in lacustrine environments

    Science.gov (United States)

    Rampen, Sebastiaan W.; Datema, Mariska; Rodrigo-Gámiz, Marta; Schouten, Stefan; Reichart, Gert-Jan; Sinninghe Damsté, Jaap S.

    2014-11-01

    Long chain 1,13- and 1,15-alkyl diols form the base of a number of recently proposed proxies used for climate reconstruction. However, the sources of these lipids and environmental controls on their distribution are still poorly constrained. We have analyzed the long chain alkyl diol (LCD) composition of cultures of ten eustigmatophyte species, with three species from different families grown at various temperatures, to identify the effect of species composition and growth temperature on the LCD distribution. The results were compared with the LCD distribution of sixty-two lake surface sediments, and with previously reported LCD distributions from marine environments. The different families within the Eustigmatophyceae show distinct LCD patterns, with the freshwater family Eustigmataceae most closely resembling LCD distributions in both marine and lake environments. Unlike the other two eustigmatophyte families analyzed (Monodopsidaceae and Goniochloridaceae), C28 and C30 1,13-alkyl diols and C30 and C32 1,15-alkyl diols are all relatively abundant in the family Eustigmataceae, while the mono-unsaturated C32 1,15-alkyl diol was below detection limit. In contrast to the marine environment, LCD distributions in lakes did not show a clear relationship with temperature. The Long chain Diol Index (LDI), a proxy previously proposed for sea surface temperature reconstruction, showed a relatively weak correlation (R2 = 0.33) with mean annual air temperature used as an approximation for annual mean surface temperature of the lakes. A much-improved correlation (R2 = 0.74, p-value lipid distributions. The obtained regression model provides good estimates of temperatures for cultures of the family Eustigmataceae, suggesting that algae belonging to this family have an important role as a source for LCDs in lacustrine environments, or, alternatively, that the main sources of LCDs are similarly affected by temperature as the Eustigmataceae. The results suggest that LCDs may have

  6. Self-reported quality of life of 8-12-year-old children with cerebral palsy

    DEFF Research Database (Denmark)

    Dickinson, Heather O; Parkinson, Kathryn N; Ravens-Sieberer, Ulrike

    2007-01-01

    (61%) reported their QoL using KIDSCREEN, an instrument with scores in ten domains, each with SD=10. Multivariable regression was used to relate QoL to impairments, pain, and sociodemographic characteristics. Comparisons were made with QoL data from the general population. FINDINGS: Impairments were.......5-5.9) and autonomy (3.3, 0.9-5.7); and speech difficulties with reduced mean for relationships with parents (4.5, 1.9-7.1). Pain was common and associated with lower QoL on all domains. Impairments and pain explained up to 3% and 7%, respectively, of variation in QoL. Children with cerebral palsy had similar Qo....... This finding should guide social and educational policy to ensure that disabled children participate fully in society. Because of its association with QoL, children's pain should be carefully assessed....

  7. Patient versus informant reported quality of life in the earliest phases of Alzheimer's disease

    DEFF Research Database (Denmark)

    Vogel, Asmus; Mortensen, Erik Lykke; Hasselbalch, Steen G

    2006-01-01

    The study investigated if patient and informant reported Quality of Life (QoL) differed in early Alzheimer's disease (AD). In addition, we examined whether anosognosia had an impact on the agreement between patient and informant ratings of QoL and whether anosognosia, dementia severity, depression...

  8. Patient‐reported outcome measures in pediatric epilepsy: A content analysis using World Health Organization definitions

    National Research Council Canada - National Science Library

    Sadeghi, Salva; Fayed, Nora; Ronen, Gabriel M

    2014-01-01

    ... of agreement in the literature about the definitions of these terms pose problems for advancing knowledge across studies due to lack of equivalence and comparability in the concepts of health, HRQOL, and QOL. This lack of agreement has been identified as a barrier to health and QOL research by many scientific groups including Patient Reported Outcom...

  9. 75 FR 9073 - Amendments to Rules Requiring Internet Availability of Proxy Materials

    Science.gov (United States)

    2010-02-26

    ... an Internet Web site; it is not intended to serve as a stand-alone basis for making a voting decision... Exchange Commission 17 CFR Parts 230 and 240 Amendments to Rules Requiring Internet Availability of Proxy... Rules Requiring Internet Availability of Proxy Materials AGENCY: Securities and Exchange Commission...

  10. Improving age-depth models using sedimentary proxies for accumulation rates in fluvio-lacustrine deposits

    NARCIS (Netherlands)

    Minderhoud, P.S.J.; Cohen, K.M.|info:eu-repo/dai/nl/185633374; Toonen, W.H.J.|info:eu-repo/dai/nl/317725505; Erkens, G.|info:eu-repo/dai/nl/323349382; Hoek, W.Z.|info:eu-repo/dai/nl/163819394

    2017-01-01

    Lacustrine fills, including those of oxbow lakes in river floodplains, often hold valuable sedimentary and biological proxy records of palaeo-environmental change. Precise dating of accumulated sediments at levels throughout these records is crucial for interpretation and correlation of (proxy) data

  11. 47 CFR 51.513 - Proxies for forward-looking economic cost.

    Science.gov (United States)

    2010-10-01

    ... SERVICES (CONTINUED) INTERCONNECTION Pricing of Elements § 51.513 Proxies for forward-looking economic cost... a cost study that complies with the forward-looking economic cost based pricing methodology... rates that apply in separate geographic areas in a state. (c) Proxies for specific elements—(1) Local...

  12. Diagnostic, Explanatory, and Detection Models of Munchausen by Proxy: Extrapolations from Malingering and Deception

    Science.gov (United States)

    Rogers, Richard

    2004-01-01

    Objective: The overriding objective is a critical examination of Munchausen syndrome by proxy (MSBP) and its closely-related alternative, factitious disorder by proxy (FDBP). Beyond issues of diagnostic validity, assessment methods and potential detection strategies are explored. Methods: A painstaking analysis was conducted of the MSBP and FDBP…

  13. Pseudo-proxy evaluation of climate field reconstruction methods of North Atlantic climate based on an annually resolved marine proxy network

    Science.gov (United States)

    Pyrina, Maria; Wagner, Sebastian; Zorita, Eduardo

    2017-10-01

    Two statistical methods are tested to reconstruct the interannual variations in past sea surface temperatures (SSTs) of the North Atlantic (NA) Ocean over the past millennium based on annually resolved and absolutely dated marine proxy records of the bivalve mollusk Arctica islandica. The methods are tested in a pseudo-proxy experiment (PPE) setup using state-of-the-art climate models (CMIP5 Earth system models) and reanalysis data from the COBE2 SST data set. The methods were applied in the virtual reality provided by global climate simulations and reanalysis data to reconstruct the past NA SSTs using pseudo-proxy records that mimic the statistical characteristics and network of Arctica islandica. The multivariate linear regression methods evaluated here are principal component regression and canonical correlation analysis. Differences in the skill of the climate field reconstruction (CFR) are assessed according to different calibration periods and different proxy locations within the NA basin. The choice of the climate model used as a surrogate reality in the PPE has a more profound effect on the CFR skill than the calibration period and the statistical reconstruction method. The differences between the two methods are clearer for the MPI-ESM model due to its higher spatial resolution in the NA basin. The pseudo-proxy results of the CCSM4 model are closer to the pseudo-proxy results based on the reanalysis data set COBE2. Conducting PPEs using noise-contaminated pseudo-proxies instead of noise-free pseudo-proxies is important for the evaluation of the methods, as more spatial differences in the reconstruction skill are revealed. Both methods are appropriate for the reconstruction of the temporal evolution of the NA SSTs, even though they lead to a great loss of variance away from the proxy sites. Under reasonable assumptions about the characteristics of the non-climate noise in the proxy records, our results show that the marine network of Arctica islandica can

  14. Pseudo-proxy evaluation of climate field reconstruction methods of North Atlantic climate based on an annually resolved marine proxy network

    Directory of Open Access Journals (Sweden)

    M. Pyrina

    2017-10-01

    Full Text Available Two statistical methods are tested to reconstruct the interannual variations in past sea surface temperatures (SSTs of the North Atlantic (NA Ocean over the past millennium based on annually resolved and absolutely dated marine proxy records of the bivalve mollusk Arctica islandica. The methods are tested in a pseudo-proxy experiment (PPE setup using state-of-the-art climate models (CMIP5 Earth system models and reanalysis data from the COBE2 SST data set. The methods were applied in the virtual reality provided by global climate simulations and reanalysis data to reconstruct the past NA SSTs using pseudo-proxy records that mimic the statistical characteristics and network of Arctica islandica. The multivariate linear regression methods evaluated here are principal component regression and canonical correlation analysis. Differences in the skill of the climate field reconstruction (CFR are assessed according to different calibration periods and different proxy locations within the NA basin. The choice of the climate model used as a surrogate reality in the PPE has a more profound effect on the CFR skill than the calibration period and the statistical reconstruction method. The differences between the two methods are clearer for the MPI-ESM model due to its higher spatial resolution in the NA basin. The pseudo-proxy results of the CCSM4 model are closer to the pseudo-proxy results based on the reanalysis data set COBE2. Conducting PPEs using noise-contaminated pseudo-proxies instead of noise-free pseudo-proxies is important for the evaluation of the methods, as more spatial differences in the reconstruction skill are revealed. Both methods are appropriate for the reconstruction of the temporal evolution of the NA SSTs, even though they lead to a great loss of variance away from the proxy sites. Under reasonable assumptions about the characteristics of the non-climate noise in the proxy records, our results show that the marine network of Arctica

  15. Cultural adaptation and validation of the Neuropathy - and Foot Ulcer - Specific Quality of Life instrument (NeuroQol for Brazilian Portuguese - Phase 1 Adaptación cultural y validación del Neuropathy - and Foot Ulcer - Specific Quality of Life (NeuroQol para el idioma portugués de Brasil - Fase 1 Adaptação cultural e validação do Neuropathy - and Foot Ulcer - Specific Quality of Life (NeuroQol para a língua portuguesa do Brasil - Fase 1

    Directory of Open Access Journals (Sweden)

    Antonia Tayana da Franca Xavier

    2011-12-01

    Full Text Available This methodological study aimed to adapt the Neuropathy - and Foot Ulcer - Specific Quality of Life instrument - NeuroQol to Brazilian Portuguese and to analyze its psychometric properties. Participants were 50 people with peripheral diabetic neuropathy and foot ulcers. The floor and ceiling effects, the convergent and discriminant validity and the reliability were analyzed. The Cronbach’s alpha coefficient was used to test the reliability and the Pearson’s correlation coefficient to estimate the convergent validity, the Student’s t test was used to evaluate the discriminant validity in the comparison of the NeuroQol scores between participants with and without ulcers. Floor and ceiling effects were found in some domains of the NeuroQol. The reliability was satisfactory. The correlations between the domains of the NeuroQol and the SF-36 were negative, significant and of moderate to strong magnitude. The findings show that the Brazilian version of the NeuroQol is reliable and valid and may be employed as a useful tool for improving nursing care for people with DM.Estudio metodológico que tuvo como objetivos adaptar el Neuropathy - and Foot Ulcer - Specific Quality of Life - NeuroQol para el idioma portugués de Brasil y analizar sus propiedades psicométricas. Participaron 50 personas con neuropatía diabética periférica y úlceras en los pies. Fueron analizados los efectos floor y ceiling, la validez convergente, la discriminante y la confiabilidad. Fue utilizado el coeficiente alfa de Cronbach para comprobar la confiabilidad y la correlación de Pearson para estimar la validez convergente; el test t-Student fue empleado para evaluar la validez discriminante en la comparación de los puntajes del NeuroQol entre los participantes con y sin úlceras. Se constataron efectos floor y ceiling en algunos dominios del NeuroQol. La confiabilidad fue satisfactoria. Las correlaciones entre los dominios del NeuroQol y SF-36 fueron negativas

  16. Millennial reconstructions: what can we learn from limited proxy data?

    Science.gov (United States)

    Annan, J. D.; Hargreaves, J. C.

    2011-12-01

    Reconstructions of the past millennium can help us to understand recent and future climate change, by placing the recent anthropogenically-forced changes in the context of natural variability. Proxy data prior to the instrumental era are, however, extremely limited, which raises the question of how well we can truly hope to understand the past. Until recently, temperature reconstructions over the past millennium have primarily used statistical regression-based methods, however approaches using data assimilation methodology (in which observational data are blended with dynamical climate models) have shown great potential and are being increasingly adopted. However, rigorous validation of these methods has been somewhat limited. Here we will present the results of some investigations into the performance, and the potential, of data assimilation approaches to estimate the climate state. We use a massive ensemble of the LOVECLIM model to generate precise results which (through being formally optimal) may be considered an upper bound on the performance of more realistic approaches. We show that the limited precision and volume of data places a severe constraint on our ability to reliably reconstruct past climate variability, especially prior to the middle of the last millennium.

  17. Identification of climatic state with limited proxy data

    Directory of Open Access Journals (Sweden)

    J. D. Annan

    2012-07-01

    Full Text Available We investigate the identifiability of the climate by limited proxy data. We test a data assimilation approach through perfect model pseudoproxy experiments, using a simple likelihood-based weighting based on the particle filtering process. Our experimental set-up enables us to create a massive 10 000-member ensemble at modest computational cost, thus enabling us to generate statistically robust results. We find that the method works well when data are sparse and imprecise, but in this case the reconstruction has a rather low accuracy as indicated by residual RMS errors. Conversely, when data are relatively plentiful and accurate, the estimate tracks the target closely, at least when considering the hemispheric mean. However, in this case, our prior ensemble size of 10 000 appears to be inadequate to correctly represent the true posterior, and the regional performance is poor. Using correlations to assess performance gives a more encouraging picture, with significant correlations ranging from about 0.3 when data are sparse to values over 0.7 when data are plentiful, but the residual RMS errors are substantial in all cases. Our results imply that caution is required in interpreting climate reconstructions, especially when considering the regional scale, as skill on this basis is markedly lower than on the large scale of hemispheric mean temperature.

  18. Medieval horse stable; the results of multi proxy interdisciplinary research.

    Science.gov (United States)

    Dejmal, Miroslav; Lisá, Lenka; Fišáková Nývltová, Miriam; Bajer, Aleš; Petr, Libor; Kočár, Petr; Kočárová, Romana; Nejman, Ladislav; Rybníček, Michal; Sůvová, Zdenka; Culp, Randy; Vavrčík, Hanuš

    2014-01-01

    A multi proxy approach was applied in the reconstruction of the architecture of Medieval horse stable architecture, the maintenance practices associated with that structure as well as horse alimentation at the beginning of 13th century in Central Europe. Finally, an interpretation of the local vegetation structure along Morava River, Czech Republic is presented. The investigated stable experienced two construction phases. The infill was well preserved and its composition reflects maintenance practices. The uppermost part of the infill was composed of fresh stabling, which accumulated within a few months at the end of summer. Horses from different backgrounds were kept in the stable and this is reflected in the results of isotope analyses. Horses were fed meadow grasses as well as woody vegetation, millet, oat, and less commonly hemp, wheat and rye. Three possible explanations of stable usage are suggested. The stable was probably used on a temporary basis for horses of workers employed at the castle, courier horses and horses used in battle.

  19. Music Therapy by Proxy: Using Humanised Images in Song

    Directory of Open Access Journals (Sweden)

    Carol Chambers

    2013-07-01

    Full Text Available Developing awareness, exploration and expression of emotionally sensitive issues can be difficult for some clients in music therapy. They may find it hard to express emotion through improvised music and may turn instead to the perceived security of the repetition of known songs.This paper presents the results from a completed research PhD, a qualitative case study based on naturalistic clinical practice, which examined the song choices of one woman in a medium-secure forensic unit over the three-year course of her music therapy. A descriptive narrative account was subjected to analysis according to a modified form of therapeutic narrative analysis (Aldridge and Aldridge 2002, resulting in the abstraction of a series of generative metaphoric images, framed within a chronological series of events. Crucially, these images were found to be humanised figures, yet they were also emotionally decentred or depersonalised. When approached from the philosophical and methodological perspective of behaviourism, which views these as conditioned responses associating music with life experiences as part of a process of developing self-identity, such images can be seen to provide an unspoken voice for the client’s feelings to be expressed in a manner that is personally revealing, socially acceptable, culturally accessible and therapeutically constructive.I assert that using these third-person characters as a form of proxy facilitates mutual reference and experimentation, and places music firmly at the heart of a socially constructed process of music therapy.

  20. A Rare Reason of Hyperinsulinism: Munchausen Syndrome by Proxy.

    Science.gov (United States)

    Akın, Onur; Yeşilkaya, Ediz; Sari, Erkan; Akar, Çağdaş; Başbozkurt, Gökalp; Macit, Enis; Aydin, Ibrahim; Taşlipinar, Abdullah; Gül, Hüsamettin

    2016-01-01

    Hyperinsulinism, one of the most important causes of hypoglycaemia, can be congenital or acquired. Rarely, drug toxicity can be a reason for hyperinsulinism. In the context of Munchausen syndrome by proxy (MSP), toxicity usually occurs in children due to drug administration by a parent or caregiver. A 7-year-old girl was referred to our department due to a hyperglycaemic period and hypoglycaemic episodes. On admission, gliclazide was initiated due to her hyperglycaemia, which we attributed to maturity onset diabetes of the young. However, during follow-up, hypoglycaemic levels were detected. Despite cessation of gliclazide, hypoglycaemic seizures occurred. Even with the medications administered, hypoglycaemia could not be prevented. During follow-up, the mother's affect, characterized by anxiety and interest in her daughter's medical care, appeared discordant with the situation. Due to our suspicion of MSP, we discovered toxic levels of gliclazide in the blood and urine samples which had been sent to the toxicology laboratory to search for hypoglycaemic agents. The patient was isolated, and all medications were stopped. After isolation, her hypoglycaemia disappeared, and she became hyperglycaemic (250 mg/dl). Physicians should consider the possibility of MSP in hyperinsulinaemic patients with discordant laboratory results and clinical symptoms, even if the child's parents display great concern. © 2016 S. Karger AG, Basel.

  1. Severe hypernatremia in a hospitalized child: munchausen by proxy.

    Science.gov (United States)

    Su, Erik; Shoykhet, Michael; Bell, Michael J

    2010-10-01

    An 8-week-old infant presented to a referring institution with profuse diarrhea and infectious enteritis for 1 week. He was initially treated for suspected Salmonella spp. sepsis and meningitis, because the organism was found in the stool, but the child's illness progressed, manifested by paroxysmal profuse diarrhea and increased urine output. After several weeks, he suffered a sagittal venous thrombosis and intracranial hemorrhage. Subsequently the child was transferred to a tertiary center for intestinal evaluation. The patient's diarrhea and excessive diuresis resolved, and his sodium normalized soon after transfer. Four days later, however, after his mother arrived, he immediately developed severe hypernatremia (serum sodium concentration [Na(+)] = 214 mEq/L), with resumption of diarrhea and excessive diuresis. A gastric aspirate during the crisis demonstrated an extremely high sodium content, [Na(+)] = 1416 mEq/L, consistent with salt intoxication. Surveillance of the mother revealed that she manipulated the indwelling nasogastric tube; confronted, she admitted to salt administration. This case describes one of the ways that Munchausen syndrome by proxy can manifest with profound neurologic sequelae, and highlights the need for close observation and swift intervention when sufficient cause is present. Copyright © 2010 Elsevier Inc. All rights reserved.

  2. Cognitive-Behavioral Therapy for Body Dysmorphic Disorder by Proxy.

    Science.gov (United States)

    Greenberg, Jennifer L; Mothi, Suraj Sarvode; Wilhelm, Sabine

    2016-07-01

    Body dysmorphic disorder (BDD) is a distressing or impairing preoccupation with a perceived defect in physical appearance. BDD by proxy (BDDBP) is a significant but understudied variant of BDD in which the primary preoccupation involves perceived imperfections of another person. Like BDD, individuals with BDDBP engage in time-consuming rituals to "fix" the other person's appearance or alleviate distress. Avoidance is common and the impact of BDDBP on social functioning is profound. Cognitive-behavioral therapy (CBT) is the best-studied and most promising psychological treatment for BDD, but no studies have examined its generalizability to the BDDBP variant. We tested feasibility, acceptability, and treatment outcome of CBT modified for BDDBP in a sample of 6 adults with primary BDDBP. Treatment was delivered in weekly individual sessions over 12-20weeks. Mean symptom severity (BDDBP-YBOCS) dropped from the moderately severe range at pretreatment to the subclinical range at posttreatment, t(6)=10.7, p<.001, d=3.3. One hundred percent of treatment completers were responders (≥30% reduction in BDDBP-YBOCS). Insight also improved. Treatment gains were maintained at 3-month follow-up. To our knowledge, this represents the first treatment study for BDDBP. Copyright © 2016. Published by Elsevier Ltd.

  3. A Multi-Component Proxy for OH Variability Measured from Space: Evaluation and Evolution

    Science.gov (United States)

    Murray, L. T.; Fiore, A. M.; Valin, L. C.

    2014-12-01

    Observed changes in the decay rate of methyl chloroform (MCF; CH3CCl3) have been the traditional top-down constraint for variability in tropospheric abundances of the hydroxyl radical (OH), and thereby the oxidative capacity of the atmosphere. However, as atmospheric MCF concentrations approach detection limits following its ban under the Montréal Protocol, it is necessary to identify new proxies for global OH and its variability. We present here a novel proxy for tropospheric OH using convolved observations of total and tropospheric columns of ozone, water vapor, NO2, and CO, available from the Aura and Aqua satellites in the NASA Earth Observing System constellation. Derived from photochemical steady-state assumptions, the satellite proxy generates spatiotemporally coherent monthly percent anomalies in column OH for Oct. 2004 through Sept. 2012. We demonstrate that the temporal evolution of the globally integrated signal is statistically consistent with changes inferred by the MCF decay rate during this period. The magnitude of interannual variability in the satellite OH proxy is smaller than that from MCF, more consistent with global chemical transport models (CTMs). We evaluate the proxy by comparing to 9-year hind-cast simulations of the GEOS-Chem global CTM driven by MERRA reanalysis meteorology at 2° x 2.5° horizontal resolution, and find that the satellite proxy correlates with the airmass-weighted tropospheric monthly mean OH anomalies (R = 0.6; n = 96 months). The satellite proxy and model simulations indicate regional-scale coherent OH anomalies for many regions and seasons; where discrepancies occur, we highlight possible causes. We present a source attribution of the spatial and temporal patterns in the satellite OH proxy, informed by the individual components of the satellite proxy, a series of zero-emission sensitivity simulations with GEOS-Chem, and independent proxies for major modes of climate variability.

  4. Climate in Sweden during the past millennium - Evidence from proxy data, instrumental data and model simulations

    Energy Technology Data Exchange (ETDEWEB)

    Moberg, Anders; Gouirand, Isabelle; Schoning, Kristian; Wohlfarth, Barbara [Stockholm Univ. (Sweden). Dept. of Physical Geography and Quaternary Geology; Kjellstroem, Erik; Rummukainen, Markku [Swedish Meteorological and Hydrological Inst., Norrkoeping (Sweden). Rossby Centre; Jong, Rixt de [Lund Univ. (Sweden). Dept. of Quaternary Geology; Linderholm, Hans [Goeteborg Univ. (Sweden). Dept. of Earth Sciences; Zorita, Eduardo [GKSS Research Centre, Geesthacht (Germany)

    2006-12-15

    last millennium. Models, however, cannot be used to deduce the exact time evolution of climate variations, but they can provide relevant information in a statistical sense, for example by defining the limits within which climate naturally has varied. Uncertainties - and also advantages - of both empirical climate data and model simulations are discussed. A main conclusion is that there have been both relatively warm and cold past periods, as well as some relatively wet and dry periods during the past 1,000 to 2,000 years. It appears that the last 70-year period in Sweden was the warmest period over at least the last 500 years. Exactly how unusual the past few decades were can, however, not yet be established due to limitations of the proxy data. There are also indications that significant past changes in precipitation, river runoff and storminess have occurred, although available proxy data do not yet allow accurate quantitative estimations. The results of the present report will be used by SKB, along with other information, in the process of defining and describing future climate scenarios. They will also be used in evaluating the impact of climate on various processes related to repository safety, for example biosphere processes. To increase knowledge of past climate variations in Sweden for the last millennium, it seems necessary to develop additional climate proxy records with annual or at least decadal resolution. Long simulations with climate models may also be used in this context.

  5. Measuring and reporting quality of life outcomes in clinical trials in cystic fibrosis: a critical review

    Directory of Open Access Journals (Sweden)

    Hart Anna

    2005-03-01

    Full Text Available Abstract Good quality clinical trials are essential to inform the best cystic fibrosis (CF management and care, by determining and comparing the effectiveness of new and existing therapies and drug delivery systems. The formal inclusion of quality of life (QoL as an outcome measure in CF clinical trials is becoming more common. Both an appropriate QoL measure and sound methodology are required in order to draw valid inferences about treatments and QoL. A review was undertaken of randomised controlled trials in cystic fibrosis where QoL was measured. EMBASE, MEDLINE and ISI Web of Science were searched to locate all full papers in the English language reporting randomised controlled trials in cystic fibrosis, published between January 1991 and December 2004. All Cochrane reviews published before December 2004 were hand searched. Papers were included if the authors had reported that they had measured QoL or well being in the trial. 16 trials were identified. The interventions investigated were: antibiotics (4; home versus hospital administration of antibiotics (1; steroids (1; mucolytic therapies (6; exercise (3 and pancreatic enzymes (1. Not one trial evaluated in this review provided conclusive results concerning QoL. This review highlights many of the pitfalls of QoL measurement in CF clinical trials and provides constructive information concerning the design and reporting of trials measuring QoL.

  6. Effects of music and art education in early life and oral functions on the QOL of the Takarazuka Revue Company OG compared with general elderly females.

    Science.gov (United States)

    Masutani, Takiko; Yamamoto, Yasuji; Konishi, Junya; Maeda, Kiyoshi

    2010-03-01

    Today, Japan is becoming a super-aged society, with senior citizens already constituting over 21% of the population. In this situation, the question of how elderly people can extend their lives and enjoy independent lifestyles is becoming more important. The present study aims to clarify the relationship between the Quality of Life (QOL) of elderly females and their current oral functions and experiences of music and art education in early life. We carried out a survey study focusing on elderly females (Takarazuka Revue Company OG group and general female group) by carrying out a questionnaire survey and comparing cognitive function, oral examinations, cerebral atrophy in magnetic resonance imaging, and other characteristics. It was shown that the Takarazuka Revue Company OG group had greater hippocampal volumes and significantly higher cognitive functions than the general female group. In addition, in the general female group, there was a significant correlation between a decrease in the number of remaining teeth and a decrease in activities in daily living, but in the Takarazuka Revue Company OG group, no such correlation was observed. The results showed that those who have received art education as part of their careers over an extensive period since early life have higher levels of cognitive function, QOL, physical activity, social activity and life satisfaction compared with the general female group; showing that they sense a purpose in life and live with a positive attitude. In contrast, in the general female group, those who have continued to enjoy hobbies have higher levels of cognitive function, QOL, physical activity, social activity and life satisfaction than those who have not, thus showing that they live with a positive attitude.

  7. Geochemical Proxies for Enhanced Process Control of Underground Coal Gasification

    Science.gov (United States)

    Kronimus, A.; Koenen, M.; David, P.; Veld, H.; van Dijk, A.; van Bergen, F.

    2009-04-01

    Underground coal gasification (UCG) represents a strategy targeting at syngas production for fuel or power generation from in-situ coal seams. It is a promising technique for exploiting coal deposits as an energy source at locations not allowing conventional mining under economic conditions. Although the underlying concept has already been suggested in 1868 and has been later on implemented in a number of field trials and even at a commercial scale, UCG is still facing technological barriers, impeding its widespread application. Field UCG operations rely on injection wells enabling the ignition of the target seam and the supply with oxidants (air, O2) inducing combustion (oxidative conditions). The combustion process delivers the enthalpy required for endothermic hydrogen production under reduction prone conditions in some distance to the injection point. The produced hydrogen - usually accompanied by organic and inorganic carbon species, e.g. CH4, CO, and CO2 - can then be retrieved through a production well. In contrast to gasification of mined coal in furnaces, it is difficult to measure the combustion temperature directly during UCG operations. It is already known that geochemical parameters such as the relative production gas composition as well as its stable isotope signature are related to the combustion temperature and, consequently, can be used as temperature proxies. However, so far the general applicability of such relations has not been proven. In order to get corresponding insights with respect to coals of significantly different rank and origin, four powdered coal samples covering maturities ranging from Ro= 0.43% (lignite) to Ro= 3.39% (anthracite) have been gasified in laboratory experiments. The combustion temperature has been varied between 350 and 900 ˚ C, respectively. During gasification, the generated gas has been captured in a cryo-trap, dried and the carbon containing gas components have been catalytically oxidized to CO2. Thereafter, the

  8. A Lattice-Based Identity-Based Proxy Blind Signature Scheme in the Standard Model

    Directory of Open Access Journals (Sweden)

    Lili Zhang

    2014-01-01

    Full Text Available A proxy blind signature scheme is a special form of blind signature which allowed a designated person called proxy signer to sign on behalf of original signers without knowing the content of the message. It combines the advantages of proxy signature and blind signature. Up to date, most proxy blind signature schemes rely on hard number theory problems, discrete logarithm, and bilinear pairings. Unfortunately, the above underlying number theory problems will be solvable in the postquantum era. Lattice-based cryptography is enjoying great interest these days, due to implementation simplicity and provable security reductions. Moreover, lattice-based cryptography is believed to be hard even for quantum computers. In this paper, we present a new identity-based proxy blind signature scheme from lattices without random oracles. The new scheme is proven to be strongly unforgeable under the standard hardness assumption of the short integer solution problem (SIS and the inhomogeneous small integer solution problem (ISIS. Furthermore, the secret key size and the signature length of our scheme are invariant and much shorter than those of the previous lattice-based proxy blind signature schemes. To the best of our knowledge, our construction is the first short lattice-based identity-based proxy blind signature scheme in the standard model.

  9. A Proxy Outcome Approach for Causal Effect in Observational Studies: A Simulation Study

    Directory of Open Access Journals (Sweden)

    Wenbin Liang

    2014-01-01

    Full Text Available Background. Known and unknown/unmeasured risk factors are the main sources of confounding effects in observational studies and can lead to false observations of elevated protective or hazardous effects. In this study, we investigate an alternative approach of analysis that is operated on field-specific knowledge rather than pure statistical assumptions. Method. The proposed approach introduces a proxy outcome into the estimation system. A proxy outcome possesses the following characteristics: (i the exposure of interest is not a cause for the proxy outcome; (ii causes of the proxy outcome and the study outcome are subsets of a collection of correlated variables. Based on these two conditions, the confounding-effect-driven association between the exposure and proxy outcome can then be measured and used as a proxy estimate for the effects of unknown/unmeasured confounders on the outcome of interest. Performance of this approach is tested by a simulation study, whereby 500 different scenarios are generated, with the causal factors of a proxy outcome and a study outcome being partly overlapped under low-to-moderate correlations. Results. The simulation results demonstrate that the conventional approach only led to a correct conclusion in 21% of the 500 scenarios, as compared to 72.2% for the alternative approach. Conclusion. The proposed method can be applied in observational studies in social science and health research that evaluates the health impact of behaviour and mental health problems.

  10. Near coast sedimentary stratigraphy as a proxy for climatic instability

    Science.gov (United States)

    McLivenny, J.

    2009-04-01

    Several studies have indicated a link between climatic deterioration and dune stability (Wilson 2002, Issar 2003, Dawson et al 2004). The frequency and magnitude of storms have been cited as a key variable in the stability of large dune systems. For the stratigraphy of dune systems to act as a regional climatic proxy there must be a good regional relationship between known climatic events and regionally correlated stratigraphic changes. Dunnet Bay in Caithness, Northern Scotland was chosen as a study site to look at the relationship between dune stability and climatic change during the late Holocene in Northern Scotland. Dunnet Bay was chosen for its physical attributes which make it an excellent natural sediment trap. Tucked in between headlands which act as barriers to long-shore transport the predominant movement of sediment there is straight onshore, with only minor amounts being lost to the sea. The immediate back-dune stratigraphy, colloquially known as "links", provided evidence of peat formation and dune stability. Stratigraphy was mapped using traditional field techniques and ground penetrating radar. The cores consisted mostly of massive layers of sand interleaved with peat. Sand layers were dated with optically stimulated luminescence (OSL) and interpreted as reflecting high wind energy regimes transporting sand inland. Peat layers were C14 dated and taken as representing climatic stability. Stratigraphy was mapped using hand auguring, percussion coring, and open sections. Ground penetrating radar was also used to look at the continuity of key layers. OSL dating in two open sections showed dates obtained from the first section (1790 AD ±70, 53 BC ± 100, 300 BC ± 100, 400 BC ± 100) mapped to the top of the second section (1800 AD ± 100, 1500 BC ± 200, 2900 BC ± 300) which was consistent with stratigraphy increasing sediment thickness towards the centre of the bay. The results were consistent with acquired C14 dates from selected peat layers. Taken

  11. Using Resin-Based 3D Printing to Build Geometrically Accurate Proxies of Porous Sedimentary Rocks.

    Science.gov (United States)

    Ishutov, Sergey; Hasiuk, Franciszek J; Jobe, Dawn; Agar, Susan

    2017-09-28

    Three-dimensional (3D) printing is capable of transforming intricate digital models into tangible objects, allowing geoscientists to replicate the geometry of 3D pore networks of sedimentary rocks. We provide a refined method for building scalable pore-network models ("proxies") using stereolithography 3D printing that can be used in repeated flow experiments (e.g., core flooding, permeametry, porosimetry). Typically, this workflow involves two steps, model design and 3D printing. In this study, we explore how the addition of post-processing and validation can reduce uncertainty in the 3D-printed proxy accuracy (difference of proxy geometry from the digital model). Post-processing is a multi-step cleaning of porous proxies involving pressurized ethanol flushing and oven drying. Proxies are validated by: (1) helium porosimetry and (2) digital measurements of porosity from thin-section images of 3D-printed proxies. 3D printer resolution was determined by measuring the smallest open channel in 3D-printed "gap test" wafers. This resolution (400 µm) was insufficient to build porosity of Fontainebleau sandstone (∼13%) from computed tomography data at the sample's natural scale, so proxies were printed at 15-, 23-, and 30-fold magnifications to validate the workflow. Helium porosities of the 3D-printed proxies differed from digital calculations by up to 7% points. Results improved after pressurized flushing with ethanol (e.g., porosity difference reduced to ∼1% point), though uncertainties remain regarding the nature of sub-micron "artifact" pores imparted by the 3D printing process. This study shows the benefits of including post-processing and validation in any workflow to produce porous rock proxies. © 2017, National Ground Water Association.

  12. Self-reported quality of life in a Scottish first-episode psychosis cohort: associations with symptomatology and premorbid adjustment.

    Science.gov (United States)

    MacBeth, Angus; Gumley, Andrew; Schwannauer, Matthias; Fisher, Rebecca

    2015-02-01

    There is increased interest in quality of life (QoL) as a clinically relevant factor in adjustment to, and recovery from, first-episode psychosis (FEP). Given the subjective nature of QoL, it is proposed that this variable may be associated with compromised functioning prior to the onset of psychosis, and may also have an impact on an individual's adjustment to psychosis after treatment is initiated. The current study aims to explore associations between subjective QoL, symptomatology, premorbid adjustment, duration of untreated psychosis (DUP) and engagement with services after onset of treatment. A cross-sectional cohort of Scottish individuals undergoing treatment for FEP were characterized in terms of psychotic symptomatology, premorbid adjustment, DUP and service engagement. Self-reported QoL was measured using the World Health Organization Quality of Life Brief Scale, allowing for the measurement of physical, psychological, social relational and environmental aspects of QoL. Higher scores for subjective QoL components were associated with better premorbid adjustment, lower positive psychotic symptoms, lower negative symptoms and less cognitive disorganization. Childhood premorbid adjustment predicted both physical and social relationship QoL. Subjective QoL domains differ in their associations with clinical and premorbid factors. The relationship between premorbid adjustment and QoL requires further exploration in FEP. © 2013 Wiley Publishing Asia Pty Ltd.

  13. An ethical analysis of proxy and waiver of consent in critical care research

    DEFF Research Database (Denmark)

    Berg, Ronan M G; Møller, Kirsten; Rossel, Peter J. Hancke

    2013-01-01

    a substituted judgement by a close relative or friend, based on knowledge of patient's values, preferences, and view of life. For the consent to be genuine, the proxy must be informed of and understand three fundamental aspects of research practice: (1) that participation is voluntary and the consent can......It is a central principle in medical ethics that vulnerable patients are entitled to a degree of protection that reflects their vulnerability. In critical care research, this protection is often established by means of so-called proxy consent. Proxy consent for research participation constitutes...

  14. Quality of life in children with psychiatric disorders: Self-, parent- and clinician report [IF: 3.8

    NARCIS (Netherlands)

    Bastiaansen, A.; Koot, H.M.; Ferdinand, R.F.; Verhulst, F.C.

    2004-01-01

    Objective: To study the relationship between child psychiatric disorders and quality of life (QoL). Method: In a sample of 310 children (ages 6-18 years) referred for psychiatric problems, children, parents, and clinicians reported on psychopathology and subjective and objective QoL indicators.

  15. Measuring self-esteem after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Self-esteem item bank and short form.

    Science.gov (United States)

    Kalpakjian, Claire Z; Tate, Denise G; Kisala, Pamela A; Tulsky, David S

    2015-05-01

    To describe the development and psychometric properties of the Spinal Cord Injury-Quality of Life (SCI-QOL) Self-esteem item bank. Using a mixed-methods design, we developed and tested a self-esteem item bank through the use of focus groups with individuals with SCI and clinicians with expertise in SCI, cognitive interviews, and item-response theory-(IRT) based analytic approaches, including tests of model fit, differential item functioning (DIF) and precision. We tested a pool of 30 items at several medical institutions across the United States, including the University of Michigan, Kessler Foundation, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital, and the James J. Peters/Bronx Department of Veterans Affairs hospital. A total of 717 individuals with SCI completed the self-esteem items. A unidimensional model was observed (CFI=0.946; RMSEA=0.087) and measurement precision was good (theta range between -2.7 and 0.7). Eleven items were flagged for DIF; however, effect sizes were negligible with little practical impact on score estimates. The final calibrated item bank resulted in 23 retained items. This study indicates that the SCI-QOL Self-esteem item bank represents a psychometrically robust measurement tool. Short form items are also suggested and computer adaptive tests are available.

  16. Enhanced Collaboration for Space Situational Awareness via Proxy Agents

    Science.gov (United States)

    Picciano, P.; Schurr, N.

    2012-09-01

    The call for dynamic partnerships demanded in the US. Space Policy confronts two formidable challenges. The first is evident in the lack of the adoption of technical innovations that could substantially enhance collaboration. The second category, and perhaps a greater impediment, involves organizational and social constraints that minimize information sharing. Compounding the technical challenges, the organizational barriers to collaboration present a different problem set. There is a culture in the space domain that predisposes most stakeholders to guard their information. Most owner/operators are reluctant to share asset data, whether experiencing an anomaly or just providing status updates. This is unfortunate, because the owner/operators generally have the most accurate and timely data pertaining to their satellite. Comprehensive Space Situational Awareness (SSA) requires the marshaling of disparate mission critical elements. The mission threads reliant on SSA are complex and often require analysis from a diverse team of experts with sophisticated systems and tools that may be dispersed across multiple entities including military, commercial, and public interests. Two significant trends are likely to further perpetuate this state of affairs: 1) the space environment continues to be more congested, contested, and competitive, and 2) further pressures to increase SSA Sharing with a greater number of stakeholders throughout the world. The challenge of delivering the right information to the right people, while protecting national security and privacy interests, is in need of an innovative solution. Our approach, entitled Space Collaboration via an Agent Network (SCAN), enables proxy software agents to represent stakeholders (as individuals and organizations) to enhance collaboration among various agency producers and consumers of space information The SCAN agent network will facilitate collaboration by identifying opportunities to collaborate, as well as optimize

  17. Apatite: a new redox proxy for silicic magmas?

    Science.gov (United States)

    Miles, Andrew; Graham, Colin; Hawkesworth, Chris; Gillespie, Martin; Bromiley, Geoff; Hinton, Richard

    2015-04-01

    Petrology, 89, 226-38. [2] Miles, A.J., Graham, C.M., Hawkesworth, C.J., Gillespie, M.R., Hinton, R.W., 2014, Mn in apatite: A new redox proxy for silicic magmas?: Geochimica et Cosmochimica Acta v. 132, p. 101-119.

  18. Stable isotope and trace element proxy data from aragonite cements of stressed reef environments (early Messinian, Mediterranean Region)

    Science.gov (United States)

    Brachert, Thomas; Bosellini, Francesca R.; Reuter, Markus; Mertz-Kraus, Regina; Vescogni, Alessandro

    2010-05-01

    Early Messinian coral reefs of the Mediterranean area are among the classical examples of Neogene reefs in the world and, according to the ecology of their biota, do not exhibit compelling evidence for significant salinity stress prior to the Messinian Salinity Crisis (MSC). Because of excellent outcrop conditions and preservation, these reefs have become prototypes of Neogene reefs worldwide. Here we present stable oxygen isotope (IRMS) and trace element data (LA-ICP-MS) from marine aragonite cement in biogenic frameworks of some Mediterranean reefs. The reworking of the cements by intraformational breccias clearly supports petrographic evidence of "syndepositional" precipitation. Reported values of 18O/16O translate into peak sea surface salinity of 50 to 60 permil, which is a lethal value for most members of the reef community. Therefore, additional proxies have been evaluated to constrain the environment in which the cements formed. 13C/12C signatures are fully within the range of marine cement, however, systematic excursions exist on outcrop-scaple over the geological sections which may suggest episodic influx of terrestrial organic matter brought in by rivers or episodic upwelling of deep water masses with CO2 enriched in 12C. Intra-cement 13C/12C, Sr/Ca and Mg/Ca measured along transects exhibits co-variant changes which are incompatible with temperature effects and more plausibly document the mixing of different fluids, or the evolution of the pore fluids upon continuing precipitation. Although the final cause underlying the discrepant aspect of biological and various inorganic proxy data remains not yet fully understood, this study shows that evaluation of one single proxy may lead to more misleading than helpful concepts of palaeoenvironments and environment change.

  19. Hygroscopic growth and cloud droplet activation of xanthan gum as a proxy for marine hydrogels

    National Research Council Canada - National Science Library

    Dawson, K. W; Petters, M. D; Meskhidze, N; Petters, S. Suda; Kreidenweis, S. M

    2016-01-01

    .... Here we use xanthan gum (XG)—a bacterial biopolymer—as a proxy for marine hydrogels. Measurements were performed for pure XG particles and mixtures of XG with sodium chloride, calcium nitrate, and calcium carbonate...

  20. Middleware Proxy: A Request-Driven Messaging Broker For High Volume Data Distribution

    CERN Document Server

    Sliwinski, W; Dworak, A

    2014-01-01

    Nowadays, all major infrastructures and data centres (commercial and scientific) make an extensive use of the publish-subscribe messaging paradigm, which helps to decouple the message sender (publisher) from the message receiver (consumer). This paradigm is also heavily used in the CERN Accelerator Control system, in Proxy broker - critical part of the Controls Middleware (CMW) project. Proxy provides the aforementioned publish-subscribe facility and also supports execution of synchronous read and write operations. Moreover, it enables service scalability and dramatically reduces the network resources and overhead (CPU and memory) on publisher machine, required to serve all subscriptions. Proxy was developed in modern C++, using state of the art programming techniques (e.g. Boost) and following recommended software patterns for achieving low-latency and high concurrency. The outstanding performance of the Proxy infrastructure was confirmed during the last 3 years by delivering the high volume of LHC equipment...

  1. Youth proxy efficacy for fruit and vegetable availability varies by gender and socio-economic status.

    Science.gov (United States)

    Geller, Karly S; Dzewaltowski, David A

    2010-06-01

    The current study examined proxy efficacy, which was defined as youth's confidence to influence their parents to provide fruits and vegetables. The overall objective was to examine change in middle-school youth's proxy efficacy over time, and to determine if changes were moderated by gender and socio-economic status. Longitudinal cohort nested within schools. Eight middle schools located in urban, suburban and rural areas of a mid-western US state. Seven hundred and twelve youth followed across their 6th, 7th and 8th grade years. The sample was 51.8 % female, 30.5 % low socio-economic status and 89.5 % Caucasian, non-Hispanic. Males and lower socio-economic status youth were significantly lower in proxy efficacy at each assessment year compared with females and high socio-economic youth, respectively. Proxy efficacy to influence parents to provide fruits and vegetables may be an important construct to target in future interventions.

  2. Multiple water isotope proxy reconstruction of extremely low last glacial temperatures in Eastern Beringia (Western Arctic)

    NARCIS (Netherlands)

    Porter, Trevor J.; Froese, Duane G.; Feakins, Sarah J.; Bindeman, Ilya N.; Mahony, Matthew E.; Pautler, Brent G.; Reichart, Gert-Jan; Sanborn, Paul T.; Simpson, Myrna J.; Weijers, Johan W H

    2016-01-01

    Precipitation isotopes are commonly used for paleothermometry in high latitude regions. Here we present multiple water isotope proxies from the same sedimentary context - perennially frozen loess deposits in the Klondike Goldfields in central Yukon, Canada, representing parts of Marine Isotope

  3. A Quantum Proxy Weak Blind Signature Scheme Based on Controlled Quantum Teleportation

    Science.gov (United States)

    Cao, Hai-Jing; Yu, Yao-Feng; Song, Qin; Gao, Lan-Xiang

    2015-04-01

    Proxy blind signature is applied to the electronic paying system, electronic voting system, mobile agent system, security of internet, etc. A quantum proxy weak blind signature scheme is proposed in this paper. It is based on controlled quantum teleportation. Five-qubit entangled state functions as quantum channel. The scheme uses the physical characteristics of quantum mechanics to implement message blinding, so it could guarantee not only the unconditional security of the scheme but also the anonymity of the messages owner.

  4. Human rights of children with intellectual disabilities: comparing self-ratings and proxy ratings.

    Science.gov (United States)

    Huus, K; Granlund, M; Bornman, J; Lygnegård, F

    2015-11-01

    A child rights-based approach to research articulates well with Article 12 of the United Nations Convention on the Rights of the Child (CRC) and highlights the importance and value of including children's own views about aspects that concern them. The aim of this study is to compare children with intellectual disability's own ratings (as self-raters) to those of their primary caregivers (as proxy raters) regarding human rights of children. The study also aims to establish whether there is an inter-rater agreement between the self-raters and proxy raters concerning Maslow's hierarchy of needs. This study is nested in a larger study examining the human rights of children with intellectual disability in South Africa. In total, 162 children with intellectual disability from 11 schools across three provinces and their primary caregivers participated by answering parts of a Children's Rights Questionnaire (CRQ) developed by the researchers based on the United Nation's CRC. We compared the answers for six questions in the questionnaire that were addressed to self-raters (children) and proxy raters (primary caregivers) in the same way. Questions regarding basic needs, such as access to clean water or whether the child had food to eat at home, were answered similarly by self-raters and proxy raters. Larger differences were found when self-raters and proxy raters were asked about whether the child had things or friends to play with at home. Socio-economic variables seemed to affect whether self-raters and proxy raters answered similarly. The results underscore the importance of promoting children's rights to express themselves by considering the opinions of both the children as self-raters and their primary caregivers as proxy raters - not only the latter. The results indicate that it is especially important to include children's own voices when more complex needs are surveyed. Agreement between self- and proxy ratings could be affected by socio-economic circumstances.

  5. Design and implementation of Ad-Hoc collaborative proxying scheme for reducing network energy waste

    OpenAIRE

    Rafiullah Khan; Sarmad Ullah Khan

    2017-01-01

    Network devices are equipped with low power states but they are rarely activated due to their inability of maintaining network connectivity. Recently, Network Connectivity Proxy (NCP) concept has been proposed in literature as an effective mechanism to exploit full potential of low power features on network devices by impersonating their virtual presence. However, the NCP concept faces several open issues and challenges especially related to proxying of TCP connections and majority of daily u...

  6. Similarity, agreement, and assumed similarity in proxy end-of-life decision making.

    Science.gov (United States)

    McDade-Montez, Elizabeth; Watson, David; Beer, Andrew

    2013-12-01

    Medical decisions near the end of life are often made by proxies who can be inaccurate in their judgments of patient preferences. Given that accuracy in surrogate decision making is an important goal in end-of-life decision making, and in light of that previously seen levels of accuracy reflect substantial disagreement, error, or both, this study examined both relationship and individual factors that potentially affect surrogate accuracy. Specifically, this study examined similarity, agreement, and assumed similarity-a process whereby raters use their own traits and preferences to rate another person-in spousal ratings of end-of-life treatment. This study expands on previous research by examining the potential influence of relationship factors and assumed similarity on end-of-life decision making among a sample of newlyweds. Newly married couples (n = 197) completed self and spouse measures of hypothetical end-of-life preferences and scales assessing marital satisfaction, personality, and attitudes. Results indicate a moderate level of similarity on husband and wife self-rated end-of-life treatment preferences (rs = .18-.29) and a moderate level of agreement between self and proxy ratings (rs = .17-.41). The largest correlations were seen between self ratings and proxy ratings (e.g., husband self ratings and husband proxy ratings of wife preferences, rs = .46-.69), reflecting strong assumed similarity in proxy ratings. For wives, similarity with husbands on a few attitudinal variables (i.e., spirituality, moral strictness, and conservatism) influenced proxy accuracy. Recognizing the potential impact of personal preferences on proxy ratings, as well as the potential influence of relationship factors, may help improve proxy accuracy and end-of-life care for patients and families.

  7. Contribution in Adaptating Web Interfaces to any Device on the Fly: The HCI Proxy

    Science.gov (United States)

    Lardon, Jérémy; Fayolle, Jacques; Gravier, Christophe; Ates, Mikaël

    2008-11-01

    Lot of work has been done on the adaptation of UIs. In the particular field of Web UI adaptation, many research projects aim at displaying web content designed for PCs on poorer supports. In this paper, we present previous work in the domain and then our proxy architecture, HCI proxy, to test solutions for the problem of adapting Web UIs for mobile phones, PDA and smartphones but also for TVs through browser-embedding STBs, and this on the fly.

  8. A Quantum Proxy Blind Signature Scheme Based on Genuine Five-Qubit Entangled State

    Science.gov (United States)

    Zeng, Chuan; Zhang, Jian-Zhong; Xie, Shu-Cui

    2017-06-01

    In this paper, a quantum proxy blind signature scheme based on controlled quantum teleportation is proposed. This scheme uses a genuine five-qubit entangled state as quantum channel and adopts the classical Vernam algorithm to blind message. We use the physical characteristics of quantum mechanics to implement delegation, signature and verification. Security analysis shows that our scheme is valid and satisfy the properties of a proxy blind signature, such as blindness, verifiability, unforgeability, undeniability.

  9. The suitability of Mytilus edulis as proxy archive and its response to ocean acidification

    OpenAIRE

    Heinemann, Agnes

    2011-01-01

    Past climate changes can be used as indicators of future scenarios, however past climatic changes can not be directly observed. Therefore, the reconstruction of past abiotic conditions can approximated using chemical or isotopic proxies. These proxies can be measured in natural archives (e.g. bivalve shells and coral skeletons). One aspect of current climate change is the acidification of the oceans, a phenomenon caused by the oceanic uptake of anthropogenic CO2 and a resulting shift in the m...

  10. Proxy-based Video Transmission: Error Resiliency, Resource Allocation, and Dynamic Caching

    OpenAIRE

    Tu, Wei

    2009-01-01

    In this dissertation, several approaches are proposed to improve the quality of video transmission over wired and wireless networks. To improve the robustness of video transmission over error-prone mobile networks, a proxy-based reference picture selection scheme is proposed. In the second part of the dissertation, rate-distortion optimized rate adaptation algorithms are proposed for video applications over congested network nodes. A segment-based proxy caching algorithm for video-on-demand a...

  11. The perpetrators of medical child abuse (Munchausen Syndrome by Proxy) - A systematic review of 796 cases.

    Science.gov (United States)

    Yates, Gregory; Bass, Christopher

    2017-10-01

    Little is known about the perpetrators of medical child abuse (MCA) which is often described as "Munchausen's syndrome by proxy" or "factitious disorder imposed on another". The demographic and clinical characteristics of these abusers have yet to be described in a sufficiently large sample. We aimed to address this issue through a systematic review of case reports and series in the professional literature. A systematic search for case reports and series published since 1965 was undertaken using MEDLINE, Web of Science and EMBASE. 4100 database records were screened. A supplementary search was then conducted using GoogleScholar and reference lists of eligible studies. Our search yielded a total sample of 796 perpetrators: 309 from case reports and 487 from case series. Information extracted included demographic and clinical characteristics, in addition to methods of abuse and case outcomes. Nearly all abusers were female (97.6%) and the victim's mother (95.6%). Most were married (75.8%). Mean caretaker age at the child's presentation was 27.6 years. Perpetrators were frequently reported to be in healthcare-related professions (45.6%), to have had obstetric complications (23.5%), or to have histories of childhood maltreatment (30%). The most common psychiatric diagnoses recorded were factitious disorder imposed on self (30.9%), personality disorder (18.6%), and depression (14.2%). From the largest analysis of MCA perpetrators to date, we provide several clinical recommendations. In particular, we urge clinicians to consider mothers with a personal history of childhood maltreatment, obstetric complications, and/or factitious disorder at heightened risk for MCA. Longitudinal studies are required to establish the true prognostic value of these factors as our method may have been vulnerable to publication bias. Copyright © 2017. Published by Elsevier Ltd.

  12. Applying a family systems lens to proxy decision making in clinical practice and research.

    Science.gov (United States)

    Rolland, John S; Emanuel, Linda L; Torke, Alexia M

    2017-03-01

    When patients are incapacitated and face serious illness, family members must make medical decisions for the patient. Medical decision sciences give only modest attention to the relationships among patients and their family members, including impact that these relationships have on the decision-making process. A review of the literature reveals little effort to systematically apply a theoretical framework to the role of family interactions in proxy decision making. A family systems perspective can provide a useful lens through which to understand the dynamics of proxy decision making. This article considers the mutual impact of family systems on the processes and outcomes of proxy decision making. The article first reviews medical decision science's evolution and focus on proxy decision making and then reviews a family systems approach, giving particular attention to Rolland's Family Systems Illness Model. A case illustrates how clinical practice and how research would benefit from bringing family systems thinking to proxy decisions. We recommend including a family systems approach in medical decision science research and clinical practices around proxy decisions making. We propose that clinical decisions could be less conflicted and less emotionally troubling for families and clinicians if family systems approaches were included. This perspective opens new directions for research and novel approaches to clinical care. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  13. Cryptanalysis and Performance Evaluation of Enhanced Threshold Proxy Signature Scheme Based on RSA for Known Signers

    Directory of Open Access Journals (Sweden)

    Raman Kumar

    2013-01-01

    Full Text Available In these days there are plenty of signature schemes such as the threshold proxy signature scheme (Kumar and Verma 2010. The network is a shared medium so that the weakness security attacks such as eavesdropping, replay attack, and modification attack. Thus, we have to establish a common key for encrypting/decrypting our communications over an insecure network. In this scheme, a threshold proxy signature scheme based on RSA, any or more proxy signers can cooperatively generate a proxy signature while or fewer of them cannot do it. The threshold proxy signature scheme uses the RSA cryptosystem to generate the private and the public key of the signers (Rivest et al., 1978. Comparison is done on the basis of time complexity, space complexity, and communication overhead. We compare the performance of four schemes (Hwang et al. (2003, Kuo and Chen (2005, Yong-Jun et al. (2007, and Li et al. (2007, with the performance of a scheme that has been proposed earlier by the authors of this paper. In the proposed scheme, both the combiner and the secret share holder can verify the correctness of the information that they are receiving from each other. Therefore, the enhanced threshold proxy signature scheme is secure and efficient against notorious conspiracy attacks.

  14. A method of separating local and large scale climate signals in coral proxies

    Science.gov (United States)

    Timm, O.; Ruprecht, E.; Pfeiffer, M.; Dullo, W.

    2003-04-01

    Coral proxies in the tropical and subtropical Indian Ocean show markedly different imprints of local climate factors. The oxygen isotopic composition (d18o) reflects a combination of SST and seawater properties. Both are the response to local effects and large scale climate variations in the oceans and the atmosphere, mainly due to air-sea fluxes. Consequently, an important step to large scale climate reconstructions from coral proxies is the separation of the individual local signal and the teleconnection with large scale climate modes such as the El Nino/Southern Oscillation (ENSO). The aim of this study is to present a method capable of extracting the large scale climate signal recorded in corals. Using multiple linear regression (MLR) techniques we first analyse the partial effects of local SST and precipitation minus evaporation on the coral d18o proxies. In a second step multivariate statistics are applied to the proxies and climate variables in order to distinguish between local signals and large scale variability in the proxies. Three d18o records from the Indian Ocean (Chagos, La Reunion, Seychelles) and the ENSO signal are used as an example demonstration. The method is also applied to Carribean corals (Guadeloupe). Preliminary results for the variability of these proxies and their relation to the North Atlantic Oscillation are given.

  15. Technical Note: Probabilistically constraining proxy age–depth models within a Bayesian hierarchical reconstruction model

    Directory of Open Access Journals (Sweden)

    J. P. Werner

    2015-03-01

    Full Text Available Reconstructions of the late-Holocene climate rely heavily upon proxies that are assumed to be accurately dated by layer counting, such as measurements of tree rings, ice cores, and varved lake sediments. Considerable advances could be achieved if time-uncertain proxies were able to be included within these multiproxy reconstructions, and if time uncertainties were recognized and correctly modeled for proxies commonly treated as free of age model errors. Current approaches for accounting for time uncertainty are generally limited to repeating the reconstruction using each one of an ensemble of age models, thereby inflating the final estimated uncertainty – in effect, each possible age model is given equal weighting. Uncertainties can be reduced by exploiting the inferred space–time covariance structure of the climate to re-weight the possible age models. Here, we demonstrate how Bayesian hierarchical climate reconstruction models can be augmented to account for time-uncertain proxies. Critically, although a priori all age models are given equal probability of being correct, the probabilities associated with the age models are formally updated within the Bayesian framework, thereby reducing uncertainties. Numerical experiments show that updating the age model probabilities decreases uncertainty in the resulting reconstructions, as compared with the current de facto standard of sampling over all age models, provided there is sufficient information from other data sources in the spatial region of the time-uncertain proxy. This approach can readily be generalized to non-layer-counted proxies, such as those derived from marine sediments.

  16. Growth rates and geochemical proxies in Late Campanian bivalves - New insights from micro-X-ray Fluorescence mapping and numerical growth modelling

    Science.gov (United States)

    de Winter, Niels; Goderis, Steven; van Malderen, Stijn; Vanhaecke, Frank; Claeys, Philippe

    2017-04-01

    Understanding the Late Cretaceous greenhouse climate is of vital importance for understanding present and future climate change. While a lot of good work has been done to reconstruct climate in this interesting period, most paleoclimatic studies have focused on long-term climate change[1]. Alternatively, multi-proxy records from marine bivalves provide us with a unique opportunity to study past climate on a seasonal scale. However, previous fossil bivalve studies have reported ambiguous results with regard to the interpretation of trace element and stable isotope proxies in marine bivalve shells[2]. One major problem in the interpretation of such records is the bivalve's vital effect and the occurrence of disequilibrium fractionation during bivalve growth. Both these problems are linked to the annual growth cycle of marine bivalves, which introduces internal effects on the incorporation of isotopes and trace elements into the shell[3]. Understanding this growth cycle in extinct bivalves is therefore of great importance for the interpretation of seasonal proxy records in their shells. In this study, three different species of extinct Late Campanian bivalves (two rudist species and one oyster species) that were found in the same stratigraphic interval are studied. Micro-X-Ray Fluorescence line scanning and mapping of trace elements such as Mg, Sr, S and Zn, calibrated by LA-ICP-MS measurements, is combined with microdrilled stable carbon and oxygen isotope analysis on the well-preserved part of the shells. Data of this multi-proxy study is compared with results from a numerical growth model written in the open-source statistics package R[4] and based on annual growth increments observed in the shells and shell thickness. This growth model is used together with proxy data to reconstruct rates of trace element incorporation into the shell and to calculate the mass balance of stable oxygen and carbon isotopes. In order to achieve this goal, 2D mapping of bivalve shell

  17. Association between "loco-check" and EuroQol, a comprehensive instrument for assessing health-related quality of life: a study of the Japanese general population.

    Science.gov (United States)

    Iizuka, Yoichi; Iizuka, Haku; Mieda, Tokue; Tajika, Tsuyoshi; Yamamoto, Atsushi; Takagishi, Kenji

    2014-09-01

    The concept of "locomotive syndrome" (LS) was proposed by the Japanese Orthopaedic Association (JOA) in 2007 to refer to the risk of elderly individuals becoming bedridden because of reduced function of locomotive organs, for example muscles, bones, and joints. The purpose of this study was to clarify the association between LS screening results based on "loco-check" and health-related quality of life (HRQoL) assessed by use of EuroQol. Four-hundred and forty-two Japanese subjects (183 males and 259 females) were evaluated for LS and HRQoL by use of "loco-check," EuroQol-5 dimensions (EQ-5D), and EuroQol-VAS (EQ-VAS). If the subjects answered "yes" to one or more of the seven items of "loco-check," they were assigned to a locomotive syndrome suspected group (L group). If they answered "no" to all seven items, they were assigned to a locomotive syndrome not suspected group (NL group). We investigated the association between the screening LS results obtained by use of "loco-check" and HRQoL status determined by use of EQ-5D utility value and EQ-VAS score. LS was suspected among 39.6% of the subjects on the basis of "loco-check." In univariate analysis, significantly higher age, higher female-to-male ratio, and more reduced HRQoL were observed in the L group than in the NL group, according to EQ-5D and EQ-VAS. Logistic regression analysis showed that EQ-5D utility value and EQ-VAS score were associated with LS and the difference was statistically significant. Furthermore, correlations were found between the number of items with a "yes" answer on "loco-check", EQ-5D, or EQ-VAS. That is, a larger number of items with a "yes" answer on "loco-check" was associated with reduced HRQoL assessed by use of EQ-5D and EQ-VAS. We demonstrated that a finding of LS on the basis of "loco-check" is significantly associated with EQ-5D utility value and EQ-VAS score, and that a population identified as having LS by use of "loco-check" also had reduced HRQoL. Furthermore, it is

  18. The “Serpentine Syndrome” (H. Jenny, 1980: A Proxy for Soil Remediation

    Directory of Open Access Journals (Sweden)

    Claudio Bini

    2014-12-01

    Full Text Available Serpentine soils have relatively high concentrations of PTEs (Co, Cr, Cu, Fe, Ni but generally low amounts of major nutrients. They often bear a distinctive vegetation, and a frequently-used approach to understanding serpentine ecology and related environmental hazard has been the chemical analysis of soils and plants. In this paper we report past and current studies on serpentine soils and serpentinophytes. The serpentine vegetation differs from the conterminous non-serpentine areas, being often endemic, and showing macroscopic physionomical characters. Similarly, at microscopic level cytomorphological characteristics of the roots and variations in biochemical parameters were recorded in serpentinophytes. Light microscopy observations showed depressed mitotic activity in the meristematic zone, and consequent reduced root growth. The different tolerance mechanisms responsible for plant adaption to high concentrations of PTEs in serpentine soils can be related to the capacity of plants to limit metal uptake and translocation. The majority of serpentinophytes tend to limit metal absorption to roots: the cell wall constitutes a barrier against metal penetration inside plant tissues. Only a few species are able to accumulate metals in their aerial parts, acting a tolerance mechanism to very high metal concentrations. Serpentinophytes, therefore, could represent proxies for plants  used in remediation of metal-contaminated soils and in phytomining as well.

  19. CHILD ABUSE IN A MEDICAL SETTING: CASE ILLUSTRATIONS OF TWO VARIANTS OF MUNCHAUSEN SINDROME BY PROXY.

    Directory of Open Access Journals (Sweden)

    Antonietta Lanzarone

    2017-04-01

    Full Text Available Munchausen syndrome is a complex type of abuse, which is often underdiagnosed or misdiagnosed in clinical practice, and has harmful consequences for children. Its relationship with child abuse, of which it is a variety, must be recognized in clinical and forensic practice. The authors report herein two observed cases of different types of Münchausen syndrome by proxy (MSbP. The first, is the most severe form of MSbP, with induced, true illness and related pathological symptoms into victim. The second case is a moderate form, much more complex to detect, in which a perpetrator parent simulates and aggravates the child‘s illness. Adequate training of health professionals and investigators is essential in revealing cases of MSbP. Diagnosis must be based on the study of the different forms of "abuse" and the knowledge of clinical protocols used to validate any suspected behaviour which could be potentially harmful to the child. Moreover, a lack of training may lead to misleading interpretations of medical history interpretation and fallacious conclusions. Our study aims to review the features that are to be considered in a suspected case of MSbP, in accordance with a recently updated consensus statement by the Committee on Child Abuse and Neglect from the American Academy of Pediatrics.

  20. Differences of Munchausen syndrome by proxy according to predominant symptoms in Japan.

    Science.gov (United States)

    Fujiwara, Takeo; Okuyama, Makiko; Kasahara, Mari; Nakamura, Ayako

    2008-08-01

    The purpose of the present paper was to investigate differing characteristics of Munchausen syndrome by proxy (MSBP) between subjects with predominantly physical symptoms and those with predominantly psychological symptoms. A questionnaire survey was sent to 11 leading doctors in the child abuse field in Japan, each located in different hospital-based sites. Child abuse doctors answered questions regarding the characteristics of MSBP subjects for whom they had helped care. The differences of characteristics between groups were analyzed using Fisher's exact test for categorical variables and Mann-Whitney U-test for continuous variables. Among 21 reported MSBP subjects, 16 MSBP subjects with predominantly physical symptoms (PHY) and five MSBP subjects with predominantly psychological symptoms (PSY) were found. PHY were more likely to be produced, whereas PSY cases were more often simulated. PHY cases were more often life-threatening than PSY cases, but decisions made by the Child Guidance Center surrounding the custodial outcome of MSBP victims did not differ between PHY and PSY cases. Social welfare services that need to decide on custody for MSBP victims should recognize the relatively high risk of life-threatening danger of PHY cases in their family of origin.

  1. Munchausen by Proxy: A Qualitative Investigation into Online Perceptions of Medical Child Abuse.

    Science.gov (United States)

    Anderson, Anoushka P A; Feldman, Marc D; Bryce, Joanne

    2017-08-02

    In Munchausen by proxy (MBP) maltreatment, increasingly termed "medical child abuse" (MCA), a caregiver fabricates or induces illness in another. The perpetrator's goal for the behavior is to meet personal emotional needs by forcing unnecessary or misguided medical or psychological treatment. Generally, a mother is the perpetrator and her child is the victim. There is a serious lack of research into most aspects of MCA, and this study is the first to utilize the anonymity of an Internet forum to investigate victims' first-hand experiences of, and the public's opinions about, suspected and confirmed MCA. Three-hundred and fifty-six posts by 348 members were explored and coded using formal qualitative content analysis. By accessing an open-thought online forum, this paper acquired information regarding social perceptions about the nonperpetrating partners who are unaware of the maltreatment; the disturbing and counterintuitive phenomenon of MCA itself; and the resistance often faced by those who attempt to report it. © 2017 American Academy of Forensic Sciences.

  2. The changing trophic status of shallow Minnesota lakes: evidence from stable isotopic and biological proxies

    Science.gov (United States)

    Theissen, K. M.; Zimmer, K.; Cotner, J. B.; Sugita, S.; Hobbs, W.; Ramstack, J. M.

    2010-12-01

    Shallow lakes can exist in two alternative stable regimes: a clear-water regime dominated by macrophytes with little phytoplankton abundance, or a turbid-water regime where conditions are the opposite. There is a need for more historical studies of shallow lakes as these systems constitute a critical habitat for waterfowl across a large region of the upper Midwestern U.S. and Canada and evidence suggests that the clear regime is preferable for healthy communities of the waterfowl and desired fish populations. Recent work also suggests that the clear regime favors the enhanced burial of organic carbon and thus might constitute an important natural sink for greenhouse gases. Here, we report on our study of C and N elemental and stable isotopic values of organic matter and biological proxies from the sediment core records of numerous shallow lakes in west-central MN and in other areas of the state. These records span the last few centuries including the time of settlement of the region and they have been age dated using 210Pb and ambrosia pollen counts. Results of our work suggest that in the past 50-60 years the majority of the lakes have shifted towards a generally more turbid, eutrophic, and algal-dominated condition that is less favorable to both carbon burial and desired animal habitat.

  3. International financial reporting standards and financial reporting ...

    African Journals Online (AJOL)

    The results showed that financial reporting quality increased after the adoption of the IFRS for all the relevant proxies. The study concludes that the adoption of IFRS to enhance financial reporting quality while reducing the probability of earnings management practices could be beneficial in the long run to the Nigerian ...

  4. [Improvement of QOL by advance in the management of respiratory disorders, dysphagia and upper gastrointestinal disorders in children with severe cerebral palsy].

    Science.gov (United States)

    Kitazumi, E

    1998-05-01

    In children with severe cerebral palsy, the daily use of naso-pharyngeal airway, daily chest physiotherapy and adequate posture control markedly improve respiratory disorders and their consequent complications. Non-invasive ventiratory support methods such as nasal IPPV and nasal CPAP can be also effective. Enteral feeding through a naso-jejunal catheter can successfully manage feeding difficulty due to gastroesophageal reflux when surgical treatment is difficult. Exact assessment of aspiration by adequately performed video-fluoroscopic swallowing examination leads to national management of dysphagia. Tube feeding by intermittent oro-gastric catheterization combined with oral feeding is useful way in many dysphagic children. Surgical treatment for prevention of aspiration markedly improves the general condition. These treatments and managements have markedly improved the QOL, of children with severe cerebral palsy in many aspects. Cooperation of pediatricians, parents, school teachers and other community staffs is necessary for appropriate daily management of medical problems of these children.

  5. EuroQol-5 dimensions utility gain according to British and Swedish preference sets in rheumatoid arthritis treated with abatacept, rituximab, tocilizumab, or tumour necrosis factor inhibitors

    DEFF Research Database (Denmark)

    Gülfe, Anders; Wallman, Johan K; Kristensen, Lars Erik

    2016-01-01

    . The compression of the experience-based SE preference set towards higher utilities may compromise its ability to detect between-group differences in quality-adjusted life-years, thus making cost-effectiveness harder to demonstrate in cost-utility analyses applying this preference set, rather than the standard UK.......BACKGROUND: The development of EuroQol-5 dimensions (EQ-5D) utility over time in rheumatoid arthritis (RA) patients, treated with biologics other than tumour necrosis factor inhibitors (TNFi), based on the standard British (UK) and the new Swedish (SE) EQ-5D preference sets, has not been previously...... described. METHODS: Demographics, core set data, EQ-5D utility, and treatment characteristics for patients with established RA, receiving biologics in southern Sweden from January 2006 to March 2014, were retrieved from observational databases. Theoretical, UK, and experience-based, SE, EQ-5D mean utilities...

  6. ["Activity scale for the elderly" as a measurement for the QOL of local elderly individuals and the assessment of the influence of age and exercise].

    Science.gov (United States)

    Kozaki, Koichi; Murata, Hisashi; Kikuchi, Reiko; Sugiyama, Youichi; Hasegawa, Hiroshi; Igata, Akihiro; Toba, Kenji

    2008-03-01

    To study the influence of exercise on the QOL of local elderly individuals, we created an activity scale for the elderly (ASE) and investigated its reliability and validity. We created 36-item ASE and performed factor analysis. The reliability of the ASE was tested by determining Cronbach's coefficient alpha and confirmatory factor analysis in a cohort of 5,280 people, living in the community. The validity of the ASE was assessed by analyzing the interrelationship between the subdomains, age, and exercise. By factor analysis, four subdomains and 20 items remained significant for measuring ASE. The average ASE in the 5,280 people was 27.18+/-5.28 points, with no sex difference. Confirmatory factor analysis showed the stability of the four subdomains. Cronbach's alpha demonstrated the internal consistency of the scale. Regarding the relationship between the four subdomains, age, and exercise, a significant difference was found between those who exercised and those who did not exercise, and between the 4 different age groups. By means of two-way ANOVA, significant interaction was found between exercise and age; ASE decreased from 26.3 points in the sixth decade of life to 23.9 in the seventh decade of life in those who did not exercise, while no decrease was found in those who exercised. Furthermore, ASE was significantly higher in those who exercised than those who did not non-exercise in each age decade group. These results suggest that exercise prevents age-associated decline in ASE. ASE provides a reliable and valid measure for the QOL of elderly individuals living in the community, and exercise appears beneficial for preventing age-associated decline in ASE.

  7. Economic valuation of informal care: lessons from the application of the opportunity costs and proxy good methods.

    Science.gov (United States)

    van den Berg, Bernard; Brouwer, Werner; van Exel, Job; Koopmanschap, Marc; van den Bos, Geertrudis A M; Rutten, Frans

    2006-02-01

    This paper reports the results of the application of the opportunity costs and proxy good methods to determine a monetary value of informal care. We developed a survey in which we asked informal caregivers in The Netherlands to indicate the different types of time forgone (paid work, unpaid work and leisure) in order to be able to provide care. Moreover, we asked informal caregivers how much time they spent on a list of 16 informal care tasks during the week before the interview. Data were obtained from surveys in two different populations: informal caregivers and their care recipients with stroke and with rheumatoid arthritis (RA). A total of 218 care recipients with stroke and their primary informal caregivers completed a survey as well as 147 caregivers and their care recipients with RA. The measurement of care according to both methods is more problematic compared to the valuation. This is especially the case for the opportunity costs method and for the housework part in the proxy good method. More precise guidelines are necessary for the consistent application of both methods in order to ensure comparability of results and of economic evaluations of health care.

  8. Scientific imperatives, clinical implications, and theoretical underpinnings for the investigation of the relationship between genetic variables and patient-reported quality-of-life outcomes

    NARCIS (Netherlands)

    Sprangers, M.A.G.; Sloan, J.A.; Barsevick, A.; Chauhan, C.; Dueck, A.C.; Raat, H.; Shi, Q.; van Noorden, C.J.F.

    2010-01-01

    Objectives There is emerging evidence for a genetic basis of patient-reported quality-of-life (QOL) outcomes that can ultimately be incorporated into clinical research and practice. Objectives are (1) to provide arguments for the timeliness of investigating the genetic basis of QOL given the

  9. Developing the draft descriptive system for the child amblyopia treatment questionnaire (CAT-Qol): a mixed methods study.

    Science.gov (United States)

    Carlton, Jill

    2013-10-22

    Amblyopia is a visual condition that occurs in childhood. Screening programmes exist within the United Kingdom (UK) to detect amblyopia, and once detected treatment is given.Existing patient reported outcome (PRO) measures for amblyopia do not meet current recommendations for the methods adopted during their development, or the way in which the instruments are administered. The overall aim of this study was to produce a self-complete PRO instrument for amblyopia for children aged 4-7 years that uses children's responses in the development phase. The study comprised a number of stages. This paper reports on the refinement of the descriptive system for the draft instrument (the Child Amblyopia Treatment Questionnaire, CAT-QoL) using qualitative and quantitative methods. The study consisted of three components. Children were asked to read, and complete the draft questionnaire as independently as possible. They were then asked about the questionnaire, and its format, in a cognitive debriefing exercise. Observations were made as to the child's ability to read the questionnaire, particular attention was made as to which individual words participants struggled to read. Children were also asked their opinion on the design layout of the questionnaire. Finally, some children were asked to complete a ranking task to help determine the order of the levels of the items as judged by the children. Mid-rank scoring and statistical level of agreement were calculated for the ranking exercise. Thirty-two (n=32) participants completed a draft questionnaire; each of these underwent a cognitive de-briefing interview. Twenty-two (n=22) children completed the ranking exercise. Ten children did not understand the concept of ranking. The results of the qualitative phase (cognitive de-briefing interview) were used to modify the wording of items and layout of the instrument. Results of the ranking exercise were used to inform the order of the response levels for the items. Responses of young

  10. Assessing the accuracy of two proxy measures for BMI in a semi-rural, low-resource setting in Guatemala.

    Science.gov (United States)

    Maupin, Jonathan N; Hruschka, Daniel J

    2014-09-19

    Validation studies of self-reported BMI are limited to populations in high-income countries or urban settings. Here, we assess the accuracy of two proxy measures of measured height, weight and BMI - self-reported values and the Stunkard figure scale - in a semi-rural population in Guatemala. Self-reported values and Stunkard figure selection were elicited prior to biometric measurements from a total of 175 non-pregnant women recruited based on a stratified random sample of households, with 92 women providing full data for validation across measures. 86.3% of participants self-reported weight and 62.3% height. Among those responding, self-reported weight is highly accurate though lower relationships for height contribute to error in reported BMI. The Stunkard scale has a higher response rate (97.1%) and while less accurate in predicting BMI values, more accurately predicts BMI categories. Self-reported measures are more accurate than the Stunkard scale in estimating BMI values, while the latter is more accurate in estimating BMI categories. High non-response rates and lower correlations between reported and measured height caution against using self-reported biometric data other than raw weight in low-resource settings.

  11. Mapping of the Insomnia Severity Index and other sleep measures to EuroQol EQ-5D health state utilities

    Directory of Open Access Journals (Sweden)

    Gu Ning Yan

    2011-12-01

    Full Text Available Abstract Background This study sought to map the Insomnia Severity Index (ISI and symptom variables onto the EQ-5D. Methods A cross-sectional survey was conducted among adult US residents with self-reported sleep problems. Respondents provided demographic, comorbidity, and sleep-related information and had completed the ISI and the EQ-5D profile. Respondents were classified into ISI categories indicating no, threshold, moderate, or severe insomnia. Generalized linear models (GLM were used to map the ISI's 7 items (Model I, summary scores (Model II, clinical categories (Model III, and insomnia symptoms (Model IV, onto the EQ-5D. We used 50% of the sample for estimation and 50% for prediction. Prediction accuracy was assessed by mean squared errors (MSEs and mean absolute errors (MAEs. Results Mean (standard deviation sleep duration for respondents (N = 2,842 was 7.8 (1.9 hours, and mean ISI score was 14.1 (4.8. Mean predicted EQ-5D utility was 0.765 (0.08 from Models I-III, which overlapped with observed utilities 0.765 (0.18. Predicted utility using insomnia symptoms was higher (0.771(0.07. Based on Model I, predicted utilities increased linearly with improving ISI (0.493 if ISI = 28 vs. 1.00 if ISI = 0, p 0.40, and results were comparable in all models. Conclusions Findings suggest that mapping relationships between the EQ-5D and insomnia measures could be established. These relationships may be used to estimate insomnia-related treatment effects on health state utilities.

  12. Mapping of the Insomnia Severity Index and other sleep measures to EuroQol EQ-5D health state utilities.

    Science.gov (United States)

    Gu, Ning Yan; Botteman, Marc F; Ji, Xiang; Bell, Christopher F; Carter, John A; van Hout, Ben

    2011-12-30

    This study sought to map the Insomnia Severity Index (ISI) and symptom variables onto the EQ-5D. A cross-sectional survey was conducted among adult US residents with self-reported sleep problems. Respondents provided demographic, comorbidity, and sleep-related information and had completed the ISI and the EQ-5D profile. Respondents were classified into ISI categories indicating no, threshold, moderate, or severe insomnia. Generalized linear models (GLM) were used to map the ISI's 7 items (Model I), summary scores (Model II), clinical categories (Model III), and insomnia symptoms (Model IV), onto the EQ-5D. We used 50% of the sample for estimation and 50% for prediction. Prediction accuracy was assessed by mean squared errors (MSEs) and mean absolute errors (MAEs). Mean (standard deviation) sleep duration for respondents (N = 2,842) was 7.8 (1.9) hours, and mean ISI score was 14.1 (4.8). Mean predicted EQ-5D utility was 0.765 (0.08) from Models I-III, which overlapped with observed utilities 0.765 (0.18). Predicted utility using insomnia symptoms was higher (0.771(0.07)). Based on Model I, predicted utilities increased linearly with improving ISI (0.493 if ISI = 28 vs. 1.00 if ISI = 0, p sleep-duration function of the EQ-5D; thus, utilities diminished after an optimal amount of sleep. The MSEs/MAEs were substantially lower when predicting EQ-5D > 0.40, and results were comparable in all models. Findings suggest that mapping relationships between the EQ-5D and insomnia measures could be established. These relationships may be used to estimate insomnia-related treatment effects on health state utilities.

  13. Elevation as a proxy for mosquito-borne Zika virus transmission in the Americas.

    Directory of Open Access Journals (Sweden)

    Alexander G Watts

    Full Text Available When Zika virus (ZIKV first began its spread from Brazil to other parts of the Americas, national-level travel notices were issued, carrying with them significant economic consequences to affected countries. Although regions of some affected countries were likely unsuitable for mosquito-borne transmission of ZIKV, the absence of high quality, timely surveillance data made it difficult to confidently demarcate infection risk at a sub-national level. In the absence of reliable data on ZIKV activity, a pragmatic approach was needed to identify subnational geographic areas where the risk of ZIKV infection via mosquitoes was expected to be negligible. To address this urgent need, we evaluated elevation as a proxy for mosquito-borne ZIKV transmission.For sixteen countries with local ZIKV transmission in the Americas, we analyzed (i modelled occurrence of the primary vector for ZIKV, Aedes aegypti, (ii human population counts, and (iii reported historical dengue cases, specifically across 100-meter elevation levels between 1,500m and 2,500m. Specifically, we quantified land area, population size, and the number of observed dengue cases above each elevation level to identify a threshold where the predicted risks of encountering Ae. aegypti become negligible.Above 1,600m, less than 1% of each country's total land area was predicted to have Ae. aegypti occurrence. Above 1,900m, less than 1% of each country's resident population lived in areas where Ae. aegypti was predicted to occur. Across all 16 countries, 1.1% of historical dengue cases were reported above 2,000m.These results suggest low potential for mosquito-borne ZIKV transmission above 2,000m in the Americas. Although elevation is a crude predictor of environmental suitability for ZIKV transmission, its constancy made it a pragmatic input for policy decision-making during this public health emergency.

  14. Statistical framework for evaluation of climate model simulations by use of climate proxy data from the last millennium – Part 2: A pseudo-proxy study addressing the amplitude of solar forcing

    Directory of Open Access Journals (Sweden)

    A. Hind

    2012-08-01

    Full Text Available The statistical framework of Part 1 (Sundberg et al., 2012, for comparing ensemble simulation surface temperature output with temperature proxy and instrumental records, is implemented in a pseudo-proxy experiment. A set of previously published millennial forced simulations (Max Planck Institute – COSMOS, including both "low" and "high" solar radiative forcing histories together with other important forcings, was used to define "true" target temperatures as well as pseudo-proxy and pseudo-instrumental series. In a global land-only experiment, using annual mean temperatures at a 30-yr time resolution with realistic proxy noise levels, it was found that the low and high solar full-forcing simulations could be distinguished. In an additional experiment, where pseudo-proxies were created to reflect a current set of proxy locations and noise levels, the low and high solar forcing simulations could only be distinguished when the latter served as targets. To improve detectability of the low solar simulations, increasing the signal-to-noise ratio in local temperature proxies was more efficient than increasing the spatial coverage of the proxy network. The experiences gained here will be of guidance when these methods are applied to real proxy and instrumental data, for example when the aim is to distinguish which of the alternative solar forcing histories is most compatible with the observed/reconstructed climate.

  15. Munchausen syndrome by proxy and pediatric nephrology.

    Science.gov (United States)

    Bertulli, Cristina; Cochat, Pierre

    2017-11-01

    Munchausen syndrome by proxy is a persistent fabrication of illness done by a person to another. Renal and urologic forms of this syndrome are not as uncommon as can be thought; a review of all the cases of Munchausen-by-proxy syndrome reveals that 25% of the children had renal or urologic issues. This syndrome can result in a serious diagnostic dilemma for the physicians; knowing this entity can allow early recognition of falsification and limit the physical and psychological damages caused in the victim. In this study, we reviewed the pediatric nephrology cases of Munchausen syndrome by proxy, grouping them through the principal signs of presentation. Copyright © 2017 Société francophone de néphrologie, dialyse et transplantation. Published by Elsevier Masson SAS. All rights reserved.

  16. A Quantum Multi-Proxy Weak Blind Signature Scheme Based on Entanglement Swapping

    Science.gov (United States)

    Yan, LiLi; Chang, Yan; Zhang, ShiBin; Han, GuiHua; Sheng, ZhiWei

    2017-02-01

    In this paper, we present a multi-proxy weak blind signature scheme based on quantum entanglement swapping of Bell states. In the scheme, proxy signers can finish the signature instead of original singer with his/her authority. It can be applied to the electronic voting system, electronic paying system, etc. The scheme uses the physical characteristics of quantum mechanics to implement delegation, signature and verification. It could guarantee not only the unconditionally security but also the anonymity of the message owner. The security analysis shows the scheme satisfies the security features of multi-proxy weak signature, singers cannot disavowal his/her signature while the signature cannot be forged by others, and the message owner can be traced.

  17. Ingestion Reiterada de Cuerpos Extranos. Forma Inusual de Presentacion del Sindrome de Munchausen por Poderes (Reiterated Ingestion of Foreign Bodies. Unusual Form of Presentation of Munchausen Syndrome by Proxy).

    Science.gov (United States)

    Terreros, I. Gomez de; And Others

    1996-01-01

    An unusual case of Munchausen syndrome by proxy is reported. A mother with a psychiatric record of behavior disorders and family dysfunction perpetrated the ingestion of foreign bodies (for example, earrings, a screw, sewing needles) on a 10-month-old infant with a history of prematurity, repeated visits to emergency rooms, and nonjustified…

  18. Temperature variations in the southern Great Lakes during the last deglaciation: Comparison between pollen and GDGT proxies

    Science.gov (United States)

    Watson, Benjamin I.; Williams, John W.; Russell, James M.; Jackson, Stephen T.; Shane, Linda; Lowell, Thomas V.

    2018-02-01

    Our understanding of deglacial climate history in the southern Great Lakes region of the United States is primarily based upon fossil pollen data, with few independent and multi-proxy climate reconstructions. Here we introduce a new, well-dated fossil pollen record from Stotzel-Leis, OH, and a new deglacial temperature record based on branched glycerol dialkyl glycerol tetraethers (brGDGTs) at Silver Lake, OH. We compare these new data to previously published records and to a regional stack of pollen-based temperature reconstructions from Stotzel-Leis, Silver Lake, and three other well-dated sites. The new and previously published pollen records at Stotzel-Leis are similar, but our new age model brings vegetation events into closer alignment with known climatic events such as the Younger Dryas (YD). brGDGT-inferred temperatures correlate strongly with pollen-based regional temperature reconstructions, with the strongest correlation obtained for a global soil-based brGDGT calibration (r2 = 0.88), lending confidence to the deglacial reconstructions and the use of brGDGT and regional pollen stacks as paleotemperature proxies in eastern North America. However, individual pollen records show large differences in timing, rates, and amplitudes of inferred temperature change, indicating caution with paleoclimatic inferences based on single-site pollen records. From 16.0 to 10.0ka, both proxies indicate that regional temperatures rose by ∼10 °C, roughly double the ∼5 °C estimates for the Northern Hemisphere reported in prior syntheses. Change-point analysis of the pollen stack shows accelerated warming at 14.0 ± 1.2ka, cooling at 12.6 ± 0.4ka, and warming from 11.6 ± 0.5ka into the Holocene. The timing of Bølling-Allerød (B-A) warming and YD onset in our records lag by ∼300-500 years those reported in syntheses of temperature records from the northern mid-latitudes. This discrepancy is too large to be attributed to uncertainties in radiocarbon dating, and

  19. A new proxy measure for state-level gun ownership in studies of firearm injury prevention.

    Science.gov (United States)

    Siegel, Michael; Ross, Craig S; King, Charles

    2014-06-01

    Since many states are considering gun control laws, researchers need reliable data on rates of gun ownership at the state level. Survey measures of gun ownership in all 50 states, however, are only available for 3 years, and no state-level data have been collected since 2004. Consequently, the National Research Council has declared the development of a valid proxy that can be constructed from accessible, annual, state-level data to be a priority. While such a proxy does exist (the proportion of suicides in a state committed using a gun (FS/S), its correlation with state estimates of gun ownership in recent years is only 0.80. Using state-level data for the years 2001, 2002 and 2004, we developed an improved proxy for state-level gun ownership that uses FS/S (firearm suicides divided by all suicides) and also the per capita number of hunting licenses. We validated this measure using data from surveys of gun ownership conducted in 48 states during 1996 and 1999, and in 21 states during 1995-1998. Adding per capita hunting licenses to the proxy increased its correlation with survey-measured gun ownership from 0.80 to 0.95. The correlations of the new proxy with gun ownership in the two validation studies were 0.95 and 0.97. We conclude that the combination of FS/S and per capita hunting licenses improves substantially upon FS/S alone. This new proxy is easily computed from data that are available annually by state and may be useful for investigating the effect of gun prevalence on firearm-related morbidity and mortality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Quantifying the magnitude of environmental exposure misclassification when using imprecise address proxies in public health research.

    Science.gov (United States)

    Healy, Martin A; Gilliland, Jason A

    2012-04-01

    In spatial epidemiologic and public health research it is common to use spatially aggregated units such as centroids of postal/zip codes, census tracts, dissemination areas, blocks or block groups as proxies for sample unit locations. Few studies, however, address the potential problems associated with using these units as address proxies. The purpose of this study is to quantify the magnitude of distance errors and accessibility misclassification that result from using several commonly-used address proxies in public health research. The impact of these positional discrepancies for spatial epidemiology is illustrated by examining misclassification of accessibility to several health-related facilities, including hospitals, public recreation spaces, schools, grocery stores, and junk food retailers throughout the City of London and Middlesex County, Ontario, Canada. Positional errors are quantified by multiple neighborhood types, revealing that address proxies are most problematic when used to represent residential locations in small towns and rural areas compared to suburban and urban areas. Findings indicate that the shorter the threshold distance used to measure accessibility between subject population and health-related facility, the greater the proportion of misclassified addresses. Using address proxies based on large aggregated units such as centroids of census tracts or dissemination areas can result in very large positional discrepancies (median errors up to 343 and 2088 m in urban and rural areas, respectively), and therefore should be avoided in spatial epidemiologic research. Even smaller, commonly-used, proxies for residential address such as postal code centroids can have large positional discrepancies (median errors up to 109 and 1363 m in urban and rural areas, respectively), and are prone to misrepresenting accessibility in small towns and rural Canada; therefore, postal codes should only be used with caution in spatial epidemiologic research

  1. A high-resolution multi-proxy record of late Cenozoic environment change from central Taklimakan Desert, China

    Science.gov (United States)

    Wang, X.; Sun, D. H.; Wang, F.; Li, B. F.; Wu, S.; Guo, F.; Li, Z. J.; Zhang, Y. B.; Chen, F. H.

    2013-12-01

    The Taklimakan Desert in the Tarim Basin is the largest desert in Central Asia, and is regarded as one of the main dust sources to the Northern Hemisphere. Late Cenozoic sedimentary sequences with intercalated in-situ aeolian dune sands in this area preserve direct evidence for the Asian desertification. Herein, we report a high-resolution multi-proxy climatic record from the precise magnetostratigraphic dated Hongbaishan section in the central Taklimakan Desert. Our results show that a fundamental climate change, characterised by significant cooling, enhanced aridity, and intensified atmospheric circulation, occurred at 2.8 Ma. Good correlations between paleo-environmental records in the dust sources and downwind areas suggest a broadly consistent climate evolution of northwestern China during the late Cenozoic, which is probably driven by the uplift of the Tibet Plateau and the Northern Hemisphere glaciation.

  2. Source-specific diatom lipid biomarkers as proxies for Arctic and Antarctic sea ice

    Science.gov (United States)

    Belt, Simon

    2016-04-01

    Sea ice plays a key role in controlling global climate due its influence over heat and gas exchange between the oceans and the atmosphere. In addition, sea ice exerts a strong influence over the absorption of incoming radiation at the ocean surface as a result of its high reflectivity or albedo. Driven, in part, by the recent dramatic changes to sea ice cover in both the Arctic and the Antarctic, the development of proxies for sea ice has received growing attention over the last 10 years or so. Amongst these, some so-called highly branched isoprenoid (HBI) lipid biomarkers have attracted considerable interest, not least, because they are derived from certain diatoms that reside and bloom within the sea ice matrix itself, thus providing a more direct indication of sea ice presence compared with some other proxies. The signature HBI sea proxies are a mono-unsaturated HBI (IP25) for the Arctic and a di-unsaturated HBI (C25:2) for the Antarctic, with different source organisms for each. Although the variability in sedimentary abundances of IP25 and C25:2 in Arctic and Antarctic sediments generally reflect the corresponding changes in sea ice conditions, a more complete picture of reconstructing sea ice conditions likely requires a multi-proxy approach involving, for example, other lipid biomarkers that serve as proxy measures of nearby open water conditions or sea surface temperature. By adoption of such an approach, a research strategy aimed at improving estimates of sea ice concentrations or better definitions of sea ice conditions (e.g. marginal ice zone, polynyas, permanent ice cover) represents the next stage in lipid-based sea ice proxy development. This presentation will focus on recent developments and future plans that involve a multi-proxy approach to improving sea ice reconstruction. An understanding of sources, ecology and environmental fate of various HBIs and other diatom lipids will likely be key in shaping the future direction of lipid-based sea ice

  3. Comparing proxy and model estimates of hydroclimate variability and change over the Common Era

    Science.gov (United States)

    Hydro2k Consortium, Pages

    2017-12-01

    Water availability is fundamental to societies and ecosystems, but our understanding of variations in hydroclimate (including extreme events, flooding, and decadal periods of drought) is limited because of a paucity of modern instrumental observations that are distributed unevenly across the globe and only span parts of the 20th and 21st centuries. Such data coverage is insufficient for characterizing hydroclimate and its associated dynamics because of its multidecadal to centennial variability and highly regionalized spatial signature. High-resolution (seasonal to decadal) hydroclimatic proxies that span all or parts of the Common Era (CE) and paleoclimate simulations from climate models are therefore important tools for augmenting our understanding of hydroclimate variability. In particular, the comparison of the two sources of information is critical for addressing the uncertainties and limitations of both while enriching each of their interpretations. We review the principal proxy data available for hydroclimatic reconstructions over the CE and highlight the contemporary understanding of how these proxies are interpreted as hydroclimate indicators. We also review the available last-millennium simulations from fully coupled climate models and discuss several outstanding challenges associated with simulating hydroclimate variability and change over the CE. A specific review of simulated hydroclimatic changes forced by volcanic events is provided, as is a discussion of expected improvements in estimated radiative forcings, models, and their implementation in the future. Our review of hydroclimatic proxies and last-millennium model simulations is used as the basis for articulating a variety of considerations and best practices for how to perform proxy-model comparisons of CE hydroclimate. This discussion provides a framework for how best to evaluate hydroclimate variability and its associated dynamics using these comparisons and how they can better inform

  4. Method of Anti-Virus Protection Based on (n, t Threshold Proxy Signature with an Arbitrator

    Directory of Open Access Journals (Sweden)

    E. A. Tolyupa

    2014-01-01

    Full Text Available The article suggests the method of anti-virus protection of mobile devices based on the usage of proxy digital signatures and an (n;t-threshold proxy signature scheme with an arbitrator. The unique feature of the suggested method is in the absence of necessity to install anti-virus software in a mobile device. It will be enough only to have the software verifying digital signatures and the Internet. The method is used on the base of public keys infrastructure /PKI/, thus minimizing implementation expenses.

  5. Forgery attack on one-time proxy signature and the improvement

    Science.gov (United States)

    Yang, Chun-Wei; Luo, Yi-Ping; Hwang, Tzonelih

    2014-09-01

    This paper points out that in Wang and Wei's scheme (Quantum Inf Process 11:455-463, 2012), an eavesdropper, Eve, can replace the original message of a proxy signature with a forged one of her choice without being detected by the verifier. Accordingly, one of the security requirements of a quantum signature, i.e., unforgeability, may not be satisfied in their scheme. An improvement is given to avoid this attack, and the comparisons with the existing quantum proxy signature are also demonstrated.

  6. An inter-bank E-payment protocol based on quantum proxy blind signature

    Science.gov (United States)

    Wen, Xiaojun; Chen, Yongzhi; Fang, Junbin

    2013-01-01

    Security and anonymity are essential to E-payment systems. However, with the increasing computing power, existing E-payment systems will gradually become insecure. In this paper, we propose an inter-bank E-payment system which is based on quantum proxy blind signature. Adopting the techniques of quantum key distribution, one-time pad and quantum proxy blind signature, our quantum E-payment system could protect user's anonymity as the traditional E-payment systems do, and also have unconditional security which the classical E-payment systems cannot provide. Furthermore, compared with the existing quantum E-payment systems, the proposed system could support inter-bank transactions.

  7. An E-payment Protocol Based on Quantum Multi-proxy Blind Signature

    Science.gov (United States)

    Shao, Ai-Xia; Zhang, Jian-Zhong; Xie, Shu-Cui

    2017-04-01

    Based on quantum multi-proxy blind signature, a new E-payment protocol is proposed in this paper. Adopting the techniques of quantum key distribution, one-time pad and quantum proxy blind signature, our E-payment protocol could protect user's anonymity as the traditional E-payment systems do, and also have unconditional security which the classical E-payment systems cannot provide. Additionally, the quantum operation can be transmitted successfully with the probability 1, which can make the protocol reliable and practical.

  8. Plant-derived terpenoids as paleovegetation proxies: evaluation of the proxy with Paleocene and Eocene megafloras and plant biomarkers in the Bighorn Basin, USA

    Science.gov (United States)

    Diefendorf, A. F.; Freeman, K. H.; Wing, S. L.

    2012-12-01

    Plant terpenoids (defense compounds synthesized from the 5-carbon building block isoprene) have a long history of use as geochemical plant biomarkers, and potentially can be used to reconstruct changes in the abundances of major land plant groups in rocks and sediments that do not preserve plant megafossils or pollen. Pentacyclic triterpenoids are synthesized almost exclusively by angiosperms whereas conifers produce the tricyclic diterpenoids. Many previous studies have focused on the use of di- to triterpenoid ratios to reconstruct floral changes in the geologic past, however few studies have compared terpenoid-based paleoflora proxies to pollen or megafossils. Prior reconstructions also did not take into account differences in biomarker production between plant functional types, such as deciduous and evergreen plants, which can be quite large. To investigate the use of terpenoids as paleoflora proxies, we examined sediments from the Bighorn Basin (Wyoming, USA) where ancient megafloras have been studied in detail. We analyzed di- and triterpenoid abundances as well as plant leaf waxes (n-alkanes) and other biomarkers in a total of 75 samples from 15 stratigraphic horizons from the late Paleocene (62 Ma) to early Eocene (52.5 Ma). By comparing terpenoid ratios with abundances estimated from plant megafossils, we can evaluate the utility of terpenoids as paleovegetation proxies. In nearly all samples, angiosperm triterpenoids are significantly lower in abundance than conifer diterpenoids. This contrasts with leaf fossil data that indicate paleofloras were dominated by angiosperms in both abundance and diversity. Traditional use of terpenoid paleovegetation proxies would therefore significantly overestimate the abundance of conifers, even when accounting for plant production differences. To determine if this overestimate is related to the loss of angiosperm triterpenoids (rather than enhanced production of diterpenoids in the geologic past), we compared angiosperm

  9. Mountain frozen grounds as small amplitude thermal proxy in southern continental Patagonia

    Science.gov (United States)

    Ruiz, Sebastian; Beriain, Eneko; Izagirre, Eñaut; Bockheim, James; Pedro, Cid-Agüero

    2015-04-01

    Frozen grounds are an important element of the cryosphere, covering between a 20-25% of the global area. Frozen grounds are becoming a relevant object of research in the southern hemisphere, being most studies focused mainly on Antarctica. With the exception of seasonally frozen grounds, perennially frozen ground is found in continental South America, for example, in high altitude terrains from 4.600m a.s.l. in central Chile. However, scarce or not information regarding permafrost on Southern Patagonia has been reported. One of the aims of this study was to establish mountain permafrost existence at 1.200m in the southern limit of the Southern Patagonian Ice-Field, a geographically active area surrounded by different kinds of glaciers on fast retreat. The area of study presents several features of past cryogenic activity such as undefined polygonal grounds with a thick clast border and sandy-loam interior. A scarce vegetal cover is limited to lichen and moss communities. The analyzed soil does not represent a thermal barrier that may avoid heat wave dynamic along the ground profile. There was neither significant snow-cover during winter nor a vegetation layer enough to consider as insulation for the analyzed ground. Oscillations above 0°C were evidenced down to 1.8m depth during winter of 2014, ruling out the existence of permafrost at that lower limit. Year round thermal dynamic down to 1.8m in the ground profile is presented as one result of the monitoring. Small amplitude temperature fluctuations were registered upon monitoring. These minimal amplitudes were stable throughout several months and as such serve as an interesting proxy for recent and long-term climatic thermal fluctuation. The influence of winds coming from nearby glaciers highly affects near-surface amplitude. This interaction was studied. The present work is part of an ongoing monitoring network along South America that intends to fill the gap between tropical Andes and the Antarctic Peninsula.

  10. Munchausen syndrome by proxy in Mexican children: medical, social, psychological and legal aspects.

    Science.gov (United States)

    Trejo-Hernández, Jorge; Loredo-Abdalá, Arturo; Orozco-Garibay, José Manuel

    2011-01-01

    The Munchausen Syndrome by Proxy (MSP), is considered as an unusual less frequent variety of child abuse (CA). In this type of abuse the perpetrators purposely provide factitious information, tamper with specimens or actually induce an illness in a child. Nowadays, it is a clinical entity described in pediatrics as more frequently than before. Despite the fact of its presence worldwide, there are still problems in order to get an appropriate diagnostic. It is also difficult to handle both the clinical and legal aspects in various countries. Make our academic fellows aware of various pediatric, psychological, social and legal aspects of a series of cases attended at the Clínica de Atención Integral al Niño Maltratado from Instituto Nacional de Pediatría (CAINM-INP), Mexico [Integral Clinic of Attention for Abused Children, at National Institute of Pediatrics, Mexico]. From a series of 25 cases, 18 minors of age were considered with this syndrome since we found that they shared medical, psychological, social and legal characteristics. 18 minors of age belonged to 14 families. 4 of those families had two affected children each one. These affected children were girls 13/18, predominant in children under six years in 10/18. Syndrome expression was distributed as follows: fever from a non determined origin, seizures, chronic diarrhea, hematuria, and probable sexual abuse. 14 children were hospitalized. In all cases, the aggressor was the mother. The psychological evaluation of six perpetrators revealed psychotic, histrionic, and compulsive-obsessive traits. The socio-economic condition was low in 50% of the cases. A legal demand was posed for seven patients in which all the children remained under the custody of the mother. In Mexico, reports of CA have increased within the last years according to experience. Some complex forms as MSP require the participation of an interdisciplinary team for both diagnosis and integral attention.

  11. Limitations of remotely sensed aerosol as a spatial proxy for fine particulate matter.

    Science.gov (United States)

    Paciorek, Christopher J; Liu, Yang

    2009-06-01

    Recent research highlights the promise of remotely sensed aerosol optical depth (AOD) as a proxy for ground-level particulate matter with aerodynamic diameter pollution exposure for public health purposes. Given the correlations reported between AOD and PM(2.5), it is tempting to interpret the spatial patterns in AOD as reflecting patterns in PM(2.5). We evaluated the degree to which AOD can help predict long-term average PM(2.5) concentrations for use in chronic health studies. We calculated correlations of AOD and PM(2.5) at various temporal aggregations in the eastern United States in 2004 and used statistical models to assess the relationship between AOD and PM(2.5) and the potential for improving predictions of PM(2.5) in a subregion, the mid-Atlantic. We found only limited spatial associations of AOD from three satellite retrievals with daily and yearly PM(2.5). The statistical modeling shows that monthly average AOD poorly reflects spatial patterns in PM(2.5) because of systematic, spatially correlated discrepancies between AOD and PM(2.5). Furthermore, when we included AOD as a predictor of monthly PM(2.5) in a statistical prediction model, AOD provided little additional information in a model that already accounts for land use, emission sources, meteorology, and regional variability. These results suggest caution in using spatial variation in currently available AOD to stand in for spatial variation in ground-level PM(2.5) in epidemiologic analyses and indicate that when PM(2.5) monitoring is available, careful statistical modeling outperforms the use of AOD.

  12. Claustrophobia: a proxy for psychological distress in patients with back pain.

    Science.gov (United States)

    Kerr, Hui-Ling; Dabke, Harshad V; Collins, Iona E; Grevitt, Michael

    2012-08-01

    Case-control study. The aim of this study was to assess the levels of psychological distress in patients with back pain who expressed claustrophobia at the time of their magnetic resonance imaging (MRI) scan, compared with sex and age-matched normal controls who did not exhibit claustrophobia. The secondary aim was to document the level of disability and intervention rates in this group. Psychosocial factors influence the outcomes of low back pain treatment with psychological distress being associated with poorer surgical outcomes in patients with low back pain. Up to 14% of patients experience claustrophobia during MRI scans requiring sedation to complete the scan. The effect of claustrophobia on back pain disability and outcomes has not been previously reported. Twenty females and 13 males all requiring MRI scan under sedation for claustrophobia (group 1) were compared with an age and sex-matched cohort that had MRI scan without sedation (group 2). Both groups were drawn from a chronic back clinic. Average age in both groups was 54 years (range, 27 to 79 y). Both groups had standard conservative therapy, together with psychometric evaluation: Zung Depression Index and Modified Somatic Perception Questionnaire. Disability was measured by Oswestry Disability Index. Primary outcome measures were intervention rates (surgery, injections, and physiotherapy sessions) and prevalence of psychological distress. Mean Zung Depression Index in group 1 was significantly higher than in group 2 (59.5 vs. 28.9, PClaustrophobia requiring sedation for MRI scans may be a proxy for psychological distress in these patients and psychometric testing is advised during assessment to help with surgical decision making.

  13. Medical Child Abuse (Munchausen Syndrome by Proxy): Multidisciplinary Approach from a Pediatric Gastroenterology Perspective.

    Science.gov (United States)

    Ali-Panzarella, Andrea Z; Bryant, Tamika J; Marcovitch, Hannah; Lewis, Jeffery D

    2017-04-01

    We highlight the need for a multidisciplinary approach to the diagnosis of medical child abuse, also known as factitious disorder imposed on another (FDIA) or Munchausen syndrome by proxy (MSP), and review our experience focusing on the variety of symptoms that often present to the pediatric gastroenterologist many months before the diagnosis is made. Recent literature on medical child abuse, mostly case reports, is markedly limited, highlighting a need for increased research on this topic. Articles agree on the value of a multidisciplinary approach to these cases and the importance of involving professionals outside the hospital setting. Given the technology-dependent nature of our current society, the use of social media to aid in making the diagnosis has emerged. Review of the literature shows that there are almost no data on long-term outcomes of the victims or perpetrators of MSP. Making the diagnosis of MSP involves a complicated process of piecing together inconsistencies among the history, examination, and clinical presentation. The diagnosis remains difficult and is not often considered during early presentation of symptoms. Once MSP is suspected, it is important that a multidisciplinary process is used, incorporating input from various sources: the outpatient care structure, the hospital, non-hospital agencies such as school and child protective services, and non-traditional sources such as social media. In our experience, a multidisciplinary approach augmented by thoughtful inpatient surveillance provides the greatest opportunity for confirming or excluding MSP. Pediatric gastroenterology is one of the most common services consulted prior to diagnosis and presents an opportunity for early intervention.

  14. 'Treating Africans differently': using skin colour as proxy for HIV risk.

    Science.gov (United States)

    Henrickson, Mark; Fisher, Meaghan

    2016-07-01

    This paper examines the qualitative results of two studies of Black African new settler communities in New Zealand. The analysis investigates the issues of stigma and microaggressions and their effects on Black African communities. Previous work that investigated experiences of stigma faced by relatively early Black African new settlers to New Zealand found that new settlers experienced stigma, and their resulting isolation had negative implications for access to health and social services, regardless of HIV status. This paper is a meta-analysis of two published studies, using original qualitative data from each. Researchers for the first study, Standing in the Fire, interviewed 13 Black Africans living with HIV who were new settlers to New Zealand. The second study, AfricaNZ Care, was a national mixed method study which surveyed 703 Black African new settlers, and included 131 participants in 23 different focus groups. The present analysis includes only the qualitative data from the second study. Some, but not most, participants of the second study were living with HIV. Black African identity is used as a proxy for HIV status among non-HIV specialist health care workers. Participants reported experiences of stigma and microaggressions based on their race, and a lack of knowledge about HIV in non-HIV specialist nurses and other health care workers. They also experienced poor health care and education practices, professional prejudice against colleagues living with HIV and institutional challenges including failure to protect patient confidentiality. HIV-related stigma and microaggressions remain significant problems, not only for people living with HIV but also for those perceived to be at high risk for HIV. Experiences of stigmatising behaviour by health care professionals have a broad and significant range of impacts on patients' health outcomes. © 2016 John Wiley & Sons Ltd.

  15. Asking the right question of informal caregivers about patient symptom experiences: multiple proxy perspectives and reducing interrater gap.

    Science.gov (United States)

    Lobchuk, Michelle M; McClement, Susan E; Daeninck, Paul J; Shay, Christopher; Elands, Heather

    2007-02-01

    Recent conceptual work on multiple proxy perspectives indicates that clinicians should be more reflective in terms of how they question or prompt informal caregivers to report on patient illness experiences. There are different ways in which therapeutic questions might be posed that can influence perceptual agreement between patients and caregivers. The purpose of this randomized, between-subjects study was to test the hypothesis that "The interrater gap between patient self-assessment and caregiver assessment on patient multidimensional symptom experiences will be reduced when caregivers are prompted to imagine-patient perspective-take." We also tested the hypothesis that "Regardless of the perspective-taking prompt provided to the caregiver, gender will have no impact on patient and caregiver discrepancy scores on patient symptom experiences." This study comprised a convenience sample of 126 dyads consisting of breast and prostate cancer patients, and their informal caregivers. Patients provided self-reports on the abbreviated Memorial Symptom Assessment Scale (MSAS). Informal caregivers also completed the abbreviated MSAS under one of three randomly assigned instructional set conditions: neutral, imagine-patient perspective-taking, and imagine-self perspective-taking. The imagine-patient prompt was effective in reducing caregiver discrepancy across symptoms and underlying dimensions in comparison to the imagine-self prompt. However, the least discrepancy between patients and caregivers occurred in the neutral condition. The greatest discrepancy by caregivers occurred in imagine-self condition. For the most part, there was no significant interaction effect between caregiver gender and induced perspective-taking across each of the symptoms and underlying frequency, severity, and distress. These results lend support for Pickard and Knight's multiple proxy perspectives model in that different perspective-taking prompts can result in varying levels of perceptual

  16. Scientific imperatives, clinical implications, and theoretical underpinnings for the investigation of the relationship between genetic variables and patient-reported quality-of-life outcomes.

    Science.gov (United States)

    Sprangers, Mirjam A G; Sloan, Jeff A; Barsevick, Andrea; Chauhan, Cynthia; Dueck, Amylou C; Raat, Hein; Shi, Quiling; Van Noorden, Cornelis J F

    2010-12-01

    There is emerging evidence for a genetic basis of patient-reported quality-of-life (QOL) outcomes that can ultimately be incorporated into clinical research and practice. Objectives are (1) to provide arguments for the timeliness of investigating the genetic basis of QOL given the scientific advances in genetics and patient-reported QOL research; (2) to describe the clinical implications of such investigations; (3) to present a theoretical foundation for investigating the genetic underpinnings of QOL; and (4) to describe a series of papers resulting from the GENEQOL Consortium that was established to move this work forward. Discussion of scientific advances based on relevant literature. In genetics, technological advances allow for increases in speed and efficiency and decreases in costs in exploring the genetic underpinnings of disease processes, drug metabolism, treatment response, and survival. In patient-based research, advances yield empirically based and stringent approaches to measurement that are scientifically robust. Insights into the genetic basis of QOL will ultimately allow early identification of patients susceptible to QOL deficits and to target care. The Wilson and Cleary model for patient-reported outcomes was refined by incorporating the genetic underpinnings of QOL. This series of papers provides a path for QOL and genetics researchers to work together to move this field forward and to unravel the intricate interplay of the genetic underpinnings of patient-reported QOL outcomes. The ultimate result will be a greater understanding of the process relating disease, patient, and doctor that will have the potential to lead to improved survival, QOL, and health services delivery.

  17. Fingerprints as a Proxy for Readership of Sales Flyers

    DEFF Research Database (Denmark)

    Schmidt, Marcus J.; Krause, Niels; Solgaard, Hans Stubbe

    2007-01-01

      Can readership of sales flyers and free newspapers be estimated by revealing fingerprints? In this paper we report the results of an empirical analysis based on 4604 flyer-pages conducted to assess the feasibility of the method. Results are encouraging, and indicate that the method presently may...... serve as a conservative estimate of readership. Advertising management may thus use the fingerprints-approach as an alternative audience measure and thereby assess the convergent validity of the traditional interview method and the fingerprint approach. While the fingerprint method appears valid...... for sales catalogues its validity of measuring audience of small flyers is questionable....

  18. Yoga increased serum estrogen levels in postmenopausal women-a case report.

    Science.gov (United States)

    Afonso, Rui Ferreira; Kozasa, Elisa Harumi; Rodrigues, Dinah; Leite, José Roberto; Tufik, Sérgio; Hachul, Helena

    2016-05-01

    This case report aimed to evaluate 4 months of yoga practice on the quality of life (QOL) and estradiol levels of two postmenopausal women. Participants were clinically healthy postmenopausal women, with follicle-stimulating hormone levels greater than or equal to 30 mIU/mL and a body mass index lower than 30 kg/m. The participants practiced yoga for 4 months in two 1-hour sessions per week. The participants exhibited an abnormal estrogen-level increase after 4 months of yoga practice and showed QOL improvements. In some cases, yoga practice can affect the female neuroendocrine system, increasing estrogen and improving QOL.

  19. Quality of life in postmenopausal women: translation and validation of MSkinQOL questionnaire to measure the effect of a skincare product in USA.

    Science.gov (United States)

    Segot-Chicq, Evelyne; Fanchon, Chantal

    2013-12-01

    The 28-item Menopausal Skin Quality Of Life (MSkinQOL), a previously validated French questionnaire, developed to assess psychological features of menopausal women and to measure the benefits of using cosmetic skincare products was translated and validated to assess a skincare product in the USA. Construct validity, reliability, reproducibility, and responsiveness were assessed with two groups of 100 nonmenopausal (NM) and 100 postmenopausal (PM) women. The group of PM women applied a specially developed skincare product twice daily for 1 month and filled in the same questionnaire after 1 month as well as a general self-assessment questionnaire about the efficacy and cosmetic properties of the product. No ceiling or floor effects were identified. Construct and internal validity was assessed using a multitrait analysis: questionnaire items proved closely correlated, and each dimension covers a different aspect of women answers profile. The three dimensions showed good reliability and stability. Baseline values for social effects of skin appearance, health status, and self-esteem were significantly different between PM and NM volunteers. Values of these three dimensions were significantly improved after 2 weeks of product application, and further improved after 4 weeks. This study shows that a careful translation and a rigorous process of validation lead to a reliable tool adapted to each country to explore and measure quality of life in healthy PM women. © 2013 Wiley Periodicals, Inc.

  20. The Effectiveness of Thai Exercise with Traditional Massage on the Pain, Walking Ability and QOL of Older People with Knee Osteoarthritis: A Randomized Controlled Trial in the Community.

    Science.gov (United States)

    Peungsuwan, Punnee; Sermcheep, Phawinee; Harnmontree, Papatsara; Eungpinichpong, Wichai; Puntumetakul, Rungthip; Chatchawan, Uraiwan; Yamauchi, Junichiro

    2014-01-01

    [Purpose] This study investigated the effectiveness of a class- and home-based exercise with massage between Thai traditional and standardized physical therapy (TPT and SPT) in older people with knee osteoarthritis (KOA). [Subjects and Methods] Thirty-one subjects with KOA (aged 50-85 years) in two selected villages were randomly assigned into the TPT or SPT programs. Seventeen TPT subjects received Thai exercise with traditional massage, and 14 SPT individuals performed strengthening exercise with Swedish massage. Both programs consisted of a class with supervision plus home self-care for 8 weeks; the subjects then managed home self-care for 1 year. [Results] After 2 months, the six-minute walk test (6MWT), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and SF-36 testing showed significant improvement in both groups, but the improvement of the TPT group was greater. After 1year, only the score for the 6MWT was greater in the TPT group than in the SPT group. [Conclusion] The TPT program yielded better results for the 6MWT, but, both programs had beneficial effects on the pain, function, and QOL of middle-aged and older patients with KOA in the community setting.

  1. Parent-proxy perception of overweight adolescents' health-related quality of life is different according to adolescent gender and age and parent gender.

    Science.gov (United States)

    Bianchini, Josiane Aparecida Alves; da Silva, Danilo Fernandes; Nardo, Claudia Christina Sanchez; Carolino, Idalina Diair Regla; Hernandes, Florencio; Nardo, Nelson

    2013-10-01

    This study assessed health-related quality of life (HRQoL) reported by overweight adolescents and compared to their parent-proxy perception of HRQoL, according to adolescent gender, adolescent age, and parent gender. Patients and a total of 179 adolescents aged 10 to 18 years with excess weight were evaluated for perceived HRQoL prior to beginning a weight-loss intervention, using the Pediatric Quality of Life Inventory (PedsQL 4.0) questionnaire, estimating quality of life in the physical, emotional, social, and school domains, as well as index measures of psychosocial and overall quality of life. Parents completed the same questionnaire estimating his or her child's HRQoL. Compared to their child's self-report, parents underestimated all the domains of HRQoL except the school domain. Parents underestimated all the domains of HRQoL among boys; however, they only underestimated the physical domain among girls. Comparisons between parent-proxy perception and self-report of the adolescent according to adolescent's age revealed that parents underestimated their children's HRQoL in the younger adolescents (10 to 13 years) for all except for the school domain and underestimated only the physical domain in older adolescents (14 to 18 years). The same comparison between parent-proxy perception and their child's self-report of HRQoL according to parent gender showed that mothers underestimated HRQoL in all domains except for the school domain, while fathers only underestimated the school domain. The differences between self-report of overweight adolescent and perceptions of their parents about the HRQoL of their children are influenced by adolescent gender and age and parent gender.

  2. Reducing handover latency in future IP-based wireless networks: Fast Proxy Mobile IPv6

    NARCIS (Netherlands)

    Heijenk, Geert; Bargh, Mortaza S.; Laganier, Julien; Prasad, Anand R.

    2008-01-01

    Current IP-level mobility protocols have difficulties meeting the stringent handover delay requirements of future wireless networks. At the same time they do not give sufficient control to the network to control the handover process. This paper presents an extension to Proxy Mobile IP, which is the

  3. Ethiopia-Eritrea : proxy wars and prospects of peace in the Horn of Africa

    NARCIS (Netherlands)

    Abbink, G.J.

    2003-01-01

    Many inter-State and intra-State conflicts in Africa become more complex by being extended into 'proxy wars', i.e. secondary, often 'low intensity' armed conflicts, pursued in the context of a major power struggle, or outright wars between States carried out by subsidiary or co-opted insurgent

  4. Sources and proxy potential of long chain alkyl diols in lacustrine environments.

    NARCIS (Netherlands)

    Rampen, Sebastiaan W.; Datema, Mariska; Rodrigo-Gámiz, M.; Schouten, Stefan; Reichart, Gert-Jan; Sinninghe Damste, Jaap S.

    2014-01-01

    Long chain 1,13- and 1,15-alkyl diols form the base of a number of recently proposed proxies used for climate reconstruction. However, the sources of these lipids and environmental controls on their distribution are still poorly constrained. We have analyzed the long chain alkyl diol (LCD)

  5. Sources and proxy potential of long chain alkyl diols in lacustrine environments

    NARCIS (Netherlands)

    Rampen, S.; Datema, M.; Rodrigo-Gámiz, M.; Schouten, S.; Reichart, G.-J.; Sinninghe Damsté, J.S.

    2014-01-01

    Long chain 1,13- and 1,15-alkyl diols form the base of a number of recently proposed proxies used for climate reconstruction. However, the sources of these lipids and environmental controls on their distribution are still poorly constrained. We have analyzed the long chain alkyl diol (LCD)

  6. Comparing children's GPS tracks with geospatial proxies for exposure to junk food.

    Science.gov (United States)

    Sadler, Richard C; Gilliland, Jason A

    2015-01-01

    Various geospatial techniques have been employed to estimate children's exposure to environmental cardiometabolic risk factors, including junk food. But many studies uncritically rely on exposure proxies which differ greatly from actual exposure. Misrepresentation of exposure by researchers could lead to poor decisions and ineffective policymaking. This study conducts a GIS-based analysis of GPS tracks--'activity spaces'--and 21 proxies for activity spaces (e.g. buffers, container approaches) for a sample of 526 children (ages 9-14) in London, Ontario, Canada. These measures are combined with a validated food environment database (including fast food and convenience stores) to create a series of junk food exposure estimates and quantify the errors resulting from use of different proxy methods. Results indicate that exposure proxies consistently underestimate exposure to junk foods by as much as 68%. This underestimation is important to policy development because children are exposed to more junk food than estimated using typical methods. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Deuterium values from volcanic glass: A paleoelevation proxy for Oregon's Cascade Range

    Science.gov (United States)

    Carlson, T. B.; Bershaw, J. T.

    2016-12-01

    Hydrated volcanic glass has been used as a proxy to constrain Cenozoic paleoclimate across many of the world's mountain ranges. However, there are concerns that volcanic glass may not preserve the isotopic composition of syndepositional meteoric water. The Cascades are an excellent location to study the validity of hydrated volcanic glass as a paleoenvironmental proxy for several reasons. Moisture is derived from a single oceanic source and falls as orographic precipitation in the Cascades, leading to a characteristic altitude effect, or inverse relationship between elevation and the isotopic composition of meteoric water (δD). In addition, past studies have inferred uplift of the Cascades and an increase in the rain shadow effect since the Eocene through independent methods such as changing fossil assemblages, and other isotopic proxies including carbonates and fossil teeth. In this study, δD values of two hydrated tuff samples are compared: one prior to ( 29 Ma) and one following ( 5 Ma) the onset of High Cascade volcanism. The isotopic composition of these samples are interpreted in the context of modern water across the range to understand the potential of volcanic glass as a proxy for paleoelevation in the Pacific Northwest.

  8. Constructing Proxy Variables to Measure Adult Learners' Time Management Strategies in LMS

    Science.gov (United States)

    Jo, Il-Hyun; Kim, Dongho; Yoon, Meehyun

    2015-01-01

    This study describes the process of constructing proxy variables from recorded log data within a Learning Management System (LMS), which represents adult learners' time management strategies in an online course. Based on previous research, three variables of total login time, login frequency, and regularity of login interval were selected as…

  9. Optical Proxies for Terrestrial Dissolved Organic Matter in Estuaries and Coastal Waters

    Directory of Open Access Journals (Sweden)

    Christopher L. Osburn

    2016-01-01

    Full Text Available Optical proxies, especially DOM fluorescence, were used to track terrestrial DOM fluxes through estuaries and coastal waters by comparing models developed for several coastal ecosystems. Key to using optical properties is validating and calibrating them with chemical measurements, such as lignin-derived phenols - a proxy to quantify terrestrial DOM. Utilizing parallel factor analysis (PARAFAC, and comparing models statistically using the OpenFluor database (http://www.openfluor.org we have found common, ubiquitous fluorescing components which correlate most strongly with lignin phenol concentrations in several estuarine and coastal environments. Optical proxies for lignin were computed for the following regions: Mackenzie River Estuary, Atchafalaya River Estuary, Charleston Harbor, Chesapeake Bay, and Neuse River Estuary. The slope of linear regression models relating CDOM absorption at 350 nm (a350 to DOC and to lignin, varied 5 to 10 fold among systems. Where seasonal observations were available from a region, there were distinct seasonal differences in equation parameters for these optical proxies. Despite variability, overall models using single linear regression were developed that related dissolved organic carbon (DOC concentration to CDOM (DOC = 40×a350+138; R2 = 0.77; N = 130 and lignin (Σ8 to CDOM (Σ8 = 2.03×a350-0.5; R2 = 0.87; N = 130. This wide variability suggested that local or regional optical models should be developed for predicting terrestrial DOM flux into coastal oceans and taken into account when upscaling to remote sensing observations and calibrations.

  10. 17 CFR 240.14a-4 - Requirements as to proxy.

    Science.gov (United States)

    2010-04-01

    ... persons making the solicitation do not know, a reasonable time before the solicitation, are to be... elected. Provided, however, That nothing in this section 240.14a-4 shall prevent any person soliciting in... authority to vote for nominees named in the registrant's proxy statement, so long as the soliciting party...

  11. The 30 cm radio flux as a solar proxy for thermosphere density modelling

    Directory of Open Access Journals (Sweden)

    Dudok de Wit Thierry

    2017-01-01

    Full Text Available The 10.7 cm radio flux (F10.7 is widely used as a proxy for solar UV forcing of the upper atmosphere. However, radio emissions at other centimetric wavelengths have been routinely monitored since the 1950 s, thereby offering prospects for building proxies that may be better tailored to space weather needs. Here we advocate the 30 cm flux (F30 as a proxy that is more sensitive than F10.7 to longer wavelengths in the UV and show that it improves the response of the thermospheric density to solar forcing, as modelled with DTM (Drag Temperature Model. In particular, the model bias drops on average by 0–20% when replacing F10.7 by F30; it is also more stable (the standard deviation of the bias is 15–40% smaller and the density variation at the the solar rotation period is reproduced with a 35–50% smaller error. We compare F30 to other solar proxies and discuss its assets and limitations.

  12. Proxy documents as a source of measurement error in the Comparative Manifestos Project.

    NARCIS (Netherlands)

    Gemenis, Konstantinos

    2012-01-01

    This paper considers the issue of document type diversity in the Comparative Manifestos Project (CMP). For many years the CMP has been collecting and coding a variety of documents, such as speeches, pamphlets, newspaper articles and leaflets, as manifesto proxies. By using previously unexplored

  13. The Deceit Continues: An Updated Literature Review of Munchausen Syndrome By Proxy.

    Science.gov (United States)

    Sheridan, Mary S.

    2003-01-01

    This updated review of the literature on Munchausen Syndrome by Proxy (MBSP) analyzes 451 cases from 154 medical and psychosocial journal articles. Typical victims were usually 4 years of age or under; 6% were dead, and 7.3% suffered long-term or permanent injury. Twenty-five percent of siblings were dead. Mothers were perpetrators in 76.5% of…

  14. Characteristics of Hospital-Based Munchausen Syndrome by Proxy in Japan

    Science.gov (United States)

    Fujiwara, Takeo; Okuyama, Makiko; Kasahara, Mari; Nakamura, Ayako

    2008-01-01

    Objective: This article explores characteristics of Munchausen Syndrome by Proxy (MSBP) in Japan, a country which provides an egalitarian, low cost, and easy-access health care system. Methods: We sent a questionnaire survey to 11 leading doctors in the child abuse field in Japan, each located in different hospital-based sites. Child abuse doctors…

  15. Beyond Munchausen by Proxy: A Proposed Conceptualization for Cases of Recurring, Unsubstantiated Sexual Abuse Allegations

    Science.gov (United States)

    Lindahl, Mary W.

    2009-01-01

    In the emerging literature, cases involving recurring, unsubstantiated allegations of child sexual abuse have generally been categorized as Munchausen by proxy. Recent scholars have recommended restricting the label to the original conceptualization, involving purposeful deception motivated by psychological needs for medical attention. This leaves…

  16. Web of Deceit: A Literature Review of Munchausen Syndrome by Proxy.

    Science.gov (United States)

    Rosenberg, Donna A.

    1987-01-01

    A literature review and case study provide detailed characteristics of Munchausen syndrome by proxy, a form of child abuse wherein the mother falsifies illness in her child through simulation and/or production of illness, presenting the child for medical care while disclaiming knowledge of its etiology. Guidelines for medical, social service, and…

  17. Repeated False Allegations of Sexual Abuse Presenting to Sheriffs: When Is It Munchausen by Proxy?

    Science.gov (United States)

    Schreier, Herbert A.

    1996-01-01

    In cases of Munchausen Syndrome by Proxy, the perpetrator (generally the mother) simulates or fabricates child abuse in order to maintain an intense relationship with hospital personnel, police personnel, child protection workers, lawyers, or school personnel. A case involving law enforcement agents as a primary "target" illustrates…

  18. Munchausen by Proxy: A Case, Chart Series, and Literature Review of Older Victims

    Science.gov (United States)

    Awadallah, Nida; Vaughan, Aaron; Franco, Kathleen; Munir, Farah; Sharaby, Na'ama; Goldfarb, Johanna

    2005-01-01

    The history of an older child victim of Munchausen by proxy (MBP) is described. He was referred for evaluation after repeated sinus surgeries for recurrent sinus infections believed to be related to a falsified history of an immunodeficiency. The perpetrator was the mother of this 14-year-old victim, consistent with the majority of such cases.…

  19. Concerns about Research and Prevention Strategies in Munchausen Syndrome by Proxy (MSBP) Abuse.

    Science.gov (United States)

    Eminson, Mary; Jureidini, Jon

    2003-01-01

    This article examines three motives for research into Munchausen Syndrome by Proxy child abuse, which are to enhance treatment, to understand the psychopathology of perpetrators, and to find interventions to prevent its occurrence. It argues that only the first justification is valid and proposes that research energy be directed toward…

  20. Care for Sick Children as a Proxy for Gender Equality in the Family

    Science.gov (United States)

    Eriksson, Rickard; Nermo, Magnus

    2010-01-01

    Swedish parents are entitled to government paid benefits to take care of sick children. In this paper we show that the gender distribution of paid care for sick children is a good proxy for the gender division of household work. Using two examples we show that registry data on care for sick children is a useful data source for studies on gender…

  1. The effect of chemical pretreatment of sediment upon foraminiferal-based proxies

    NARCIS (Netherlands)

    Feldmeijer, W.; Metcalfe, B.; Scussolini, P.; Arthur, K.L.

    2013-01-01

    Paleoceanographic studies routinely combine different foraminiferal proxies (i.e., weight, abundance, trace metal, and stable isotope measurements) into a cohesive narrative. The application of chemical treatment to disaggregate ocean sediments in the most efficient way to isolate the fossils of

  2. Proxy records of Holocene storm events in coastal barrier systems: Storm-wave induced markers

    Science.gov (United States)

    Goslin, Jérôme; Clemmensen, Lars B.

    2017-10-01

    Extreme storm events in the coastal zone are one of the main forcing agents of short-term coastal system behavior. As such, storms represent a major threat to human activities concentrated along the coasts worldwide. In order to better understand the frequency of extreme events like storms, climate science must rely on longer-time records than the century-scale records of instrumental weather data. Proxy records of storm-wave or storm-wind induced activity in coastal barrier systems deposits have been widely used worldwide in recent years to document past storm events during the last millennia. This review provides a detailed state-of-the-art compilation of the proxies available from coastal barrier systems to reconstruct Holocene storm chronologies (paleotempestology). The present paper aims (I) to describe the erosional and depositional processes caused by storm-wave action in barrier and back-barrier systems (i.e. beach ridges, storm scarps and washover deposits), (ii) to understand how storm records can be extracted from barrier and back-barrier sedimentary bodies using stratigraphical, sedimentological, micro-paleontological and geochemical proxies and (iii) to show how to obtain chronological control on past storm events recorded in the sedimentary successions. The challenges that paleotempestology studies still face in the reconstruction of representative and reliable storm-chronologies using these various proxies are discussed, and future research prospects are outlined.

  3. Multi-proxy summer and winter precipitation reconstruction for southern Africa over the last 200 years

    NARCIS (Netherlands)

    Neukom, R.; Nash, D.J.; Endfield, G.H.; Grab, S.W; Grove, C.A.; Kelso, C.; Vogel, C.H.; Zinke, J.

    2014-01-01

    This study presents the first consolidation of palaeoclimate proxy records from multiple archives to develop statistical rainfall reconstructions for southern Africa covering the last two centuries. State-of-the-art ensemble reconstructions reveal multi-decadal rainfall variability in the summer and

  4. Phylogenetic patterns are not proxies of community assembly mechanisms (they are far better)

    NARCIS (Netherlands)

    Gerhold, Pille; Cahill, J.F.; Winter, Marten; Bartish, I.V.; Prinzing, Andreas

    2015-01-01

    The subdiscipline of 'community phylogenetics' is rapidly growing and influencing thinking regarding community assembly. In particular, phylogenetic dispersion of co-occurring species within a community is commonly used as a proxy to identify which community assembly processes may have structured

  5. Linking coral river runoff proxies with climate variability, hydrology and land-use in Madagascar catchments

    NARCIS (Netherlands)

    Maina, J.; de Moel, H.; Vermaat, J.E.; Bruggemann, J.H.; Guillaume, M.M.M.; Grove, C.A.; Madin, J.S.; Merz-Kraus, R.; Zinke, J.

    2012-01-01

    Understanding the linkages between coastal watersheds and adjacent coral reefs is expected to lead to better coral reef conservation strategies. Our study aims to examine the main predictors of environmental proxies recorded in near shore corals and therefore how linked near shore reefs are to the

  6. Fluxes, diagenesis, and the variation of proxies in eastern Mediterranean sediments

    NARCIS (Netherlands)

    Santvoort, Petrus Johannes Maria van

    2004-01-01

    In this thesis diagenetic processes in both organic-poor and organic-rich eastern Mediterranean sediments are studied. Furthermore, (present-day) fluxes and the variations in several proxies are discussed. Chapter 2 deals with the aerobic mineralisation of Corg in surface sediments of the deep

  7. Psychometrics of the Short Form 36 Health Survey Version 2 (SF-36v2) and the Quality of Life Scale for Drug Addicts (QOL-DAv2.0) in Chinese Mainland Patients with Methadone Maintenance Treatment

    Science.gov (United States)

    Zhou, Kaina; Zhuang, Guihua; Zhang, Hongmei; Liang, Peifeng; Yin, Juan; Kou, Lingling; Hao, Mengmeng; You, Lijuan

    2013-01-01

    Objective To test psychometrics of the Short Form 36 Health Survey version 2 (SF-36v2) and the Quality of Life Scale for Drug Addicts (QOL-DAv2.0) in Chinese mainland patients with methadone maintenance treatment (MMT). Methods A total of 1,212 patients were recruited from two MMT clinics in Xi’an, China. Reliability was estimated with Cronbach’s α and intra-class correlation (ICC). Convergent and discriminant validity was assessed using multitrait-multimethod correlation matrix. Sensitivity was measured with ANOVA and relative efficiency. Responsiveness was evaluated by pre-post paired-samples t-test and standardized response mean based on the patients’ health status changes following 6-month period. Results Cronbach’s α of the SF-36v2 physical and mental summary components were 0.80 and 0.86 (eight scales range 0.73–0.92) and the QOL-DAv2.0 was 0.96 (four scales range: 0.80–0.93). ICC of the SF-36v2 two components were 0.86 and 0.85 (eight scales range: 0.72–0.87) and the QOL-DAv2.0 was 0.94 (four scales range: 0.88–0.92). Convergent validity was lower between the two instruments (γ SF-36v2 physical functioning and vitality scales; QOL-DAv2.0 except psychology scale). Responsiveness was acceptable in the improved health status change (SF-36v2 except vitality scale; QOL-DAv2.0 except psychology and symptoms scales) and deteriorated health status change (SF-36v2 except vitality, social functioning and mental health scales; QOL-DAv2.0 except society scale). Conclusions The SF-36v2 and the QOL-DAv2.0 are valid tools and can be used independently or complementary according to different emphases of health-related quality of life evaluation in patients with MMT. PMID:24278188

  8. Calcium isotopic composition of high-latitude proxy carrier Neogloboquadrina pachyderma (sin.

    Directory of Open Access Journals (Sweden)

    A. Eisenhauer

    2009-01-01

    Full Text Available The accurate reconstruction of sea surface temperature (SST history in climate-sensitive regions (e.g. tropical and polar oceans became a challenging task in palaeoceanographic research. Biogenic shell carbonate SST proxies successfully developed for tropical regions often fail in cool water environments. Their major regional shortcomings and the cryptic diversity now found within the major high latitude proxy carrier Neogloboquadrina pachyderma (sin. highlight an urgent need to explore complementary SST proxies for these cool-water regions. Here we incorporate the genetic component into a calibration study of a new SST proxy for the high latitudes. We found that the calcium isotopic composition (δ44/40Ca of calcite from genotyped net catches and core-top samples of the planktonic foraminifera Neogloboquadrina pachyderma (sin. is related to temperature and unaffected by genetic variations. The temperature sensitivity has been found to be 0.17 (±0.02‰ per 1°C, highlighting its potential for downcore applications in open marine cool-water environments. Our results further indicate that in extreme polar environments, below a critical threshold temperature of 2.0 (±0.5°C associated with salinities below 33.0 (±0.5‰, a prominent shift in biomineralization affects the δ44/40Ca of genotyped and core-top N. pachyderma (sin., becoming insensitive to temperature. These findings highlight the need of more systematic calibration studies on single planktonic foraminiferal species in order to unravel species-specific factors influencing the temperature sensitivity of Ca isotope fractionation and to validate the proxies' applicability.

  9. Ethnicity or cultural group identity of pregnant women in Sydney, Australia: Is country of birth a reliable proxy measure?

    Science.gov (United States)

    Porter, M; Todd, A L; Zhang, L Y

    2016-04-01

    Australia has one of the most ethnically and culturally diverse maternal populations in the world. Routinely few variables are recorded in clinical data or health research to capture this diversity. This paper explores how pregnant women, Australian-born and overseas-born, respond to survey questions on ethnicity or cultural group identity, and whether country of birth is a reliable proxy measure. As part of a larger study, pregnant women attending public antenatal clinics in Sydney, Australia, completed a survey about their knowledge and expectations of pregnancy duration. The survey included two questions on country of birth, and identification with an ethnicity or cultural group. Country of birth data were analysed using frequency tabulations. Responses to ethnicity or cultural group were analysed using inductive coding to identify thematic categories. Among the 762 with 75 individual cultural groups or ethnicities and 68 countries of birth reported. For Australian-born women (n=293), 23% identified with a cultural group or ethnicity, and 77% did not. For overseas-born women (n=469), 44% identified with a cultural group or ethnicity and 56% did not. Responses were coded under five thematic categories. Ethnicity and cultural group identity are complex concepts; women across and within countries of birth identified differently, indicating country of birth is not a reliable measure. To better understand the identities of the women receiving maternity care, midwives, clinicians and researchers have an ethical responsibility to challenge practices that quantify cultural group or ethnicity, or use country of birth as a convenient proxy measure. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  10. Preliminary Validation of the PROMIS Parent-Proxy Peer Relationships Measure in Children with Autism Spectrum Disorder: A DBPNet Study.

    Science.gov (United States)

    Toomey, Marisa; Schwartz, Justin; Laverdiere, Michele; Tucker, Carole A; Bevans, Katherine; Forrest, Christopher B; Blum, Nathan J

    To evaluate the content and construct validity of the existing PROMIS Pediatric Parent-Proxy Peer Relationships Measure in 5- to 12-year-old children with autism spectrum disorder (ASD). Parents of 121 children aged 5 to 12 years who met DSM-IV criteria for ASD completed the Peer Relationships Measure using computerized adaptive testing (CAT). Parents also completed the Social Responsiveness Scale, Second Edition (SRS-2) and a demographic form. Intelligence quotient test results were extracted from clinical or research records. Five parents participated in semi-structured interviews about their child's peer relationships and the item content on the Peer Relationships Measure. The children in the sample were primarily male (87%). The sample was racially and ethnically diverse, and parents were predominantly highly educated. The mean T-score (SD) on the Peer Relationships Measure was 36 (8), with a range from 15 to 62. For 98% of subjects, the CAT required administration of 5 items to reach a standard error of measurement of less than 4 T-score units. The Peer Relationships Measure demonstrated a large correlation with the SRS-2 (r = -0.60, p Peer Relationships Measure were relevant to the peer relationships of their child with ASD, but they reported a few challenges related to variability in their children's peer relationships over time and to somewhat limited knowledge of relationships in school. The PROMIS Pediatric Parent-Proxy Peer Relationships Measure may be an efficient, precise, and valid measure of peer relationships for 5- to 12-year-old children with ASD.

  11. Calibration, validation and application of foraminiferal carbonate based proxies. Reconstructing temperature, salinity and sea water Mg/Ca

    NARCIS (Netherlands)

    Wit, J.C.

    2012-01-01

    The chemistry of the calcite test of foraminifera is often relating to the environmental conditions under which they lived. These so-called proxy-relations are regularly used as a tool to reconstruct past climates. Accuracy of these proxies is, however, often limited due to uncertainties or absence

  12. Pharmacological and non-pharmacological treatment preferences of healthcare professionals and proxies for challenging behaviors in patients with dementia

    NARCIS (Netherlands)

    Janus, Sarah I; van Manen, Jeannette G; van Til, Janine A; Zuidema, Sytse U; IJzerman, Maarten J.

    BACKGROUND: Prescribing antipsychotics to patients with neuropsychiatric symptoms is a matter of concern. Physicians have to make treatment decisions for patients with dementia together with proxies and/or nurses. However, it is unknown whether physicians, nurses, and proxies' treatment preferences

  13. Proxying UPnP service discovery and access to a non-IP Bluetooth network on a mobile phone

    NARCIS (Netherlands)

    Delphinanto, A.; Koonen, A.M.J.; Peeters, M.E.; Hartog, F.T.H. den

    2007-01-01

    The current service- and device discovery protocols are not platform- and network independent. Therefore, proxy servers will be needed to extend the range of IP-based discovery protocols to non-IP domains. We developed an architecture of a proxy that enables Universal Plug and Play (UPnP) devices

  14. A traditional herbal formula, Hyangsa-Pyeongwi san (HPS), improves quality of life (QoL) of the patient with functional dyspepsia (FD): randomized double-blinded controlled trial.

    Science.gov (United States)

    Kim, Jeung-Bae; Shin, Jang-Woo; Kang, Ji-Young; Son, Chang-Gue; Kang, Weechang; Lee, Hye-Won; Lee, Dong-Soo; Park, Yang-Chun; Cho, Jung-Hyo

    2014-01-01

    Hyangaa-Pyeongwi san is the most well known description in Traditional Chinese Medicine for treating functional gastrointestinal disorders. Functional dyspepsia (FD) is a main concern of intimidating quality of life (QoL) in recent days. Although many medicines have been developed to improve FD symptoms as well as QoL, there are no potential drugs and treatments for FD. The aim of this study is to investigate the effects of Hyangaa-Pyeongwi san (HPS) on QoL of patients with FD. This study was designed as a randomized, double blinded, placebo controlled, and parallel group trial. Participants received either placebo or HPS (9.68g of HPS at once, three times daily) for 4-weeks, and the efficacy evaluations were performed by assessing the Nepean Dyspepsia Index (NDI) and functional dyspepsia-quality of life (FD-QoL) at 0-, 4- and 8-weeks. Total of 170 patients participated and were randomly allocated into placebo or HPS groups. Total symptom score of NDI decreased after 4-weeks trial in both groups (p>0.05). HPS significantly improved QoL scores, especially in the area of 'interference and eat/drink' in NDI (p=0.0031) as well as 'liveliness status', 'role-functioning status', and total score in FD-QoL (p=0.026 for liveliness status and p=0.035 for role-functioning status). This significant improvement of FD-QoL had lasted for 4-weeks. HPS treatment is markedly effective in improving QoL in patients with FD. Moreover, we observed that this improvement had lasted for 4 weeks after finishing the trial through the follow-up study. © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Self-reported quality of life before and after aerobic exercise training in individuals with hypertension: a randomised-controlled trial.

    Science.gov (United States)

    Maruf, Fatai A; Akinpelu, Aderonke O; Salako, Babatunde L

    2013-07-01

    The Effects of Aerobic Exercise Training (AET) on self-reported Quality of Life (QoL) in people with hypertension have been previously documented. However, data on black populations, especially from Africa, seem not to be available. This study investigated the effects of AET on QoL and exercise capacity in Nigerians on treatment for essential hypertension. This randomised-controlled trial involved newly diagnosed individuals, with mild-to-moderate essential hypertension randomly assigned to antihypertensive drugs (ADs) alone (control: n = 60) and AET+ADs (exercise: n = 60) groups. The study lasted for 12 weeks. QoL was measured using the World Health Organization QoL Short Form (WHOQoL-BREF) and exercise capacity was assessed using the Rockport Fitness Walk Test pre- and post-study. Physical health, psychological health, and social relationships domains of QoL improved significantly in the exercise and control groups post-intervention. The environment domain of QoL and exercise capacity improved significantly in only the exercise group. There were larger improvements in the physical health, psychological health, and environment domains of QoL, and exercise capacity in the exercise group. Aerobic exercise improves QoL and exercise capacity in individuals with essential hypertension. © 2013 The Authors. Applied Psychology: Health and Well-Being © 2013 The International Association of Applied Psychology.

  16. Nuclear magnetic resonance relaxation and diffusion measurements as a proxy for soil properties

    Science.gov (United States)

    Duschl, Markus; Pohlmeier, Andreas; Galvosas, Petrik; Vereecken, Harry

    2013-04-01

    correlated the results with various soil properties like texture, water retention parameters, and hydraulic conductivity. This way we show that we can predict soil properties by NMR measurements and that we are able use results of NMR measurements as a proxy without the need of direct measurements. [1] Song, Y.-Q., Vadose Zone Journal, 9 (2010) [2] Stingaciu, L. R., et al., Water Resources Research, 46 (2010) [3] Vogt, C., et al., Journal of Applied Geophysics, 50 (2002) [4] Barrie, P. J., Annual Reports on NMR Spectroscopy, 41 (2000) [5] Stallmach, F., Galvosas, P., Annual Reports on NMR Spectroscopy, 61 (2007)

  17. Randomised clinical study: discrepancies between patient?reported outcomes and endoscopic appearance in moderate to severe ulcerative colitis

    OpenAIRE

    Jharap, B.; Sandborn, W J; Reinisch, W.; D'Haens, G; Robinson, A M; Wang, W; Huang, B; A. Lazar; Thakkar,R B; Colombel, J.F.

    2015-01-01

    Summary Background Associations between patient?reported outcomes and mucosal healing have not been established in ulcerative colitis (UC). Aim To evaluate relationships of rectal bleeding and stool frequency with mucosal healing and quality of life (QoL) in patients with UC in two Phase 3 studies (ULTRA 1 and 2). Methods Associations of patient?reported rectal bleeding and stool frequency subscores with mucosal healing (Mayo endoscopy subscore?=?0 or 0/1) and QoL [inflammatory bowel disease ...

  18. Impact evaluation and association with EuroQol 5D health-related utility values in Ménière's disease.

    Science.gov (United States)

    Pyykkő, Ilmari; Manchaiah, Vinaya; Levo, Hilla; Kentala, Erna

    2015-01-01

    The study was aimed at evaluating the validity of impact measures among patients with Ménière's disease (MD) with outcome variables of EuroQol generic health-related quality of life (HRQoL) measures (i.e., EQ-5D) by using Visual Analogue Scale (VAS) and EQ-5D index values. 183 members (out of 200 contacted) of the Finish Ménière Association returned the questionnaires that they had filled out. Various open-ended and structured questionnaires focusing on diagnostic aspects of symptoms and impairment caused by the disease were used. For activity limitation and participation restriction, standardized questionnaires were used. Open-ended questions on impact of the disease were asked, and subsequently classified based on the WHO-ICF classification. The general HRQoL was evaluated with EQ-5D index value and EQ VAS instruments. Correlation and linear regression analyses were used to explore the association between HRQoL and other aspects. Based on the explanatory power of different models the disease specific semeionic model provides the most accurate prediction in EQ-5D index calculations (38 % of the variance explained). In EQ VAS scores, HRQoL is most accurately determined by participation restriction (53 % of the variance explained), but the worst prediction was in ICF-based limitations (8 % of the variance explained). Interestingly, attitude and personal trait explained the reduction of HRQoL somewhat better than ICF-based variables. Activity limitation and participation restrictions are significant components of MD, but are less frequently recognized as significant factors in self-evaluating the effect of MD on the quality of life. The current study results suggest that MD patients seem to have problem identifying factors causing activity limitation and participation restrictions and hence use the semiotic description focusing on complaints.

  19. Impact of educational level on health-related quality of life (HRQL): results from Germany based on the EuroQol 5D (EQ-5D).

    Science.gov (United States)

    Mielck, Andreas; Reitmeir, Peter; Vogelmann, Martin; Leidl, Reiner

    2013-02-01

    To date, there is hardly any study focussing on the question how the concept of HRQL could deepen our understanding of health inequalities. The study aims at describing this potential by analysing data for adults from Germany. The analyses are based on three national, representative surveys conducted from 2006 to 2008. HRQL was assessed by the EuroQol-5D (EQ-5D), the descriptive part (problems in five dimensions) and the valuation of health by visual analogue scale (VAS) rendering a value between '0' (worst) and '100' (best imaginable). The major independent variable is educational level (high vs. low). Four other variables were included (i.e. age, sex, per capita income and chronic disease). Multivariate analyses were performed by logistic and linear regression. Data were available for 5676 persons aged ≥ 20 years (response rate 73%). The prevalence of 'moderate or severe problems' is especially high in the dimension 'pain/discomfort' (low resp. high educational level: 46.3% resp. 25.0%). The mean VAS-value is 79.8 (low resp. high educational level: 75.3 resp. 83.6). Bivariate and multivariate analyses show that similar differences in VAS-values can be seen even after restricting the analyses to participants with a chronic disease. Empirical analyses concerning HRQL could further our understanding of health inequalities. They indicate that low status groups are faced with a double burden, first by increased levels of health impairments, and second by lower levels of HRQL once health is impaired. Thus, the extent of health inequalities could be underestimated if measures of HRQL are not taken into account.

  20. INTERNATIONAL FINANCIAL REPORTING STANDARDS AND ...

    African Journals Online (AJOL)

    PUBLICATIONS1

    ABSTRACT. The study examines the impact of the adoption of International Financial Reporting Standards. (IFRS) on the quality of financial reporting in Nigeria. The study utilises a period based ap- proach to analyse changes in the degree of financial reporting quality (FRQ) that hinges on three proxies: Value Relevance, ...

  1. Heterogeneity of Cr in Mytilus edulis: Implications for the Cr isotope system as a paleo-redox proxy

    Science.gov (United States)

    Bruggmann, Sylvie; Klaebe, Robert; Frei, Robert

    2017-04-01

    Changes in 53Cr/52Cr (δ53Cr) values recorded by biogenic carbonates are emerging as a proxy for variations in the redox state of the Earth's oceans and atmosphere (e.g. [1], [2]). We investigate the ability of modern carbonate shells (Mytilus edulis) to record the δ53Cr composition of ambient seawater in order to assess their utility as a paleo-redox proxy. Samples of cultivated M. edulis from the Kiel Fjord, Germany, were analyzed for their δ53Cr composition and Cr concentrations [Cr] using TIMS. To disentangle the pathway of Cr into the carbonate shell, a series of step-digestions of their organic outer sheaths (periostraca) and their intra-layer composition were performed. Bulk analyses of specimens with intact periostraca returned 16 to 34 ppb Cr with δ53Cr values ranging from 0.28 to 0.65 ± 0.1 (2SE) and thus fall within the range of surface seawater from the Baltic Sea (0.3 - 0.6 \\permil [3]). Partial removal of periostraca resulted in lower [Cr] (5 to 17 ppb) and δ53Cr values (-0.05 ± 0.15 \\permil). These results show a positive correlation between the amount of organic matter present in a sample and both [Cr] and δ53Cr (n = 9). With nearly complete removal of periostraca, the remaining [Cr] is significantly lower (less than 5 ppb) and can only be accessed by incineration of the carbonate shell. The correlation between [Cr], δ53Cr and the amount of periostracum present in bulk samples indicates that a significant proportion of preserved Cr may be associated with the organic outer sheath. The Cr endmember accessed after incineration is less likely associated with the carbonate crystal lattice. Instead, the δ53Cr values obtained after incineration are similar to those reported from terrestrial rocks, suggesting the influence of detrital particles. Alternatively, Cr may be reduced and subsequently re-oxidized during the mineralization of biogenic carbonates [4]. Seasonal changes in primary productivity in seawater may further influence the shell

  2. Light is an active contributor to the vital effects of coral skeleton proxies

    Science.gov (United States)

    Juillet-Leclerc, Anne; Reynaud, Stéphanie; Dissard, Delphine; Tisserand, Guillaume; Ferrier-Pagès, Christine

    2014-09-01

    Symbiotic colonies of the coral Acropora sp. were cultured in a factorial design of three temperatures (21, 25 and 28 °C) and two light intensities (200 and 400 μmol photon m-2 s-1), under constant conditions. A temperature of 25 °C and a light intensity of 200 μmol photon m-2 s-1 was the starting culture condition. Metabolic (photosynthesis, respiration, calcification and surface expansion rate) and geochemical measurements (δ18O, δ13C, Sr/Ca and Mg/Ca) were conducted on 6 colonies for each experimental condition. Metabolic measurements confirmed that respiration, photosynthesis, calcification and surface expansion rate responded to the combined effect of temperature and light. Under each light intensity, mean calcification rate was linearly correlated with mean photosynthetic activity. Geochemical measurements were also influenced by temperature and, to a lesser degree, by light. All geochemical proxies measured on 6 nubbins showed a wide scattering of values, regardless of the environmental condition. Compared to the other proxies, δ18O exhibited a different behavior. It was the only proxy exhibiting temperature tracer behavior. However, while mean values of Sr/Ca, Mg/Ca and δ13C were well correlated, the correlation between the later and mean δ18O differed with light level. This suggests that both skeleton deposition and temperature oxygen fractionation differs according to light intensity. Overall, the effect of light on geochemical values seems to compromise the use of proxy calibrations solely based on temperature influence. Under high light conditions, the great amplitude shown by individual net photosynthesis is directly proportional to the highly variable zooxanthellae density. As light is affecting all of the proxies, we thus assume that the strong geochemical variability observed could be explained by various algae densities, each nubbin responding according to its zooxanthellae amount. Accordingly, we suggest that each symbiosome (the

  3. An Anonymous Access Authentication Scheme Based on Proxy Ring Signature for CPS-WMNs

    Directory of Open Access Journals (Sweden)

    Tianhan Gao

    2017-01-01

    Full Text Available Access security and privacy have become a bottleneck for the popularization of future Cyber-Physical System (CPS networks. Furthermore, users’ need for privacy-preserved access during movement procedure is more urgent. To address the anonymous access authentication issue for CPS Wireless Mesh Network (CPS-WMN, a novel anonymous access authentication scheme based on proxy ring signature is proposed. A hierarchical authentication architecture is presented first. The scheme is then achieved from the aspect of intergroup and intragroup anonymous mutual authentication through proxy ring signature mechanism and certificateless signature mechanism, respectively. We present a formal security proof of the proposed protocol with SVO logic. The simulation and performance analysis demonstrate that the proposed scheme owns higher efficiency and adaptability than the typical one.

  4. Proxy-Based IPv6 Neighbor Discovery Scheme for Wireless LAN Based Mesh Networks

    Science.gov (United States)

    Lee, Jihoon; Jeon, Seungwoo; Kim, Jaehoon

    Multi-hop Wireless LAN-based mesh network (WMN) provides high capacity and self-configuring capabilities. Due to data forwarding and path selection based on MAC address, WMN requires additional operations to achieve global connectivity using IPv6 address. The neighbor discovery operation over WLAN mesh networks requires repeated all-node broadcasting and this gives rise to a big burden in the entire mesh networks. In this letter, we propose the proxy neighbor discovery scheme for optimized IPv6 communication over WMN to reduce network overhead and communication latency. Using simulation experiments, we show that the control overhead and communication setup latency can be significantly reduced using the proxy-based neighbor discovery mechanism.

  5. Solar forced Dansgaard-Oeschger events and their phase relation with solar proxies

    DEFF Research Database (Denmark)

    Ditlevsen, Peter; Braun, H.; Chialvo, D. R.

    2008-01-01

    of a highly nonlinear system to quasi-periodic solar forcing plus noise. This hypothesis was challenged as inconsistent with the observed variability in the phase relation between proxies of solar activity and Greenland climate. Here we reject the claim of inconsistency by showing that this phase variability...... is a robust, generic feature of the nonlinear dynamics of DO events, as described by a model. This variability is expected from the fact that the events are threshold crossing events, resulting from a cooperative process between the periodic forcing and the noise. This process produces a fluctuating phase...... relation with the periodic forcing, consistent with proxies of solar activity and Greenland climate. Udgivelsesdato: 25 March...

  6. A study of practical proxy reencryption with a keyword search scheme considering cloud storage structure.

    Science.gov (United States)

    Lee, Sun-Ho; Lee, Im-Yeong

    2014-01-01

    Data outsourcing services have emerged with the increasing use of digital information. They can be used to store data from various devices via networks that are easy to access. Unlike existing removable storage systems, storage outsourcing is available to many users because it has no storage limit and does not require a local storage medium. However, the reliability of storage outsourcing has become an important topic because many users employ it to store large volumes of data. To protect against unethical administrators and attackers, a variety of cryptography systems are used, such as searchable encryption and proxy reencryption. However, existing searchable encryption technology is inconvenient for use in storage outsourcing environments where users upload their data to be shared with others as necessary. In addition, some existing schemes are vulnerable to collusion attacks and have computing cost inefficiencies. In this paper, we analyze existing proxy re-encryption with keyword search.

  7. Surrogate Decision Makers and Proxy Ownership: Challenges of Privacy Management in Health Care Decision Making

    Science.gov (United States)

    Bute, Jennifer J.; Petronio, Sandra; Torke, Alexia M.

    2016-01-01

    This study explored the communicative experiences of surrogates who served as decision makers for patients who were unable to convey health information and choices about treatment options. Drawing on assumptions from communication privacy management theory (Petronio, 2002), 35 surrogates were interviewed to explore how they navigated the role of guardian of patients’ private health information while the patient was hospitalized. This research determined that surrogates are not only guardians and thereby co-owners of the patients’ private health information, they actually served in a “proxy ownership” role. Surrogates described obstacles to both obtaining and sharing private health information about the patient, suggesting that their rights as legitimate co-owners of the patients’ information were not fully acknowledged by the medical teams. Surrogates also described challenges in performing the proxy ownership role when they were not fully aware of the patient's wishes. Theoretical and practical implications of these challenges are discussed. PMID:25175060

  8. A proxy analysis of urban air quality hazards in Bergen, Norway under a changing climate.

    Science.gov (United States)

    Wolf, Tobias; Esau, Igor; Reuder, Joachim

    2014-05-01

    The urban air quality in Bergen, Norway is characterized by clean air throughout most of the year interrupted by short episodes of hazardous pollution levels especially in close proximity to major road-emission sources. These pollution episodes are linked to winter time anti-cyclonic weather conditions with persistent stable temperature stratification (inversions) in the Atmospheric Boundary Layer. Although the pollution episodes are local events, the high pollution episodes are linked to large-scale persistent blockings in the atmospheric circulation. Here we present an atmospheric circulation proxy for the pollution episodes based on the ECMWF ERA-Interim reanalysis. The proxy is based on local 3-hourly instantaneous wind-speeds and directions at the 1000 hPa pressure level, and 1-day running mean temperature deviations at 2 m above ground from the 1-day running mean temperatures averaged over the full ERA-Interim record length. We tuned the thresholds for each quantity to the occurrence of events with an hourly mean NO2 concentration > 150 μg/m3 at a high pollution reference station. A condition on cloud cover had only little effect, sea-level pressure was not applicable. High pollution episodes predicted during typical low traffic days (Sundays, Christmas, New Year) were removed. The final proxy had a detection rate of 82 %, a false alarm rate of 77 % and a correct null prediction rate of 96 %. The high false alarm rate was expected because of the relaxed thresholds chosen in order to include a large fraction of possible states of atmospheric circulation that lead to hazardous air quality. Additionally, the false alarm rate was high because no constraint on the persistence of adverse meteorological conditions was set and because of the high variability of traffic, not always leading to hazardous pollution levels, even if the atmospheric circulation would allow for it. The Scandinavian index, an often used proxy for the occurrence of atmospheric circulation

  9. From Antarctic ice cores to Australia's water resources: Investigating an alternative streamflow proxy

    Science.gov (United States)

    Tozer, Carly; Kiem, Anthony; Vance, Tessa; Roberts, Jason; Curran, Mark; Moy, Andrew

    2017-04-01

    Past research worldwide shows that streamflow reconstructions, developed from paleoclimate proxies, provide a broader view of the range of climate variability possible relative to the comparatively short instrumental flow records on which water resource management plans are currently based. Hence there is a clear need for the development of streamflow reconstructions to allow us to better manage our water resources into the future. In Australia, however, there is a dearth of local high resolution proxies, particularly in catchments of interest, from which to develop streamflow reconstructions. This has led researchers to look beyond catchment boundaries and also Australia's borders to explore the utility of remote proxies for reconstructing Australian streamflow. Here we investigate, for a case study catchment located on Australia's eastern seaboard, the development of a millennial-length, annual streamflow reconstruction based on 1013 years of summer sea salt deposition recorded in ice cores from East Antarctica. The streamflow reconstruction realistically captures interannual to decadal variability in the gauged streamflow over the 1929-2009 calibration period. For the pre-instrumental period (i.e. pre-1900), the streamflow reconstruction shows longer wet and dry epochs than those recorded in the instrumental period. Furthermore, the variation in the distribution of the duration of wet and dry epochs between centuries suggests that water resources management and planning based on the statistics of the last 100 years of data (or less) is problematic. This information can be utilised to generate more realistic flow scenarios that better capture the range of hydroclimatic variability that Australia has experienced. This work emphasises a novel combination of ice core science, paleoclimatology and catchment-scale hydrology that is now being used to develop more robust water resources planning and management. The continuing work to further develop ice core based

  10. The potential of carbonyl sulfide as a proxy for gross primary production at flux tower sites

    Science.gov (United States)

    Blonquist, J. Mark, Jr.

    Seasonal dynamics of atmospheric carbonyl sulfide (OCS) at regional and continental scales and plant OCS exchange at the leaf level have shown a close relationship with those for CO2. CO2 has both sinks and sources within terrestrial ecosystems, but the primary terrestrial exchange for OCS is thought to be leaf uptake, suggesting potential for OCS uptake as a proxy for gross primary production (GPP). The utility of OCS uptake as a GPP proxy in micrometeorological studies of biosphere-atmosphere CO2 exchange was explored by applying theoretical concepts from earlier OCS studies to estimate GPP. Measured net ecosystem exchange (NEE) was partitioned using the ratio of measured vertical mole fraction gradients of OCS and CO2. At the Harvard Forest AmeriFlux site, measured CO2 and OCS vertical gradients were correlated, and were related to NEE and GPP, respectively. Estimates of GPP from OCS-based NEE partitioning were similar to those from established regression techniques, providing evidence that OCS uptake can potentially serve as a GPP proxy. Measured vertical CO 2 mole fraction gradients at five other AmeriFlux sites were used to project anticipated vertical OCS mole fraction gradients to provide indication of potential OCS signal magnitudes at sites where no OCS measurements were made. Projected OCS gradients at sites with short canopies were greater than those in forests, including measured OCS gradients at Harvard Forest, indicating greater potential for OCS uptake as a GPP proxy at these sites. This exploratory study suggests that continued investigation of linkages between OCS and GPP is warranted.

  11. Multi-periodic climate dynamics: spectral analysis of long-term instrumental and proxy temperature records

    OpenAIRE

    H.-J. Lüdecke; A. Hempelmann; Weiss, C. O.

    2012-01-01

    The longest six instrumental temperature records of monthly means reach back maximally to 1757 AD and were recorded in Europe. All six show a V-shape, with temperature drop in the 19th and rise in the 20th century. Proxy temperature time series of Antarctic ice cores show this same characteristic shape, indicating this pattern as a global phenomenon. We used the mean of the 6 instrumental records for analysis by discrete Fourier transformation (DFT), wavelets, and the detrended fluctuati...

  12. Multi-periodic climate dynamics: spectral analysis of long-term instrumental and proxy temperature records

    OpenAIRE

    Lüdecke, H.-J.; A. Hempelmann; Weiss, C. O.

    2013-01-01

    The longest six instrumental temperature records of monthly means reach back maximally to 1757 AD and were recorded in Europe. All six show a V-shape, with temperature drop in the 19th and rise in the 20th century. Proxy temperature time series of Antarctic ice cores show this same characteristic shape, indicating this pattern as a global phenomenon. We used the mean of the six instrumental records for analysis by discrete Fourier transform (DFT), wavelets, and the detren...

  13. Testing Novel pH Proxies through Inorganic Calcite Precipitations and K/Pg Foraminifera

    Science.gov (United States)

    Super, J. R.; Pagani, M.; Wang, Z.

    2013-12-01

    Ocean pH proxies help constrain the carbon system in the paleocean and can be used to infer atmospheric CO2 when coupled with estimates of total alkalinity, aqueous pCO2 or dissolved inorganic carbon. This project investigates two novel pH proxies (cerium abundance and kinetically-controlled oxygen isotopes) through a series of precipitations of inorganic calcite, as well as the previously established boron isotope pH proxy. Precipitations are performed using varied pH and carbonate saturation states that span the range of typical ocean values as well as a 'free drift' that allows pH and saturation state to vary. The light rare earth element cerium speciates, depending on local oxidation-reduction conditions, between the soluble Ce3+ and highly insoluble Ce4+ ions, causing a relative depletion of cerium in ocean water. This project demonstrates how a suite rare earth elements, including cerium, partitions into inorganic calcite and how partitioning varies with changing pH and carbonate saturation state. Oxygen isotope fractionation is primarily controlled by temperature, but this project examines how pH and carbonate saturation state correlate with oxygen isotope values under kinetic conditions during the initial stage of precipitation. The effect of diagenesis on each proxy is simulated by dissolution of precipitated calcite in a pressure vessel. Results from the precipitations are used to inform a record of well-preserved benthic and planktonic foraminifera from DSDP Site 356 that range in age from the K/Pg boundary to the period when the δ13C gradient between the surface and deep ocean returned to pre-event levels. The pH record is used to infer the magnitude and length of the perturbation to the oceanic carbon system following the extinction event, particularly in terms of export productivity.

  14. Distance-based kriging relying on proxy simulations for inverse conditioning

    OpenAIRE

    Ginsbourger, David; Rosspopoff, Bastien; Pirot, Guillaume; Durrande, Nicolas; Renard, Philippe

    2013-01-01

    We consider the problem of rapidly identifying, among a large set of candidate parameter fields, a subset of candidates whose responses computed by accurate forward flow and transport simulation match a reference response curve. In order to keep the number of calls to the flow simulator computationally tractable, a recent distance-based approach relying on fast proxy simulations is revisited, and turned into a non-stationary Kriging method. The covariance kernel is obtained by combining a cla...

  15. An Improved Quantum Proxy Blind Signature Scheme Based on Genuine Seven-Qubit Entangled State

    Science.gov (United States)

    Yang, Yuan-Yuan; Xie, Shu-Cui; Zhang, Jian-Zhong

    2017-07-01

    An improved quantum proxy blind signature scheme based on controlled teleportation is proposed in this paper. Genuine seven-qubit entangled state functions as quantum channel. We use the physical characteristics of quantum mechanics to implement delegation, signature and verification. Security analysis shows that our scheme is unforgeability, undeniability, blind and unconditionally secure. Meanwhile, we propose a trust party to provide higher security, the trust party is costless.

  16. A novel salinity proxy based on Na incorporation into foraminiferal calcite

    Directory of Open Access Journals (Sweden)

    J. C. Wit

    2013-10-01

    Full Text Available Salinity and temperature determine seawater density, and differences in both thereby control global thermohaline circulation. Whereas numerous proxies have been calibrated and applied to reconstruct temperature, a direct and independent proxy for salinity is still missing. Ideally, a new proxy for salinity should target one of the direct constituents of dissolved salt, such as [Na+] or [Cl−]. This study investigates the impact of salinity on foraminiferal Na/Ca values by laser ablation ICP-MS analyses of specimens of the benthic foraminifer Ammonia tepida cultured at a range of salinities (30.0–38.6. Foraminifera at lower salinities (30.0 and 32.5 added more chambers (10–11 to their test over the course of the culturing experiment than those maintained at higher salinities (36.1, 7–8 chambers, and 38.6, 6–7 chambers, suggesting that growth rates in this species are promoted by lower salinities. The Na/Ca of cultured specimens correlates significantly with seawater salinity (Na/Ca = 0.22S–0.75, R2 = 0.96, p DNa vary between 5.17 and 9.29 mmol mol−1 and 0.12–0.16 × 10−3, which are similar to values from inorganic precipitation experiments. The significant correlation between test size and Na/Ca results from co-variation with salinity. This implies that foraminiferal Na/Ca could serve as a robust and independent proxy for salinity, enabling salinity reconstructions independent of calcitic δ18O.

  17. Corporate Governance Objectives of Labor Union Shareholders: Evidence from Proxy Voting

    OpenAIRE

    Ashwini K. Agrawal

    2012-01-01

    Labor union pension funds have become increasingly vocal in governance matters; however, their motives are subject to fierce debate. I examine the proxy votes of AFL-CIO union funds around an exogenous change in the union representation of workers across firms. AFL-CIO-affiliated shareholders become significantly less opposed to directors once the AFL-CIO labor organization no longer represents a firm's workers. Other institutional investors, including mutual funds and public pension funds, d...

  18. Cryptanalysis of an inter-bank E-payment protocol based on quantum proxy blind signature

    Science.gov (United States)

    Cai, Xiao-Qiu; Wei, Chun-Yan

    2013-04-01

    We analyze the security of an inter-bank E-payment protocol based on quantum proxy blind signature, and find that there is a security leak in the quantum channels of this protocol, which gives a chance for an outside opponent to launch a special denial-of-service attack. Furthermore, we show that the dishonest merchant can succeed to change the purchase information of the customer in this protocol.

  19. A New Quantum Proxy Multi-signature Scheme Using Maximally Entangled Seven-Qubit States

    Science.gov (United States)

    Cao, Hai-Jing; Zhang, Jia-Fu; Liu, Jian; Li, Zeng-You

    2016-02-01

    In this paper, we propose a new secure quantum proxy multi-signature scheme using seven-qubit entangled quantum state as quantum channels, which may have applications in e-payment system, e-government, e-business, etc. This scheme is based on controlled quantum teleportation. The scheme uses the physical characteristics of quantum mechanics to guarantee its anonymity, verifiability, traceability, unforgetability and undeniability.

  20. CAN ACCOUNTING INFORMATION ACT AS A PROXY FOR EX ANTE UNCERTAINTY IN INITIAL PUBLIC OFFERINGS?

    OpenAIRE

    Tatang Ary Gumanti

    2003-01-01

    This paper reviews and summarizes previous works and the rationale for the proposition that accounting information is in fact value relevant in the determination of an initial public offering IPO).Theoretical and empirical evidence has indicated that certain accounting measures can he used as proxies for total firm risk, that is, they could determine the riskiness of a corporation. The literature also advocates that accounting information is relevant in determining the value and thus the risk...