Proxy and patient reports of health-related quality of life in a national cancer survey.

Science.gov (United States)

Roydhouse, Jessica K; Gutman, Roee; Keating, Nancy L; Mor, Vincent; Wilson, Ira B

2018-01-05

Proxy respondents are frequently used in surveys, including those assessing health-related quality of life (HRQOL). In cancer, most research involving proxies has been undertaken with paired proxy-patient populations, where proxy responses are compared to patient responses for the same individual. In these populations, proxy-patient differences are small and suggest proxy underestimation of patient HRQOL. In practice, however, proxy responses will only be used when patient responses are not available. The difference between proxy and patient reports of patient HRQOL where patients are not able to report for themselves in cancer is not known. The objective of this study was to evaluate the difference between patient and proxy reports of patient HRQOL in a large national cancer survey, and determine if this difference could be mitigated by adjusting for clinical and sociodemographic information about patients. Data were from the Cancer Care Outcomes Research and Surveillance (CanCORS) study. Patients or their proxies were recruited within 3-6 months of diagnosis with lung or colorectal cancer. HRQOL was measured using the SF-12 mental and physical composite scales. Differences of ½ SD (=5 points) were considered clinically significant. The primary independent variable was proxy status. Linear regression models were used to adjust for patient sociodemographic and clinical covariates, including cancer stage, patient age and education, and patient co-morbidities. Of 6471 respondents, 1011 (16%) were proxies. Before adjustment, average proxy-reported scores were lower for both physical (-6.7 points, 95% CI -7.4 to -5.9) and mental (-6 points, 95% CI -6.7 to -5.2) health. Proxy-reported scores remained lower after adjustment (physical: -5.8 points, -6.6 to -5; mental: -5.8 points, -6.6 to 5). Proxy-patient score differences remained clinically and statistically significant, even after adjustment for sociodemographic and clinical variables. Proxy-reported outcome scores

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...

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

Science.gov (United States)

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

Utility analysis and calibration of QOL assessment in disease management.

Science.gov (United States)

Liu, Mo

2018-05-02

In clinical trials, the assessment of health-related quality of life (QOL) (or patient-reported outcome [PRO] measure) has become very popular especially for clinical studies conducted for evaluating clinical benefits of patients with chronic, severe, and/or life threatening diseases. Health-related QOL information and PRO measures are useful for disease management for achieving best clinical practice. In this article, we will focus on health-related QOL assessment. The concept, design, and analysis of health-related QOL in clinical trials are reviewed. Validation of the use of health-related QOL instrument in terms of some key performance characteristics such as accuracy, reliability, sensitivity, and responsibility for assuring quality, integrity, and validity of collected QOL data are discussed. The concept of utility analysis and calibration (e.g., with respect to life events) for achieving the optimization of disease management are proposed. The change of the QOL could be translated into different life events for effective disease management. These translations could evaluate the treatment effect by more directly displaying the change of the QOL.

Analyzing differences between patient and proxy on Patient Reported Outcomes in multiple sclerosis.

Science.gov (United States)

Sonder, Judith M; Holman, Rebecca; Knol, Dirk L; Bosma, Libertje V A E; Polman, Chris H; Uitdehaag, Bernard M J

2013-11-15

Proxy respondents, partners of multiple sclerosis (MS) patients, can provide valuable information on the MS patients' disease. In an earlier publication we found relatively good agreement on patient reported outcomes (PROs) measuring physical impact and functioning, but we found large differences on (neuro)psychological scales. We aim to identify patient and proxy related variables explaining differences between patients' and proxies' ratings on five PROs. We report on data from 175 MS patients and proxy respondents. Regression analyses were performed, using as dependent variable the mean differences on five scales: Physical and Psychological scale of the Multiple Sclerosis Impact Scale (MSIS-29), the Multiple Sclerosis Walking Scale (MSWS), Guy's Neurological Disability Scale (GNDS) and the Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ). The independent variables were patient, proxy and disease related variables. Caregiver strain was significantly related to differences between patient and proxy scores for all five PROs. A higher level of patient anxiety on the HADS was linked to larger differences on all PROs except the GNDS. In addition, cognitive functioning, proxy depression, walking ability, proxy gender and MS related disability were contributing to the discrepancies. We found several patient and proxy factors that may contribute to discrepancies between patient and proxy scores on MS PROs. The most important factor is caregiver burden. © 2013 Elsevier B.V. All rights reserved.

Sensitivity and responsiveness of the patient-reported TED-QOL to rehabilitative surgery in thyroid eye disease.

Science.gov (United States)

Fayers, Tessa; Fayers, Peter M; Dolman, Peter J

2016-12-01

We tested the sensitivity and responsiveness of the TED-QOL to rehabilitative surgery in thyroid eye disease (TED). The 3-item TED-QOL and 16-item GO-QOL, which assess quality of life (QoL) in TED, were administered to consecutive patients undergoing rehabilitative surgery. The questionnaires were completed pre-and post-operatively to assess sensitivity (ability to discriminate between different surgical groups) and responsiveness (ability to detect within patient changes over time).56 patients underwent 69 procedures for TED (29 orbital decompressions, 15 strabismus operations, 25 eyelid procedures). The differences in scores between the three types of surgery (a measure of sensitivity) were statistically significant at the 5% level pre-operatively and post-operatively for all 3 TED-QOL scales and for both GO-QOL scales, but much more so for the TED-QOL scales in each case. The within-patient changes between the pre- and post-operative scores for the same subjects (a measure of responsiveness) were statistically very highly significant for the TED-QOL overall and appearance scales for each of the surgeries. The pre- and post-operative difference for the TED-QOL functioning scale was highly statistically significant for strabismus surgery but not for decompression or lid surgery. The change between the pre- and post-operative scores for the GO-QOL was significant for the functioning scale with strabismus and lid surgery, and was highly significant for the appearance scale with lid surgery but not for strabismus surgery or decompression. The 3-item TED-QOL is sensitive and responsive to rehabilitative surgery in TED and compares favorably with the lengthier GO-QOL for these parameters.

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…

[Relationship between Quality of Life (QOL) and cognitive function among community-dwelling elderly].

Science.gov (United States)

Konagaya, Yoko; Watanabe, Tomoyuki; Ohta, Toshiki; Takata, Kazuko

2009-03-01

It has become important for elderly to live better rather than to live longer. There have been many reports about quality of life (QOL) of the elderly, but we have no knowledge about the relation between the QOL and the cognitive function. We investigated the relationship between the QOL and the cognitive function among community-dwelling elderly. A total of 12,059 community-dwelling elderly were invited to join a cognitive screening study by telephone (TICS-J) combined with a mailed QOL questionnaire. Among them, 1,920 subjects (age 71.87+/-5.50 (mean+/-SD) years old, duration of education 11.08+/-2.61 years) who completed both TICS-J and QOL questionnaire were actually measured. TICS-J was administered by the previously reported method, and the QOL questionnaire was developed based on the component of QOL proposed by Lawton, and consisted of 6 subscales (daily activity, satisfaction with health, satisfaction with human support, satisfaction with economic state, symptoms of depression, and positive mental attitude). Correlations were analyzed among the scores of TICS-J, age, duration of education, and scores on each QOL subscale. Multiple linear regression analysis was conducted after QOL subscale scores, adjusting for gender, age, and duration of education, were entered as dependent variables. Four out of 6 subscales scores of QOL showed significant differences between men and women. All QOL subscale scores showed significant differences between the two groups in the TICS-J scores. Partial correlations were seen among TICS-J scores and each QOL subscale score. Multiple linear regression analysis revealed significant influence of cognitive function by TICS-J on QOL subscales scores. Cognitive function was considered to have more influence on QOL scores than gender or age. TICS-J and the QOL questionnaire in this study were useful to evaluate the outcome of welfare in community-dwelling elderly.

Accuracy of Caregiver Proxy Reports of Home Care Service Use.

Science.gov (United States)

Chappell, Neena L; Kadlec, Helena

2016-12-01

Although much of the research on service use by older adults with dementia relies on proxy reports by informal caregivers, little research assesses the accuracy of these reports, and that which does exist, does not focus on home care services. This brief report compares proxy reports by family caregivers to those with dementia with provincial Ministry of Health records collected for payment and monitoring. The four home care services examined include home nursing care, adult day care, home support, and respite care. Data come from a province-wide study of caregivers in British Columbia, Canada. Caregiver reports are largely consistent with Ministry records, ranging from 81.0% agreement for home support to 96.6% for respite care. Spouses living with the care recipient (the vast majority of the sample) are the most accurate. Others, whether living with the care recipient or not, have only a 50-50 chance of being correct.

Methodological Considerations in Couples' Fertility Intentions: Missing Men and the Viability of Women's Proxy Reports.

Science.gov (United States)

Stykes, J Bart

2018-02-19

Introduction Recent efforts show potential to advance research on unintended childbearing by taking a couple-level approach. However, this work has neither adequately addressed methodological concerns stemming from the challenges associated with male fertility data nor considered the viability of women's proxy reports of fathers intentions. Methods Data from the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B) were used to assess the implications of low response rates among men on couples' unintended childbearing. Then, the accuracy of women's proxy reports of fathers intentions was assessed. Weighted logistic regression analyses were conducted to determine how women's characteristics were associated with men's survey participation whereas weighted multinomial logistic regression analyses were applied to determine how women's characteristics were linked with the accuracy of her proxy report. Results Almost half (46%) of women cannot be matched with data from the child's father, and this discrepancy is most problematic for women who are black, foreign-born, less educated, and unmarried at birth. Women's proxy reports appear viable as 75% of women's reports are consistent with men's responses. Yet, proxy reports underestimate disagreement in couples' intentions as mothers who intended the birth are at an increased risk of "inaccurately" reporting that fathers share their intentions. Discussion Direct approaches to couples' intentions yield privileged samples and systematically omit women at the greatest risk of an unintended birth. However, proxies underestimate disagreement in couples' intentions-a key contribution to the couple approach. Accordingly each approach has its own merits which must be considered in light of specified research questions.

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.

Internal consistency and construct validity of the Quality of Life in Alzheimer's Disease (QoL-AD) proxy – a secondary data analysis

Science.gov (United States)

Hylla, Jonas; Schwab, Christian G G; Isfort, Michael; Halek, Margareta; Dichter, Martin N

2016-07-01

Background: The maintenance and promotion of Quality of Life (QoL) of people with dementia is a major outcome in intervention studies and health care. The Quality of Life Alzheimer's Disease (QoL-AD) is an internationally recommended QoL measurement also available in German language. Until now, only a few results on the psychometric properties of the German QoL-AD were available. Objective: Evaluation of internal consistency and construct validity of the QoL-AD proxy. Method: A principal component analysis (secondary data analysis) of the 13 QoL-AD items was carried out based on the total sample of 234 people with dementia from nine nursing homes in Germany. Subsequently, the internal consistency of the identified factors was examined using Cronbach's alpha. Results: Two factors physical and mental health and social network were determined. Both factors explain 53 % of the total variance. The stability of both factors was validated in two sensitivity analyses. The internal consistency is good for both factors with a Cronbach's alpha of 0.88 (physical and mental health) and 0.75 (social network). Conclusion: The QoL-AD proxy allows the assessment of two relevant health-related QoL domains of people with dementia. However, in future studies especially the inter-rater reliability of the QoL-AD proxy has to be examined.

Overview of the Spinal Cord Injury--Quality of Life (SCI-QOL) measurement system.

Science.gov (United States)

Tulsky, David S; Kisala, Pamela A; Victorson, David; Tate, Denise G; Heinemann, Allen W; Charlifue, Susan; Kirshblum, Steve C; Fyffe, Denise; Gershon, Richard; Spungen, Ann M; Bombardier, Charles H; Dyson-Hudson, Trevor A; Amtmann, Dagmar; Kalpakjian, Claire Z; Choi, Seung W; Jette, Alan M; Forchheimer, Martin; Cella, David

2015-05-01

The Spinal Cord Injury--Quality of Life (SCI-QOL) measurement system was developed to address the shortage of relevant and psychometrically sound patient reported outcome (PRO) measures available for clinical care and research in spinal cord injury (SCI) rehabilitation. Using a computer adaptive testing (CAT) approach, the SCI-QOL builds on the Patient Reported Outcomes Measurement Information System (PROMIS) and the Quality of Life in Neurological Disorders (Neuro-QOL) initiative. This initial manuscript introduces the background and development of the SCI-QOL measurement system. Greater detail is presented in the additional manuscripts of this special issue. Classical and contemporary test development methodologies were employed. Qualitative input was obtained from individuals with SCI and clinicians through interviews, focus groups, and cognitive debriefing. Item pools were field tested in a multi-site sample (n=877) and calibrated using item response theory methods. Initial reliability and validity testing was performed in a new sample of individuals with traumatic SCI (n=245). Five Model SCI System centers and one Department of Veterans Affairs Medical Center across the United States. Adults with traumatic SCI. n/a n/a The SCI-QOL consists of 19 item banks, including the SCI-Functional Index banks, and 3 fixed-length scales measuring physical, emotional, and social aspects of health-related QOL (HRQOL). The SCI-QOL measurement system consists of psychometrically sound measures for individuals with SCI. The manuscripts in this special issue provide evidence of the reliability and initial validity of this measurement system. The SCI-QOL also links to other measures designed for a general medical population.

Quality of life (QOL) assessment in patients received carbon ion radiotherapy

International Nuclear Information System (INIS)

Imai, Reiko; Kamada, Tadashi; Tsujii, Hirohiko

2004-01-01

The purpose of this study was to investigate changes in quality of life (QoL) of medically inoperable bone and soft tissue sarcoma treated carbon ion radiotherapy (CIRT). Fifty-eight patients followed over 1 year were reviewed in this report. The questionnaire, European Organaization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC-QLQ-C30) was assessed before the start of CIRT, and subsequently at the end of CIRT, 3, 6, 12, 24 months after CIRT. During follow-up, it was send to the patients by mail. The compliance was 98% for all follow-up period in this study. The scores about QoL and functioning did not significantly change for 1 year. QoL scores tended to decrease in large clinical target volume (CTV) (>600 cc) group compared to small CTV group. CIRT could keep QoL levels of patients with medically inoperable bone and soft tissue tumors. (author)

Overview of the Spinal Cord Injury – Quality of Life (SCI-QOL) measurement system

Science.gov (United States)

Tulsky, David S.; Kisala, Pamela A.; Victorson, David; Tate, Denise G.; Heinemann, Allen W.; Charlifue, Susan; Kirshblum, Steve C.; Fyffe, Denise; Gershon, Richard; Spungen, Ann M.; Bombardier, Charles H.; Dyson-Hudson, Trevor A.; Amtmann, Dagmar; Z. Kalpakjian, Claire; W. Choi, Seung; Jette, Alan M.; Forchheimer, Martin; Cella, David

2015-01-01

Context/Objective The Spinal Cord Injury – Quality of Life (SCI-QOL) measurement system was developed to address the shortage of relevant and psychometrically sound patient reported outcome (PRO) measures available for clinical care and research in spinal cord injury (SCI) rehabilitation. Using a computer adaptive testing (CAT) approach, the SCI-QOL builds on the Patient Reported Outcomes Measurement Information System (PROMIS) and the Quality of Life in Neurological Disorders (Neuro-QOL) initiative. This initial manuscript introduces the background and development of the SCI-QOL measurement system. Greater detail is presented in the additional manuscripts of this special issue. Design Classical and contemporary test development methodologies were employed. Qualitative input was obtained from individuals with SCI and clinicians through interviews, focus groups, and cognitive debriefing. Item pools were field tested in a multi-site sample (n = 877) and calibrated using item response theory methods. Initial reliability and validity testing was performed in a new sample of individuals with traumatic SCI (n = 245). Setting Five Model SCI System centers and one Department of Veterans Affairs Medical Center across the United States. Participants Adults with traumatic SCI. Interventions n/a Outcome Measures n/a Results The SCI-QOL consists of 19 item banks, including the SCI-Functional Index banks, and 3 fixed-length scales measuring physical, emotional, and social aspects of health-related QOL (HRQOL). Conclusion The SCI-QOL measurement system consists of psychometrically sound measures for individuals with SCI. The manuscripts in this special issue provide evidence of the reliability and initial validity of this measurement system. The SCI-QOL also links to other measures designed for a general medical population. PMID:26010962

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

Science.gov (United States)

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.

Health-related quality of life in children and adolescents: Current normative data, determinants and reliability on proxy-report.

Science.gov (United States)

Meyer, Michael; Oberhoffer, Renate; Hock, Julia; Giegerich, Tobias; Müller, Jan

2016-06-01

Health-related quality of life (HrQoL) is a multidimensional concept including self-reported measures of physical and mental health. Throughout the last decades, HrQoL has become a more and more important outcome measure not only in clinical conditions. This study evaluates current HrQoL of healthy children and adolescents, determinants of HrQoL, and the agreement between self- and proxy-report. From April 2012 to July 2013, we prospectively examined 530 healthy children (13.2 ± 2.1 years, 236 girls) and their parents on their childrens HrQoL using the KINDL-R self-report questionnaire and the parent's proxy-report. Data was compared to the established reference value from 2007 and the agreement of self- and parent's proxy-report was assessed by calculation of intraclass correlation coefficient (ICC). In general, the HrQoL improved compared to references in both children's (104.5 ± 12.6 % of predicted reference value, P proxy-report (104.3 ± 12.3 % of predicted reference value, P proxy-report (ICC: .774). Only in the domains 'self-esteem' (ICC: .558) and 'Emotional well-being' (ICC: .612) the agreements were moderate. HrQoL perception has increased throughout the past 10 years and worsens with increasing age. Moreover, the parent's proxy-report of the KINDL-R questionnaire is a good supplementary method to provide additional information regarding to children's HrQoL. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

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.

Evaluation of QOL in cancer patients treated with radiation therapy

International Nuclear Information System (INIS)

Takahashi, Takeo; Machida, Kikuo; Honda, Norinari; Hosono, Makoto; Murata, Osamu; Osada, Hisato; Omichi, Masahide

2002-01-01

Evaluation of quality of life (QOL) in cancer patients is an important theme. However, we do not have an established method to assess QOL in cancer patients during radiotherapy in Japan. We evaluated both the changes of QOL and the factors affecting QOL in radiotherapy patients. Three hundred fifty-five cancer patients, who filled in a questionnaire at the beginning, middle, and end of radiotherapy between 1998 and 2001, were studied. We used The QOL Questionnaire for Cancer Patients Treated with Anticancer Drugs (QOL-ACD)'' devised by Kurihara et al, the Ministry of Health and Welfare. The QOL Questionnaire had five categories: physical activity, physical condition, mental state, social interaction, and face scale. The total score, sum of the score of five categories, were established synthetically (maximum score is 110). The mean of total QOL scores were 75.8, 77.6, and 78.2 at the beginning, middle, and end of radiotherapy respectively. Patients with symptoms related to cancer had apparent improvement of QOL score. Patients receiving chemotherapy had a decreased QOL score at the end of radiotherapy. The score of physical condition was reduced improvement. It was suggested that radiotherapy could be performed without losing QOL of cancer patients, including older patients. However, patients receiving chemotherapy and those with head and neck cancer may lose their QOL, therefore, we should treat such patients carefully. (author)

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

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.

Evaluation of the convergence between "self-reporters" and "proxies" in a disability questionnaire by means of behaviour coding method

NARCIS (Netherlands)

Benitez Baena, Isabel; Padilla Garcia, Jose Luis; Ongena, Yfke

Household surveys often require including proxy reporters to obtain information about other household members who cannot be interviewed. The participation of proxies can undermine survey data quality due to the fact that proxies must respond to questions thinking about other people. The objectives

Development of a proxy-reported pulmonary outcome scale for preterm infants with bronchopulmonary dysplasia

Directory of Open Access Journals (Sweden)

Laughon Matthew M

2011-07-01

Full Text Available Abstract Background To develop an accurate, proxy-reported bedside measurement tool for assessment of the severity of bronchopulmonary dysplasia (also called chronic lung disease in preterm infants to supplement providers' current biometric measurements of the disease. Methods We adapted Patient-Reported Outcomes Measurement Information System (PROMIS methodology to develop the Proxy-Reported Pulmonary Outcomes Scale (PRPOS. A multidisciplinary group of registered nurses, nurse practitioners, neonatologists, developmental specialists, and feeding specialists at five academic medical centers participated in the PRPOS development, which included five phases: (1 identification of domains, items, and responses; (2 item classification and selection using a modified Delphi process; (3 focus group exploration of items and response options; (4 cognitive interviews on a preliminary scale; and (5 final revision before field testing. Results Each phase of the process helped us to identify, classify, review, and revise possible domains, questions, and response options. The final items for field testing include 26 questions or observations that a nurse assesses before, during, and after routine care time and feeding. Conclusions We successfully created a prototype scale using modified PROMIS methodology. This process can serve as a model for the development of proxy-reported outcomes scales in other pediatric populations.

The measurement of health-related quality of life (QOL in paediatric clinical trials: a systematic review

Directory of Open Access Journals (Sweden)

Eiser Christine

2004-11-01

Full Text Available Abstract Background The goal of much care in chronic childhood illness is to improve quality of life (QOL. However, surveys suggest QOL measures are not routinely included. In addition, there is little consensus about the quality of many QOL measures. Objectives To determine the extent to which quality of life (QOL measures are used in paediatric clinical trials and evaluate the quality of measures used. Design Systematic literature review. Review Methods Included paediatric trials published in English between 1994 and 2003 involving children and adolescents up to the age of 20 years, and use of a standardised QOL measure. Data Sources included MEDLINE, CINAHL, EMB Reviews, AMED, BNI, PSYCHINFO, the Cochrane library, Internet, and reference lists from review articles. Results We identified 18 trials including assessment of QOL (4 Asthma, 4 Rhinitis, 2 Dermatitis, and single studies of Eczema, Cystic fibrosis, Otis media, Amblyopia, Diabetes, Obesity associated with a brain tumour, Idiopathic short stature, and Congenital agranulocytosis. In three trials, parents rated their own QOL but not their child's. Fourteen different QOL measures were used but only two fulfilled our minimal defined criteria for quality. Conclusions This review confirms previous reports of limited use of QOL measures in paediatric clinical trials. Our review provides information about availability and quality of measures which will be of especial value to trial developers.

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

[Analysis of prevalence of self-reported hearing loss and associated factors: primary versus proxy informant].

Science.gov (United States)

Quevedo, André Luis Alves de; Leotti, Vanessa Bielefeldt; Goulart, Bárbara Niegia Garcia de

2017-07-03

The objective was to evaluate differences between prevalence rates for self-reported hearing loss and associated factors, obtained from responses by primary and proxy informants in a Population-Based Study on Human Communication Disorders (DCH-POP in Portuguese). This was a study on epidemiological methods using data from a cross-sectional household survey with a sample of 1,253 individuals from Southern Brazil. To verify differences between prevalence rates comparing primary informants and proxy informants, we used the chi-square or Fisher's exact test for categorical variables and Mann-Whitney for continuous variables. The log-binomial model was adjusted for hearing loss as the dependent variable, considering three datasets: the entire sample, only primary informants, and only proxy informants, estimating association by prevalence ratios. In the final models, only the independent variables age and dizziness were associated with hearing loss, independently of the dataset that was used. Proxy informants generally underestimated the prevalence rates for the target outcomes, when compared to primary informants.

Self-initiated coping with Tourette's syndrome: Effect of tic suppression on QOL.

Science.gov (United States)

Matsuda, Natsumi; Kono, Toshiaki; Nonaka, Maiko; Fujio, Miyuki; Kano, Yukiko

2016-02-01

Because of the semi-voluntary nature of tics, patients with Tourette' syndrome (TS) often report self-initiated coping with tics. Our goals were to understand the experiences of self-initiated coping with tics by individuals with TS (e.g., suppression frequency, suppression ability, and side effects of tic suppression), and investigate the effects of tic control on quality of life (QOL). One hundred participants with TS (38 children and 62 adults) answered a questionnaire concerning tic control, QOL, and other clinical characteristics. Fifty-eight percent of the participants always or frequently tried to suppress tics daily. In contrast, over 90% felt uncomfortable or incomplete when they suppressed tics and needed concentration or extra effort to suppress them. Thirty-four percent could suppress tics for less than one minute and 65% could suppress tics for less than 10min. Higher subjective satisfaction with tic control was positively correlated with life satisfaction and QOL. Individuals with TS often attempt self-initiated coping in their daily lives, especially through tic suppression, despite experiencing subjective discomfort and being aware that the duration of tic suppression is often limited. Moreover, it was found that their subjective satisfaction with tic control and effective tic suppression might have a positive influence on their life satisfaction and QOL. Thus, self-initiated coping with tics is vital for improving the QOL of individuals with TS and intervention aimed at enhancing subjective satisfaction with tic control could help manage TS. Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

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.

Dysphagia-related quality of life in oculopharyngeal muscular dystrophy: Psychometric properties of the SWAL-QOL instrument.

Science.gov (United States)

Youssof, Sarah; Romero-Clark, Carol; Warner, Teddy; Plowman, Emily

2017-07-01

The Swallowing Quality of Life instrument (SWAL-QOL) is a patient-reported outcome measure of swallowing-related quality of life (SR-QoL). Its psychometric properties in oculopharyngeal muscular dystrophy (OPMD) are not known. We administered the SWAL-QOL to U.S. OPMD Registry participants. We described SR-QoL profiles and assessed reliability and validity. The mean composite score in 113 individuals with OPMD was 54.4 ± 20.7, indicating moderate impairment. Severe impairments were observed in eating duration, burden, and fatigue scales. Internal consistency reliability of all scales was found to be satisfactory, and 9 of 10 scales demonstrated adequate test-retest reliability. Data confirmed 86% of hypotheses, supporting construct validity. The SWAL-QOL limitations in OPMD include: floor/ceiling effects in 7 of 10 scales and low specificity of sleep, fatigue, and communication scales for dysphagia. SR-QoL is reduced in OPMD. Given several limitations of the SWAL-QOL, development of an improved dysphagia-specific QoL instrument for OPMD is warranted. Muscle Nerve 56: 28-35, 2017. © 2016 Wiley Periodicals, Inc.

Methodology for the development and calibration of the SCI-QOL item banks.

Science.gov (United States)

Tulsky, David S; Kisala, Pamela A; Victorson, David; Choi, Seung W; Gershon, Richard; Heinemann, Allen W; Cella, David

2015-05-01

To develop a comprehensive, psychometrically sound, and conceptually grounded patient reported outcomes (PRO) measurement system for individuals with spinal cord injury (SCI). Individual interviews (n=44) and focus groups (n=65 individuals with SCI and n=42 SCI clinicians) were used to select key domains for inclusion and to develop PRO items. Verbatim items from other cutting-edge measurement systems (i.e. PROMIS, Neuro-QOL) were included to facilitate linkage and cross-population comparison. Items were field tested in a large sample of individuals with traumatic SCI (n=877). Dimensionality was assessed with confirmatory factor analysis. Local item dependence and differential item functioning were assessed, and items were calibrated using the item response theory (IRT) graded response model. Finally, computer adaptive tests (CATs) and short forms were administered in a new sample (n=245) to assess test-retest reliability and stability. A calibration sample of 877 individuals with traumatic SCI across five SCI Model Systems sites and one Department of Veterans Affairs medical center completed SCI-QOL items in interview format. We developed 14 unidimensional calibrated item banks and 3 calibrated scales across physical, emotional, and social health domains. When combined with the five Spinal Cord Injury--Functional Index physical function banks, the final SCI-QOL system consists of 22 IRT-calibrated item banks/scales. Item banks may be administered as CATs or short forms. Scales may be administered in a fixed-length format only. The SCI-QOL measurement system provides SCI researchers and clinicians with a comprehensive, relevant and psychometrically robust system for measurement of physical-medical, physical-functional, emotional, and social outcomes. All SCI-QOL instruments are freely available on Assessment CenterSM.

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 ...

Developing a proxy version of the Adult social care outcome toolkit (ASCOT).

Science.gov (United States)

Rand, Stacey; Caiels, James; Collins, Grace; Forder, Julien

2017-05-19

Social care-related quality of life is a key outcome indicator used in the evaluation of social care interventions and policy. It is not, however, always possible to collect quality of life data by self-report even with adaptations for people with cognitive or communication impairments. A new proxy-report version of the Adult Social Care Outcomes Toolkit (ASCOT) measure of social care-related quality of life was developed to address the issues of wider inclusion of people with cognitive or communication difficulties who may otherwise be systematically excluded. The development of the proxy-report ASCOT questionnaire was informed by literature review and earlier work that identified the key issues and challenges associated with proxy-reported outcomes. To evaluate the acceptability and content validity of the ASCOT-Proxy, qualitative cognitive interviews were conducted with unpaid carers or care workers of people with cognitive or communication impairments. The proxy respondents were invited to 'think aloud' while completing the questionnaire. Follow-up probes were asked to elicit further detail of the respondent's comprehension of the format, layout and content of each item and also how they weighed up the options to formulate a response. A total of 25 unpaid carers and care workers participated in three iterative rounds of cognitive interviews. The findings indicate that the items were well-understood and the concepts were consistent with the item definitions for the standard self-completion version of ASCOT with minor modifications to the draft ASCOT-Proxy. The ASCOT-Proxy allows respondents to rate the proxy-proxy and proxy-patient perspectives, which improved the acceptability of proxy report. A new proxy-report version of ASCOT was developed with evidence of its qualitative content validity and acceptability. The ASCOT-Proxy is ready for empirical testing of its suitability for data collection as a self-completion and/or interview questionnaire, and also

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

Driving with Mild Cognitive Impairment or Dementia: Cognitive Test Performance and Proxy Report of Daily Life Function in Older Women.

Science.gov (United States)

Vaughan, Leslie; Hogan, Patricia E; Rapp, Stephen R; Dugan, Elizabeth; Marottoli, Richard A; Snively, Beverly M; Shumaker, Sally A; Sink, Kaycee M

2015-09-01

To investigate associations between proxy report of cognitive and functional limitations and cognitive performance and current or former driving status in older women with mild cognitive impairment (MCI) and all-cause dementia. Cross-sectional data analysis of retrospectively identified older women with adjudicated MCI and all-cause dementia in the Women's Health Initiative Memory Study-Epidemiology of Cognitive Health Outcomes (WHIMS-ECHO). Academic medical center. Women (mean age ± standard deviation 83.7 ± 3.5) adjudicated with MCI or dementia during Year 1, 2, 3, or 4 of the WHIMS-ECHO follow-up period (N = 385). The telephone-administered cognitive battery included tests of attention, verbal learning and memory, verbal fluency, executive function, working memory, and global cognitive function plus self-report measures of depressive symptomatology. The Dementia Questionnaire (DQ) was administered to a knowledgeable proxy (family member, friend). Sixty percent of women with MCI and 40% of those with dementia are current drivers. Proxy reports of functional limitations in instrumental activities of daily living (IADLs) are associated with current driving status in women with MCI, whereas performance-based cognitive tests are not. In women with dementia, proxy reports of functional limitations in IADLs and performance-based cognitive tests are associated with current driving status, as expected. These findings have clinical implications for the importance of evaluating driving concurrently with other instrumental functional abilities in MCI and dementia. Additional work is needed to determine whether proxy report of cognitive and functional impairments should help guide referrals for driving assessment and rehabilitation or counseling for driving transition. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Quality of life in children with OCD with and without comorbidity.

Science.gov (United States)

Weidle, Bernhard; Jozefiak, Thomas; Ivarsson, Tord; Thomsen, Per Hove

2014-10-29

Quality of life (QoL) is a well-established outcome measure. However, in contrast to adult obsessive-compulsive disorder (OCD), little is known about QoL in children with OCD. This study aimed to assess QoL, social competence and school functioning of paediatric patients with OCD by comparing them with the general population and assessing the relations between comorbidity, duration and severity of symptoms, family accommodation and QoL. Children and adolescents (n = 135), aged 7-17 (mean 13 [SD 2.7] years; 48.1% female) were assessed at baseline for treatment. QoL was assessed by self-report and caregiver's proxy report on the Questionnaire for Measuring Health-related Quality of Life in Children and Adolescents (KINDL-R) and compared with an age- and sex-matched sample from the general population. Social competence and school functioning were assessed with the Child Behavior Checklist, comorbidity with the Kiddie Schedule for Affective Disorders and Schizophrenia (Present and Lifetime Version), severity of OCD with the Children's Yale-Brown Obsessive Compulsive Scale and the families' involvement with the child's OCD symptoms with the Family Accommodation Scale. QoL and social competence were reduced (p OCD compared with controls (KINDL-R mean score 62.40 [SD 13.00] versus 69.72 [12.38] in self-reports and 61.63 [SD 13.27] versus 74.68 [9.97] in parent reports). Patients with comorbidity had lower QoL (p = .001) in proxy ratings than those with OCD only (mean score 56.26 [SD 12.47] versus 64.30 [SD 12.75]). In parent proxy reports, severity of OCD (r = -.28) and family accommodation (r = -.40) correlated moderately negatively with QoL. To our knowledge, this is the largest QoL study of paediatric OCD. QoL was markedly reduced in children with OCD, especially in those with comorbid psychiatric disorders. Based on our findings, we suggest employing QoL assessment in order to have a more comprehensive understanding of childhood OCD. This study was

Concordance of patient and caregiver reports in evaluating quality of life in patients with malignant gliomas and an assessment of caregiver burden

Science.gov (United States)

Jacobs, Daniel I.; Kumthekar, Priya; Stell, Becky V.; Grimm, Sean A.; Rademaker, Alfred W.; Rice, Laurie; Chandler, James P.; Muro, Kenji; Marymont, MaryAnne; Helenowski, Irene B.; Wagner, Lynne I.; Raizer, Jeffrey J.

2014-01-01

Background Given the neurocognitive impairment experienced by many patients with malignant gliomas, caregiver reports can be critical in assessing the quality of life (QOL) of these patients. In this study, we explored whether assessment of patient QOL by the primary caregiver shows concordance with the patient's self-reported QOL, and we quantified the burden faced by caregivers. Methods QOL of 45 patients was evaluated by both the patient and primary caregiver on 3 or more separate occasions using the Functional Assessment of Cancer Therapy-Brain (FACT-Br) instrument, and concordance between the 2 reports was evaluated. Caregiver burden was measured using the Caregiver Quality of Life Index-Cancer (CQOL-C) instrument. Results Overall, good concordance was observed between the patient and caregiver FACT-Br reports (intraclass correlation coefficient = 0.74). Patient-reported FACT-Br scores were 4.75 (95% CI, 1.44–8.05) points higher than paired caregiver reports on the 200-point scale (P = .008); however, this difference did not achieve clinical significance. Caregiver burden, as measured by the CQOL-C, was significantly greater among caregivers in this study than those previously reported for caregivers of patients with lung, breast, or prostate cancer (P < .001). Conclusions Despite minor discrepancies in caregiver assessments of patient QOL relative to patient self-reports, our results suggest that the caregiver assessments can serve as adequate proxies for patient reports. Our results also illustrate the particularly heavy burden faced by caregivers of patients with malignant glioma. Further research into both of these areas is warranted. PMID:26034616

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.

Evaluation of thyroid eye disease: quality-of-life questionnaire (TED-QOL) in Korean patients.

Science.gov (United States)

Son, Byeong Jae; Lee, Sang Yeul; Yoon, Jin Sook

2014-04-01

To assess impaired quality of life (QOL) of Korean patients with thyroid eye disease (TED) using the TED-QOL questionnaire, to evaluate the adaptability of the questionnaire, and to assess the correlation between TED-QOL and scales of disease severity. Prospective, cross-sectional study. Total of 90 consecutive adult patients with TED and Graves' disease were included in this study. TED-QOL was translated into Korean and administered to the patients. The results were compared with clinical severity scores (clinical activity score, VISA (vision loss (optic neuropathy); inflammation; strabismus/motility; appearance/exposure) classification, modified NOSPECS (no signs or symptoms; only signs; soft tissue; proptosis; extraocular muscle; cornea; sight loss) score, Gorman diplopia scale, and European Group of Graves' Orbitopathy Classification). Clinical scores indicating inflammation and strabismus in patients with TED were positively correlated with overall and visual function-related QOL (Spearman coefficient 0.21-0.38, p < 0.05). Clinical scores associated with appearance were positively correlated with appearance-related QOL (Spearman coefficient 0.26-0.27, p < 0.05). In multivariate analysis, age, soft-tissue inflammation, motility disorder of modified NOSPECS, and motility disorder of VISA classification had positive correlation with overall and function-related QOL. Sex, soft-tissue inflammation, proptosis of modified NOSPECS, and appearance of VISA classification had correlation with appearance-related QOL. In addition, validity of TED-QOL was proved sufficient based on the outcomes of patient interviews and correlation between the subscales of TED-QOL. TED-QOL showed significant correlations with various objective clinical parameters of TED. TED-QOL was a simple and useful tool for rapid evaluation of QOL in daily outpatient clinics, which could be readily translated into different languages to be widely applicable to various populations. Copyright © 2014

Subjective Fatigue in Children with Hearing Loss Assessed Using Self- and Parent-Proxy Report

Science.gov (United States)

Hornsby, Benjamin W. Y.; Gustafson, Samantha J.; Lancaster, Hope; Cho, Sun-Joo; Camarata, Stephen; Bess, Fred H.

2017-01-01

Purpose: The primary purposes of this study were to examine the effects of hearing loss and respondent type (self- vs. parent-proxy report) on subjective fatigue in children. We also examined associations between child-specific factors and fatigue ratings. Method: Subjective fatigue was assessed using the Pediatric Quality of Life Inventory…

Factors that influence the QOL of cancer patients who have undergone radiotherapy as outpatients

International Nuclear Information System (INIS)

Senuma, Maiko; Shinoda, Shizuyo; Kitada, Yoko; Takei, Akemi; Kanda, Kiyoko; Seyama, Ruka; Igarashi, Reiko

2011-01-01

The purpose of this study was to elucidate the factors that influence the QOL of cancer patients who have undergone radiotherapy in the outpatient setting. The patient's quality of life (QOL) was investigated by using the QOL evaluation standard functional assessment of cancer therapy-general (FACT-G) in 73 cancer patients (mean age 64.2±12.2 yrs standard deviation (SD)) who had undergone radiotherapy as outpatients. The mean QOL score was 74.8±17.1 pointy, and a significant difference was seen in about 25 items as a result of examining the factors that influenced the patient's QOL. In addition, a stepwise multiple regression analysis revealed that the factors which influenced the QOL were the operation due to the original disease, social support (excluding the family), tiredness, relapse and the metastasis, performance status (PS), uneasiness of presence in descending order of influence. The results revealed the strong influence of psychological, mental and social factors on the QOL score. From the patient of view of nursing support for cancer patients, screening for these factors may allow earlier detection of any decrease in the QOL, or identify when the QOL has already decreased. Furthermore, support should be initiated at as early a stage as possible. (author)

Reliability and validity of a self-administration version of DEMQOL-Proxy.

Science.gov (United States)

Hendriks, A A Jolijn; Smith, Sarah C; Chrysanthaki, Theopisti; Black, Nick

2017-07-01

This study aimed to investigate the reliability and validity of a self-administered version of DEMQOL-Proxy, a disease-specific instrument that measures health-related quality of life in people with dementia. The sample consisted of 173 informal carers of people with dementia, aged 29 to 89 years old. Carers were mostly female, White/White British and closely related to the patient. They completed DEMQOL-Proxy (self-administered), EQ-5D-3L (proxy reported about the person with dementia), EQ-5D-3L (self-reported about their own health) and the Zarit Burden Interview. Using well-established methods from classical test theory, we evaluated scale level acceptability, reliability and convergent, discriminant and known-groups validity of DEMQOL-Proxy. DEMQOL-Proxy (self-administered) showed high acceptability (3.5% missing data and 0% scores at floor or ceiling), high internal consistency reliability (α = 0.93) and good convergent and discriminant validity. Amongst others, we found a moderately high correlation with EQ-5D-3L proxy reported (r = 0.52) and low to essentially zero correlations with EQ-5D-3L self-reported (r = 0.20) and carer and patient background variables (r ≤ 0.20). As predicted, DEMQOL-Proxy (self-administered) showed a modest correlation with DEMQOL (r = 0.32). Known-groups differences on health-related quality of life (comparing people with versus people without cognitive impairment) were of moderate effect size (d = 0.38) and in the expected direction. DEMQOL-Proxy (self-administered) has comparable acceptability, reliability and validity with DEMQOL-Proxy (interviewer administered). DEMQOL-Proxy (self-administered) can be used in a wider variety of contexts than its interviewer-administered version, including routine use in busy clinics. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

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 (Pasthma attack in the past 6 months (kappa=0.61 [0.54, 0.68]) compared to children who did not (kappa=0.25 [0.00, 0.59]). Parents of asthmatic children are reliable reporters of their child's respiratory-related urgent health services utilization.

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.

Validation of a health-related quality of life instrument for primary ciliary dyskinesia (QOL-PCD).

Science.gov (United States)

Behan, Laura; Leigh, Margaret W; Dell, Sharon D; Dunn Galvin, Audrey; Quittner, Alexandra L; Lucas, Jane S

2017-09-01

Quality of life (QOL)-primary ciliary dyskinesia (PCD) is the first disease-specific, health-related QOL instrument for PCD. Psychometric validation of QOL-PCD assesses the performance of this measure in adults, including its reliability, validity and responsiveness to change. Seventy-two adults (mean (range) age: 33 years (18-79 years); mean (range) FEV 1 % predicted: 68 (26-115)) with PCD completed the 49-item QOL-PCD and generic QOL measures: Short-Form 36 Health Survey, Sino-Nasal Outcome Test 20 (SNOT-20) and St George Respiratory Questionnaire (SGRQ)-C. Thirty-five participants repeated QOL-PCD 10-14 days later to measure stability or reproducibility of the measure. Multitrait analysis was used to evaluate how the items loaded on 10 hypothesised scales: physical, emotional, role and social functioning, treatment burden, vitality, health perceptions, upper respiratory symptoms, lower respiratory symptoms and ears and hearing symptoms. This analysis of item-to-total correlations led to 9 items being dropped; the validated measure now comprises 40 items. Each scale had excellent internal consistency (Cronbach's α: 0.74 to 0.94). Two-week test-retest demonstrated stability for all scales (intraclass coefficients 0.73 to 0.96). Significant correlations were obtained between QOL-PCD scores and age and FEV 1 . Strong relationships were also found between QOL-PCD scales and similar constructs on generic questionnaires, for example, lower respiratory symptoms and SGRQ-C (r=0.72, pmeasures of different constructs. QOL-PCD has demonstrated good internal consistency, test-retest reliability, convergent and divergent validity. QOL-PCD offers a promising tool for evaluating new therapies and for measuring symptoms, functioning and QOL during routine care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A new questionnaire for measuring quality of life - the Stark QoL.

Science.gov (United States)

Hardt, Jochen

2015-10-26

The Stark questionnaire measures health-related quality of life (QoL) using pictures almost exclusively. It is supplemented by a minimum of words. It comprises a mental and a physical health component. A German sample of n = 500 subjects, age and gender stratified, filled out the Stark Qol questionnaire along with various other questionnaires via internet. The physical component shows good reliability (Cronbach's alpha = McDonalds Omega = greatest lower bound = .93), the mental component can be improved (Cronbach's alpha = .63, McDonalds Omega = .72, greatest lower bound = .77). Confirmatory factor analysis shows a good fit (Bentlers CFI = .97). Construct validity was proven. The Stark QoL is a promising new development in measuring QoL, it is a short and easy to apply questionnaire. Additionally, it is particularly promising for international research.

Measuring adolescents' HRQoL via self reports and parent proxy reports: an evaluation of the psychometric properties of both versions of the KINDL-R instrument.

Science.gov (United States)

Erhart, Michael; Ellert, Ute; Kurth, Bärbel-Maria; Ravens-Sieberer, Ulrike

2009-08-26

Several instruments are available to assess children's health-related quality of life (HRQoL) based on self reports as well as proxy reports from parents. Previous studies have found only low-to-moderate agreement between self and proxy reports, but few studies have explicitly compared the psychometric qualities of both. This study compares the reliability, factorial validity and convergent and known group validity of the self-report and parent-report versions of the HRQoL KINDL-R questionnaire for children and adolescents. Within the nationally representative cross-sectional German Health Interview and Examination Survey for Children and Adolescents (KiGGS), 6,813 children and adolescents aged 11 to 17 years completed the KINDL-R generic HRQoL instrument while their parents answered the KINDL proxy version (both in paper-and-pencil versions). Cronbach's alpha and confirmatory factor-analysis models (linear structural equation model) were obtained. Convergent and discriminant validity were assessed by calculating the Pearson's correlation coefficient for the Strengths and Difficulties Questionnaire. Known-groups differences were examined (ANOVA) for obese children and children with a lower familial socio-economic status. The parent reports achieved slightly higher Cronbach's alpha values for the total score (0.86 vs. 0.83) and most sub-scores. Confirmatory factor analysis revealed an acceptable fit of the six-dimensional measurement model of the KINDL for the parent (RMSEA=0.07) and child reports (RMSEA=0.06). Factorial invariance across the two versions did not hold with regards to the pattern of loadings, the item errors and the covariation between latent concepts. However the magnitude of the differences was rather small. The parent report version achieved slightly higher convergent validity (r=0.44-0.63 vs. r=0.33-0.59) in the Strengths and Difficulties Questionnaire. No clear differences were observed for known-groups validity. Our study showed that parent

Measuring adolescents' HRQoL via self reports and parent proxy reports: an evaluation of the psychometric properties of both versions of the KINDL-R instrument

Directory of Open Access Journals (Sweden)

Ravens-Sieberer Ulrike

2009-08-01

Full Text Available Abstract Background Several instruments are available to assess children's health-related quality of life (HRQoL based on self reports as well as proxy reports from parents. Previous studies have found only low-to-moderate agreement between self and proxy reports, but few studies have explicitly compared the psychometric qualities of both. This study compares the reliability, factorial validity and convergent and known group validity of the self-report and parent-report versions of the HRQoL KINDL-R questionnaire for children and adolescents. Methods Within the nationally representative cross-sectional German Health Interview and Examination Survey for Children and Adolescents (KiGGS, 6,813 children and adolescents aged 11 to 17 years completed the KINDL-R generic HRQoL instrument while their parents answered the KINDL proxy version (both in paper-and-pencil versions. Cronbach's alpha and confirmatory factor-analysis models (linear structural equation model were obtained. Convergent and discriminant validity were assessed by calculating the Pearson's correlation coefficient for the Strengths and Difficulties Questionnaire. Known-groups differences were examined (ANOVA for obese children and children with a lower familial socio-economic status. Results The parent reports achieved slightly higher Cronbach's alpha values for the total score (0.86 vs. 0.83 and most sub-scores. Confirmatory factor analysis revealed an acceptable fit of the six-dimensional measurement model of the KINDL for the parent (RMSEA = 0.07 and child reports (RMSEA = 0.06. Factorial invariance across the two versions did not hold with regards to the pattern of loadings, the item errors and the covariation between latent concepts. However the magnitude of the differences was rather small. The parent report version achieved slightly higher convergent validity (r = 0.44 – 0.63 vs. r = 0.33 – 0.59 in the Strengths and Difficulties Questionnaire. No clear differences were

[Validity and reliability of the spanish EQ-5D-Y proxy version].

Science.gov (United States)

Gusi, N; Perez-Sousa, M A; Gozalo-Delgado, M; Olivares, P R

2014-10-01

A proxy version of the EQ-5D-Y, a questionnaire to evaluate the Health Related Quality of Life (HRQoL) in children and adolescents, has recently been developed. There are currently no data on the validity and reliability of this tool. The objective of this study was to analyze the validity and reliability of the EQ-5D-Y proxy version. A core set of self-report tools, including the Spanish version of the EQ-5D-Y were administered to a group of Spanish children and adolescents drawn from the general population. A similar core set of internationally standardized proxy tools, including the EQ-5D-Y proxy version were administered to their parents. Test-retest reliability was determined, and correlations with other generic measurements of HRQoL were calculated. Additionally, known group validity was examined by comparing groups with a priori expected differences in HRQoL. The agreement between the self-report and proxy version responses was also calculated. A total of 477 children and adolescents and their parents participated in the study. One week later, 158 participants completed the EQ-5D-Y/EQ-5D-Y proxy to facilitate reliability analysis. Agreement between the test-retest scores was higher than 88% for EQ-5D-Y self-report, and proxy version. Correlations with other health measurements showed similar convergent validity to that observed in the international EQ-5D-Y. Agreement between the self-report and proxy versions ranged from 72.9% to 97.1%. The results provide preliminary evidence of the reliability and validity of the EQ-5D-Y proxy version. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Quality of Life Measurement and Its Use in the Field of Learning Disabilities.

Science.gov (United States)

Lefort, Shelley; Fraser, Mary

2002-01-01

This article examines issues in the measurement of quality of life (QOL) within the field of learning disabilities. Discussion considers objective and subjective measures, value-based and value-free approaches, and traditional versus participatory approaches. The issue of using self-reports or proxies to gather and measure QOL data is addressed. A…

Water Isotope Proxy-Proxy and Proxy-Model Convergence for Late Pleistocene East Asian Monsoon Rainfall Reconstructions

Science.gov (United States)

Clemens, S. C.; Holbourn, A.; Kubota, Y.; Lee, K. E.; Liu, Z.; Chen, G.

2017-12-01

Confidence in reconstruction of East Asian paleomonsoon rainfall using precipitation isotope proxies is a matter of considerable debate, largely due to the lack of correlation between precipitation amount and isotopic composition in the present climate. We present four new, very highly resolved records spanning the past 300,000 years ( 200 year sample spacing) from IODP Site U1429 in the East China Sea. We demonstrate that all the orbital- and millennial-scale variance in the onshore Yangtze River Valley speleothem δ18O record1 is also embedded in the offshore Site U1429 seawater δ18O record (derived from the planktonic foraminifer Globigerinoides ruber and sea surface temperature reconstructions). Signal replication in these two independent terrestrial and marine archives, both controlled by the same monsoon system, uniquely identifies δ18O of precipitation as the primary driver of the precession-band variance in both records. This proxy-proxy convergence also eliminates a wide array of other drivers that have been called upon as potential contaminants to the precipitation δ18O signal recorded by these proxies. We compare East Asian precipitation isotope proxy records to precipitation amount from a CCSM3 transient climate model simulation of the past 300,000 years using realistic insolation, ice volume, greenhouse gasses, and sea level boundary conditions. This model-proxy comparison suggests that both Yangtze River Valley precipitation isotope proxies (seawater and speleothem δ18O) track changes in summer-monsoon rainfall amount at orbital time scales, as do precipitation isotope records from the Pearl River Valley2 (leaf wax δ2H) and Borneo3 (speleothem δ18O). Notably, these proxy records all have significantly different spectral structure indicating strongly regional rainfall patterns that are also consistent with model results. Transient, isotope-enabled model simulations will be necessary to more thoroughly evaluate these promising results, and to

The Last Millennium Reanalysis: Improvements to proxies and proxy modeling

Science.gov (United States)

Tardif, R.; Hakim, G. J.; Emile-Geay, J.; Noone, D.; Anderson, D. M.

2017-12-01

The Last Millennium Reanalysis (LMR) employs a paleoclimate data assimilation (PDA) approach to produce climate field reconstructions (CFRs). Here, we focus on two key factors in PDA generated CFRs: the set of assimilated proxy records and forward models (FMs) used to estimate proxies from climate model output. In the initial configuration of the LMR [Hakim et al., 2016], the proxy dataset of [PAGES2k Consortium, 2013] was used, along with univariate linear FMs calibrated against annually-averaged 20th century temperature datasets. In an updated configuration, proxy records from the recent dataset [PAGES2k Consortium, 2017] are used, while a hierarchy of statistical FMs are tested: (1) univariate calibrated on annual temperature as in the initial configuration, (2) univariate against temperature as in (1) but calibration performed using expert-derived seasonality for individual proxy records, (3) as in (2) but expert proxy seasonality replaced by seasonal averaging determined objectively as part of the calibration process, (4) linear objective seasonal FMs as in (3) but objectively selecting relationships calibrated either on temperature or precipitation, and (5) bivariate linear models calibrated on temperature and precipitation with objectively-derived seasonality. (4) and (5) specifically aim at better representing the physical drivers of tree ring width proxies. Reconstructions generated using the CCSM4 Last Millennium simulation as an uninformed prior are evaluated against various 20th century data products. Results show the benefits of using the new proxy collection, particularly on the detrended global mean temperature and spatial patterns. The positive impact of using proper seasonality and temperature/moisture sensitivities for tree ring width records is also notable. This updated configuration will be used for the first generation of LMR-generated CFRs to be publicly released. These also provide a benchmark for future efforts aimed at evaluating the

Family factors in end-of-life decision-making: family conflict and proxy relationship.

Science.gov (United States)

Parks, Susan Mockus; Winter, Laraine; Santana, Abbie J; Parker, Barbara; Diamond, James J; Rose, Molly; Myers, Ronald E

2011-02-01

Few studies have examined proxy decision-making regarding end-of-life treatment decisions. Proxy accuracy is defined as whether proxy treatment choices are consistent with the expressed wishes of their index elder. The purpose of this study was to examine proxy accuracy in relation to two family factors that may influence proxy accuracy: perceived family conflict and type of elder-proxy relationship. Telephone interviews with 202 community-dwelling elders and their proxy decision makers were conducted including the Life-Support Preferences Questionnaire (LSPQ), and a measure of family conflict, and sociodemographic characteristics, including type of relationship. Elder-proxy accuracy was associated with the type of elder-proxy relationship. Adult children demonstrated the lowest elder-proxy accuracy and spousal proxies the highest elder-proxy accuracy. Elder-proxy accuracy was associated with family conflict. Proxies reporting higher family conflict had lower elder-proxy accuracy. No interaction between family conflict and relationship type was revealed. Spousal proxies were more accurate in their substituted judgment than adult children, and proxies who perceive higher degree of family conflict tended to be less accurate than those with lower family conflict. Health care providers should be aware of these family factors when discussing advance care planning.

Development and evaluation of oral Cancer quality-of-life questionnaire (QOL-OC).

Science.gov (United States)

Nie, Min; Liu, Chang; Pan, Yi-Chen; Jiang, Chen-Xi; Li, Bao-Ru; Yu, Xi-Jie; Wu, Xin-Yu; Zheng, Shu-Ning

2018-05-03

In this study scales and items for the Oral Cancer Quality-of-life Questionnaire (QOL-OC) were designed and the instrument was evaluated. The QOL-OC was developed and modified using the international definition of quality of life (QOL) promulgated by the European Organization for Research and Treatment of Cancer (EORTC) and analysis of the precedent measuring instruments. The contents of each item were determined in the context of the specific characteristics of oral cancer. Two hundred thirteen oral cancer patients were asked to complete both the EORTC core quality of life questionnaire (EORTC QLC-C30) and the QOL-OC. Data collected was used to conduct factor analysis, test-retest reliability, internal consistency, and construct validity. Questionnaire compliance was relatively high. Fourteen of the 213 subjects accepted the same tests after 24 to 48 h demonstrating a high test-retest reliability for all five scales. Overall internal consistency surpasses 0.8. The outcome of the factor analysis coincides substantially with our theoretical conception. Each item shows a higher correlation coefficient within its own scale than the others which indicates high construct validity. QOL-OC demonstrates fairly good statistical reliability, validity, and feasibility. However, further tests and modification are needed to ensure its applicability to the quality-of-life assessment of Chinese oral cancer patients.

Multi-proxy studies in palaeolimnology

OpenAIRE

Birks, Hilary H.; Birks, Harry John Betteley

2006-01-01

Multi-proxy studies are becoming increasingly common in palaeolimnology. Eight basic requirements and challenges for a multi-proxy study are outlined in this essay – definition of research questions, leadership, site selection and coring, data storage, chronology, presentation of results, numerical tools, and data interpretation. The nature of proxy data is discussed in terms of physical proxies and biotic proxies. Loss-on-ignition changes and the use of transfer functions are reviewed as exa...

Here be web proxies

DEFF Research Database (Denmark)

Weaver, Nicholas; Kreibich, Christian; Dam, Martin

2014-01-01

,000 clients that include a novel proxy location technique based on traceroutes of the responses to TCP connection establishment requests, which provides additional clues regarding the purpose of the identified web proxies. Overall, we see 14% of Netalyzr-analyzed clients with results that suggest the presence...... of web proxies....

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".

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.

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.

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.

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

International Nuclear Information System (INIS)

Trotti, Andy; Johnson, Darlene J.; Gwede, Clement; Casey, Linda; Cantor, Alan

1997-01-01

N is being compared to the Functional Assessment Cancer Tool with a Head and Neck module (FACT-H and N). The FACT-H and N will be administered one time at week 4, on the same day that the QOL-RTI/H and N is administered. Follow-up administration of the QOL-RTI/H and N will continue at the patient's 6-8 weeks post-radiotherapy checkup, and at the six month and one year check-ups to determine when and if the quality of life returns to the baseline level and perhaps determine the impact of late effects on quality of life. Results: At this time, twenty-eight (28) patients have been consented and 27 patients are evaluable for the analyses reported here. Mean age at the start of treatment was 62 years (range 40-75). Internal consistency reliability of the module was satisfactory (Chronbach's α=0.844). Chronbach's alpha previously reported for the general tool (α=0.82). Test-retest reliability correlation coefficient for the module was 0.90 (p<0.001). Test-retest reliability was previously reported for the general tool 0.79 (p<0.0001) in a mixed group of patients (n=19) and 0.75 (p<0.0001) in a group of prostate patients (n=70). In this study test-retest for the general tool is 0.82 (n=23; p<0.001). Concurrent validity is being established by comparison to the F.A.C.T./H. and N. Preliminary analysis shows significant changes in quality of life scores due to treatment for both general QOL and disease targeted items. The average general QOL reported at baseline (n=26) was 7.185 (SD .622) and at end of treatment it was 5.828 (SD .799) (p<0.001). The mean average head and neck score reported at baseline (n=27) was 7.285 (SD 1.854) and the end of treatment head and neck score was 4.184 (SD 1.727) (p<0.001). Other areas with statistical significance included: KPS, appearance, appetite and taste, nausea, tiredness, pain in throat, swallowing difficulty, changes in saliva, trouble with breathing and coughing, and understandability were all significant (p=0.001). Conclusion

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.

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.

Measuring depression after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Depression item bank and linkage with PHQ-9.

Science.gov (United States)

Tulsky, David S; Kisala, Pamela A; Kalpakjian, Claire Z; Bombardier, Charles H; Pohlig, Ryan T; Heinemann, Allen W; Carle, Adam; Choi, Seung W

2015-05-01

To develop a calibrated spinal cord injury-quality of life (SCI-QOL) item bank, computer adaptive test (CAT), and short form to assess depressive symptoms experienced by individuals with SCI, transform scores to the Patient Reported Outcomes Measurement Information System (PROMIS) metric, and create a crosswalk to the Patient Health Questionnaire (PHQ)-9. We used grounded-theory based qualitative item development methods, large-scale item calibration field testing, confirmatory factor analysis, item response theory (IRT) analyses, and statistical linking techniques to transform scores to a PROMIS metric and to provide a crosswalk with the PHQ-9. Five SCI Model System centers and one Department of Veterans Affairs medical center in the United States. Adults with traumatic SCI. Spinal Cord Injury--Quality of Life (SCI-QOL) Depression Item Bank Individuals with SCI were involved in all phases of SCI-QOL development. A sample of 716 individuals with traumatic SCI completed 35 items assessing depression, 18 of which were PROMIS items. After removing 7 non-PROMIS items, factor analyses confirmed a unidimensional pool of items. We used a graded response IRT model to estimate slopes and thresholds for the 28 retained items. The SCI-QOL Depression measure correlated 0.76 with the PHQ-9. The SCI-QOL Depression item bank provides a reliable and sensitive measure of depressive symptoms with scores reported in terms of general population norms. We provide a crosswalk to the PHQ-9 to facilitate comparisons between measures. The item bank may be administered as a CAT or as a short form and is suitable for research and clinical applications.

Measuring pain phenomena after spinal cord injury: Development and psychometric properties of the SCI-QOL Pain Interference and Pain Behavior assessment tools.

Science.gov (United States)

Cohen, Matthew L; Kisala, Pamela A; Dyson-Hudson, Trevor A; Tulsky, David S

2018-05-01

To develop modern patient-reported outcome measures that assess pain interference and pain behavior after spinal cord injury (SCI). Grounded-theory based qualitative item development; large-scale item calibration field-testing; confirmatory factor analyses; graded response model item response theory analyses; statistical linking techniques to transform scores to the Patient Reported Outcome Measurement Information System (PROMIS) metric. Five SCI Model Systems centers and one Department of Veterans Affairs medical center in the United States. Adults with traumatic SCI. N/A. Spinal Cord Injury - Quality of Life (SCI-QOL) Pain Interference item bank, SCI-QOL Pain Interference short form, and SCI-QOL Pain Behavior scale. Seven hundred fifty-seven individuals with traumatic SCI completed 58 items addressing various aspects of pain. Items were then separated by whether they assessed pain interference or pain behavior, and poorly functioning items were removed. Confirmatory factor analyses confirmed that each set of items was unidimensional, and item response theory analyses were used to estimate slopes and thresholds for the items. Ultimately, 7 items (4 from PROMIS) comprised the Pain Behavior scale and 25 items (18 from PROMIS) comprised the Pain Interference item bank. Ten of these 25 items were selected to form the Pain Interference short form. The SCI-QOL Pain Interference item bank and the SCI-QOL Pain Behavior scale demonstrated robust psychometric properties. The Pain Interference item bank is available as a computer adaptive test or short form for research and clinical applications, and scores are transformed to the PROMIS metric.

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

Background: The majority of patients with testicular cancer become long-term survivors. However, treatment is associated with late effects which may hamper QoL. The aims of the present study were to assess the impact of treatment on long-term QoL and evaluate the influence of neurotoxicity on Qo...

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

Science.gov (United States)

Boyer, Laurent; Dousset, Alix; Roussel, Philippe; Dossetto, Nathalie; Cammilleri, Serge; Piano, Virginie; Khalfa, Stéphanie; Mundler, Olivier; Donnet, Anne; Guedj, Eric

2014-04-08

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. Thirty-eight patients were randomly assigned to receive high-frequency rTMS (n = 19) or sham stimulation (n = 19), applied to left primary motor cortex in 14 sessions over 10 weeks. Primary clinical outcomes were QoL changes at the end of week 11, measured using the Fibromyalgia Impact Questionnaire (FIQ). Secondary clinical outcomes were mental and physical QoL component measured using the 36-Item Short Form Health Survey (SF-36), but also pain, mood, and anxiety. Resting-state [(18)F]-fluorodeoxyglucose-PET metabolism was assessed at baseline, week 2, and week 11. Whole-brain voxel-based analysis was performed to study between-group metabolic changes over time. At week 11, patients of the active rTMS group had greater QoL improvement in the FIQ (p = 0.032) and in the mental component of the SF-36 (p = 0.019) than the sham stimulation group. No significant impact was found for other clinical outcomes. Compared with the sham stimulation group, patients of the active rTMS group presented an increase in right medial temporal metabolism between baseline and week 11 (p FIQ and mental component SF-36 concomitant changes (r = -0.38, p = 0.043; r = 0.51, p = 0.009, respectively). QoL improvement involved mainly affective, emotional, and social dimensions. Our study shows that rTMS improves QoL of patients with fibromyalgia. This improvement is associated with a concomitant increase in right limbic metabolism, arguing for a neural substrate to the impact of rTMS on emotional dimensions involved in QoL. This study provides Class II evidence that rTMS compared with sham rTMS improves QoL in patients with fibromyalgia.

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.

Comparison of QOL between patients with different degenerative dementias, focusing especially on positive and negative affect.

Science.gov (United States)

Kurisu, Kairi; Terada, Seishi; Oshima, Etsuko; Horiuchi, Makiko; Imai, Nao; Yabe, Mayumi; Yokota, Osamu; Ishihara, Takeshi; Yamada, Norihito

2016-08-01

Quality of life (QOL) has become an important outcome measure in the care of dementia patients. However, there have been few studies focusing on the difference in QOL between different dementias. Two-hundred seventy-nine consecutive outpatients with Alzheimer's disease (AD), dementia with Lewy bodies (DLB) or frontotemporal dementia (FTD) were recruited. The QOL was evaluated objectively using the QOL Questionnaire for Dementia (QOL-D).The QOL-D comprises six domains: positive affect, negative affect and actions, communication, restlessness, attachment to others, and spontaneity. General cognition, daily activities, and behavioral and psychological symptoms of dementia were also evaluated. The scores of positive affect of QOL-D of AD patients were significantly higher than those of patients with DLB or FTD (AD 3.1 ± 0.8, DLB 2.6 ± 0.9, FTD 2.6 ± 0.7). The scores of negative affect and action of QOL-D of FTD patients were significantly higher than those of patients with AD or DLB (FTD 2.0 ± 0.8, AD 1.4 ± 0.5, DLB 1.5 ± 0.6). The apathy scores of FTD and DLB patients were significantly higher than those of patients with AD. The disinhibition scores of FTD patients were significantly higher than those of patients with AD or DLB. The apathy of FTD and DLB patients and depression of DLB patients might affect the lower positive affect of FTD and DLB patients compared to AD patients. The disinhibition of FTD patients might affect the abundance of negative affect & actions in FTD patients compared to AD and DLB patients.

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 influence of the 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

Food allergy QoL questionnaire for children aged 0-12 years : content, construct, and cross-cultural validity

NARCIS (Netherlands)

DunnGalvin, A.; de BlokFlokstra, B. M. J.; Burks, A. W.; Dubois, A. E. J.; Hourihane, J. O'B.

Background To date, there is no food allergy-specific questionnaire that allows parents to report children's health-related QoL (HRQL) from the child's perspective. Objective The aim of this study was to develop a sensitive, multi-dimensional measure to assess parental perception of HRQL in children

Quality of life assessment in cosmetics: specificity and interest of the international BeautyQol instrument.

Science.gov (United States)

Beresniak, Ariel; Auray, Jean-Paul; Duru, Gérard; Aractingi, Selim; Krueger, Gerald G; Talarico, Sergio; Tsutani, Kiichiro; Dupont, Danielle; de Linares, Yolaine

2015-09-01

The wide use of cosmetics and their perceived benefits upon well-being imply objective descriptions of their effects upon the different dimensions contributing to the quality of life (QoL). Such a goal pleas for using relevant and validated scientific instruments with robust measurement methods. This paper discusses the interest of the new validated questionnaire BeautyQoL specifically designed to assess the effect of cosmetic products on physical appearance and QoL. After conducting a review of skin appearance and QoL, three phases of the international codevelopment have been carried out in the following sequence: semi-directed interviews (Phase 1), acceptability study (Phase 2), and validation study (Phase 3). Data collection and validation process have been carried out in 16 languages. This review confirms that QoL instruments developed in dermatology are not suitable to assess cosmetic products, mainly because of their lack of sensitivity. General acceptability of BeautyQol was very good. Forty-two questions have been structured in five dimensions that explained 76.7% of the total variance: Social Life, Self-confidence, Mood, Vitality, and Attractiveness. Cronbach's alpha coefficients are between 0.932 and 0.978, confirming the good internal consistency of the results. The BeautyQol questionnaire is the first international instrument specific to cosmetic products and physical appearance that has been validated in 16 languages and could be used in a number of clinical trials and descriptive studies to demonstrate the added value of these products on the QoL. © 2015 Wiley Periodicals, Inc.

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.

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.

High-dose radiotherapy or concurrent chemo-radiation in lung cancer patients only induces a temporary, reversible decline in QoL

International Nuclear Information System (INIS)

Pijls-Johannesma, Madelon; Houben, Ruud; Boersma, Liesbeth; Grutters, Janneke; Seghers, Katarina; Lambin, Philippe; Wanders, Rinus; De Ruysscher, Dirk

2009-01-01

Background and purpose: Aggressive radiotherapy or concurrent chemo-radiation therapy for lung cancer leads to a high incidence of severe, mostly esophageal, toxicity. The purpose of this study was to investigate the evolution of quality of life (QoL) in patients with lung cancer, selected for curative radiotherapy (RT) or chemo-RT. Methods: Seventy-five lung cancer patients completed a longitudinal the EORTC QLQ-C30 and LC13. Linear mixed regression models were fitted to investigate the impact of different factors on overall QoL. Results: Overall QoL decreased shortly after the end of RT (4 points, p = 0.19), but increased back to baseline within 3 months. Mean scores of role functioning (p = 0.018), cognitive functioning (p = 0.002), dyspnoea (EORTC QLQ-LC13; p = 0.043), dysphagia (p = 0.005) and hoarseness (p = 0.029), showed a significant worsening over time. Emotional functioning (p = 0.033) improved significantly over time. Severe esophagitis (≥grade 2) was reported in only 12% of the patients. Next to maximal esophageal toxicity ≥grade 2 (p = .0.010), also tumor stage IIIA (p < 0.001), tumor stage IIIB (p = 0.003), gender (p = 0.042) and fatigue (p < 0.001) appeared to be significant predictors of QoL. Conclusion: High-dose radiotherapy or concurrent chemo-radiation in the treatment of lung cancer seems to be a well-tolerated treatment option with preservation of QoL.

Validity of proxies and correction for proxy use when evaluating social determinants of health in stroke patients.

Science.gov (United States)

Skolarus, Lesli E; Sánchez, Brisa N; Morgenstern, Lewis B; Garcia, Nelda M; Smith, Melinda A; Brown, Devin L; Lisabeth, Lynda D

2010-03-01

The purpose of this study was to evaluate stroke patient-proxy agreement with respect to social determinants of health, including depression, optimism, and spirituality, and to explore approaches to minimize proxy-introduced bias. Stroke patient-proxy pairs from the Brain Attack Surveillance in Corpus Christi Project were interviewed (n=34). Evaluation of agreement between patient-proxy pairs included calculation of intraclass correlation coefficients, linear regression models (ProxyResponse=alpha(0)+alpha(1)PatientResponse+delta, where alpha(0)=0 and alpha(1)=1 denotes no bias) and kappa statistics. Bias introduced by proxies was quantified with simulation studies. In the simulated data, we applied 4 approaches to estimate regression coefficients of stroke outcome social determinants of health associations when only proxy data were available for some patients: (1) substituting proxy responses in place of patient responses; (2) including an indicator variable for proxy use; (3) using regression calibration with external validation; and (4) internal validation. Agreement was fair for depression (intraclass correlation coefficient, 0.41) and optimism (intraclass correlation coefficient, 0.48) and moderate for spirituality (kappa, 0.48 to 0.53). Responses of proxies were a biased measure of the patients' responses for depression, with alpha(0)=4.88 (CI, 2.24 to 7.52) and alpha(1)=0.39 (CI, 0.09 to 0.69), and for optimism, with alpha(0)=3.82 (CI, -1.04 to 8.69) and alpha(1)=0.81 (CI, 0.41 to 1.22). Regression calibration with internal validation was the most accurate method to correct for proxy-induced bias. Fair/moderate patient-proxy agreement was observed for social determinants of health. Stroke researchers who plan to study social determinants of health may consider performing validation studies so corrections for proxy use can be made.

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.

The impact of dysphagia on quality of life in ageing and Parkinson's disease as measured by the swallowing quality of life (SWAL-QOL) questionnaire.

Science.gov (United States)

Leow, Li Pyn; Huckabee, Maggie-Lee; Anderson, Tim; Beckert, Lutz

2010-09-01

This prospective, cross-sectional study evaluated the impact of dysphagia on quality of life in healthy ageing and in subjects with Parkinson's disease (PD) using the Swallowing Quality of Life (SWAL-QOL) questionnaire. Sixteen healthy young adults (8 males, mean age = 25.1 years) and 16 healthy elders (8 males, mean age = 72.8 years) were recruited. Thirty-two subjects with idiopathic PD (mean age = 68.5 years) were recruited from a movement disorders clinic. The severity of PD was staged using the Hoehn and Yahr scale. Results revealed that elders experienced symptoms of dysphagia more frequently than young adults but the overall SWAL-QOL scores were not significantly different. Subjects with PD who experienced dysphagia reported greatly reduced QOL, and significant differences were found in all but one subsection of the SWAL-QOL. Disease progression detrimentally impacts QOL, with subjects in later-stage PD experiencing further reduction in the desire to eat, difficulty with food selection, and prolonged eating duration. These features, which increase with disease severity, are likely to impact negatively upon nutritional status, which is already under threat from PD-related dysphagia.

Limiting exercise options: depending on a proxy may inhibit exercise self-management.

Science.gov (United States)

Shields, Christopher A; Brawley, Lawrence R

2007-07-01

We examined the influence of proxy-assistance on exercisers' social cognitions and behavior. Fifty-six fitness class participants reported preference for proxy-assistance and reacted to exercising in different contexts. A 2 (proxy-led vs self-managed exercise context) by 2 (preferred assistance) MANOVA revealed significant assistance by context interactions for self-regulatory efficacy (SRE) and difficulty. Regarding self-managed exercise, high-assistance individuals expressed lower SRE and higher difficulty. Chi-square analysis revealed that significantly fewer high-assistance participants chose self-managed exercise. A one-way MANOVA on preferred assistance indicated that high-assistance participants were less confident, satisfied and perceived their self-managed exercise as more difficult. Results support Bandura's theorizing that use of a proxy can limit SRE of those preferring the proxy's control of their behavior.

Measuring health-related quality of life in high-grade glioma patients at the end of life using a proxy-reported retrospective questionnaire

NARCIS (Netherlands)

Sizoo, E.M.; Dirven, L.; Reijneveld, J.C.; Postma, T.J.; Heimans, J.J.; Deliens, L.; Pasman, H.R.W.; Taphoorn, M.J.B.

2014-01-01

To develop, validate, and report on the use of a retrospective proxy-reported questionnaire measuring health-related quality of life (HRQoL) in the end-of-life (EOL) phase of high-grade glioma (HGG) patients. Items relevant for the defined construct were selected using existing questionnaires,

12 CFR 569.4 - Proxy soliciting material.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Proxy soliciting material. 569.4 Section 569.4 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY PROXIES § 569.4 Proxy soliciting material. No solicitation of a proxy shall be made by means of any statement, form of proxy...

12 CFR 569.2 - Form of proxies.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Form of proxies. 569.2 Section 569.2 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY PROXIES § 569.2 Form of proxies. Every form of proxy shall conform to the following requirements: (a) The proxy shall be revocable at will by...

QOL in caregivers of Japanese patients with Prader-Willi syndrome with reference to age and genotype.

Science.gov (United States)

Ihara, Hiroshi; Ogata, Hiroyuki; Sayama, Masayuki; Kato, Aya; Gito, Masao; Murakami, Nobuyuki; Kido, Yasuhiro; Nagai, Toshiro

2014-09-01

This study aimed to measure quality of life (QOL) of the primary family caregivers for patients with Prader-Willi syndrome (PWS). Comparisons were made between caregivers' QOL in regard to their dependents' genotype and age group. The participants with PWS consisted of 22 children (aged from 6 to 12 years) and 23 adolescents (aged from 13 to 19 years), including 6 children and 7 adolescents with maternal uniparental disomy (mUPD) and 16 children and 16 adolescents with deletion (DEL). The QOL of the primary family caregiver for each patient was assessed using the Japanese version of the WHOQOL-BREF. To examine the effect that age (children vs. adolescents) and genotype (DEL vs. mUPD) have on the QOL of caregivers, a two-way ANOVA was conducted, followed by the Bonferroni procedure to test the simple main effects. The two age groups and the two genotypes of PWS were used as independent variables and the total QOL of caregivers as a dependent variable. The two-way ANOVA (F(1, 41) = 6.98, P caregivers of DEL adolescents showed little difference from that with DEL children, but the QOL of caregivers for mUPD adolescents was shown to be lower than that with mUPD children along with that of caregivers with DEL adolescents. There is hence a growing tendency for the deterioration in the QOL of caregivers to manifest itself later in the patients' adolescence, found mainly with mUPD patients. © 2014 The Authors. American Journal of Medical Genetics Part A Published by Wiley Periodicals, Inc.

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.

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.

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

Science.gov (United States)

Mazaheri, Mehrdad

2011-01-01

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. 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 WHOQOL-BREF and The Depression Anxiety Stress Scale (DASS-42). 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. 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.

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

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

Evaluation of patient and proxy responses on the activity measure for postacute care.

Science.gov (United States)

Jette, Alan M; Ni, Pengsheng; Rasch, Elizabeth K; Appelman, Jed; Sandel, M Elizabeth; Terdiman, Joseph; Chan, Leighton

2012-03-01

Our objective was to examine the agreement between adult patients with stroke and family member or clinician proxies in activity measure for postacute care (AM-PAC) summary scores for daily activity, basic mobility, and applied cognitive function. This study involved 67 patients with stroke admitted to a hospital within the Kaiser Permanente of Northern California system and were participants in a parent study on stroke outcomes. Each participant and proxy respondent completed the AM-PAC by personal or telephone interview at the point of hospital discharge or during ≥1 transitions to different postacute care settings. The results suggest that for patients with a stroke proxy, AM-PAC data are robust for family or clinician proxy assessment of basic mobility function and clinician proxy assessment of daily activity function, but less robust for family proxy assessment of daily activity function and for all proxy groups' assessments of applied cognitive function. The pattern of disagreement between patient and proxy was, on average, relatively small and random. There was little evidence of systematic bias between proxy and patient reports of their functional status. The degree of concordance between patient and proxy was similar for those with moderate to severe strokes compared with mild strokes. Patient and proxy ratings on the AM-PAC achieved adequate agreement for use in stroke research when using proxy respondents could reduce sample selection bias. The AM-PAC data can be implemented across institutional as well as community care settings while achieving precision and reducing respondent burden.

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

International Nuclear Information System (INIS)

Trotti, Andy; Johnson, Darlene J.; Gwede, Clement; Casey, Linda; Sauder, Bonnie; Cantor, Alan; Pearlman, James

1998-01-01

Purpose/Objective: 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. Methods and Materials: 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 and 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 and N was compared to the functional assessment cancer tool head and neck (FACT-H and N) questionnaire. The FACT-H and N was administered one time at week 4, on the same day as the QOL-RTI/H and N. This report includes the treatment phase of the study (during the course of radiation). Results: Mean age was 62 years (range 40-75). Internal consistency of the module was satisfactory (Chronbach's α = 0.85). Test-retest yielded a correlation coefficient of 0.90 (p < 0.001). Concurrent validity, established by comparing the module to the FACT/H and N , yielded a correlation coefficient of 0.85. Significant changes in quality of life scores during a course of radiation was noted for both general quality of life tool and the site specific module. For the head and neck module, the difference in the mean baseline

Measuring anxiety after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Anxiety item bank and linkage with GAD-7.

Science.gov (United States)

Kisala, Pamela A; Tulsky, David S; Kalpakjian, Claire Z; Heinemann, Allen W; Pohlig, Ryan T; Carle, Adam; Choi, Seung W

2015-05-01

To develop a calibrated item bank and computer adaptive test to assess anxiety symptoms in individuals with spinal cord injury (SCI), transform scores to the Patient Reported Outcomes Measurement Information System (PROMIS) metric, and create a statistical linkage with the Generalized Anxiety Disorder (GAD)-7, a widely used anxiety measure. Grounded-theory based qualitative item development methods; large-scale item calibration field testing; confirmatory factor analysis; graded response model item response theory analyses; statistical linking techniques to transform scores to a PROMIS metric; and linkage with the GAD-7. Setting Five SCI Model System centers and one Department of Veterans Affairs medical center in the United States. Participants Adults with traumatic SCI. Spinal Cord Injury-Quality of Life (SCI-QOL) Anxiety Item Bank Seven hundred sixteen individuals with traumatic SCI completed 38 items assessing anxiety, 17 of which were PROMIS items. After 13 items (including 2 PROMIS items) were removed, factor analyses confirmed unidimensionality. Item response theory analyses were used to estimate slopes and thresholds for the final 25 items (15 from PROMIS). The observed Pearson correlation between the SCI-QOL Anxiety and GAD-7 scores was 0.67. The SCI-QOL Anxiety item bank demonstrates excellent psychometric properties and is available as a computer adaptive test or short form for research and clinical applications. SCI-QOL Anxiety scores have been transformed to the PROMIS metric and we provide a method to link SCI-QOL Anxiety scores with those of the GAD-7.

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

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......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...... 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 strength during knee...

Depression, quality of life (QoL) and will to live of community-dwelling postmenopausal women in three Asian countries: Korea, China and Japan.

Science.gov (United States)

Ina, Koichiro; Hayashi, Toshio; Nomura, Hideki; Ishitsuka, Asako; Hirai, Hisako; Iguchi, Akihisa

2011-01-01

The purpose of this study was to examine the prevalence of screening-detected depression and the association of depression with QoL in community-dwelling postmenopausal women living in three Asian countries. We examined self-reported questionnaires and conducted the study. A total of 698 community-dwelling postmenopausal women living in three Asian countries participated in this study. The mean age was 59.4±6.6 years (±SD) Depressive symptoms were assessed using a 15-item geriatric depression scale (GDS-15). Using the cut-off of 5/6 for the GDS-15, the percentages of subjects with depression were 39.0% of the Korean subjects, 29.2% of the Chinese subjects, and 33.9% of the Japanese subjects. For the assessment of QoL, we used the EQ-5D of the EuroQoL Group. The following five dimensions were assessed: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. The proportions of subjects reporting problems for each dimension were examined. Subjects with depression had significantly lower levels of some dimensions of QoL than those without depression in all three countries. In all three countries, 29.2-39.0% of community-dwelling postmenopausal women had screening-detected depression, which was significantly associated with a lower level of some dimensions of QoL. These results suggest that clinicians should pay more attention to depression in community-dwelling postmenopausal women. Copyright © 2010. Published by Elsevier Ireland Ltd.

Validity and reliability of the TED-QOL: a new three-item questionnaire to assess quality of life in thyroid eye disease.

Science.gov (United States)

Fayers, Tessa; Dolman, Peter J

2011-12-01

To develop and test a user-friendly questionnaire for rapidly assessing quality of life (QOL) in thyroid eye disease (TED). A three-item questionnaire, the TED-QOL, was designed and compared to the 16-item Graves Ophthalmopathy (GO)-QOL and the nine-item GO-Quality of Life Scale (QLS). 100 patients with TED were administered all three questionnaires on two occasions. Results were compared to clinical severity scores (Vision, Inflammation, Strabismus, Appearance (VISA) classification). Main outcomes were construct and criterion validity, test-retest reliability, duration, comprehension and completion rates. TED-QOL correlated strongly with the other questionnaires for corresponding items (Pearson correlation: appearance 0.71, 0.62; functioning 0.69, 0.66; overall QOL 0.53). Test-retest analysis demonstrated good reliability for all three questionnaires (intraclass correlations: TED-QOL 0.81, 0.74, 0.87; GO-QOL 0.81, 0.82; GO-QLS 0.74, 0.86, 0.67). TED-QOL was significantly faster to complete (1.6 min vs GO-QOL 3.1 min, GO-QLS 2.7 min, p<0.0001) and had a higher completion rate (100% vs GO-QOL 78%, GO-QLS 94%). There was only moderate correlation between items on all three questionnaires and VISA scores. The TED-QOL is rapid and easy to complete and analyse and has similar validity and reliability to longer questionnaires. All questionnaires showed only moderate correlation with disease severity, emphasising the discrepancy between objective and subjective assessments and the importance of measuring both.

Prevalence of swallowing and speech problems in daily life after chemoradiation for head and neck cancer based on cut-off scores of the patient-reported outcome measures SWAL-QOL and SHI.

Science.gov (United States)

Rinkel, Rico N; Verdonck-de Leeuw, Irma M; Doornaert, Patricia; Buter, Jan; de Bree, Remco; Langendijk, Johannes A; Aaronson, Neil K; Leemans, C René

2016-07-01

The objective of this study is to assess swallowing and speech outcome after chemoradiation therapy for head and neck cancer, based on the patient-reported outcome measures Swallowing Quality of Life Questionnaire (SWAL-QOL) and Speech Handicap Index (SHI), both provided with cut-off scores. This is a cross-sectional study. Department of Otolaryngology/Head and Neck Surgery of a University Medical Center. Sixty patients, 6 months to 5 years after chemoradiation for head and neck squamous cell carcinoma. Swallowing Quality of Life Questionnaire (SWAL-QOL) and SHI, both validated in Dutch and provided with cut-off scores. Associations were tested between the outcome measures and independent variables (age, gender, tumor stage and site, and radiotherapy technique, time since treatment, comorbidity and food intake). Fifty-two patients returned the SWAL-QOL and 47 the SHI (response rate 87 and 78 %, respectively). Swallowing and speech problems were present in 79 and 55 %, respectively. Normal food intake was noticed in 45, 35 % had a soft diet and 20 % tube feeding. Patients with soft diet and tube feeding reported more swallowing problems compared to patients with normal oral intake. Tumor subsite was significantly associated with swallowing outcome (less problems in larynx/hypopharynx compared to oral/oropharynx). Radiation technique was significantly associated with psychosocial speech problems (less problems in patients treated with IMRT). Swallowing and (to a lesser extent) speech problems in daily life are frequently present after chemoradiation therapy for head and neck cancer. Future prospective studies will give more insight into the course of speech and swallowing problems after chemoradiation and into efficacy of new radiation techniques and swallowing and speech rehabilitation programs.

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)

Physical and Mental Quality of Life (QOL) in Chronic Pancreatitis(CP): A Case-Control Study from the NAPS2 cohort

Science.gov (United States)

Amann, Stephen T.; Yadav, Dhiraj; Barmada, M. Micheal; O’Connell, Michael; Kennard, Elizabeth D.; Anderson, Michelle; Baillie, John; Sherman, Stuart; Romagnuolo, Joseph; Hawes, Robert H.; AlKaade, Samer; Brand, Randall E.; Lewis, Michele D.; Gardner, Timothy B.; Gelrud, Andres; Money, Mary E.; Banks, Peter A.; Slivka, Adam; Whitcomb, David C

2012-01-01

Objectives Define the Quality of Life (QOL) in chronic pancreatitis (CP) subjects Methods We studied 443 well phenotyped CP subjects and 611 controls prospectively enrolled from 20 US centers between 2000–2006 in the North American Pancreatitis Study 2 (NAPS2). Responses to the SF-12 questionnaire were used to calculate the Mental (MCS) and Physical component summary scores (PCS) with norm based scoring (normal ≥50). QOL in CP subjects was compared with controls after controlling for demographic factors, drinking history, smoking and medical conditions. QOL in CP was also compared with known scores for several chronic conditions. Results Both PCS (38±11.5 vs. 52±9.4) and MCS (44±11.5 vs. 51±9.2) were significantly lower in CP compared with controls (p<0.001). On multivariable analyses, compared to controls, a profound decrease in physical QOL (PCS 12.02 points lower) and a clinically significant decrease in mental QOL (MCS 4.24 points lower) was seen due to CP. QOL in CP was similar to (heart, kidney, liver, lung disease) or worse than (non-skin cancers, diabetes mellitus, hypertension, rheumatoid arthritis) other chronic conditions. Conclusions The impact of CP on QOL appears substantial. The QOL in CP subjects appears to be worse or similar to the QOL of many other chronic conditions. PMID:23357924

12 CFR 569.3 - Holders of proxies.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Holders of proxies. 569.3 Section 569.3 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY PROXIES § 569.3 Holders of proxies. No proxy of a mutual savings association with a term greater than eleven months or solicited at...

Detecting instabilities in tree-ring proxy calibration

Directory of Open Access Journals (Sweden)

H. Visser

2010-06-01

Full Text Available Evidence has been found for reduced sensitivity of tree growth to temperature in a number of forests at high northern latitudes and alpine locations. Furthermore, at some of these sites, emergent subpopulations of trees show negative growth trends with rising temperature. These findings are typically referred to as the "Divergence Problem" (DP. Given the high relevance of paleoclimatic reconstructions for policy-related studies, it is important for dendrochronologists to address this issue of potential model uncertainties associated with the DP. Here we address this issue by proposing a calibration technique, termed "stochastic response function" (SRF, which allows the presence or absence of any instabilities in growth response of trees (or any other climate proxy to their calibration target to be visualized and detected. Since this framework estimates confidence limits and subsequently provides statistical significance tests, the approach is also very well suited for proxy screening prior to the generation of a climate-reconstruction network.

Two examples of tree growth/climate relationships are provided, one from the North American Arctic treeline and the other from the upper treeline in the European Alps. Instabilities were found to be present where stabilities were reported in the literature, and vice versa, stabilities were found where instabilities were reported. We advise to apply SRFs in future proxy-screening schemes, next to the use of correlations and RE/CE statistics. It will improve the strength of reconstruction hindcasts.

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…

Differences between Proxy and Patient Assessments of Cancer Care Experiences and Quality Ratings.

Science.gov (United States)

Roydhouse, Jessica K; Gutman, Roee; Keating, Nancy L; Mor, Vincent; Wilson, Ira B

2018-04-01

To assess the impact of proxy survey responses on cancer care experience reports and quality ratings. Secondary analysis of data from Cancer Care Outcomes Research and Surveillance (CanCORS). Recruitment occurred from 2003 to 2005. The study was a cross-sectional observational study. The respondents were patients with incident colorectal or lung cancer or their proxies. Analyses used linear regression models with an independent variable for proxy versus patient responses as well as study site and clinical covariates. The outcomes were experiences with medical care, nursing care, care coordination, and care quality rating. Multiple imputation was used for missing data. Among 6,471 respondents, 1,011 (16 percent) were proxies. The proportion of proxy respondents varied from 6 percent to 28 percent across study sites. Adjusted proxy scores were modestly higher for medical care experiences (+1.28 points [95 percent CI:+ 0.05 to +2.51]), but lower for nursing care (-2.81 [95 percent CI: -4.11 to -1.50]) and care coordination experiences (-2.98 [95 percent CI: -4.15 to -1.81]). There were no significant differences between adjusted patient and proxy ratings of quality. Proxy responses have small but statistically significant differences from patient responses. However, if ratings of care are used for financial incentives, such differences could be exaggerated across practices or areas if proxy use varies. © Health Research and Educational Trust.

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.

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

International Nuclear Information System (INIS)

Shiba, Tadaaki; Tanishima, Satoru; Sato, Masahiko; Yanagisawa, Terumasa; Yoshino, Masaaki; Takatsuka, Jun

1996-01-01

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.)

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.)

[QOL questionnaire for pediatric patients with bronchial asthma and their parents or caregivers. Preparation and evaluation of the short form version 2008 (Gifu)].

Science.gov (United States)

Kondo, Naomi; Hirayama, Koichiro; Matsui, Eiko; Teramoto, Takahide; Kaneko, Hideo; Fukao, Toshiyuki; Orii, Kenji; Kawamoto, Minako; Funato, Michinori; Ohnishi, Hidenori; Kawamoto, Norio; Morita, Hideyuki; Kimura, Takeshi; Nada, Masatoshi; Tokumi, Tetsuji; Hori, Tomohiro; Watanabe, Rinko

2008-08-01

The QOL questionnaire version 2001 for pediatric patients with bronchial asthma and their parents or caregivers includes 15 questions for patients under the age of 4 years and 20 questions for patients over the age of 4 years. We have already reported that the QOL questionnaire version 2001 reflects reliability (including reproducibility), factorial validity, and changes in paroxysmal attacks of asthma. In this study, we revised the questionnaire for use in routine medical practice. In this study, based on the data of a previous report, the number of questions was reduced further and it was revised to the questionnaire the short form by integrated data. The revised version 2008 (Gifu) consisted of emotional burden, asthma attack, instability of symptoms and proper acceptance of asthma as a common factor, moreover 4 or more years old added load of exercise factor which consisted of two questions in each factor. This QOL short form questionnaire version 2008 (Gifu) is a disease specific questionnaire in comparison with health control, bronchial asthma and non-asthmatic patients, such as atopic dermatitis and allergic rhinitis. Although Cronbach's alpha fell with reduction of the number of questions, we conclude that it was acceptable in the clinical practice.

[The relationship of quality of life (QOL) with physical fitness, competence and stress response in elderly in Japan].

Science.gov (United States)

Uemura, Shinichi; Machida, Kazuhiki

2003-09-01

In order to evaluate the relationship of quality of life (QOL) with physical fitness, competence and stress response in the elderly population in Japan, a cross sectional field survey of elderly subjects was conducted. This survey was taken in Naguri village, Saitama. The data collected included physical fitness, competence, stress response and QOL in addition to demographic variables. As for physical fitness indexes, grip strength (GS), single leg balance with eyes closed (SLB), bar grip ping reaction time (RT), trunk flexion (RF), ten-meter walking time (WT) and vital capacity (VC) were measured. The SF-36 was used for QOL assessment. A total of 120 elderly subjected participated to the survey. There were 42 males (73.5 +/- 5.74 years) and 78 females (74.2 +/- 6.17 years). The associations between physical health parameters in SF-36 and WT were highly significant: physical functioning (beta = -2.96, p fit indexes of the structural equation model describing the relationships among physical fitness, competence, stress response and QOL indicated excellent fit to the data with GFI = 0.95 and AGFI = 0.88. Stress response showed relatively stronger influence on QOL than physical fitness or competence. Although there were slight differences in degree of influence, physical fitness, stress response and competence were found to be clearly related to QOL in elderly subjects. To keep good QOL status, it is important to maintain good physical fitness and level of competence and to reduce stress response.

The Validity and Reliability Test of the Indonesian Version of Gastroesophageal Reflux Disease Quality of Life (GERD-QOL) Questionnaire.

Science.gov (United States)

Siahaan, Laura A; Syam, Ari F; Simadibrata, Marcellus; Setiati, Siti

2017-01-01

to obtain a valid and reliable GERD-QOL questionnaire for Indonesian application. at the initial stage, the GERD-QOL questionnaire was first translated into Indonesian language and the translated questionnaire was subsequently translated back into the original language (back-to-back translation). The results were evaluated by the researcher team and therefore, an Indonesian version of GERD-QOL questionnaire was developed. Ninety-one patients who had been clinically diagnosed with GERD based on the Montreal criteria were interviewed using the Indonesian version of GERD-QOL questionnaire and the SF 36 questionnaire. The validity was evaluated using a method of construct validity and external validity, and reliability can be tested by the method of internal consistency and test retest. the Indonesian version of GERD-QOL questionnaire had a good internal consistency reliability with a Cronbach Alpha of 0.687-0.842 and a good test retest reliability with an intra-class correlation coefficient of 0.756-0.936; pGERD-QOL questionnaire has been proven valid and reliable to evaluate the quality of life of GERD patients.

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.

Longitudinal proxy measurements in multiple sclerosis: patient-proxy agreement on the impact of MS on daily life over a period of two years

Directory of Open Access Journals (Sweden)

Thompson Alan J

2008-02-01

Full Text Available Abstract Background The use of self-report measurements in clinical settings is increasing. However, in patients with limitations that interfere with reliable self-assessment such as cognitive impairment or mood disturbances, as may be the case in multiple sclerosis (MS, data collection might be problematic. In these situations, information obtained from proxy respondents (e.g. partners may replace self-ratings. The aim of this study was to examine the value of proxy ratings at separate points in time and to assess patient-proxy agreement on possible changes in disease impact of MS. Methods Fifty-six MS patients and their partners completed the Multiple Sclerosis Impact Scale (MSIS-29 at baseline and follow-up, two years later. Patient-proxy agreement was assessed at both time points by calculating intraclass correlation coefficients (ICCs, exact and global agreement and the mean directional differences between groups. Agreement of change over time was assessed by calculating ICCs between change scores. In parallel, global ratings of both patients and proxy respondents of the extent to which the patient had improved or deteriorated over the past two years were collected to validate possible changes on the MSIS-29. Results At both time points, agreement on the physical scale was higher than agreement on the psychological scale (ICCs at baseline were 0.81 for the physical scale and 0.72 for the psychological scale; at follow-up, the ICC values were 0.86 and 0.65 respectively. At follow-up, statistically significant mean differences between patients and proxies were noted for the physical scale (-4.8 ± 12.7, p = 0.006 and the psychological scale (-8.9 ± 18.8, p = 0.001. Agreement between change scores on the MSIS-29 was fair (ICC Conclusion Proxy respondents could act as a reliable source of information in cross-sectional studies. Moreover, results suggested that agreement on change over time might be better for proxy respondents compared to

How to integrate proxy data from two informants in life event assessment in psychological autopsy.

Science.gov (United States)

Zhang, Jie; Wang, Youqing; Fang, Le

2018-04-27

Life event assessment is an important part in psychological autopsy, and how to integrate its proxy data from two informants is a major methodological issue which needs solving. Totally 416 living subjects and their two informants were interviewed by psychological autopsy, and life events were assessed with Paykel's Interview for Recent Life Events. Validities of integrated proxy data using six psychological autopsy information reconstruction methods were evaluated, with living subjects' self-reports used as gold-standard criteria. For all the life events, average value of Youden Indexes for proxy data by type C information reconstruction method (choosing positive value from two informants) was larger than other five methods'. For family life related events, proxy data by type 1st information reconstruction method were not significantly different from living subjects' self-reports (P = 0.828). For all other life events, proxy data by type C information reconstruction method were not significantly different from the gold-standard. Choosing positive value is a relatively better method for integrating dichotomous (positive vs. negative) proxy data from two informants in life event assessment in psychological autopsy, except for family life related events. In that case, using information provided by 1st informants (mainly family member) is recommended.

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.

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

African Journals Online (AJOL)

Afrikaans version of the P-QOL limits studies in Afrikaans-speaking patients with pelvic organ prolapse (POP). Objective. ... The Cronbach alpha was used to determine internal consistency and ... German,[11] ..... quality of life, and risk factors.

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)

Witnessing entanglement by proxy

International Nuclear Information System (INIS)

Bäuml, Stefan; Bruß, Dagmar; Kampermann, Hermann; Huber, Marcus; Winter, Andreas

2016-01-01

Entanglement is a ubiquitous feature of low temperature systems and believed to be highly relevant for the dynamics of condensed matter properties and quantum computation even at higher temperatures. The experimental certification of this paradigmatic quantum effect in macroscopic high temperature systems is constrained by the limited access to the quantum state of the system. In this paper we show how macroscopic observables beyond the mean energy of the system can be exploited as proxy witnesses for entanglement detection. Using linear and semi-definite relaxations we show that all previous approaches to this problem can be outperformed by our proxies, i.e. entanglement can be certified at higher temperatures without access to any local observable. For an efficient computation of proxy witnesses one can resort to a generalised grand canonical ensemble, enabling entanglement certification even in complex systems with macroscopic particle numbers. (paper)

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

What is important for Quality of Life in adolescents and adults with ASD?

DEFF Research Database (Denmark)

Knüppel, Ane; Kjærsdam Telléus, Gry; Lauritsen, Marlene Briciet

Title: What is important for Quality of Life in adolescents and adults with ASD? Results from a nation-wide Danish follow-up study Background: It is becoming increasingly common to measure Quality of life (QoL) among people with autism spectrum disorders (ASD). Most often, this is undertaken...... by using proxy reporting but letting people with ASD self-report on their QoL is possible and in some researchers’ opinion the most correct method to apply. Furthermore, it is important to explore the factors of importance for having a higher level of QoL. However, usually only a few factors are included...... within a study, which makes it difficult to conduct a profound analysis of, what is important for QoL. Additionally, the ASD populations studied are often characterized by few females within each sample and a large age-span, including diversity in age at diagnosis. Objectives: To investigate a range...

Quality of life in patients with fibromyalgia: validation and psychometric properties of the German Quality of Life Scale (QOLS-G).

Science.gov (United States)

Offenbächer, Martin; Sauer, Sebastian; Kohls, Niko; Waltz, Millard; Schoeps, Peter

2012-10-01

Our objectives were to translate the Quality of Life Scale (QOLS) into German and to evaluate its reliability and validity for the use in patients with fibromyalgia (FMS). Together with German versions of the Fibromyalgia Impact Questionnaire (FIQ), the SF-36, a tender point count (TPC) and other questionnaires, we administered the QOLS to 146 patients with FMS. Patients were asked about the severity of pain today (VAS) and the duration of symptoms. Test-retest reliability was assessed using Spearman's correlations. Internal consistency was evaluated with Cronbach's alpha. Construct validity of the QOLS was evaluated by correlating the QOLS with the FIQ, the SF-36, the Beck Depression Inventory (BDI), and the Symptom Checklist (SCL-90-R) as well as with the pain variables. An exploratory factor analysis (EFA) was also conducted. Mean age was 53.1 years. Means were for pain today 6.8 and for duration of symptoms 11.8 years. Test-retest reliability for the total QOLS was rho = .91. Internal consistency was α = .90. Low-to-moderate correlations were obtained between the QOLS and the total FIQ (rho = -.42), the SF-36 (e.g. physical functioning rho = .37; mental health rho = .56) as well as the pain variables (VAS rho = -.11 ns; TPC rho = -.20). Psychological variables were moderately to substantially correlated with the QOLS (e.g. BDI rho = -.61). An EFA suggested a three-factor solution. The QOLS-G is a reliable and valid instrument for measuring quality of life in German patients with FMS.

Edentulism and dental prostheses in the elderly: impact on quality of life measured with EuroQol--visual analog scale (EQ-VAS).

Science.gov (United States)

Cano-Gutiérrez, Carlos; Borda, Miguel G; Arciniegas, Antonio J; Borda, Claudia X

2015-01-01

The objective of this study was to measure the impact of edentulism and dental prostheses on quality of life (QOL) in older adults in Bogota, Colombia. Edentulism is a frequent condition in older adults and has great impact on their QOL. No epidemiological data are currently available on edentulism among older adults in Colombia. Data were obtained from the SABE-Bogota study, a cross-sectional study conducted in 2012, and used to analyze the EQ-VAS (Visual Analog Scale) from the EuroQol instrument to measure the perception of quality of life (QOL) in relation to edentulism. The study included 2,000 individuals over 60 years old. The Spearman-Rho correlation was used to analyze the correlation between EQ-VAS and edentulism. Chi-Square, ANOVA and t-test were used to study the differences in EQ-VAS scores between edentulous and healthy subjects. Statistical significance was set at peducation were related to edentulism. Individuals with fewer teeth and dental prostheses had lower EQ-VAS scores (pmeasuring the perception of QOL in dental health scenarios. Edentulism significantly affects QOL in older adults and the use of dental prosthesis does not improve the perception of QOL.

Quality of life in children with OCD before and after treatment.

Science.gov (United States)

Weidle, Bernhard; Ivarsson, Tord; Thomsen, Per Hove; Lydersen, Stian; Jozefiak, Thomas

2015-09-01

Quality of life (QoL) is a well-established outcome measure. In contrast to adult obsessive-compulsive disorder (OCD), little is known about the effects of treatment on QoL in children with OCD. This study aimed to assess QoL after cognitive behavioural therapy (CBT) in children and adolescents with OCD compared with the general population and to explore factors associated with potential changes in QoL after treatment. QoL was assessed in 135 children and adolescents (ages 7-17; mean 13 [SD 2.7] years; 48.1% female) before and after 14 CBT sessions, using self-report and a caregivers proxy report of the Questionnaire for Measuring Health-related Quality of Life in Children and Adolescents (KINDL-R). QoL was compared with an age- and gender-matched sample from the general population. Before treatment, QoL was markedly lower in children with OCD compared with the general population. QoL improved significantly in CBT responders (mean score change 7.4), to the same range as QoL in the general population. Non-responders reported no QoL changes after treatment, except for one patient. Comorbidity, family accommodation and psychosocial functioning were not associated with changes in QoL after treatment. To our knowledge, this is the first study of the changes in QoL after treatment of paediatric OCD. The assessment of QoL beyond symptoms and function in children with OCD has been shown to be reliable and informative. The results of this study support the application of QoL assessment as an additional measure of treatment outcome in children and adolescents with OCD.

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...

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…

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 �

Clinical Utility and Psychometric Properties of the Traumatic Brain Injury Quality of Life Scale (TBI-QOL) in US Military Service Members.

Science.gov (United States)

Lange, Rael T; Brickell, Tracey A; Bailie, Jason M; Tulsky, David S; French, Louis M

2016-01-01

To examine the clinical utility and psychometric properties of the Traumatic Brain Injury Quality of Life (TBI-QOL) scale in a US military population. One hundred fifty-two US military service members (age: M = 34.3, SD = 9.4; 89.5% men) prospectively enrolled from the Walter Reed National Military Medical Center and other nationwide community outreach initiatives. Participants included 99 service members who had sustained a mild traumatic brain injury (TBI) and 53 injured or noninjured controls without TBI (n = 29 and n = 24, respectively). Participants completed the TBI-QOL scale and 5 other behavioral measures, on average, 33.8 months postinjury (SD = 37.9). Fourteen TBI-QOL subscales; Neurobehavioral Symptom Inventory; Posttraumatic Stress Disorder Checklist-Civilian version; Alcohol Use Disorders Identification Test; Combat Exposure Scale. The internal consistency reliability of the TBI-QOL scales ranged from α = .91 to α = .98. The convergent and discriminant validity of the 14 TBI-QOL subscales was high. The mild TBI group had significantly worse scores on 10 of the 14 TBI-QOL subscales than the control group (range, P quality of life in a mild TBI military sample. Additional research is recommended to further evaluate the clinical utility of the TBI-QOL scale in both military and civilian settings.

Validation and psychometric properties of the Spanish version of the Quality of Life Scale (QOLS) in patients with fibromyalgia.

Science.gov (United States)

Latorre-Román, Pedro A; Martínez-Amat, Antonio; Martínez-López, Emilio; Moral, Angel; Santos, María A; Hita-Contreras, Fidel

2014-04-01

Fibromyalgia (FM) is a chronic disease associated with high disability levels, which in turn lead to low quality of life (QOL). The objectives of this study were to translate the Quality of Life Scale (QOLS) into Spanish and to assess its reliability and validity for its use in patients with FM. A total of 140 women are suffering from FM (52.87 ± 9.35 years old). All belonged to an association of FM patients (AFIXA, Jaén, Spain). The Spanish versions of the FM impact questionnaire (FIQ), the SF-36, and Beck's Depression Inventory were used to assess them. The construct's validity was checked by means of exploratory factorial analysis (varimax with Kaiser normalization). Test-retest reliability was assessed through intraclass correlation coefficient (ICC), and convergent validity through Spearman's correlation. Results show that Cronbach's alpha was 0.887, which revealed high internal consistency. The value of ICC for the QOLS total was 0.765 (95 % CI 0.649-0.843, p < 0.001). QOLS presented a significant Spearman's correlation (p < 0.01) with Beck's Inventory, with the physical and mental subtotals of SF-36 and with FIQ. The main component analysis and the varimax rotation revealed the convergence on three factors that account for 54.05 % of variance. Taking into account the severity of the disorder, significant differences (p < 0.05) appeared in QOLS, with moderately afflicted patients getting higher scores than the most severe cases. In conclusion, our study shows that the Spanish version of the QOLS is a reliable instrument, with a good convergent and discriminant construct validity, for measuring the QOL of Spanish FM patients.

Development and psychometric characteristics of the SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks and short forms and the SCI-QOL Bladder Complications scale.

Science.gov (United States)

Tulsky, David S; Kisala, Pamela A; Tate, Denise G; Spungen, Ann M; Kirshblum, Steven C

2015-05-01

To describe the development and psychometric properties of the Spinal Cord Injury--Quality of Life (SCI-QOL) Bladder Management Difficulties and Bowel Management Difficulties item banks and Bladder Complications scale. Using a mixed-methods design, a pool of items assessing bladder and bowel-related concerns were developed using focus groups with individuals with spinal cord injury (SCI) and SCI clinicians, cognitive interviews, and item response theory (IRT) analytic approaches, including tests of model fit and differential item functioning. Thirty-eight bladder items and 52 bowel items were tested at the University of Michigan, Kessler Foundation Research Center, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital, and the James J. Peters VA Medical Center, Bronx, NY. Seven hundred fifty-seven adults with traumatic SCI. The final item banks demonstrated unidimensionality (Bladder Management Difficulties CFI=0.965; RMSEA=0.093; Bowel Management Difficulties CFI=0.955; RMSEA=0.078) and acceptable fit to a graded response IRT model. The final calibrated Bladder Management Difficulties bank includes 15 items, and the final Bowel Management Difficulties item bank consists of 26 items. Additionally, 5 items related to urinary tract infections (UTI) did not fit with the larger Bladder Management Difficulties item bank but performed relatively well independently (CFI=0.992, RMSEA=0.050) and were thus retained as a separate scale. The SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks are psychometrically robust and are available as computer adaptive tests or short forms. The SCI-QOL Bladder Complications scale is a brief, fixed-length outcomes instrument for individuals with a UTI.

QOL models constructed for the community-dwelling elderly with ikigai (purpose in life) as a composition factor, and the effect of habitual exercise.

Science.gov (United States)

Demura, Shinichi; Kobayashi, Hidetsugu; Kitabayashi, Tamotsu

2005-09-01

The purpose of this study was to construct QOL models for the elderly that included ikigai as a composition factor and to clarify differences in two kinds of models, one constructed for the elderly with habitual exercise and the other for those without it. The subjects were 1,566 healthy community-dwelling independent people aged 60 years or more (752 males, 814 females). First, the ratio of subjects with ikigai was calculated. The ratios of subjects with different kinds of objects of ikigai were also calculated. Next, structural equation models (SEM) were constructed on the basis of social, physical, and mental QOL and ikigai. Fits of the models were evaluated. To examine whether the presence or absence of habitual exercise caused any difference in the QOL model, subjects were divided into 4 groups according to whether they were male or female and whether they had or did not have an exercise habit. Multi-population group simultaneous analysis was then performed among the four groups. More than 85% of the subjects had objects of ikigai. Ikigai is an important factor for comprehending the QOL of the elderly. It was possible to construct QOL models for the elderly with ikigai as a composition factor. The effect of physical QOL on mental QOL was negligible in females irrespective of whether they had an exercise habit. The effect of social QOL on mental QOL was profound in aged females with an exercise habit. The effect of the living situation on mental QOL was profound in aged females without an exercise habit. The effect of mental QOL on ikigai was more marked in subjects without an exercise habit than in those with an exercise habit.

Level of agreement between patient and proxy responses to the EQ-5D health questionnaire 12 months after injury.

Science.gov (United States)

Gabbe, Belinda J; Lyons, Ronan A; Sutherland, Ann M; Hart, Melissa J; Cameron, Peter A

2012-04-01

Health-related quality of life represents a patient's experiences and expectations and should be collected from the patient. In trauma, collection of information from the patient can be challenging, particularly for subgroups where cognitive impairment is prevalent, increasing reliance on proxy reporting. This study assessed the agreement between patient and proxy reporting of health-related quality of life 12 months after injury. The Victorian State Trauma Registry and Victorian Orthopaedic Trauma Outcomes Registry collect EQ-5D data at 12 months after injury. Cases where data were collected from the patient and proxy were extracted. Agreement between patient and proxy responses was compared using kappa (K) coefficients for the individual EQ-5D items, and Bland-Altman plots and Wilcoxon signed-rank tests for the EQ-5D summary score and visual analog scale (VAS). Agreement between patient and proxy respondents was substantial for the mobility (K = 0.61) and personal care items (K = 0.67) and moderate for the usual activities (K = 0.50), pain/discomfort (K = 0.42), and anxiety/depression items (K = 0.47). The mean difference between proxy and patient-reported scores for the VAS (0.74, 95% confidence interval: -2.73, 4.21) and the EQ-5D summary score (-0.02, 95% confidence interval: -0.07, 0.03) was small, but the limits of agreement were wide (-34.22 to 35.71 for VAS and -0.55 to 0.51 for summary score), suggesting no systematic bias. Although proxy and patient responses for the EQ-5D VAS may differ, the differences show random variability rather than systematic bias. Group comparisons using proxy responses are unlikely to be biased, but proxy responses should be used with caution when assessing individual patient recovery.

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

Triangulated Proxy Reporting: a technique for improving how communication partners come to know people with severe cognitive impairment.

Science.gov (United States)

Lyons, Gordon; De Bortoli, Tania; Arthur-Kelly, Michael

2017-09-01

This paper explains and demonstrates the pilot application of Triangulated Proxy Reporting (TPR); a practical technique for enhancing communication around people who have severe cognitive impairment (SCI). An introduction explains SCI and how this impacts on communication; and consequently on quality of care and quality of life. This is followed by an explanation of TPR and its origins in triangulation research techniques. An illustrative vignette explicates its utility and value in a group home for a resident with profound multiple disabilities. The Discussion and Conclusion sections propose the wider application of TPR for different cohorts of people with SCIs, their communication partners and service providers. TPR presents as a practical technique for enhancing communication interactions with people who have SCI. The paper demonstrates the potential of the technique for improving engagement amongst those with profound multiple disabilities, severe acquired brain injury and advanced dementia and their partners in and across different care settings. Implications for Rehabilitation Triangulated Proxy Reporting (TPR) shows potential to improve communications between people with severe cognitive impairments and their communication partners. TPR can lead to improved quality of care and quality of life for people with profound multiple disabilities, very advanced dementia and severe acquired brain injury, who otherwise are very difficult to support. TPR is a relatively simple and inexpensive technique that service providers can incorporate into practice to improving communications between clients with severe cognitive impairments, their carers and other support professionals.

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 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.

The role of proxy information in missing data analysis.

Science.gov (United States)

Huang, Rong; Liang, Yuanyuan; Carrière, K C

2005-10-01

This article investigates the role of proxy data in dealing with the common problem of missing data in clinical trials using repeated measures designs. In an effort to avoid the missing data situation, some proxy information can be gathered. The question is how to treat proxy information, that is, is it always better to utilize proxy information when there are missing data? A model for repeated measures data with missing values is considered and a strategy for utilizing proxy information is developed. Then, simulations are used to compare the power of a test using proxy to simply utilizing all available data. It is concluded that using proxy information can be a useful alternative when such information is available. The implications for various clinical designs are also considered and a data collection strategy for efficiently estimating parameters is suggested.

Multiattribute health utility scoring for the computerized adaptive measure CAT-5D-QOL was developed and validated.

Science.gov (United States)

Kopec, Jacek A; Sayre, Eric C; Rogers, Pamela; Davis, Aileen M; Badley, Elizabeth M; Anis, Aslam H; Abrahamowicz, Michal; Russell, Lara; Rahman, Md Mushfiqur; Esdaile, John M

2015-10-01

The CAT-5D-QOL is a previously reported item response theory (IRT)-based computerized adaptive tool to measure five domains (attributes) of health-related quality of life. The objective of this study was to develop and validate a multiattribute health utility (MAHU) scoring method for this instrument. The MAHU scoring system was developed in two stages. In phase I, we obtained standard gamble (SG) utilities for 75 hypothetical health states in which only one domain varied (15 states per domain). In phase II, we obtained SG utilities for 256 multiattribute states. We fit a multiplicative regression model to predict SG utilities from the five IRT domain scores. The prediction model was constrained using data from phase I. We validated MAHU scores by comparing them with the Health Utilities Index Mark 3 (HUI3) and directly measured utilities and by assessing between-group discrimination. MAHU scores have a theoretical range from -0.842 to 1. In the validation study, the scores were, on average, higher than HUI3 utilities and lower than directly measured SG utilities. MAHU scores correlated strongly with the HUI3 (Spearman ρ = 0.78) and discriminated well between groups expected to differ in health status. Results reported here provide initial evidence supporting the validity of the MAHU scoring system for the CAT-5D-QOL. Copyright © 2015 Elsevier Inc. All rights reserved.

Transparent Proxy for Secure E-Mail

Science.gov (United States)

Michalák, Juraj; Hudec, Ladislav

2010-05-01

The paper deals with the security of e-mail messages and e-mail server implementation by means of a transparent SMTP proxy. The security features include encryption and signing of transported messages. The goal is to design and implement a software proxy for secure e-mail including its monitoring, administration, encryption and signing keys administration. In particular, we focus on automatic public key on-the-fly encryption and signing of e-mail messages according to S/MIME standard by means of an embedded computer system whose function can be briefly described as a brouter with transparent SMTP proxy.

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 28 ˚ C. In contrast, LDI temperatures were considerably lower and varied only between 21 and 19 ˚ C. MBT'-CBT derived mean annual temperatures for the ages of 9 and 20 Ma align well with the TEX86H SSTs. Overall, the agreement of the paleotemperature proxies in terms of main tendencies, and the covariation with the global benthic oxygen isotope compilation suggests that temperatures in this region varied in concert with global climate variability. The fact that offsets between the different proxies used here remain fairly constant down to 90 Ma ago

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.

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.

Validity and QOL of neck dissection preceding radiation therapy for hypopharyngeal cancer

International Nuclear Information System (INIS)

Uemura, Hirokazu; Yoshino, Kunitoshi; Fujii, Takashi; Suzuki, Motoyuki

2009-01-01

Thirty-one cases of hypopharyngeal cancer with neck dissection preceding radiation and 16 cases of hypopharyngeal cancer with neck dissection for locoregional recurrences after radiation were reviewed in order to make comparative evaluations of difficulty in surgical operation, postoperative complications, laryngeal preservation rate, and cause specific 5-year survival rate retrospectively. And quality of life (QOL) after neck dissection was additionally evaluated through the questionnaire. Since neck dissection preceding radiation for hypopharyngeal cancer may be superior to neck dissection for radiation failure, with easy surgical approach an non-lymphoid tissue preservation, that modality can be a reasonable choice of treatment for patients with nodal lesions, which are probably difficult to treat with radiation alone. Even though further investigation on QOL questionnaire is necessary, this modality can make a contribution to the neck and shoulder condition after neck dissection. (author)

Psychological adjustment and quality of life in children and adolescents following open-heart surgery for congenital heart disease: a systematic review

Directory of Open Access Journals (Sweden)

Bauersfeld Urs

2009-01-01

Full Text Available Abstract Background Children with congenital heart defects (CHD requiring open-heart surgery are a group at high risk for health-related sequelae. Little consensus exists regarding their long-term psychological adjustment (PA and health-related quality of life (QoL. Thus, we conducted a systematic review to determine the current knowledge on long-term outcome in this population. Methods We included randomized controlled trials, case control, or cohort studies published between 1990–2008 evaluating self- and proxy-reported PA and QoL in patients aged between two and 17 years with a follow-up of at least two years after open heart surgery for CHD. Results Twenty-three studies assessing psychological parameters and 12 studies assessing QoL were included. Methodological quality of the studies varied greatly with most studies showing a moderate quality. Results were as follows: (a A considerable proportion of children experienced psychological maladjustment according to their parents; (b studies on self-reported PA indicate a good outcome; (c the studies on QoL suggest an impaired QoL for some children in particular for those with more severe cardiac disease; (d parental reports of psychological maladjustment were related to severity of CHD and developmental delay. Conclusion A significant proportion of survivors of open-heart surgery for CHD are at risk for psychological maladjustment and impaired QoL. Future research needs to focus on self-reports, QoL data and adolescents.

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.

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.

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.

Measuring the quality of life of people with dementia in nursing homes in Germany - the study protocol for the Qol-Dem Project.

Science.gov (United States)

Dichter, Martin Nikolaus; Halek, Margareta; Dortmann, Olga; Meyer, Gabriele; Bartholomeyczik, Sabine

2013-01-01

QUALIDEM is a standardized dementia-specific quality of life (Qol) measurement, which was developed and validated in the Netherlands. A German version has been available since 2008. This study protocol describes the design and methodology for the quality of life of people with dementia (Qol-Dem) project. This project aims to evaluate the reliability and validity of the German version of the QUALIDEM. Due to the lack of both a universal definition of Qol and of standards to verify the validity of Qol measurements, this study is divided into three phases. The aim of the first theoretical phase is the development of a dementia-specific Qol model as a result of a meta-synthesis of qualitative studies. The second empirical phase consists of the three following steps: (a) an investigation of the scalability and internal consistency of the measure, (b) an evaluation of the interrater and intrarater reliability, and (c) an extensive evaluation of the validity of the QUALIDEM. The resulting Qol model (phase 1) will be used for the selection of appropriate comparators for validity testing. In the third phase, the QUALIDEM will be adapted, if necessary, based on the knowledge generated in the first two phases. The findings of the Qol-Dem project should deliver an accurate assessment of the psychometric properties of the German version of the QUALIDEM. The results will contribute to the further development of the instrument. Furthermore, the results will contribute to the theoretical development of the concept of Qol among people with dementia.

Treatment, patient and tumor characteristics impact quality of life (QOL) in patients with locally advanced head and neck cancer: Report of the radiation therapy oncology group (RTOG) trial 90-03

International Nuclear Information System (INIS)

Fisher, J.; Scott, C.; Fu, K.; Trotti, A.; Spencer, S.; Garden, A.; Phillips, T.; Movsas, B.; Byhardt, R.; Ang, K.

2001-01-01

Purpose: To determine factors that effect QOL in patients with locally advanced squamous cell cancer of the head and neck randomized to standard fractionation radiotherapy (SFX), hyperfractionation (HFX), Accelerated Fractionation with Split (AFX-S) and Accelerated Fractionation with Concomitant Boost (AFX-C). Materials and Methods: RTOG 90-03 used the Head and Neck Performance Status Scale (HNPSS) and the Functional Assessment of Cancer Therapy (FACT-H and N), version 2 to assess QOL. The HNPSS has three components Normalcy of Diet, Eating in Public, and Understandability of Speech. The FACT-H and N has two components: a global QOL questionnaire (FACT-G) consisting of 4 domains; Physical Well Being (PWB), Social Well Being (SWB), Emotional Well Being (EWB), Functional Well Being (FWB), and an additional H and N specific questionnaire (AC). Between 3/92 and 8/97, 1113 pts. were randomized; 718 completed a pretreatment FACT-H and N. Pts. completed the HNPSS and FACT-H and N; pretreatment, 4 weeks post-RT, every 3 months for 1 year. Results: Prior to the start of radiotherapy (RT) 48% of pts had normal diets, 64% had normal public eating, and 77% had normal speech. Age ( 60), KPS, tumor site (oral cavity vs. other), T-stage (T3+T4 vs. T1+T2+TX), N-stage (N0 vs. other), Race (Non-White vs. White), and marital status (single vs. married), FACT-G, PWB, EWB, FWB, AC, use of oral nutrient supplements, feeding tube, and parenteral nutrition predicted for pretreatment diet, public eating, and speech. During the acute toxicity phase diet, eating, and speech were related to the intensity of RT (HFX or AFX-C), marital status (single), tumor site (oral cavity), use of oral nutrient supplements, and feeding tube. At one-year oral cavity tumors, AFX-C, oral nutrient supplements, feeding tube, and single patients had worse diet, eating, and speech. Conclusion: Pretreatment patient and tumor characteristics impact on QOL prior to the initiation of therapy. Intensification of

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.

[Quality of life of newly diagnosed, treatment naive children and adolescents with attention-deficit hyperactivity disorder].

Science.gov (United States)

Velö, Szabina; Keresztény, Ágnes; Miklósi, Mónika; Dallos, Gyöngyvér; Szentiványi, Dóra; Gádoros, Júlia; Balázs, Judit

2014-01-01

Attention-deficit hyperactivity disorder (ADHD) is one of the most prevalent childhood psychiatric disorder, it affects around 3-12% of the children. ADHD is associated with numerous social and emotional impairments. Quality of life (QoL) studies of children with ADHD established low QoL in the most cases. Our aim was to examine QoL of children with ADHD according to the following aspects: age, children's self-report and parentproxy report, and we also would like to compare them with healthy control group along several dimensions of QoL. The clinical group consist of a treatmant naive group of children with ADHD, who were just diagnosed in the Vadaskert Hospital. The healthy control group consist of children from elementary schools. The children of control group do not have ADHD and do not stand under psychological or psychiatrical treatment. In our study we applied Mini International Neuropsychiatric Interview Kid and Intervertat Lebensqualitat Kindern und Jugendlichen questionare. Compared children with ADHD to healthy control group they have significantly lower QoL at many areas (school, peer realtions, generally) due their self report. By parent's proxy report children with ADHD have lower QoL according to all of the QoL domains. Parents of children with ADHD reported significantly lower QoL for their children in the most areas (school, family, peer realtion, mental state, generally) then the affected children. Adolescent with ADHD have lower QoL in 3 domains (school, peer relations, generally) than children with ADHD, while children with ADHD have lower QoL in one dimension (being alone) compared with adolescents with ADHD. Based on our results children with ADHD compared to healthy control group have lower QoL in many dimensions and there are age-related differences in the assessment of QoL. Additionally, our study draw the attention to the differences of QoL assessment between children and parents.

Completeness and utility of interview data from proxy respondents in prenatal care research in rural China.

Science.gov (United States)

Nwaru, Bright I; Klemetti, Reija; Yuan, Shen; Kun, Huang; Wang, Yang; Hemminki, Elina

2012-05-01

In household surveys, the use of data provided by relatives can increase response rates and generalisability of research findings. This study assessed the quality of data from relatives and the impact of the data source on the association between the use of prenatal care and pregnancy outcomes. Data for 3,673 new mothers and 293 proxy respondents were available from a house-hold survey in 2008-2009 in rural China. Analyses were performed using chi-square test, ANOVA, Kruskal-Wallis test, and logistic regression models. Differences in the studied variables were small, but proxy respondents were slightly more likely to have missing data than the new mothers. Differences and missing data were more common for the use of prenatal care and outcome variables (mode of delivery, place of delivery, birth weight, use of postnatal care, and gestational age at birth) than for the background characteristics of the participants. Husbands' reports were closer to the index reports than that of the other proxies. The associations between the exposures and outcomes were mostly similar between the proxy and index respondents. Relatives can be interviewed instead of women to study prenatal care without a substantial negative impact on study results. Studies using proxy respondents should stratify the analysis by type of respondents.

Time-and-ID-Based Proxy Reencryption Scheme

OpenAIRE

Mtonga, Kambombo; Paul, Anand; Rho, Seungmin

2014-01-01

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 wi...

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

Role of Advance Care Planning in Proxy Decision Making Among Individuals With Dementia and Their Family Caregivers.

Science.gov (United States)

Kwak, Jung; De Larwelle, Jessica A; Valuch, Katharine O'Connell; Kesler, Toni

2016-01-01

Health care proxies make important end-of-life decisions for individuals with dementia. A cross-sectional survey was conducted to examine the role of advance care planning in proxy decision making for 141 individuals with cognitive impairment, Alzheimer's disease, or other types of dementia. Proxies who did not know the preferences of individuals with dementia for life support treatments reported greater understanding of their values. Proxies of individuals with dementia who did not want life support treatments anticipated receiving less support and were more uncertain in decision making. The greater knowledge proxies had about dementia trajectory, family support, and trust of physicians, the more informed, clearer, and less uncertain they were in decision making. In addition to advance care planning, multiple factors influence proxy decision making, which should be considered in developing interventions and future research to support informed decision making for individuals with dementia and their families. Copyright 2016, SLACK Incorporated.

The Proxy Challenge: Why bespoke proxy indicators can help solve the anti-corruption measurement problem

OpenAIRE

Johnsøn, Jesper; Mason, Phil

2013-01-01

Practitioners working in anti-corruption face perennial challenges in measuring changes in corruption levels and evaluating whether anti-corruption efforts are successful. These two challenges are linked but not inseparable. To make progress on the latter front, that is, evaluating whether anti-corruption efforts are having an impact, the U4 Anti-Corruption Resource Centre and the UK Department for International Development are launching an exploration into the use of proxy indicators. Proxy ...

Oral health-related quality of life in youth receiving cleft-related surgery: self-report and proxy ratings.

Science.gov (United States)

Broder, Hillary L; Wilson-Genderson, Maureen; Sischo, Lacey

2017-04-01

This paper evaluated the impact of cleft-related surgery on the oral health-related quality of life (OHRQoL) of youth with cleft over time. Data were derived from a 5-year, multi-center, prospective, longitudinal study of 1196 youth with cleft lip and/or palate and their caregivers. Eligible youth were between 7.5 and 18.5 years old, spoke English or Spanish, and were non-syndromic. During each observational period, which included baseline, and 1- and 2-year post-baseline follow-up visits, youths and their caregivers completed the Child Oral Health Impact Profile, a validated measure of OHRQoL. Multilevel mixed-effects models were used to analyze the effects of receipt of craniofacial surgery on OHRQoL over time. During the course of this study a total of 516 patients (43 %) received at least one surgery. Youth in the surgery recommendation group had lower self- (β = -2.18, p self- and proxy-rated OHRQoL at baseline. Both surgical and non-surgical youth (β = 3.73, p self-reported OHRQoL for youth postsurgery (β = 1.04, p self- and caregiver-rated OHRQoL when compared to non-surgical youth. Youth who underwent cleft-related surgery had significant incremental improvements in self-rated but not caregiver (proxy)-rated OHRQoL after surgery.

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.

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

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.…

Optimizing TCP Performance over UMTS with Split TCP Proxy

DEFF Research Database (Denmark)

Hu, Liang; Dittmann, Lars

2009-01-01

. To cope with large delay bandwidth product, we propose a novel concept of split TCP proxy which is placed at GGSN between UNITS network and Internet. The split proxy divides the bandwidth delay product into two parts, resulting in two TCP connections with smaller bandwidth delay products which can...... be pipelined and thus operating at higher speeds. Simulation results show, the split TCP proxy can significantly improve the TCP performance in terms of RLC throughput under high bit rate DCH channel scenario (e.g.256 kbps). On the other hand, it only brings small performance improvement under low bit rate DCH...... 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...

Quality of life in Alzheimer disease: a comparison of patients' and caregivers' points of view.

Science.gov (United States)

Zucchella, Chiara; Bartolo, Michelangelo; Bernini, Sara; Picascia, Marta; Sinforiani, Elena

2015-01-01

Unlike in other chronic diseases, the Quality of Life (QoL) of patients affected by Alzheimer Disease (AD) has not been well established, primarily because of the difficulties stemming from the study of patients with cognitive disorders. Because no cure is currently available for AD, the optimization of QoL represents the best possible outcome attainable in all stages of disease, making QoL assessment mandatory. This study identified variables related to patients' QoL and examined the agreement between patients' and caregivers' QoL ratings. A total of 135 dyads (patient and principal caregiver) were enrolled in the study. Patients' QoL evaluations showed a negative relationship with depressive mood and a positive relationship with Activities of Daily Living (ADL), whereas caregivers' QoL ratings showed a negative relationship with patients' depressive mood and behavioral disturbances. Caregivers tended to underestimate patients' QoL compared with the patients' own self-evaluations, with patients' dependency in performing ADL and behavioral disorders as well as caregivers' burdens and depression being the main factors associated with the discrepancy in these evaluations. These findings suggest that the use of proxies as a substitute for the self-report of QoL data should be treated with caution, always accounting for the presence of potential bias.

Statistical analysis with missing exposure data measured by proxy respondents: a misclassification problem within a missing-data problem.

Science.gov (United States)

Shardell, Michelle; Hicks, Gregory E

2014-11-10

In studies of older adults, researchers often recruit proxy respondents, such as relatives or caregivers, when study participants cannot provide self-reports (e.g., because of illness). Proxies are usually only sought to report on behalf of participants with missing self-reports; thus, either a participant self-report or proxy report, but not both, is available for each participant. Furthermore, the missing-data mechanism for participant self-reports is not identifiable and may be nonignorable. When exposures are binary and participant self-reports are conceptualized as the gold standard, substituting error-prone proxy reports for missing participant self-reports may produce biased estimates of outcome means. Researchers can handle this data structure by treating the problem as one of misclassification within the stratum of participants with missing self-reports. Most methods for addressing exposure misclassification require validation data, replicate data, or an assumption of nondifferential misclassification; other methods may result in an exposure misclassification model that is incompatible with the analysis model. We propose a model that makes none of the aforementioned requirements and still preserves model compatibility. Two user-specified tuning parameters encode the exposure misclassification model. Two proposed approaches estimate outcome means standardized for (potentially) high-dimensional covariates using multiple imputation followed by propensity score methods. The first method is parametric and uses maximum likelihood to estimate the exposure misclassification model (i.e., the imputation model) and the propensity score model (i.e., the analysis model); the second method is nonparametric and uses boosted classification and regression trees to estimate both models. We apply both methods to a study of elderly hip fracture patients. Copyright © 2014 John Wiley & Sons, Ltd.

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.

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.

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

Comparison of health-related quality of life and functional recovery measurement tools in out-of-hospital cardiac arrest survivors.

Science.gov (United States)

Andrew, Emily; Nehme, Ziad; Bernard, Stephen; Smith, Karen

2016-10-01

Although a number of validated health-related quality of life (HR-QOL) instruments exist for critical care populations, a standardised approach to assessing the HR-QOL of out-of-hospital cardiac arrest (OHCA) survivors has not been developed. We sought to compare the responses of 12-month OHCA survivors to three HR-QOL and functional recovery instruments, and assess instrument validity. The Victorian Ambulance Cardiac Arrest Registry invited 12-month OHCA survivors to participate in telephone follow-up between January 2011 and December 2015. Responders provided answers to the 12 Item Short Form Health Survey (SF-12), Three-Level EuroQol-5D (EQ-5D-3L) and the Glasgow Outcome Scale-Extended (GOSE). The SF-12 was also used to derive the SF-6D. Responses were used to assess the interpretability and construct validity of the instruments. A total of 1188 patients and proxies responded. Large ceiling effects were observed for the EQ-5D-3L (patients=46%, proxies=23%). Substantial variability was also observed in SF-6D responses for patients who reported full health according to the EQ-5D-3L. For patient responders, the strongest correlations were observed between the EQ-5D-3L index score and SF-6D (ρ=0.65, pGOSE outcome and lower or upper good recovery (pGOSE suggest that these may be useful measures of HR-QOL and functional recovery in OHCA survivors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

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.

Estimation of sedimentary proxy records together with associated uncertainty

OpenAIRE

Goswami, B.; Heitzig, J.; Rehfeld, K.; Marwan, N.; Anoop, A.; Prasad, S.; Kurths, J.

2014-01-01

Sedimentary proxy records constitute a significant portion of the recorded evidence that allows us to investigate paleoclimatic conditions and variability. However, uncertainties in the dating of proxy archives limit our ability to fix the timing of past events and interpret proxy record intercomparisons. While there are various age-modeling approaches to improve the estimation of the age–depth relations of archives, relatively little focus has been placed on the propagation...

Validation of a proxy for estrogen receptor status in breast cancer patients using dispensing data.

Science.gov (United States)

Srasuebkul, Preeyaporn; Dobbins, Timothy A; Pearson, Sallie-Anne

2014-06-01

To assess the performance of a proxy for estrogen receptor (ER) status in breast cancer patients using dispensing data. We derived our proxy using 167 patients. ER+ patients had evidence of at least one dispensing record for hormone therapy during the lookback period, irrespective of diagnosis date and ER- had no dispensing records for hormone therapy during the period. We validated the proxy against our gold standard, ER status from pathology reports or medical records. We assessed the proxy's performance using three lookback periods: 4.5 years, 2 years, 1 year. More than half of our cohort (62%) were >50 years, 54% had stage III/IV breast cancer at recruitment, (46%) were diagnosed with breast cancer in 2009 and 23% were diagnosed before 2006. Sensitivity and specificity were high for the 4.5 year lookback period (93%, 95% CI: 86-96%; and 95%: 83-99%), respectively) and remained high for the 2-year lookback period (91%: 84-95%; and 95%: 83-99%). Sensitivity decreased (83%: 75.2-89%) but specificity remained high (95%: 83-99%) using the 1-year lookback period and the period is long enough to allow sufficient time for hormone therapy to be dispensed. Our proxy accurately infers ER status in studies of breast cancer treatment based on secondary health data. The proxy is most robust with a minimum lookback period of 2 years. © 2012 Wiley Publishing Asia Pty Ltd.

The validity of proxy-based NEO-Five Factor Inventory data in suicide research: a study of 18- to 64-year-old Hong Kong Chinese who attempted suicide.

Science.gov (United States)

Chan, S S M; Wong, C S M; Chiu, H F K

2011-06-01

To examine the validity of proxy-based NEO-Five Factor Inventory ratings for 18- to 64-year-old Chinese who attempted suicide. In all, 71 suicide attempters and their proxy-informants were recruited. Data based on structured interviews with the proxy respondents were compared with data obtained from interviews of the subjects themselves. For the 71 subject-proxy pairs, the overall correlations were fair to moderate (r = 0.30-0.45; p data that correlated less strongly with subjects' self-reports. Spousal ratings and self-reports correlated significantly in all domains, except extraversion (r = 0.42-0.63; p proxy-based data on NEO-Five Factor Inventory in research of suicidal behaviour in this age-group.

Analisis Algoritma Pergantian Cache Pada Proxy Web Server Internet Dengan Simulasi

OpenAIRE

Nurwarsito, Heru

2007-01-01

Pertumbuhan jumlah client internet dari waktu ke waktu terus bertambah, maka respon akses internet menjadi semakin lambat. Untuk membantu kecepatan akses tersebut maka diperlukan cache pada Proxy Server. Penelitian ini bertujuan untuk menganalisis performansi Proxy Server pada Jaringan Internet terhadap penggunaan algoritma pergantian cache-nya.Analisis Algoritma Pergantian Cache Pada Proxy Server didesain dengan metoda pemodelan simulasi jaringan internet yang terdiri dari Web server, Proxy ...

Gradient-based model calibration with proxy-model assistance

Science.gov (United States)

Burrows, Wesley; Doherty, John

2016-02-01

Use of a proxy model in gradient-based calibration and uncertainty analysis of a complex groundwater model with large run times and problematic numerical behaviour is described. The methodology is general, and can be used with models of all types. The proxy model is based on a series of analytical functions that link all model outputs used in the calibration process to all parameters requiring estimation. In enforcing history-matching constraints during the calibration and post-calibration uncertainty analysis processes, the proxy model is run for the purposes of populating the Jacobian matrix, while the original model is run when testing parameter upgrades; the latter process is readily parallelized. Use of a proxy model in this fashion dramatically reduces the computational burden of complex model calibration and uncertainty analysis. At the same time, the effect of model numerical misbehaviour on calculation of local gradients is mitigated, this allowing access to the benefits of gradient-based analysis where lack of integrity in finite-difference derivatives calculation would otherwise have impeded such access. Construction of a proxy model, and its subsequent use in calibration of a complex model, and in analysing the uncertainties of predictions made by that model, is implemented in the PEST suite.

The Association of Mindful Parenting with Glycemic Control and Quality of Life in Adolescents with Type 1 Diabetes

DEFF Research Database (Denmark)

Serkel-Schrama, Inge J P; de Vries, Jolanda; Nieuwesteeg, Anke M

2016-01-01

The objective of this study was to examine associations between the mindful parenting style of parents of adolescents (aged 12-18) with type 1 diabetes mellitus (T1DM), and the glycaemic control and quality of life (QoL) of the adolescents. Chronic health conditions, such as T1DM, that require...... mindful parenting style (IM-P-NL) and the adolescents' glycaemic control. Parents and the adolescents with T1DM (N = 129) both reported on adolescents' generic and diabetes-specific QoL (PedsQL™). The results showed that a more mindful parenting style was associated with more optimal hemoglobin A1c (HbA1c......) values for boys. For girls, a more mindful parenting style was associated with not having been hospitalized for ketoacidosis. For both boys and girls, a more mindful parenting style was associated with better generic and diabetes-specific proxy-reported QoL. In conclusion, mindful parenting style may...

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

Science.gov (United States)

Guo, Yuzhu; Storm, Fabio; Zhao, Yifan; Billings, Stephen A; Pavic, Aleksandar; Mazzà, Claudia; Guo, Ling-Zhong

2017-09-22

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.

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.

Prevalence and determinants of misreporting among European children in proxy-reported 24 h dietary recalls.

Science.gov (United States)

Börnhorst, C; Huybrechts, I; Ahrens, W; Eiben, G; Michels, N; Pala, V; Molnár, D; Russo, P; Barba, G; Bel-Serrat, S; Moreno, L A; Papoutsou, S; Veidebaum, T; Loit, H-M; Lissner, L; Pigeot, I

2013-04-14

Dietary assessment is strongly affected by misreporting (both under- and over-reporting), which results in measurement error. Knowledge about misreporting is essential to correctly interpret potentially biased associations between diet and health outcomes. In young children, dietary data mainly rely on proxy respondents but little is known about determinants of misreporting here. The present analysis was conducted within the framework of the multi-centre IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study and is based on 6101 children aged 2-9 years with 24 h dietary recall (24-HDR) and complete covariate information. Adapted Goldberg cut-offs were applied to classify the 24-HDR as 'over-report', 'plausible report' or 'under-report'. Backward elimination in the course of multi-level logistic regression analyses was conducted to identify factors significantly related to under- and over-reporting. Next to characteristics of the children and parents, social factors and parental concerns/perceptions concerning their child's weight status were considered. Further selective misreporting was addressed, investigating food group intakes commonly perceived as more or less socially desirable. Proportions of under-, plausible and over-reports were 8.0, 88.6 and 3.4 %, respectively. The risk of under-reporting increased with age (OR 1.19, 95 % CI 1.05, 1.83), BMI z-score of the child (OR 1.23, 95 % CI 1.10, 1.37) and household size (OR 1.12, 95 % CI 1.01, 1.25), and was higher in low/medium income groups (OR 1.45, 95 % CI 1.13, 1.86). Over-reporting was negatively associated with BMI z-scores of the child (OR 0.78, 95 % CI 0.69, 0.88) and higher in girls (OR 1.70, 95 % CI 1.27, 2.28). Further social desirability and parental concerns/perceptions seemed to influence the reporting behaviour. Future studies should involve these determinants of misreporting when investigating diet-disease relationships in children

Is the content of the Chinese Quality of Life Instrument (ChQOL) really valid in the context of traditional Chinese medicine in Hong Kong?

Science.gov (United States)

Wong, Wendy; Lam, Cindy L K; Leung, K F; Zhao, L

2009-01-01

Content validity is crucial in quality of life instrument development but there is very little literature on this in Chinese culture. The Chinese Quality of Life Instrument (ChQOL) was developed in Mainland China to capture the health-related quality of life (HRQOL) concepts specific to traditional Chinese medicine (TCM). The aim of this study was to evaluate the content validity of ChQOL in a Chinese population whose spoken dialect and health-care system are different from those of Mainland China to find out whether the instrument is generalizable. 8 TCM practitioners and 10 patients rated the clarity, relevance and appropriateness of each of the 50 items of the ChQOL (HK version), and completed qualitative cognitive debriefing interviews. The content of ChQOL was rated valid by TCM practitioners with CVIs on clarity, relevance and appropriateness ranging from 80 to 100%. 49 out of 50 items were well understood by patients, but 12 items had CVI on relevance and 5 items had CVI on appropriateness lower than 70% among patients. After reviewing the patients and TCM practitioners' opinions, revisions were made for three items (2, 8 and 29) to form the ChQOL (HK version)-2008. In general, the ChQOL was found to be too long which called for shorter version. The content of ChQOL was shown to be really valid in the context of Chinese Medicine for Cantonese speaking Chinese. There was some discrepancy between the judgments of TCM practitioners and patients indicating the importance of evaluation by both experts and lay persons.

Long-term functional outcomes of PPPD in children--Nutritional status, pancreatic function, GI function and QOL.

Science.gov (United States)

Park, Hwon-Ham; Kim, Hyun-Young; Jung, Sung-Eun; Lee, Seong-Cheol; Park, Kwi-Won

2016-03-01

The purpose of this study was to analyze the long-term outcomes, such as nutritional status, pancreatic function, gastrointestinal (GI) function, and quality of life (QOL), in children who underwent pylorus-preserving pancreaticoduodenectomy (PPPD). Between 1992 and 2013, there were 15 children who underwent PPPD at Seoul National University Children's Hospital, and 10 of them participated in this study. A retrospective review of the patients' medical records and follow-up was done. Their nutritional statuses were estimated by height, body weight, weight for age Z-score, body mass index (BMI), and serum protein, albumin levels. The endocrine and exocrine functions of the pancreas were estimated by diabetes mellitus (DM), steatorrhea, and Bristol stool chart. The GI function and QOL were evaluated via questionnaires. The follow-up period ranged from 3 to 18years. There were no severe growth disturbances, 6 patients experienced mild steatorrhea and 3 showed above the category 6 in Bristol stool chart. All the patients experienced mild GI symptoms. As for the QOL, there were no significant negative answers, except for one patient with DM. Almost all the study subjects, who underwent PPPD in their childhood, did not present significant problems except for one patient with DM. Copyright © 2016 Elsevier Inc. All rights reserved.

Munchausen by Proxy Syndrome

Science.gov (United States)

... the Child Getting Help for the Parent or Caregiver Print Munchausen by proxy syndrome (MBPS) is a relatively rare form of child abuse that involves the exaggeration or fabrication of illnesses or symptoms by a primary caretaker. Also known as "medical child abuse," MBPS ...

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.

Validation and application of a death proxy in adult cancer patients.

Science.gov (United States)

Mealing, Nicole M; Dobbins, Timothy A; Pearson, Sallie-Anne

2012-07-01

PURPOSE: Fact of death is not always available on data sets used for pharmacoepidemiological research. Proxies may be an appropriate substitute in the absence of death data. The purposes of this study were to validate a proxy for death in adult cancer patients and to assess its performance when estimating survival in two cohorts of cancer patients. METHODS: We evaluated 30-, 60-, 90- and 180-day proxies overall and by cancer type using data from 12 394 Australian veterans with lung, colorectal, breast or prostate cancer. The proxy indicated death if the difference between the last dispensing record and the end of the observational period exceeded the proxy cutoff. We then compared actual survival to 90-day proxy estimates in a subset of 4090 veterans with 'full entitlements' for pharmaceutical items and in 3704 Australian women receiving trastuzumab for HER2+ metastatic breast cancer. RESULTS: The 90-day proxy was optimal with an overall sensitivity of 99.3% (95%CI: 98.4-99.7) and a specificity of 97.6% (95%CI: 91.8-99.4). These measures remained high when evaluated by cancer type and spread of disease. The application of the proxy using the most conservative date of death estimate (date of last dispensing) generally underestimated survival, with estimates up to 3 months shorter than survival based on fact of death. CONCLUSIONS: A 90-day death proxy is a robust substitute to identify death in a chronic population when fact of death is not available. The proxy is likely to be valid across a range of chronic diseases as it relies on the presence of 'regular' dispensing records for individual patients. Copyright © 2011 John Wiley & Sons, Ltd. Copyright © 2011 John Wiley & Sons, Ltd.

Quality of Life in Children with Thalassemia and their Caregivers in India.

Science.gov (United States)

Sharma, Sapna; Seth, Bageshree; Jawade, Prashant; Ingale, Madhavi; Setia, Maninder Singh

2017-03-01

To assess and compare the Quality of Life (QOL) of children with beta-thalassemia major on regular transfusion therapy with normal children, and of the caregivers of children with beta-thalassemia major to that of caregivers of normal children. A cross-sectional comparison of QOL in 75 thalassemic and 80 non-thalassemic children was conducted using the PedsQL™ 4.0 generic core scale. Also self-rated health was assessed in their caregivers using Short Form-36 Health Survey. The total QOL score according to child-self report [83.7 (10.8) vs. 97.6 (3.3); p < 0.001] and parent-proxy report [84.2 (11.9) vs. 96.7 (3.5); p < 0.001] was significantly lower in cases as compared with controls. It was found that a significantly higher proportion of caregivers of cases reported poor health compared with caregivers of controls (29.2% vs. 2.5%, p < 0.001). Even after adjusting for age, sex, socio-economic status, and total QOL score by the parent, it was found that caregivers of thalassemic children were significantly more likely to report poor health compared with those of controls (odds ratio: 15.8, 95% confidence intervals: 2.8-89.9). Health Related QOL is significantly affected in children with beta-thalassemia major on regular transfusion across all age groups, gender and socio-economic classes and also in their caregivers.

The Effects of Season of Birth on the Inflammatory Response to Psychological Stress in Hainan Island, China.

Directory of Open Access Journals (Sweden)

Aki Yazawa

Full Text Available Season of birth (SOB has been investigated as one of the environmental factors that might epigenetically determine the physiology of individuals. This study investigated the role of SOB in the association between Quality of Life (QOL, a proxy of psychological stress status, and C-reactive protein (CRP concentration (i.e., inflammatory status among 1,085 adults (aged 20-57 years old in Hainan Island, China. High sensitivity CRP concentration was measured in dried blood spot samples, while the abbreviated version of the World Health Organization's QOL questionnaire was used to gather information on six QOL domains. Analysis stratified by three historically distinct age groups revealed a significant association between CRP concentration, SOB, QOL and an interaction between SOB and QOL among the youngest and oldest groups. In the oldest group, those born in the dry season had a higher CRP concentration with worse QOL whereas in the youngest group, there was a higher CRP concentration with better QOL. Annual per capita rice production, a proxy of population nutritional status in the year of birth, was found to predict CRP concentration only among the second oldest group. These findings suggest that the early environment might affect the immune response to psychological stress in adulthood and that its effect may differ by the time period in which people were born.

The Effects of Season of Birth on the Inflammatory Response to Psychological Stress in Hainan Island, China.

Science.gov (United States)

Yazawa, Aki; Inoue, Yosuke; Stickley, Andrew; Li, Dandan; Du, Jianwei; Watanabe, Chiho

2015-01-01

Season of birth (SOB) has been investigated as one of the environmental factors that might epigenetically determine the physiology of individuals. This study investigated the role of SOB in the association between Quality of Life (QOL), a proxy of psychological stress status, and C-reactive protein (CRP) concentration (i.e., inflammatory status) among 1,085 adults (aged 20-57 years old) in Hainan Island, China. High sensitivity CRP concentration was measured in dried blood spot samples, while the abbreviated version of the World Health Organization's QOL questionnaire was used to gather information on six QOL domains. Analysis stratified by three historically distinct age groups revealed a significant association between CRP concentration, SOB, QOL and an interaction between SOB and QOL among the youngest and oldest groups. In the oldest group, those born in the dry season had a higher CRP concentration with worse QOL whereas in the youngest group, there was a higher CRP concentration with better QOL. Annual per capita rice production, a proxy of population nutritional status in the year of birth, was found to predict CRP concentration only among the second oldest group. These findings suggest that the early environment might affect the immune response to psychological stress in adulthood and that its effect may differ by the time period in which people were born.

Fighting terrorism in Africa by proxy

DEFF Research Database (Denmark)

Olsen, Gorm Rye

2014-01-01

The French intervention in Mali in early 2013 emphasizes that the decision-makers in Paris, Brussels, and Washington considered the establishment of the radical Islamist regime in Northern Mali a threat to their security interests. The widespread instability including the rise of radical Islamist...... groups in Somalia was perceived as a threat to western interests. It is the core argument of the paper if western powers decide to provide security in Africa, they will be inclined to use proxy instead of deploying own troops. Security provision by proxy in African means that African troops are doing...

Quality of life (QOL) among community dwelling older people in Taiwan measured by the CASP-19, an index to capture QOL in old age.

Science.gov (United States)

Wu, Tai-Yin; Chie, Wei-Chu; Kuo, Kuan-Liang; Wong, Wai-Kuen; Liu, Jen-Pei; Chiu, Shih-Ting; Cheng, Yeung-Hung; Netuveli, Gopal; Blane, David

2013-01-01

There was no existing scale in Mandarin Chinese to specifically measure QOL in old age. We aimed to validate a Chinese Taiwan version of the CASP-19 (control, autonomy, self-realization, pleasure), a QOL questionnaire, in Taiwan. The existing CASP-19 Cantonese version was modified into Chinese Taiwan version and pilot tested. Data were then gathered from 699 older people. Score distribution, exploratory and confirmatory factor structure, reliability and clinical validity of the CASP-19 and its shortened version, the CASP-12, were examined. The mean age of the participants was 75.5 (standard deviation (SD) 6.5), and half (49.5%) were female. The mean CASP-19 score was 38.2 (range 11-56; SD 7.1), lower than that of Western countries. Exploratory factor analysis revealed an additional factor, 'participation' (CASPP-19). There was satisfactory internal consistency (Cronbach's α 0.63-0.85) for the subscales, except for the control domain. For the 19-item scale, the first order five-domain model (CASPP-19) yielded the best fit. For the CASP-12, first and second order original CASP-12 models performed equally well. There was an inverse relationship between the CASP total scores and frailty, chronic diseases, depressive disorders, living alone and fall events in the past 12months, supporting good clinical validity for all versions of the CASP scale (CASP-19, CASPP-19, original and new CASP-12). The original CASP-12 may be presently the best choice for use in China, Taiwan or other Mandarin-speaking populations due to its conciseness and model parsimony. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Serum magnesium and not vitamin D is associated with better QoL in COPD

DEFF Research Database (Denmark)

Hashim Ali Hussein, Sarah; Nielsen, Lars Peter; Dolberg, Mette K.Bøgebjerg

2015-01-01

BACKGROUND: Deficiency of serum levels of vitamin D3 (se vitD), magnesium (se Mg) and calcium (se Ca) may be associated with increased exacerbation risk in chronic obstructive pulmonary disease (COPD). However, associations with other aspects of COPD, e.g. lung function and quality of life (QoL),...

RESPONSE OF THREE PALEO-PRIMARY PRODUCTION PROXY MEASURES TO DEVELOPMENT OF AN URBAN ESTUARY

Science.gov (United States)

In this study we present a novel comparison of three proxy indicators of paleoproductivity, pigments, biogenic silica (BSi), and cysts of autotrophic dinoflagellates measured in cored sediments from New Bedford Harbor, Massachusetts. In addition to detailed historical reports we ...

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

Quality of life (QOL) assessment in patients received carbon ion radiotherapy

International Nuclear Information System (INIS)

Kamada, Tadashi; Mizoe, Jun-Etsu; Tsuji, Hiroshi; Yanagi, Tsuyoshi; Miyamoto, Tada-aki; Kato, Hirotoshi; Oono, Tatsuya; Yamada, Shigeru; Tsujii, Hirohiko

2003-01-01

Until February 2003, a total of 1,463 patients were enrolled in clinical trials of carbon ion radiotherapy. Most of the patients had locally advanced and/or medically inoperable tumors. The clinical trials revealed that carbon ion radiotherapy provided definite local control and offered a survival advantage without unacceptable morbidity in a variety of tumors that were hard to cure by other modalities. In this study, quality of life (QOL) outcomes of patients with unresectable bone and soft tissue sarcoma after carbon ion radiotherapy are investigated. (author)

Quality of Life (QoL) Survey in Hong Kong: Understanding the Importance of Housing Environment and Needs of Residents from Different Housing Sectors.

Science.gov (United States)

Gou, Zhonghua; Xie, Xiaohuan; Lu, Yi; Khoshbakht, Maryam

2018-01-27

This study presents a Quality of Life (QoL) survey to understand the influence of the housing environment and needs of residents from different housing sectors. The research focuses on Hong Kong where living conditions have become the main affect for people's QoL. Through a household survey using a standard instrument "Word Health Organisation (WHO) Quality of Life-BREF", the article found that among the four WHO QoL domains (Physical Health, Psychological Health, Social Relations And Environment), Environment, particularly its constitute aspect housing environment was the most influential factor for overall quality of life for the public rental housing sector where low-income people live. This research also found that different groups of people have differing needs of their housing environments: the low-income group needs better location and privacy while the medium and high-income groups need better architectural quality. Based on differentiating their needs and wants, this research argues for prioritizing the low-income group's needs for effectively improving their QoL.

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...... domain). Associations were assessed using linear regression. RESULTS: Between childhood and adolescence, average QoL reduced in six domains (1.3-3.8 points, pChildhood...... QoL was a strong predictor of all domains of adolescent QoL. Severe impairments of motor function, IQ or communication predicted higher adolescent QoL on some domains; except that severe motor impairment predicted lower adolescent QoL on the Autonomy domain. More psychological problems and higher...

Quality of life in children with epilepsy: How does it compare with the quality of life in typical children and children with cerebral palsy?

Science.gov (United States)

Mezgebe, Meron; Akhtar-Danesh, Gileh-Gol; Streiner, David L; Fayed, Nora; Rosenbaum, Peter L; Ronen, Gabriel M

2015-11-01

Our objective was to compare the quality of life (QoL) of children with epilepsy to that of typical children and children with cerebral palsy (CP). We measured self- and proxy-reported QoL of children with epilepsy and contrasted that with data for typical children (European KIDSCREEN project) and children with CP (SPARCLE study). Children ages 8-12 years with epilepsy were recruited from six Canadian sites. Same-aged children with CP and children in the general population aged 8-11 years came from several European countries. All participants completed the KIDSCREEN-52 questionnaire. Our results showed no clinically important differences (>0.5 SD) between self-reported QoL in 345 children with epilepsy compared with 489 children with CP or 5950 children in the general population. However, parents reported clinically important differences between the epilepsy and the other groups in five KIDSCREEN-52 domains. Compared with the CP group, parents of children with epilepsy reported better QoL in physical well-being (Cohen d=0.81), social support (d=0.80), and autonomy (d=0.72). Parents reported poorer QoL in the domains of mood and emotions compared with both contrast groups (d=-0.72 and d=-0.53), and in the domain of bullying compared with the CP group (d=-0.51). Families should find comfort in the results, which indicate that children with epilepsy do not perceive any important differences in QoL compared with their typical peers. The comparisons of parental reports detect their group-specific observations and worries that need to be addressed by the health-care providers and may require specifically designed assessment batteries followed by appropriate interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

The design and implementation about the project of optimizing proxy servers

International Nuclear Information System (INIS)

Wu Ling; Liu Baoxu

2006-01-01

Proxy server is an important facility in the network of an organization, which play an important role in security and access control and accelerating access of Internet. This article introduces the action of proxy servers, and expounds the resolutions to optimize proxy servers at IHEP: integration, dynamic domain name resolves and data synchronization. (authors)

Pattern-mixture models for analyzing normal outcome data with proxy respondents.

Science.gov (United States)

Shardell, Michelle; Hicks, Gregory E; Miller, Ram R; Langenberg, Patricia; Magaziner, Jay

2010-06-30

Studies of older adults often involve interview questions regarding subjective constructs such as perceived disability. In some studies, when subjects are unable (e.g. due to cognitive impairment) or unwilling to respond to these questions, proxies (e.g. relatives or other care givers) are recruited to provide responses in place of the subject. Proxies are usually not approached to respond on behalf of subjects who respond for themselves; thus, for each subject, data from only one of the subject or proxy are available. Typically, proxy responses are simply substituted for missing subject responses, and standard complete-data analyses are performed. However, this approach may introduce measurement error and produce biased parameter estimates. In this paper, we propose using pattern-mixture models that relate non-identifiable parameters to identifiable parameters to analyze data with proxy respondents. We posit three interpretable pattern-mixture restrictions to be used with proxy data, and we propose estimation procedures using maximum likelihood and multiple imputation. The methods are applied to a cohort of elderly hip-fracture patients. (c) 2010 John Wiley & Sons, Ltd.

Some Proxy Signature and Designated verifier Signature Schemes over Braid Groups

OpenAIRE

Lal, Sunder; Verma, Vandani

2009-01-01

Braids groups provide an alternative to number theoretic public cryptography and can be implemented quite efficiently. The paper proposes five signature schemes: Proxy Signature, Designated Verifier, Bi-Designated Verifier, Designated Verifier Proxy Signature And Bi-Designated Verifier Proxy Signature scheme based on braid groups. We also discuss the security aspects of each of the proposed schemes.

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

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...... 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......, rather, have oriented it in certain ways. It is shown how the participating researchers – both senior and junior - have distinctive, incorporated dispositions with which they pre-consciously participate in an implicit and subtle relation that can make it very easy to overlook distortions during...

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.

The Difference Between Using Proxy Server and VPN

Directory of Open Access Journals (Sweden)

David Dwiputra Kurniadi

2015-11-01

For example, looking for software, game through internet. But sometimes, there are some websites that cannot be opened as they have Internet Positive notificatio. To solve that problem, hacker found the solution by creating Proxy Server or VPN. In this time internet is very modern and very easy to access and there are a lot of Proxy Server and VPN that can be easly used.

The Intra-Industry Effects of Proxy Contests

OpenAIRE

Fang Chen; Jian Huang; Han Yu

2018-01-01

This paper is the first study on the intra-industry effects of proxy contests. Using a sample of proxy contests from January 1988 through December 2008, we identify a striking cross-sectional difference in market reaction to the target companies. As much as 61% of the target firms have a significant positive cumulative abnormal return (CARs) in the period (‒10, +10) around the announcement day, while 39% of the target firms have the negative CARs in the same event window. Moreover, we find th...

A randomized control intervention trial to improve social skills and quality of life in pediatric brain tumor survivors.

Science.gov (United States)

Barrera, Maru; Atenafu, Eshetu G; Sung, Lillian; Bartels, Ute; Schulte, Fiona; Chung, Joanna; Cataudella, Danielle; Hancock, Kelly; Janzen, Laura; Saleh, Amani; Strother, Douglas; Downie, Andrea; Zelcer, Shayna; Hukin, Juliette; McConnell, Dina

2018-01-01

To determine if a group social skills intervention program improves social competence and quality of life (QOL) in pediatric brain tumor survivors (PBTS). We conducted a randomized control trial in which PBTS (8-16 years old, off therapy for over 3 months) were allocated to receive social skills training (eg, cooperation, assertion, using social cognitive problem solving strategies, role playing, games, and arts and crafts) in 8 weekly 2-hour sessions, or an attention placebo control (games and arts and crafts only). Outcomes were self-reported, proxy-reported (caregiver), and teacher-reported using the Social Skills Rating System (SSRS), to measure social competence, and the Pediatric Quality of Life (PedsQL4.0, generic) to measure QOL at baseline, after intervention, and at 6 months follow-up. At baseline, SSRS were stratified into low and high scores and included as a covariate in the analysis. Compared to controls (n = 48), PBTS in the intervention group (n = 43) reported significantly better total and empathy SSRS scores, with improvements persisting at follow-up. The PBTS in the intervention group who had low scores at baseline reported the greatest improvements. Proxy and teacher reports showed no intervention effect. Participating in group social skills intervention can improve self-reported social competence that persisted to follow up. The PBTS should be given the opportunity to participate in social skills groups to improve social competence. Copyright © 2017 John Wiley & Sons, Ltd.

Architecture of a bi-directional Bluetooth-UPnP proxy

NARCIS (Netherlands)

Delphinanto, A.; Lukkien, J.J.; Koonen, A.M.J.; Hartog, F.T.H. den; Madureira, A.J.P.S.; Niemegeers, I.G.M.M.; Selgert, F.

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 UPnP devices and services to be discovered

Quality of life in patients with cognitive impairment: validation of the Quality of Life-Alzheimer's Disease scale in Portugal.

Science.gov (United States)

Bárrios, Helena; Verdelho, Ana; Narciso, Sofia; Gonçalves-Pereira, Manuel; Logsdon, Rebecca; de Mendonça, Alexandre

2013-07-01

Quality of Life-Alzheimer's Disease (QOL-AD) is a widely used scale for the study of quality of life in patients with dementia. The aim of this study is the transcultural adaptation and validation of the QOL-AD scale in Portugal. Translation and transcultural adaptation was performed according to state-of-the-art recommendations. For the validation study, 104 patient/caregiver pairs were enrolled. Patients had mild cognitive impairment or mild-to-moderate dementia (due to Alzheimer's disease or vascular dementia). Participants were recruited in a dementia outpatient clinic setting and a long-term care dementia ward. An additional comparison group of 22 patients without cognitive impairment, and their proxies, was recruited in a family practice outpatient clinic. Sociodemographic information on patients and caregivers was obtained. Acceptability, reliability, and construct validity were analyzed. Internal consistency of the Portuguese version of QOL-AD was good for both patient and caregiver report (Cronbach's α = 0.867 and 0.858, respectively). Construct validity was confirmed by the correlation of patient reported QOL-AD with patient geriatric depression scale scores (ρ = -0.702, p cognitive impairment than in the comparison group without cognitive impairment (p < 0.01). A Portuguese version of QOL-AD with consistent psychometric properties was obtained and is proposed as a useful tool for research and clinical purposes.

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.

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...

Host, family and community proxies for infections potentially associated with leukaemia

International Nuclear Information System (INIS)

Law, G. R.

2008-01-01

Three hypotheses have proposed the involvement of infections in the aetiology of childhood leukaemia, suggesting either a specific leukemogenic infection or a series of common infections that lead to a dys-regulation of the immune system. Much of the evidence for the link with infections has been based on epidemiological observations, often using proxy measures of infection. Proxy measures include population mixing, parental occupation, age distribution of incidence, spatial and space-time clustering of cases, birth order and day care during infancy. This paper discusses the proxies used and examines to what extent a commonly used proxy measure, birth order, is a fair representation of either specific infections or general infectious load. It is clear that although leukaemia, and other diseases, may be linked with infections, one needs to (1) measure specific and general infections with more accuracy and (2) understand how proxy measures relate to real infections in the population. (authors)

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

Forecasting Lightning Threat Using WRF Proxy Fields

Science.gov (United States)

McCaul, E. W., Jr.

2010-01-01

Objectives: Given that high-resolution WRF forecasts can capture the character of convective outbreaks, we seek to: 1. Create WRF forecasts of LTG threat (1-24 h), based on 2 proxy fields from explicitly simulated convection: - graupel flux near -15 C (captures LTG time variability) - vertically integrated ice (captures LTG threat area). 2. Calibrate each threat to yield accurate quantitative peak flash rate densities. 3. Also evaluate threats for areal coverage, time variability. 4. Blend threats to optimize results. 5. Examine sensitivity to model mesh, microphysics. Methods: 1. Use high-resolution 2-km WRF simulations to prognose convection for a diverse series of selected case studies. 2. Evaluate graupel fluxes; vertically integrated ice (VII). 3. Calibrate WRF LTG proxies using peak total LTG flash rate densities from NALMA; relationships look linear, with regression line passing through origin. 4. Truncate low threat values to make threat areal coverage match NALMA flash extent density obs. 5. Blend proxies to achieve optimal performance 6. Study CAPS 4-km ensembles to evaluate sensitivities.

Association between quality of life and treatment response in children with attention Deficit Hyperactivity Disorder and their parents.

Science.gov (United States)

van der Kolk, Annemarie; Bouwmans, Clazien A M; Schawo, Saskia J; Buitelaar, Jan K; van Agthoven, Michel; Hakkaart-van Roijen, Leona

2014-09-01

It has been shown that Attention Deficit Hyperactivity Disorder (ADHD) lowers the Quality of Life (QoL) of patients and their families. Medication as part of the treatment has a favourable effect on symptoms as well as functioning. Evidence on the impact of pharmacological treatment on symptoms of ADHD and the QoL of the patient and their family is still limited. There is a need for further research on QoL in ADHD as well as the relationship between ADHD and the impact on families rather than solely on patients. Measure QoL of children with ADHD and their parents and explore the association of QoL with treatment response. A cross-sectional survey was performed using an online questionnaire to collect QoL data of children with ADHD (based on proxy reporting of parents) and their parents in a sample of members of an ADHD parent association. QoL was measured by EQ-5D and KIDSCREEN-10. Treatment response was based on descriptions by experts, based on compliance and functioning. Analyses were based on 618 questionnaires (treatment responder n=428, treatment non-responder n=190). Mean age of the children was 11.8 years (82.4% male). QoL according to EQ-5D utility was 0.83 and 0.74 for responders and non-responders, respectively (pchildren and EQ-5D utility of the parents (R2=0.207, pchildren's QoL was significantly influenced by age category, having a sibling with ADHD, and presence of comorbidity. Strengths of this study are its sample size and the inclusion of QoL of parents, which has not been reported simultaneously before. The facts that data were derived from members of the ADHD parent association, the data for children were based on parents' report, and lack of possibility for confirmation of the clinical diagnosis are the main study limitations. QoL of children with ADHD was shown to be significantly positively associated with response to treatment and negatively affected by comorbidity. In determining the treatment effects in ADHD, QoL and family overall well

Analysis of Quality of Proxy Questions in Health Surveys by Behavior Coding

NARCIS (Netherlands)

Benitez, I.; Padilla, J.L.; Ongena, Yfke

2012-01-01

The aim of this study is to show how to analyze the quality of questions for proxy informants by means of behavior coding. Proxy questions can undermine survey data quality because of the fact that proxies respond to questions on behalf of other people. Behavior coding can improve questions by

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.

Robotic Vehicle Proxy Simulation, Phase I

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...

Summary scores captured changes in subjects' QoL as measured by the multiple scales of the EORTC QLQ-C30.

Science.gov (United States)

Phillips, Rachel; Gandhi, Mihir; Cheung, Yin Bun; Findlay, Michael P; Win, Khin Maung; Hai, Hoang Hoa; Yang, Jin Mo; Lobo, Rolley Rey; Soo, Khee Chee; Chow, Pierce K H

2015-08-01

To examine the performance of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) global health status/quality of life (QoL) scale and two summary scores to detect changes in the QoL profile over time, according to changes in the individual scales. Data came from 167 clinical trial patients with unresectable (advanced) hepatocellular carcinoma. The global health status/QoL scale of the questionnaire contained two items: overall health and overall QoL. Nordin and Hinz proposed summary scores for the questionnaire. A mixed-effect model was fitted to estimate trends in scores over time. Predominantly the individual scale scores declined over time; however, the global health status/QoL score was stable [rate of change = -0.3 per month; 95% confidence interval (CI): -1.2, 0.6]. Nordin's summary score, which gave equal weight to the 15 questionnaire scales, and Hinz's summary score, which gave equal weight to the 30 questionnaire items, showed a statistically significant decline over time, 3.4 (95% CI: -4.5, -2.4) and 4.2 (95% CI: -5.3, -3.0) points per month, respectively. In contrast to the global health status/QoL scale, the summary scores proposed by Nordin and Hinz detected changes in subjects' QoL profile described by the EORTC QLQ-C30 individual scales. Copyright © 2015 Elsevier Inc. All rights reserved.

System Identification Based Proxy Model of a Reservoir under Water Injection

Directory of Open Access Journals (Sweden)

Berihun M. Negash

2017-01-01

Full Text Available Simulation of numerical reservoir models with thousands and millions of grid blocks may consume a significant amount of time and effort, even when high performance processors are used. In cases where the simulation runs are required for sensitivity analysis, dynamic control, and optimization, the act needs to be repeated several times by continuously changing parameters. This makes it even more time-consuming. Currently, proxy models that are based on response surface are being used to lessen the time required for running simulations during sensitivity analysis and optimization. Proxy models are lighter mathematical models that run faster and perform in place of heavier models that require large computations. Nevertheless, to acquire data for modeling and validation and develop the proxy model itself, hundreds of simulation runs are required. In this paper, a system identification based proxy model that requires only a single simulation run and a properly designed excitation signal was proposed and evaluated using a benchmark case study. The results show that, with proper design of excitation signal and proper selection of model structure, system identification based proxy models are found to be practical and efficient alternatives for mimicking the performance of numerical reservoir models. The resulting proxy models have potential applications for dynamic well control and optimization.

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...

Testing the timing of radiocarbon-dated events between proxy archives

NARCIS (Netherlands)

Christen, J. A.; Mauquoy, D.; van der Plicht, J.; Bennett, K. D.; Blaauw, Maarten

For interpreting past changes on a regional or global scale, the timings of proxy-inferred events are usually aligned with data from other locations. However, too often chronological uncertainties are ignored in proxy diagrams and multisite comparisons, making it possible for researchers to fall

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.

An Efficient Identity-Based Proxy Blind Signature for Semioffline Services

Directory of Open Access Journals (Sweden)

Hongfei Zhu

2018-01-01

Full Text Available Fog computing extends the cloud computing to the network edge and allows deploying a new type of semioffline services, which can provide real-time transactions between two entities, while the central cloud server is offline and network edge devices are online. For an e-payment system and e-voting with such feature, proxy blind signature is a cornerstone to protect users’ privacy. However, the signature based on number theorem, such as hard mathematical problems on factoring problem, discrete logarithm problem, and bilinear pairings, cannot defeat quantum computers attack. Meanwhile, these schemes need to depend on complex public key infrastructure. Thus, we construct an identity-based proxy blind signature scheme based on number theorem research unit lattice, which can defeat quantum computers attack and does not need to depend on public key infrastructure. The security of the proposed scheme is dependent on Ring-Small Integer Solution problem over number theorem research unit lattice. The proposed scheme meets the properties of blind signature and proxy signature. Then we compare the proposed scheme with other existing proxy blind signature schemes; the result shows that the proposed scheme outperforms ZM scheme except in proxy signer’s signature size and can be more secure than TA scheme and MMHP scheme.

47 CFR 51.513 - Proxies for forward-looking economic cost.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Proxies for forward-looking economic cost. 51... 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...

17 CFR 274.129 - Form N-PX, annual report of proxy voting record of registered management investment company.

Science.gov (United States)

2010-04-01

... proxy voting record of registered management investment company. 274.129 Section 274.129 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION (CONTINUED) FORMS PRESCRIBED UNDER THE INVESTMENT... registered management investment company. This form shall be used by registered management investment...

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.

Satellite Altimeters and Gravimeters as Proxy of the Indonesian Throughflow

Science.gov (United States)

Susanto, R. D.; Song, Y. T.

2014-12-01

The Indonesian Throughflow (ITF), the only pathway for interocean exchange between the Pacific to the Indian Ocean, plays an important role in global ocean circulation and climate. Yet, continuous ITF measurement is difficult and expensive. We demonstrate a plausible approach to derive the ITF transport proxy using satellite altimetry sea surface height (SSH), gravimetry ocean bottom pressure (OBP) data, in situ measurements from the Makassar Strait from 1996-1998 and 2004-2009, and a theoretical formulation. We first identified the optimal locations in the Pacific and Indian Ocean based on the optimal correlation between the ITF transport through the Makassar Strait and the pressure gradients, represented by the SSH and OBP differences between the Pacific and Indian Oceans at a 1° x 1° horizontal resolution. These geographical locations (centred at off-equatorial in the western Pacific Ocean and centred at along the equator in the eastern Indian Ocean) that control the strength and variability of the ITF transport in the Makassar Strait differ from early studies. The proxy time series follow the observation time series quite well, resolving the intraseasonal, monsoonal, and interannual signals with the 1993-2011 annual mean proxy transport of 11.6 ± 3.2 Sv. Our formulation provides a continuous approach to derive the ITF proxy as long as the satellite data are available. Such a continuous record would be difficult to achieve by in situ measurements alone due to logistical and financial challenges. Ideally, the proxy can be used to complement or fill in the gaps of the observations for a continuous ITF proxy for better understanding the ocean climate and validating ocean circulation models.

Effects of Aqua Exercises Towards Improving The Quality of Life (QoL) of Obese Women in Malaysia

Science.gov (United States)

Karim, Noor Liyana Binti; Jalil, Asma Diyana binti Abd; Hasri, Noor Haninah Binti; Rahman, Hezlin Aryani Binti Abd; Shari, Maisarah Binti; Idris, Nur Izzati Binti

2018-05-01

Aqua exercise is a form of water exercise, done in the water which is beneficial for weight loss as well as improving the quality of life. It is suitable for all age group and fitness levels whereby due to the water buoyancy makes it easier to perform exercises especially for obese and knee-injured people. However, there was not much study done to measure the effectiveness of the aqua exercises in improving the quality life. Thus, this study aims to investigate and compare the effectiveness of aqua exercises towards obese women within eight domains of the Quality of Life (QoL). This study uses the 36-Items Short Form Health Survey (SF-36) questionnaire and a purposive sample of 61 participants to measure the effectiveness of the aqua exercise before and after 36 days of aqua workout. As the nature of the data collected was not normally distributed, hence the Wilcoxon signed rank test was used as the statistical method of analysis. The findings of this study showed that there was a significant difference between the overall QoL pre and post since the p-value physical functioning, general health, social functioning, mental health, and health transition were the domains showing significant difference between the pre and post-test (p-value < 0.05), and where majority of the participants showed a significant improvement after the aqua workouts. Thus, it can be concluded that aqua exercises is effective in improving the general QoL of obese women.

Proxy-Produced Ethnographic Work: What Are the Problems, Issues, and Dilemmas Arising from Proxy-Ethnography?

Science.gov (United States)

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

2018-01-01

This article addresses the implications of researcher-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. Although there are clear advantages, the specific relations and positions arising…

Foraminifera Models to Interrogate Ostensible Proxy-Model Discrepancies During Late Pliocene

Science.gov (United States)

Jacobs, P.; Dowsett, H. J.; de Mutsert, K.

2017-12-01

Planktic foraminifera faunal assemblages have been used in the reconstruction of past oceanic states (e.g. the Last Glacial Maximum, the mid-Piacenzian Warm Period). However these reconstruction efforts have typically relied on inverse modeling using transfer functions or the modern analog technique, which by design seek to translate foraminifera into one or two target oceanic variables, primarily sea surface temperature (SST). These reconstructed SST data have then been used to test the performance of climate models, and discrepancies have been attributed to shortcomings in climate model processes and/or boundary conditions. More recently forward proxy models or proxy system models have been used to leverage the multivariate nature of proxy relationships to their environment, and to "bring models into proxy space". Here we construct ecological models of key planktic foraminifera taxa, calibrated and validated with World Ocean Atlas (WO13) oceanographic data. Multiple modeling methods (e.g. multilayer perceptron neural networks, Mahalanobis distance, logistic regression, and maximum entropy) are investigated to ensure robust results. The resulting models are then driven by a Late Pliocene climate model simulation with biogeochemical as well as temperature variables. Similarities and differences with previous model-proxy comparisons (e.g. PlioMIP) are discussed.

Neuro-QOL and the NIH Toolbox: implications for epilepsy

Science.gov (United States)

Nowinski, Cindy J; Victorson, David; Cavazos, Jose E; Gershon, Richard; Cella, David

2011-01-01

The impact of neurological disorders on the lives of patients is often far more complex than what is measured in routine examination. Measurement of this impact can be challenging owing to a lack of brief, psychometrically sound and generally accepted instruments. Two NIH-funded initiatives are developing assessment tools, in English and Spanish, which address these issues, and should prove useful to the study and treatment of epilepsy and other neurological conditions. The first, Neuro-QOL, has created a set of health-related quality of life measures that are applicable for people with common neurological disorders. The second, the NIH Toolbox for the Assessment of Neurological and Behavioral Function, is assembling measures of cognitive, emotional, motor and sensory health and function that can be used across all ages, from 3 to 85 years. This article describes both the projects and their potential value to epilepsy treatment and research. PMID:21552344

Quality of life and BMI changes in youth participating in an integrated pediatric obesity treatment program.

Science.gov (United States)

Pratt, Keeley J; Lazorick, Suzanne; Lamson, Angela L; Ivanescu, Andrada; Collier, David N

2013-07-10

Changes in Quality of Life (QOL) measures over time with treatment of obesity have not previously been described for youth. We describe the changes from baseline through two follow up visits in youth QOL (assessed by the Pediatric Quality Life Inventory, PedsQL4.0), teen depression (assessed by the Patient Health Questionnaire, PHQ9A), Body Mass Index (BMI) and BMI z-score. We also report caregiver proxy ratings of youth QOL. A sample of 267 pairs of youth and caregiver participants were recruited at their first visit to an outpatient weight-treatment clinic that provides care integrated between a physician, dietician, and mental health provider; of the 267, 113 attended a visit two (V2) follow-up appointment, and 48 attended visit three (V3). We investigated multiple factors longitudinally experienced by youth who are overweight and their caregivers across up to three different integrated care visits. We determined relationships at baseline in QOL, PHQ9A, and BMI z-score, as well as changes in variables over time using linear mixed models with time as a covariate. Overall across three visits the results indicate that youth had slight declines in relative BMI, significant increases in their QOL and improvements in depression. We encourage clinicians and researchers to track youth longitudinally throughout treatment to investigate not only youth's BMI changes, but also psychosocial changes including QOL.

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.

Does Parent Stress Predict the Quality of Life of Children With a Diagnosis of ADHD? A Comparison of Parent and Child Perspectives.

Science.gov (United States)

Galloway, Helen; Newman, Emily; Miller, Nicola; Yuill, Clare

2016-05-13

There are indicators that parental psychological factors may affect how parents evaluate their child's quality of life (QoL) when the child has a health condition. This study examined the impact of parents' perceived stress on parent and child ratings of the QoL of children with ADHD. A cross-sectional sample of 45 matched parent-child dyads completed parallel versions of the KIDSCREEN-27. Children were 8 to 14 years with clinician diagnosed ADHD. Parents who rated their child's QoL lower than their child had higher perceived stress scores. Parent stress was a unique predictor of child QoL from parent proxy-rated but not child-rated QoL scores. Parents' perceived stress may play an important role in their assessments of their child's QoL, suggesting both parent and child perspectives of QoL should be utilized wherever possible. Interventions that target parent stress may contribute to improvements in the child's QoL. © The Author(s) 2016.

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.

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

African Journals Online (AJOL)

in international markets. The proxy is a coincidental and pro-cyclic indicator, with a correlation of 0.86. Key similarities exist between the economy and the profitability of hardware stores, although the proxy is not as accurate as the volume of sales in hardware stores. The correlation is measured at 0.85. The profitability of the ...

Evaluating and Optimizing Online Advertising: Forget the Click, but There Are Good Proxies.

Science.gov (United States)

Dalessandro, Brian; Hook, Rod; Perlich, Claudia; Provost, Foster

2015-06-01

Online systems promise to improve advertisement targeting via the massive and detailed data available. However, there often is too few data on exactly the outcome of interest, such as purchases, for accurate campaign evaluation and optimization (due to low conversion rates, cold start periods, lack of instrumentation of offline purchases, and long purchase cycles). This paper presents a detailed treatment of proxy modeling, which is based on the identification of a suitable alternative (proxy) target variable when data on the true objective is in short supply (or even completely nonexistent). The paper has a two-fold contribution. First, the potential of proxy modeling is demonstrated clearly, based on a massive-scale experiment across 58 real online advertising campaigns. Second, we assess the value of different specific proxies for evaluating and optimizing online display advertising, showing striking results. The results include bad news and good news. The most commonly cited and used proxy is a click on an ad. The bad news is that across a large number of campaigns, clicks are not good proxies for evaluation or for optimization: clickers do not resemble buyers. The good news is that an alternative sort of proxy performs remarkably well: observed visits to the brand's website. Specifically, predictive models built based on brand site visits-which are much more common than purchases-do a remarkably good job of predicting which browsers will make a purchase. The practical bottom line: evaluating and optimizing campaigns using clicks seems wrongheaded; however, there is an easy and attractive alternative-use a well-chosen site-visit proxy instead.

The relationship between emotion regulation capacity, heart rate variability, and quality of life in individuals with alcohol-related brain damage

Directory of Open Access Journals (Sweden)

Steinmetz JP

2016-08-01

Full Text Available Jean-Paul Steinmetz,1,2 Claus Vögele,3,4 Christiane Theisen-Flies,5 Carine Federspiel,1,2 Stefan Sütterlin6,7 1Department of Research and Development, ZithaSenior, 2Centre for Memory and Mobility, ZithaSenior, 3Institute for Health and Behaviour, Integrative Research Unit on Social and Individual Development (INSIDE, University of Luxembourg, Luxembourg; 4Research Group Health Psychology, University of Leuven, Leuven, Belgium; 5Home St Joseph, ZithaSenior, Luxembourg; 6Department of Psychology, Lillehammer University College, Lillehammer, 7Division of Surgery and Clinical Neuroscience, Department of Psychosomatic Medicine, Oslo University Hospital – Rikshospitalet, Oslo, Norway Abstract: The reliable measurement of quality of life (QoL presents a challenge in individuals with alcohol-related brain damage. This study investigated vagally mediated heart rate variability (vmHRV as a physiological predictor of QoL. Self- and proxy ratings of QoL and dysexecutive symptoms were collected once, while vmHRV was repeatedly assessed over a 3-week period at weekly intervals in a sample of nine alcohol-related brain damaged patients. We provide robustness checks, bootstrapped correlations with confidence intervals, and standard errors for mean scores. We observed low to very low heart rate variability scores in our patients in comparison to norm values found in healthy populations. Proxy ratings of the QoL scale “subjective physical and mental performance” and everyday executive dysfunctions were strongly related to vmHRV. Better proxy-rated QoL and fewer dysexecutive symptoms were observed in those patients with higher vmHRV. Overall, patients showed low parasympathetic activation favoring the occurrence of dysfunctional emotion regulation strategies. Keywords: heart rate variability, emotion regulation, alcohol-related brain damage, quality of life

Late Life Immigration and Quality of Life among Asian Indian Older Adults.

Science.gov (United States)

Mukherjee, Anita J; Diwan, Sadhna

2016-09-01

Late-life immigration among seniors for purposes of family reunification is a growing phenomenon in developed countries. Using the World Health Organization's Quality of Life instrument short form (WHOQOL-BREF) and other psychosocial measures related to the political/legal context of immigration, and personal and environmental autonomy (mastery, immigration status, access to transportation, and language barrier), this study examined quality of life (QoL) in Asian Indian seniors (N = 109), who immigrated to the United States to reunite with their adult children. The sample scores on Overall QoL and QoL domains (physical and psychological health, social relationships, and environment) were similar to established norms. Although all QoL domains correlated significantly with Overall QoL at the bivariate level, multivariate analysis showed that only environmental domain contributed significantly to Overall QoL. Linear regressions indicated: Mastery contributed significantly to Overall QoL and all QoL domains; access to transport contributed to Overall QoL, physical health, and environmental QoL; immigration status (a proxy for political/legal context) contributed to environmental QoL whereas language barrier contributed to none. Implications for improving perceptions of QoL, mastery, access to transport and other services are discussed.

Sincronización de estadísticas entre servidores y proxies

OpenAIRE

Catullo, María José

1999-01-01

Un caching proxy server colecciona todas las páginas que pasan a través de él, así cuando un usuario pregunta por una página, el proxy server, si la tiene, la retoma de su cache, sin necesidad de acceder al servidor real. De ésta manera se ahorra ancho de banda y se agilizan las respuestas. Cada requerimiento que arriba a un proxy ó a un servidor, se almacena en archivos de logs. Existen varios tipos de archivos de logs, que se utilizan para auditoría del rendimiento, monitoreo, control de...

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

OpenAIRE

Mehrdad Mazaheri

2011-01-01

"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 depress...

Parental quality of life in the framework of paediatric chronic gastrointestinal disease.

Science.gov (United States)

Knez, Rajna; Francisković, Tanja; Samarin, Radenka Munjas; Niksić, Milan

2011-09-01

Chronic gastrointestinal diseases, such as inflammatory bowel disease (IBD) and celiac disease (CD), might have impact not only on the affected child but also on their parents since inside the family framework, a change in each member may have influence on the whole system. The aim of this study was to test the hypothesis that parents whose children have IBD or CD will have a lower quality of life (QoL) compared to parents of healthy children, as well as that lower QoL will be found among parents who perceive lower health related quality of life (HRQOL) of their child. 55 parents of children with IBD, 49 of CD and 53 parents of healthy children were included in the study. Children were aged 7-18 years. In order to measure parental QoL, a Croatian version of the WHOQOL-BREF questionnaire was administered, with four domains: physical health, psychological health, social relationship and environment. The Total QoL was calculated as a sum of all domain items. The parent-proxy report of children's HRQOL, PedsQL 4.0 Generic Core Scales was used. Main result shows that parents of children with IBD report a significantly lower psychological health, compared to parents of other children, and significantly lower physical health compared to parents of healthy children. Among parents of children with CD and parents of healthy children, better parental Total QoL was significantly correlated with better parental report of children's HRQOL, while for parents of children with IBD those associations were not found. Results of study show association between presence of the disease in offspring with poorer parental QoL, thus highlight the importance of supporting not only children with chronic disease but also involving their parents in psychosocial interventions, as well as supporting the patient's association groups which gather both children with chronic disease and their parents.

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…

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

BACKGROUND: Little is known about the quality of life (QoL) of disabled children. We describe self-reported QoL of children with cerebral palsy, factors that influence it, and how it compares with QoL of the general population. METHODS: 1174 children aged 8-12 years were randomly selected from...... eight population-based registers of children with cerebral palsy in six European countries and 743 (63%) agreed to participate; one further region recruited 75 children from multiple sources. Researchers visited these 818 children. 318 (39%) with severe intellectual impairment could not self-report; 500.......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...

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....

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.

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

Engagement in Advance Care Planning and Surrogates' Knowledge of Patients' Treatment Goals.

Science.gov (United States)

Fried, Terri R; Zenoni, Maria; Iannone, Lynne; O'Leary, John; Fenton, Brenda T

2017-08-01

A key objective of advance care planning (ACP) is improving surrogates' knowledge of patients' treatment goals. Little is known about whether ACP outside of a trial accomplishes this. The objective was to examine patient and surrogate reports of ACP engagement and associations with surrogate knowledge of goals. Cohort study SETTING: Primary care in a Veterans Affairs Medical Center. 350 community-dwelling veterans age ≥55 years and the individual they would choose to make medical decisions on their behalf, interviewed separately. Treatment goals were assessed by veterans' ratings of 3 health states: severe physical disability, cognitive disability, and pain, as an acceptable or unacceptable result of treatment for severe illness. Surrogates had knowledge if they correctly predicted all 3 responses. Veterans and surrogates were asked about living will and health care proxy completion and communication about life-sustaining treatment and quality versus quantity of life (QOL). Over 40% of dyads agreed that the veteran had not completed a living will or health care proxy and that there was no QOL communication. For each activity, sizeable proportions (18-34%) disagreed about participation. In dyads who agreed QOL communication had occurred, 30% of surrogates had knowledge, compared to 21% in dyads who agreed communication had not occurred and 15% in dyads who disagreed (P = .01). This relationship persisted in multivariable analysis. Agreement about other ACP activities was not associated with knowledge. Disagreement about ACP participation was common. Agreement about communication regarding QOL was modestly associated with surrogate knowledge of treatment goals. Eliciting surrogates' perspectives is critical to ACP. Even dyads who agree about participation may need additional support for successful engagement. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Complex tibial fractures are associated with lower social classes and predict early exit from employment and worse patient-reported QOL: a prospective observational study of 46 complex tibial fractures treated with a ring fixator.

Science.gov (United States)

Elsoe, Rasmus; Larsen, Peter; Petruskevicius, Juozas; Kold, Søren

2018-04-01

The long-term outcomes following complex fractures of the tibia are reported to carry a risk of knee pain, malalignment, articular injury and post-traumatic osteoarthritis. The main objective of this study was to account for the patient-reported quality of life (QOL) 12 months after ring fixator 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 showed a significantly worse EQ5D-5L index. The majority of patients (87%) were in the lower social classes suggesting a higher degree of social deprivation in the study population. Twenty-seven per cent of patients who were employed prior to injury had returned to employment at approximately 19 months following fracture. The onset of post-traumatic osteoarthritis was present in the knee joint in 29% of patients following a proximal intra-articular fracture, whereas osteoarthritis was present at the ankle joint in 35% of patients following a distal intra-articular fracture 12 months after frame removal. This study indicates that at 12 months after frame removal there are poorer patient-reported QOL as when compared to reference populations. Furthermore, this study

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

OpenAIRE

Mazaheri, Mehrdad

2011-01-01

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. Method 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, anxiet...

Validation of the quality of life-radiation therapy instrument (QOL-RTI) in patients receiving definitive radiation therapy for locally advanced prostate cancer

International Nuclear Information System (INIS)

Gwede, Clement; Friedland, Jay L.; Johnson, Darlene J.; Casey, Linda; Cantor, Alan; Sauder, Bonnie; Beres, Kathleen L.

1996-01-01

Purpose/Objective: The incidence of prostate cancer has tripled over the last 10 years, doubled over the last four years and continues to increase. A common method of treating prostate cancer is with external beam radiotherapy with or without hormones. Accurate and comprehensive documentation through prospective studies with long term follow-up is necessary to reduce the negative impact of treatment on a patient's quality of life. While it is increasingly recognized that radiation therapy treatment for prostate cancer may result in permanent alteration of the patient's quality of life, the extent and timing of this change in quality of life has not been adequately investigated in a comprehensive and prospective manner. Furthermore, there are limited instruments developed for use with patients undergoing definitive radiotherapy. The purpose of this paper is to report on the validation of the Quality of Life Radiation Therapy Instrument (QOL-RTI), a 24-item visual analogue general quality of life tool developed for use with patients receiving radiotherapy. Materials and Methods: Health related quality of life was assessed in a prospective study of 62 patients treated with either combined hormonal therapy (HT) plus external beam radiotherapy (EBRT) or EBRT alone for locally advanced prostate cancer. Quality life was measured prospectively before, during, and after radiation therapy. Results: The estimated reliability of the subscales was assessed with coefficient alpha which ranged from 0.57 to 0.68. Internal consistency was calculated using initial questionnaires for the entire sample, yielding a Cronbach's alpha of 0.82. Test-retest produced a correlation coefficient of 0.75 (p<0.0001) [n=60]. Construct validity was assessed by a repeated measures design to look for time effect, group effect, group and time interaction effect. We examined quality of life total scores, subscale total scores and performance status scores for patients who were treated with HT+ EBRT and

Measurement properties of quality-of-life measurement instruments for infants, children and adolescents with eczema: a systematic review.

Science.gov (United States)

Heinl, D; Prinsen, C A C; Sach, T; Drucker, A M; Ofenloch, R; Flohr, C; Apfelbacher, C

2017-04-01

Quality of life (QoL) is one of the core outcome domains identified by the Harmonising Outcome Measures for Eczema (HOME) initiative to be assessed in every eczema trial. There is uncertainty about the most appropriate QoL instrument to measure this domain in infants, children and adolescents. To systematically evaluate the measurement properties of existing measurement instruments developed and/or validated for the measurement of QoL in infants, children and adolescents with eczema. A systematic literature search in PubMed and Embase, complemented by a thorough hand search of reference lists, retrieved studies on measurement properties of eczema QoL instruments for infants, children and adolescents. For all eligible studies, we judged the adequacy of the measurement properties and the methodological study quality with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Results from different studies were summarized in a best-evidence synthesis and formed the basis to assign four degrees of recommendation. Seventeen articles, three of which were found by hand search, were included. These 17 articles reported on 24 instruments. No instrument can be recommended for use in all eczema trials because none fulfilled all required adequacy criteria. With adequate internal consistency, reliability and hypothesis testing, the U.S. version of the Childhood Atopic Dermatitis Impact Scale (CADIS), a proxy-reported instrument, has the potential to be recommended depending on the results of further validation studies. All other instruments, including all self-reported ones, lacked significant validation data. Currently, no QoL instrument for infants, children and adolescents with eczema can be highly recommended. Future validation research should primarily focus on the CADIS, but also attempt to broaden the evidence base for the validity of self-reported instruments. © 2016 British Association of Dermatologists.

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...

Photospheric activity of the Sun with VIRGO and GOLF. Comparison with standard activity proxies

Science.gov (United States)

Salabert, D.; García, R. A.; Jiménez, A.; Bertello, L.; Corsaro, E.; Pallé, P. L.

2017-12-01

We study the variability of solar activity using new photospheric proxies originally developed for the analysis of stellar magnetism with the CoRoT and Kepler photometric observations. These proxies were obtained by tracking the temporal modulations in the observations associated with the spots and magnetic features as the Sun rotates. We analyzed 21 yr of observations, spanning solar cycles 23 and 24, collected by the space-based photometric VIRGO and radial velocity GOLF instruments on board the SoHO satellite. We then calculated the photospheric activity proxy Sph is for each of the three VIRGO photometers and the associated Svel proxy from the radial velocity GOLF observations. Comparisons with several standard solar activity proxies sensitive to different layers of the Sun demonstrate that these new activity proxies, Sph and Svel, provide a new manner to monitor solar activity. We show that both the long- and short-term magnetic variabilities respectively associated with the 11-yr cycle and the quasi-biennial oscillation are well monitored, and that the magnetic field interaction between the subsurface, photosphere, and chromosphere of the Sun was modified between Cycle 24 and Cycle 23. Furthermore, the photometric proxies show a wavelength dependence of the response function of the solar photosphere among the three channels of the VIRGO photometers, providing inputs for the study of the stellar magnetism of Sun-like stars.

Among nonagenarians, congruence between self-rated and proxy-rated health was low but both predicted mortality.

Science.gov (United States)

Vuorisalmi, Merja; Sarkeala, Tytti; Hervonen, Antti; Jylhä, Marja

2012-05-01

The congruence between self-rated global health (SRH) and proxy-rated global health (PRH), the factors associated with congruence between SRH and PRH, and their associations with mortality are examined using data from the Vitality 90+ study. The data consist of 213 pairs of subjects--aged 90 years and older--and proxies. The relationship between SRH and PRH was analyzed by chi-square test and Cohen's kappa. Logistic regression analysis was used to find out the factors that are associated with the congruence between health ratings. The association between SRH and PRH with mortality was studied using Cox proportional hazard models. The subjects rated their health more negatively than the proxies. Kappa value indicated only slight congruence between SRH and PRH, and they also predicted mortality differently. Good self-reported functional ability was associated with congruence between SRH and PRH. The results imply that the evaluation processes of SRH and PRH differ, and the measures are not directly interchangeable. Both measures are useful health indicators in very old age but SRH cannot be replaced by PRH in analyses. Copyright © 2012 Elsevier Inc. All rights reserved.

Mixtures of Gaussians for uncertainty description in bivariate latent heat flux proxies

NARCIS (Netherlands)

Wójcik, R.; Troch, P.A.A.; Stricker, J.N.M.; Torfs, P.J.J.F.

2006-01-01

This paper proposes a new probabilistic approach for describing uncertainty in the ensembles of latent heat flux proxies. The proxies are obtained from hourly Bowen ratio and satellite-derived measurements, respectively, at several locations in the southern Great Plains region in the United States.

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.

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. �

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.

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

2014-01-01

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

Depressive symptomatology in severe dementia in a European sample: prevalence, associated factors and prescription rate of antidepressants.

Science.gov (United States)

Giebel, Clarissa M; Sutcliffe, Caroline; Renom-Guiteras, Anna; Arve, Seija; Hallberg, Ingalill Rahm; Soto, Maria; Zabalegui, Adelaida; Hamers, Jan; Saks, Kai; Challis, David

2015-04-01

Depression is a common comorbid disorder of dementia. This study explores the prevalence of and factors associated with depressive symptomatology, and antidepressant prescription rates in severe dementia across eight European countries. In total, 414 people with severe dementia completed measures of cognition and quality of life (QoL), whilst carers completed proxy measures of activities of daily living (ADLs), depression, neuropsychiatric symptoms, QoL and comorbidity. Findings indicated that 30% of the sample had depression, whilst the highest and lowest prevalence of depression was reported in Germany and Finland, respectively. Lower QoL, the presence of pain and more frequent neuropsychiatric symptoms were associated with depressive symptomatology, whilst no significant relationship between impairment of ADLs, comorbidity, and depression emerged. Spain and Estonia had the highest and lowest rates of antidepressant prescribing, respectively, whilst Germany had the highest discrepancy between depressive symptomatology and prescription. The study highlights variations across countries in the prevalence of depressive symptomatology in severe dementia and prescription of antidepressants. Information about factors associated with depressive symptomatology may help to better identify and manage depression.

Brief report: glycemic control, quality of life, and school experiences among students with diabetes.

Science.gov (United States)

Wagner, Julie; Heapy, Alicia; James, Amy; Abbott, Gina

2006-09-01

To investigate the relationships among perceived school experiences, diabetes control, and quality of life (QOL) in children with diabetes. Fifty-eight children with type 1 diabetes and their parents participated. The typical child was 12 years old, had diabetes for 5 years, and attended public, suburban, middle/junior high schools with 300-500 students. Children whose parents reported that school personnel received diabetes training showed significantly better diabetes control than those who reported untrained school personnel. Children who reported their classmates received diabetes training had significantly better QOL than those who reported untrained classmates. Children who reported greater flexibility in performing diabetes care tasks at school had significantly better diabetes control than children who reported less flexibility. Students with diabetes continue to face challenges at school. Training staff and classmates and allowing students the maximum appropriate flexibility in diabetes care appears beneficial for disease control and QOL.

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.

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

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

Science.gov (United States)

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

2017-10-10

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

78 FR 70987 - Proxy Advisory Firm Roundtable

Science.gov (United States)

2013-11-27

... Firm Roundtable AGENCY: Securities and Exchange Commission. ACTION: Notice of roundtable discussion... advisory firms. The panel will be asked to discuss topics including the current state of proxy advisory firm use by investment advisers and institutional investors and potential changes that have been...

Implication for QOL after I-125 brachytherapy for prostate cancer

International Nuclear Information System (INIS)

Teishima, Jun; Yasumoto, Hiroaki; Inoue, Syogo; Masumoto, Hiroshi; Hasegawa, Yasuhisa; Matsubara, Akio

2009-01-01

The aim of this study is to evaluate the quality of life (QOL) of patients following prostate brachytherapy. Between July 2004 and May 2008, 139 patients underwent I-125 permanent brachytherapy. Among those patients, 69 who were followed up for more than one year using the Expanded Prostate Index Composite (EPIC), Japanese version v1 TM , were enrolled in this study. Urinary summary scores became worse temporarily at 1 month after the end of treatment, but then recovered gradually to the level before treatment. Sexual summary scores before treatment were 42.2±16.3. They became worse temporarily at 1 month after treatment but then recovered gradually in patients whose sexual summary scores were more than 40. Urinary morbidity scores after prostate brachytherapy were not so severe and recovered within a short period. Further long-term observation is thought to be required in the future. Sexual function scores of patients before treatment in the present study were lower compared with those recorded in previous studies. (author)

Correlation of physical aptitude; functional capacity, corporal balance and quality of life (QoL) among elderly women submitted to a post-menopausal physical activities program.

Science.gov (United States)

de Souza Santos, César Augusto; Dantas, Estélio Enrique Martin; Moreira, Maria Helena Rodrigues

2011-01-01

The objective of this study was to evaluate the effect of physical activity from the "Menopause in Form" program on physical aptitude, functional capacity, corporal balance and QoL among elderly women. In addition, correlations among these variables were examined. The present work was a longitudinal study that was quasi-experimental and correlational. A total of 323 elderly women (age: 69.0±5.53 years) participated in this study. Subjects were non-institutionalized, post-menopausal individuals residing at the Elderly Care Center in Belém Municipality (Pará, Brazil) and practiced one activity (i.e., dancing or walking) over a 10-month period. The assessment protocols used were the following: the Fullerton functional fitness test battery (physical aptitude); the activities of daily living (ADL) indices (functional capacity); the Tinetti-scale (corporal balance); and the WHOQOL-OLD questionnaire (QoL). The adopted significance level was p<0.05. Results from the Wilcoxon test demonstrated significant differences for the post-test assessment of functional capacity (Δ%=5.63%; p=0.0001) and general QoL (Δ%=9.19%; p=0.001). These results suggest that the physical activities employed during the "Menopause in Form" program resulted in significant improvements in the functional capacity and QoL of post-menopausal elderly women. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Evaluation of the sea ice proxy IP against observational and diatom proxy data in the SW Labrador Sea

DEFF Research Database (Denmark)

Weckström, K.; Andersen, M.L.; Kuijpers, A.

2013-01-01

The recent rapid decline in Arctic sea ice cover has increased the need to improve the accuracy of the sea ice component in climate models and to provide detailed long-term sea ice concentration records, which are only available via proxy data. Recently, the highly branched isoprenoid IP25...

Folie a deux and delusional disorder by proxy: an atypical presentation.

Science.gov (United States)

Daulatabad, Deepashree; Sonthalia, Sidharth; Srivastava, Ankur; Bhattacharya, Sambit Nath; Kaul, Subuhi; Moyal, Deepak

2017-08-01

Delusion of parasitosis is a rare condition characterised by an individual harbouring the delusion of being infested with insects or parasites. We report a rare and interesting case of delusion of parasitosis presenting as folie a deux, that is, the delusion is shared by both the parents of an 18-month-old child, with proxy projection of parental delusion on the child. The case highlights the rare concomitant occurrence of two psychocutaneous disorders and emphasizes the importance of early recognition and appropriate intervention to safeguard the well-being of the child. © 2016 The Australasian College of Dermatologists.

Tropical Hydroclimate Change during Heinrich Stadial 1: An Integrative Proxy-Model Synthesis

Science.gov (United States)

Lawman, A. E.; Sun, T.; Shanahan, T. M.; Di Nezio, P. N.; Gomez, K.; Piatrunia, N.; Sun, C.; Wu, X.; Kageyama, M.; Merkel, U.; Otto-Bliesner, B. L.; Abe-Ouchi, A.; Lohmann, G.; Singarayer, J. S.

2017-12-01

We explore the response of tropical climate to abrupt cooling of the North Atlantic (NA) during Heinrich Stadial 1 (HS1) combining paleoclimate proxies with model simulations. A total of 146 published paleoclimate records from tropical locations are used to categorize whether HS1 was wetter, drier, or unchanged relative to a deglacial baseline state. Only records with sufficient resolution to resolve HS1 and sufficient length to characterize the deglacial trend are considered. This synthesis reveals large-scale patterns of hydroclimate change relative to glacial conditions, confirming previously reported weaker Indian summer monsoon, a wetter southern Africa, and drying over the Caribbean. Our synthesis also reveals large-scale drying over the Maritime continent as well as wetter conditions in northern Australia and southern tropical South America. Our reinterpretation of the available proxy data reveals far more complexity and uncertainties for equatorial East Africa, a region that appears to straddle a pattern of dryer conditions to the north and wetter conditions to the south. Overall, these patterns of hydroclimate change depart from a southward shift of the Inter Tropical Convergence Zone (ITCZ), particularly outside the tropical Atlantic. We explore mechanisms driving these changes using a multi-model ensemble of "hosing" simulations performed relative to glacial conditions. The models show robust weakening of the Afro-Asian Monsoon, which we attribute to ventilation of colder mid-latitude air. Not all models simulate the remaining patterns inferred from the proxy data. The best-agreeing models indicate that cooling over the tropical NA and the Caribbean may be essential to communicate the response to the global tropics. This response can induce warming over the tropical South Atlantic via the wind-evaporation-SST feedback, driving wetter conditions in South Africa and tropical South America. Cooling over the Caribbean is communicated to the Pacific over the

Comparing Apples to Apples: Paleoclimate Model-Data comparison via Proxy System Modeling

Science.gov (United States)

Dee, Sylvia; Emile-Geay, Julien; Evans, Michael; Noone, David

2014-05-01

The wealth of paleodata spanning the last millennium (hereinafter LM) provides an invaluable testbed for CMIP5-class GCMs. However, comparing GCM output to paleodata is non-trivial. High-resolution paleoclimate proxies generally contain a multivariate and non-linear response to regional climate forcing. Disentangling the multivariate environmental influences on proxies like corals, speleothems, and trees can be complex due to spatiotemporal climate variability, non-stationarity, and threshold dependence. Given these and other complications, many paleodata-GCM comparisons take a leap of faith, relating climate fields (e.g. precipitation, temperature) to geochemical signals in proxy data (e.g. δ18O in coral aragonite or ice cores) (e.g. Braconnot et al., 2012). Isotope-enabled GCMs are a step in the right direction, with water isotopes providing a connector point between GCMs and paleodata. However, such studies are still rare, and isotope fields are not archived as part of LM PMIP3 simulations. More importantly, much of the complexity in how proxy systems record and transduce environmental signals remains unaccounted for. In this study we use proxy system models (PSMs, Evans et al., 2013) to bridge this conceptual gap. A PSM mathematically encodes the mechanistic understanding of the physical, geochemical and, sometimes biological influences on each proxy. To translate GCM output to proxy space, we have synthesized a comprehensive, consistently formatted package of published PSMs, including δ18O in corals, tree ring cellulose, speleothems, and ice cores. Each PSM is comprised of three sub-models: sensor, archive, and observation. For the first time, these different components are coupled together for four major proxy types, allowing uncertainties due to both dating and signal interpretation to be treated within a self-consistent framework. The output of this process is an ensemble of many (say N = 1,000) realizations of the proxy network, all equally plausible

The self-reported quality of life of Lithuanian children with asthma was comparable to Western populations.

Science.gov (United States)

Taminskiene, Vaida; Vaitkaitiene, Egle; Valiulis, Algirdas; Turner, Steve; Hadjipanayis, Adamos; Stukas, Rimantas; Valiulis, Arunas

2018-02-01

Quality of life (QoL) has been widely researched among children with asthma in Western countries, but there is a lack of data from eastern Europe, where the prevalence is relatively low, but hospital admission rates are higher. We evaluated the overall level and major determinants of QoL in Lithuanian children aged 5-11 years with asthma. This study was carried out in six asthma outpatient clinics in the two largest cities of Lithuania from January 2015 to July 2016. The children's QoL was measured using the Pediatric Quality of Life Inventory (PedsQL) asthma module, which was completed by the child and one parent. We collected questionnaires from 226 children (68% boys) with a mean age of eight (±2) years: 65% had mild asthma, 31% had moderate asthma and 4% had severe asthma. One in 10 had been hospitalised in the preceding 6 months. The mean self-reported QoL score was 74 and the parent-reported QoL score was 73. QoL was associated with asthma severity and control, shortness of breath and the child's general health, but not socioeconomic factors. The overall level and major determinants of QoL in children with asthma in Lithuania were comparable with Western populations. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Effects of interactive metronome training on upper extremity function, ADL and QOL in stroke patients.

Science.gov (United States)

Yu, Ga-Hui; Lee, Jae-Shin; Kim, Su-Kyoung; Cha, Tae-Hyun

2017-01-01

Rhythm and timing training is stimulation that substitutes for a damaged function controls muscular movement or temporal element, which has positive impacts on the neurological aspect and movement of the brain. This study is to assess the changes caused by rhythm and timing training using an interactive metronome (IM) on upper extremity function, ADL and QOL in stroke patients. In order to assess the effects of IM training, a group experiment was conducted on 30 stroke patients. Twelve sessions of IM training were provided for the experimental group three times a week for four weeks, while the control group was trained with a Bilateral arm Self-Exercise (BSE) for the same period. Both groups were evaluated by pre- and post-tests through MFT, MAL, K-MBI and SS-QOL. There were more statistically significant differences (<0.05) in the total score of MFT and the finger control item in the IM Group than in the BSE Group. With respect to ADL, there were more statistically significant differences (<0.05) in the total score of K-MBI and the dressing item in the IM Group than in the BSE Group. The study proposes that IM training can be applied as an occupational therapy program in patients with various diseases who need to adjust the time for performing movements as well as stroke patients.

Correlates of self-reported quality of life in adults and children with morphea.

Science.gov (United States)

Das, Shinjita; Bernstein, Ira; Jacobe, Heidi

2014-05-01

Determining a disease's impact on life quality is important in clinical decision making, research, and resource allocation. Determinants of quality of life (QOL) in morphea are poorly understood. We sought to ascertain demographic and clinical variables correlated with negative impact on self-reported QOL in morphea. We conducted a cross-sectional survey of the Morphea in Adults and Children cohort. Symptoms (pruritus and pain) and functional impairment were correlated with decreased QOL in children and adults. This was true in both sexes and was independent of subtype and age. Patient-reported QOL correlated with physician-based measures of disease severity in adults, but not in children. Patients with linear and generalized morphea had the greatest impact on QOL. Small sample size is a limitation. Symptoms and functional impairment were determinants of impaired life quality in both children and adults independent of morphea subtype. These results suggest that clinicians should consider suppressing the accumulation of new lesions (when rapidly accumulating) and symptoms (pain and pruritus) in the treatment of patients with morphea. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

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

This paper presents a study of changes in eutrophication over the past 100 years in a fertile estuary. The Danish estuary Mariager Fjord is a long, narrow sill-fjord with a permanently anoxic basin. In 1997 anoxia spread from the basin to the entire inner estuary, killing almost all eukaryotes...... 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...... 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...

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.

Climate proxy data as groundwater tracers in regional flow systems

Science.gov (United States)

Clark, J. F.; Morrissey, S. K.; Stute, M.

2008-05-01

The isotopic and chemical signatures of groundwater reflect local climate conditions. By systematically analyzing groundwater and determining their hydrologic setting, records of past climates can be constructed. Because of their chemistries and relatively uncomplicated source functions, dissolved noble gases have yielded reliable records of continental temperatures for the last 30,000 to 50,000 years. Variations in the stable isotope compositions of groundwater due to long term climate changes have also been documented over these time scales. Because glacial - interglacial climate changes are relatively well known, these climate proxies can be used as "stratigraphic" markers within flow systems and used to distinguish groundwaters that have recharged during the Holocene from those recharged during the last glacial period, important time scales for distinguishing regional and local flow systems in many aquifers. In southern Georgia, the climate proxy tracers were able to identify leakage from surface aquifers into the Upper Floridan aquifer in areas previously thought to be confined. In south Florida, the transition between Holocene and glacial signatures in the Upper Floridan aquifer occurs mid-way between the recharge area and Lake Okeechobee. Down gradient of the lake, the proxies are uniform, indicating recharge during the last glacial period. Furthermore, there is no evidence for leakage from the shallow aquifers into the Upper Floridan. In the Lower Floridan, the climate proxies indicate that the saline water entered the aquifer after sea level rose to its present level.

Expert versus proxy rating of verbal communicative ability of people with aphasia after stroke.

Science.gov (United States)

de Jong-Hagelstein, Marjolein; Kros, Lieke; Lingsma, Hester F; Dippel, Diederik W J; Koudstaal, Peter J; Visch-Brink, Evy G

2012-11-01

In randomized clinical trials of aphasia treatment, a functional outcome measure like the Amsterdam-Nijmegen Everyday Language Test (ANELT), administered by speech-language therapists, is often used. However, the agreement between this expert rating and the judgment of the proxy about the quality of the daily life communication of the person with aphasia is largely unknown. We examined the association between ANELT scores by speech-language therapists and proxy judgments on the Partner Communication Questionnaire both at 3 and 6 months in 39 people with aphasia after stroke. We also determined which factors affected the level of agreement between expert and proxy judgment of the communicative ability at 6 months in 53 people with aphasia. We found moderate agreement (at 3 months r = .662; p = aphasia, measured with the Aphasia Severity Rating Scale, was associated with better agreement. In conclusion, although proxies were slightly more positive than experts, we found moderate agreement between expert and proxy rating of verbal communicative ability of people with aphasia after stroke, especially in milder cases.

Evaluation of proxy-based millennial reconstruction methods

Energy Technology Data Exchange (ETDEWEB)

Lee, Terry C.K.; Tsao, Min [University of Victoria, Department of Mathematics and Statistics, Victoria, BC (Canada); Zwiers, Francis W. [Environment Canada, Climate Research Division, Toronto, ON (Canada)

2008-08-15

A range of existing statistical approaches for reconstructing historical temperature variations from proxy data are compared using both climate model data and real-world paleoclimate proxy data. We also propose a new method for reconstruction that is based on a state-space time series model and Kalman filter algorithm. The state-space modelling approach and the recently developed RegEM method generally perform better than their competitors when reconstructing interannual variations in Northern Hemispheric mean surface air temperature. On the other hand, a variety of methods are seen to perform well when reconstructing surface air temperature variability on decadal time scales. An advantage of the new method is that it can incorporate additional, non-temperature, information into the reconstruction, such as the estimated response to external forcing, thereby permitting a simultaneous reconstruction and detection analysis as well as future projection. An application of these extensions is also demonstrated in the paper. (orig.)

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

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...

Usable Authentication with an Offline Trusted Device Proxy Architecture (long version)

OpenAIRE

Johansen, Christian; Jøsang, Audun; Migdal, Denis

2016-01-01

Client platform infection poses a significant threat to secure user authentication. Com- bining vulnerable client platforms with special security devices, as often the case in e- banking, can increase significantly the security. This paper describes a new architecture where a security proxy on the client platform communicates with both a trusted security device and the server application. The proxy switches between two TLS channels, one from the client and another from the trusted device. The...

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

Validating a proxy for disease progression in metastatic cancer patients using prescribing and dispensing data.

Science.gov (United States)

Joshi, Vikram; Adelstein, Barbara-Ann; Schaffer, Andrea; Srasuebkul, Preeyaporn; Dobbins, Timothy; Pearson, Sallie-Anne

2017-10-01

Routine data collections are used increasingly to examine outcomes of real-world cancer drug use. These datasets lack clinical details about important endpoints such as disease progression. To validate a proxy for disease progression in metastatic cancer patients using prescribing and dispensing claims. We used data from a cohort study of patients undergoing chemotherapy who provided informed consent to the collection of cancer-treatment data from medical records and linkage to pharmaceutical claims. We derived proxy decision rules based on changes to drug treatment in prescription histories (n = 36 patients) and validated the proxy in prescribing data (n = 62 patients). We adapted the decision rules and validated the proxy in dispensing data (n = 109). Our gold standard was disease progression ascertained in patient medical records. Individual progression episodes were the unit of analysis for sensitivity and Positive Predictive Value (PPV) calculations and specificity and Negative Predictive Value (NPV) were calculated at the patient level. The sensitivity of our proxy in prescribing data was 74.3% (95% Confidence Interval (CI), 55.6-86.6%) and PPV 61.2% (95% CI, 45.0-75.3%); specificity and NPV were 87.8% (95% CI, 73.8-95.9%) and 100% (95% CI, 90.3-100%), respectively. In dispensing data, the sensitivity of our proxy was 64% (95% CI, 55.0-77.0%) and PPV 56.0% (95% CI, 43.0-69.0%); specificity and NPV were 81% (95% CI, 70.05-89.0%) and 91.0% (95% CI, 82.0-97.0%), respectively. Our proxy overestimated episodes of disease progression. The proxy's performance is likely to improve if the date of prescribing is used instead of date of dispensing in claims data and by incorporating medical service claims (such as imaging prior to drug changes) in the algorithm. Our proxy is not sufficiently robust for use in real world comparative effectiveness research for cancer medicines. © 2016 John Wiley & Sons Australia, Ltd.

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...

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, depressio...

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.

Evaluation of Organic Proxies for Quantifying Past Primary Productivity

Science.gov (United States)

Raja, M.; Rosell-Melé, A.; Galbraith, E.

2017-12-01

Ocean primary productivity is a key element of the marine carbon cycle. However, its quantitative reconstruction in the past relies on the use of biogeochemical models as the available proxy approaches are qualitative at best. Here, we present an approach that evaluates the use of phytoplanktonic biomarkers (i.e. chlorins and alkenones) as quantitative proxies to reconstruct past changes in marine productivity. We compare biomarkers contents in a global suite of core-top sediments to sea-surface chlorophyll-a abundance estimated by satellites over the last 20 years, and the results are compared to total organic carbon (TOC). We also assess satellite data and detect satellite limitations and biases due to the complexity of optical properties and the actual defined algorithms. Our findings show that sedimentary chlorins can be used to track total sea-surface chlorophyll-a abundance as an indicator for past primary productivity. However, degradation processes restrict the application of this proxy to concentrations below a threshold value (1µg/g). Below this threshold, chlorins are a useful tool to identify reducing conditions when used as part of a multiproxy approach to assess redox sedimentary conditions (e.g. using Re, U). This is based on the link between anoxic/disoxic conditions and the flux of organic matter from the sea-surface to the sediments. We also show that TOC is less accurate than chlorins for estimating sea-surface chlorophyll-a due to the contribution of terrigenous organic matter, and the different degradation pathways of all organic compounds that TOC includes. Alkenones concentration also relates to primary productivity, but they are constrained by different processes in different regions. In conclusion, as lons as specific constraints are taken into account, our study evaluates the use of chlorins and alkenones as quantitative proxies of past primary productivity, with more accuracy than by using TOC.

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

2014-01-01

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…

Contracts, covenants and advance care planning: an empirical study of the moral obligations of patient and proxy.

Science.gov (United States)

Fins, Joseph J; Maltby, Barbara S; Friedmann, Erika; Greene, Michele G; Norris, Kaye; Adelman, Ronald; Byock, Ira

2005-01-01

Previously we had speculated that the patient-proxy relationship existed on a contractual to covenantal continuum. In order to assess this hypothesis, and to better understand the moral obligations of the patient-proxy relationship, we surveyed 50 patient-proxy pairs as well as 52 individuals who had acted as proxies for someone who had died. Using structured vignettes representative of three distinct disease trajectories (cancer, acute stroke, and congestive heart failure), we assessed whether respondents believed that proxies should follow explicit instructions regarding life-sustaining therapy and act contractually or whether more discretionary or covenantal judgments were ethically permissible. Additional variables included the valence of initial patient instructions--for example, "to do nothing" or "to do everything"--as well as the quality of information available to the proxy. Responses were graded on a contractual to covenantal continuum using a modified Likert scale employing a prospectively scored survey instrument. Our data indicate that the patient-proxy relationship exists on a contractual to covenantal continuum and that variables such as disease trajectory, the clarity of prognosis, instructional valence, and the quality of patient instructions result in statistically significant differences in response. The use of interpretative or covenantal judgment was desired by patients and proxies when the prognosis was grim, even if initial instructions were to pursue more aggressive care. Nonetheless, there was a valence effect: patients and proxies intended that negative instructions to be left alone be heeded. These data suggest that the delegation of patient self-determination is morally complex. Advance care planning should take into account both the exercise of autonomy and the interpretative burdens assumed by the proxy. Patients and proxies think inductively and contextually. Neither group viewed deviation from patient instructions as a violation of

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.

Quick, “Imputation-free” meta-analysis with proxy-SNPs

Directory of Open Access Journals (Sweden)

Meesters Christian

2012-09-01

Full Text Available Abstract Background Meta-analysis (MA is widely used to pool genome-wide association studies (GWASes in order to a increase the power to detect strong or weak genotype effects or b as a result verification method. As a consequence of differing SNP panels among genotyping chips, imputation is the method of choice within GWAS consortia to avoid losing too many SNPs in a MA. YAMAS (Yet Another Meta Analysis Software, however, enables cross-GWAS conclusions prior to finished and polished imputation runs, which eventually are time-consuming. Results Here we present a fast method to avoid forfeiting SNPs present in only a subset of studies, without relying on imputation. This is accomplished by using reference linkage disequilibrium data from 1,000 Genomes/HapMap projects to find proxy-SNPs together with in-phase alleles for SNPs missing in at least one study. MA is conducted by combining association effect estimates of a SNP and those of its proxy-SNPs. Our algorithm is implemented in the MA software YAMAS. Association results from GWAS analysis applications can be used as input files for MA, tremendously speeding up MA compared to the conventional imputation approach. We show that our proxy algorithm is well-powered and yields valuable ad hoc results, possibly providing an incentive for follow-up studies. We propose our method as a quick screening step prior to imputation-based MA, as well as an additional main approach for studies without available reference data matching the ethnicities of study participants. As a proof of principle, we analyzed six dbGaP Type II Diabetes GWAS and found that the proxy algorithm clearly outperforms naïve MA on the p-value level: for 17 out of 23 we observe an improvement on the p-value level by a factor of more than two, and a maximum improvement by a factor of 2127. Conclusions YAMAS is an efficient and fast meta-analysis program which offers various methods, including conventional MA as well as inserting proxy

Multiscale combination of climate model simulations and proxy records over the last millennium

Science.gov (United States)

Chen, Xin; Xing, Pei; Luo, Yong; Nie, Suping; Zhao, Zongci; Huang, Jianbin; Tian, Qinhua

2018-05-01

To highlight the compatibility of climate model simulation and proxy reconstruction at different timescales, a timescale separation merging method combining proxy records and climate model simulations is presented. Annual mean surface temperature anomalies for the last millennium (851-2005 AD) at various scales over the land of the Northern Hemisphere were reconstructed with 2° × 2° spatial resolution, using an optimal interpolation (OI) algorithm. All target series were decomposed using an ensemble empirical mode decomposition method followed by power spectral analysis. Four typical components were obtained at inter-annual, decadal, multidecadal, and centennial timescales. A total of 323 temperature-sensitive proxy chronologies were incorporated after screening for each component. By scaling the proxy components using variance matching and applying a localized OI algorithm to all four components point by point, we obtained merged surface temperatures. Independent validation indicates that the most significant improvement was for components at the inter-annual scale, but this became less evident with increasing timescales. In mid-latitude land areas, 10-30% of grids were significantly corrected at the inter-annual scale. By assimilating the proxy records, the merged results reduced the gap in response to volcanic forcing between a pure reconstruction and simulation. Difficulty remained in verifying the centennial information and quantifying corresponding uncertainties, so additional effort should be devoted to this aspect in future research.

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...

Performance of Solar Proxy Options of IRI-Plas Model for Equinox Seasons

Science.gov (United States)

Sezen, Umut; Gulyaeva, Tamara L.; Arikan, Feza

2018-02-01

International Reference Ionosphere (IRI) is the most acclaimed climatic model of the ionosphere. Since 2009, the range of the IRI model has been extended to the Global Positioning System (GPS) orbital height of 20,000 km in the plasmasphere. The new model, which is called IRI extended to Plasmasphere (IRI-Plas), can input not only the ionosonde foF2 and hmF2 but also the GPS-total electron content (TEC). IRI-Plas has been provided at www.ionolab.org, where online computation of ionospheric parameters is accomplished through a user-friendly interface. The solar proxies that are available in IRI-Plas can be listed as sunspot number (SSN1), SSN2, F10.7, global electron content (GEC), TEC, IG, Mg II, Lyman-α, and GEC_RZ. In this study, ionosonde foF2 data are compared with IRI-Plas foF2 values with the Consultative Committee International Radio (CCIR) and International Union of Radio Science (URSI) model choices for each solar proxy, with or without the GPS-TEC input for the equinox months of October 2011 and March 2015. It has been observed that the best fitting model choices in Root Mean Square (RMS) and Normalized RMS (NRMS) sense are the Jet Propulsion Laboratory global ionospheric maps-TEC input with Lyman-α solar proxy option for both months. The input of TEC definitely lowers the difference between the model and ionosonde foF2 values. The IG and Mg II solar proxies produce similar model foF2 values, and they usually are the second and third best fits to the ionosonde foF2 for the midlatitude ionosphere. In high-latitude regions, Jet Propulsion Laboratory global ionospheric map-TEC inputs to IRI-Plas with Lyman-α, GEC_RZ, and TEC solar proxies are the best choices. In equatorial region, the best fitting solar proxies are IG, Lyman-α, and Mg II.

Multiple imputation using linked proxy outcome data resulted in important bias reduction and efficiency gains: a simulation study.

Science.gov (United States)

Cornish, R P; Macleod, J; Carpenter, J R; Tilling, K

2017-01-01

When an outcome variable is missing not at random (MNAR: probability of missingness depends on outcome values), estimates of the effect of an exposure on this outcome are often biased. We investigated the extent of this bias and examined whether the bias can be reduced through incorporating proxy outcomes obtained through linkage to administrative data as auxiliary variables in multiple imputation (MI). Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC) we estimated the association between breastfeeding and IQ (continuous outcome), incorporating linked attainment data (proxies for IQ) as auxiliary variables in MI models. Simulation studies explored the impact of varying the proportion of missing data (from 20 to 80%), the correlation between the outcome and its proxy (0.1-0.9), the strength of the missing data mechanism, and having a proxy variable that was incomplete. Incorporating a linked proxy for the missing outcome as an auxiliary variable reduced bias and increased efficiency in all scenarios, even when 80% of the outcome was missing. Using an incomplete proxy was similarly beneficial. High correlations (> 0.5) between the outcome and its proxy substantially reduced the missing information. Consistent with this, ALSPAC analysis showed inclusion of a proxy reduced bias and improved efficiency. Gains with additional proxies were modest. In longitudinal studies with loss to follow-up, incorporating proxies for this study outcome obtained via linkage to external sources of data as auxiliary variables in MI models can give practically important bias reduction and efficiency gains when the study outcome is MNAR.

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

Graphite-(Mo,W)S2 intergrowth as a palaeoenvironmental proxy in metasedimentary rocks

Science.gov (United States)

Cabral, Alexandre Raphael; Zeh, Armin; da Silva Viana, Nívea Cristina; Schirmer, Thomas; Lehmann, Bernd

2017-12-01

Molybdenum enrichment in pristine organic-C-rich sedimentary rocks forms the basis for inferring the presence of dissolved oxygen in seawater. Organic matter removes dissolved hexavalent Mo from seawater where anoxic and euxinic conditions are attained. However, it is unknown whether this Mo-based proxy is retained under metamorphic conditions where organic C is no longer preserved. Here, we describe aggregates of graphite and molybdenite (MoS2) containing up to 21 mass per cent of W as tungstenite (WS2) in solid solution. These aggregates are disseminated in a sulfide-rich Mn-silicate-carbonate rock (queluzite), metamorphosed under amphibolite-facies conditions within the Archaean Barbacena greenstone belt in Minas Gerais, Brazil. Our finding indicates that: (i) W is, like Mo, a palaeoenvironmental proxy; (ii) the W proxy is sensitive to high fS2/fO2 environments; (iii) both Mo and W proxies survive amphibolite-facies overprint as (Mo,W)S2 intergrown with graphite. Archaean greenstones are potential candidates for storing palaeoenvironmental information as (Mo,W)S2-graphite intergrowths.

Servidor proxy caché: comprensión y asimilación tecnológica

Directory of Open Access Journals (Sweden)

Carlos E. Gómez

2012-01-01

Full Text Available Los proveedores de acceso a Internet usualmente incluyen el concepto de aceleradores de Internet para reducir el tiempo promedio que tarda un navegador en obtener los archivos solicitados. Para los administradores del sistema es difícil elegir la configuración del servidor proxy caché, ya que es necesario decidir los valores que se deben usar en diferentes variables. En este artículo se presenta la forma como se abordó el proceso de comprensión y asimilación tecnológica del servicio de proxy caché, un servicio de alto impacto organizacional. Además, este artículo es producto del proyecto de investigación “Análisis de configuraciones de servidores proxy caché”, en el cual se estudiaron aspectos relevantes del rendimiento de Squid como servidor proxy caché.

Factor Structure of the Schalock and Keith Quality of Life Questionnaire (QOL-Q): Validation on Mexican and Spanish Samples

Science.gov (United States)

Caballo, C.; Crespo, M.; Jenaro, C.; Verdugo, M. A.; Martinez, J. L.

2005-01-01

Background: The Quality of Life Questionnaire (QOL-Q) is used widely to evaluate the quality of life of persons with intellectual disability (ID). Its validity for use with Spanish-speaking cultures has been demonstrated for individuals with visual disabilities, but not for those with physical or intellectual disabilities. Such was the purpose of…

Perceptions of health and somatic sensations in women reporting premenstrual syndrome and premenstrual dysphoric disorder.

Science.gov (United States)

Craner, Julia; Sigmon, Sandra; Martinson, Amber; McGillicuddy, Morgan

2013-09-01

Focus on bodily sensations may be involved in the etiology of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). This study investigated the relationship between two types of somatic self-focus (i.e., health anxiety and anxiety sensitivity) and health-related quality of life (QOL) in women with provision diagnoses of PMS and PMDD. On the basis of responses to a screening measure, 731 college women were divided into three groups: PMDD, Moderate/Severe PMS, and Mild/No PMS. Measures included health-related QOL, health anxiety, anxiety sensitivity, and trait anxiety. Women with provisional diagnoses of PMDD and moderate/severe PMS reported higher levels of health anxiety and anxiety sensitivity. These relationships were not accounted for by trait anxiety. Furthermore, women in the PMDD and Moderate/Severe PMS groups reported lower health-related QOL. There is a significant health-related QOL burden for college women with PMDD and PMS. Health anxiety and anxiety sensitivity may contribute to the etiology of premenstrual disorders.

Slices: A shape-proxy based on planar sections

KAUST Repository

McCrae, James; Singh, Karan S.; Mitra, Niloy J.

2011-01-01

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

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.

Use of modified electroconvulsive therapy in a case of polymyositis presenting with delusion of nihilism of proxy (Odysseus syndrome).

Science.gov (United States)

Shah, Ruchita; Grover, Sandeep; Krishna, Kodakandla; Singh, Dharminder

2011-03-01

We present a case of psychotic depression with polymyositis presenting with the distinct phenomenon of nihilism by proxy, which was treated with electroconvulsive therapy (ECT). A female patient with polymyositis was initially treated with pharmacotherapy. After initial response, there was deterioration in her mental state and hence, after careful consideration, neurological, and anaesthetic consultations, modified ECT was given with close monitoring. The mental state of the patient improved with a course of ECT, which proceeded without any complications. Her depressive symptoms including the delusion of nihilism by proxy responded to ECT. To the best of our knowledge, the use of ECT has not been reported in a case of polymyositis before, and this case shows that modified ECT can be given successfully in patients with polymyositis.

Revocable identity-based proxy re-signature against signing key exposure.

Science.gov (United States)

Yang, Xiaodong; Chen, Chunlin; Ma, Tingchun; Wang, Jinli; Wang, Caifen

2018-01-01

Identity-based proxy re-signature (IDPRS) is a novel cryptographic primitive that allows a semi-trusted proxy to convert a signature under one identity into another signature under another identity on the same message by using a re-signature key. Due to this transformation function, IDPRS is very useful in constructing privacy-preserving schemes for various information systems. Key revocation functionality is important in practical IDPRS for managing users dynamically; however, the existing IDPRS schemes do not provide revocation mechanisms that allow the removal of misbehaving or compromised users from the system. In this paper, we first introduce a notion called revocable identity-based proxy re-signature (RIDPRS) to achieve the revocation functionality. We provide a formal definition of RIDPRS as well as its security model. Then, we present a concrete RIDPRS scheme that can resist signing key exposure and prove that the proposed scheme is existentially unforgeable against adaptive chosen identity and message attacks in the standard model. To further improve the performance of signature verification in RIDPRS, we introduce a notion called server-aided revocable identity-based proxy re-signature (SA-RIDPRS). Moreover, we extend the proposed RIDPRS scheme to the SA-RIDPRS scheme and prove that this extended scheme is secure against adaptive chosen message and collusion attacks. The analysis results show that our two schemes remain efficient in terms of computational complexity when implementing user revocation procedures. In particular, in the SA-RIDPRS scheme, the verifier needs to perform only a bilinear pairing and four exponentiation operations to verify the validity of the signature. Compared with other IDPRS schemes in the standard model, our SA-RIDPRS scheme greatly reduces the computation overhead of verification.

Munchausen syndrome by proxy: a family anthology.

Science.gov (United States)

Pickford, E; Buchanan, N; McLaughlan, S

1988-06-20

While the Munchausen-by-proxy syndrome is well recognized, the story of one family has been related to describe some remarkable features. These include the psychopathology of the mother, the involvement of both children in the family, the great difficulty in obtaining proof of child abuse and, finally, the prosecution of the mother in the criminal court.

Understanding the Cognitive and Affective Mechanisms that Underlie Proxy Risk Perceptions among Caregivers of Asthmatic Children.

Science.gov (United States)

Shepperd, James A; Lipsey, Nikolette P; Pachur, Thorsten; Waters, Erika A

2018-07-01

Medical decisions made on behalf of another person-particularly those made by adult caregivers for their minor children-are often informed by the decision maker's beliefs about the treatment's risks and benefits. However, we know little about the cognitive and affective mechanisms influencing such "proxy" risk perceptions and about how proxy risk perceptions are related to prominent judgment phenomena. Adult caregivers of minor children with asthma ( N = 132) completed an online, cross-sectional survey assessing 1) cognitions and affects that form the basis of the availability, representativeness, and affect heuristics; 2) endorsement of the absent-exempt and the better-than-average effect; and 3) proxy perceived risk and unrealistic comparative optimism of an asthma exacerbation. We used the Pediatric Asthma Control and Communication Instrument (PACCI) to assess asthma severity. Respondents with higher scores on availability, representativeness, and negative affect indicated higher proxy risk perceptions and (for representativeness only) lower unrealistic optimism, irrespective of asthma severity. Conversely, respondents who showed a stronger display of the better-than-average effect indicated lower proxy risk perceptions but did not differ in unrealistic optimism. The absent-exempt effect was unrelated to proxy risk perceptions and unrealistic optimism. Heuristic judgment processes appear to contribute to caregivers' proxy risk perceptions of their child's asthma exacerbation risk. Moreover, the display of other, possibly erroneous, judgment phenomena is associated with lower caregiver risk perceptions. Designing interventions that target these mechanisms may help caregivers work with their children to reduce exacerbation risk.

Sea ice and primary production proxies in surface sediments from a High Arctic Greenland fjord

DEFF Research Database (Denmark)

Ribeiro, Sofia; Sejr, Mikael K; Limoges, Audrey

2017-01-01

Monitoring Programme. Clear spatial gradients in organic carbon and biogenic silica contents reflected marine influence, nutrient availability and river-induced turbidity, in good agreement with in situ measurements. The sea ice proxy IP25 was detected at all sites but at low concentrations, indicating...... that IP25 records from fjords need to be carefully considered and not directly compared to marine settings. The sea ice-associated biomarker HBI III revealed an open-water signature, with highest concentrations near the mid-July ice edge. This proxy evaluation is an important step towards reliable......In order to establish a baseline for proxy-based reconstructions for the Young Sound–Tyrolerfjord system (Northeast Greenland), we analysed the spatial distribution of primary production and sea ice proxies in surface sediments from the fjord, against monitoring data from the Greenland Ecosystem...

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.

Proxy support for service discovery using mDNS/DNS-SD in low power networks

NARCIS (Netherlands)

Stolikj, M.; Verhoeven, R.; Cuijpers, P.J.L.; Lukkien, J.J.

2014-01-01

We present a solution for service discovery of resource constrained devices based on mDNS/DNS-SD. We extend the mDNS/DNS-SD service discovery protocol with support for proxy servers. Proxy servers temporarily store information about services offered on resource constrained devices and respond on

Spatial linkages between coral proxies of terrestrial runoff across a large embayment in Madagascar

Directory of Open Access Journals (Sweden)

C. A. Grove

2012-08-01

Full Text Available Coral cores provide vital climate reconstructions for site-specific temporal variability in river flow and sediment load. Yet, their ability to record spatial differences across multiple catchments is relatively unknown. Here, we investigate spatial linkages between four coral proxies of terrestrial runoff and their relationships between sites. Coral cores were drilled in and around Antongil Bay, the largest bay in Madagascar, and individually analysed for fifteen years of continuous luminescence (G / B, Ba / Ca, δ¹⁸O_sw and δ¹³C data. Each coral core was drilled close to individual river mouths (≥ 7 km, and proxy data were compared to modelled river discharge and sediment runoff data for the three corresponding catchments. A reasonable agreement between terrestrial runoff proxies with modelled river discharge and sediment yield was observed. Some inconsistencies between proxy and modelled data are likely linked to proxy behaviour, watershed size and local environmental physiochemical parameters. In general, the further a coral resided from its river source, the weaker the proxy relationship was with modelled data and other corals, due to mixing gradients and currents. Nevertheless, we demonstrate that two coral Ba / Ca and luminescence (G / B records influenced by the same watershed are reproducible. Furthermore, a strong Ba / Ca relationship was observed between two cores from distant watersheds, with baseline averages in agreement with modelled sediment runoff data. As humic acids behave conservatively in the water column, luminescence (G / B data gave the highest regional correlations between cores, and showed the most consistent relationship with site specific modelled discharge. No statistical relationship was observed between cores in terms of interannual δ¹⁸O_sw and δ¹³C, meaning corals were recording a localised signal at their respective sites, confounded by vital

Cross-cultural validity of the thyroid-specific quality-of-life patient-reported outcome measure, ThyPRO

NARCIS (Netherlands)

Watt, T.; Barbesino, G.; Bjorner, J.B.; Bonnema, S.J.; Bukvic, B.; Drummond, R.; Groenvold, M.; Hegedus, L.; Kantzer, V.; Lasch, K.E.; Marcocci, C.; Mishra, A.; Netea-Maier, R.T.; Ekker, M.; Paunovic, I.; Quinn, T.J.; Rasmussen, A.K.; Russell, A.; Sabaretnam, M.; Smit, J.W.; Torring, O.; Zivaljevic, V.; Feldt-Rasmussen, U.

2015-01-01

BACKGROUND AND PURPOSE: Thyroid diseases are common and often affect quality of life (QoL). No cross-culturally validated patient-reported outcome measuring thyroid-related QoL is available. The purpose of the present study was to test the cross-cultural validity of the newly developed

Testing New Proxies for Photosymbiosis in the Fossil Record

Science.gov (United States)

Tornabene, C.; Martindale, R. C.; Schaller, M. F.

2015-12-01

Photosymbiosis is a mutualistic relationship that many corals have developed with dinoflagellates called zooxanthellae. The dinoflagellates, of the genus Symbiodinium, photosynthesize and provide corals with most of their energy, while in turn coral hosts live in waters where zooxanthellae have optimal exposure to sunlight. Thanks to this relationship, symbiotic corals calcify faster than non-symbiotic corals. Photosymbiosis is therefore considered the evolutionary innovation that allowed corals to become major reef-builders through geological time.This relationship is extremely difficult to study. Zooxanthellae, which are housed in the coral tissue, are not preserved in fossil coral skeletons, thus determining whether corals had symbionts requires a robust proxy. In order to address this critical question, the goal of this research is to test new proxies for ancient photosymbiosis. Currently the project is focused on assessing the nitrogen (δ15N) isotopes of corals' organic matrices, sensu Muscatine et al. (2005), as well as carbon and oxygen (δ13C, δ18O) isotopes of fossil coral skeletons. Samples from Modern, Pleistocene, Oligocene and Triassic coral skeletons were analyzed to test the validity of these proxies. Coral samples comprise both (interpreted) symbiotic and non-symbiotic fossil corals from the Oligocene and Triassic as well as symbiotic fossil corals from the Modern and Pleistocene to corroborate our findings with the results of Muscatine et al. (2005). Samples were tested for diagenesis through petrographic and scanning electron microscope (SEM) analyses to avoid contamination. Additionally, a novel technique that has not yet been applied to the fossil record was tested. The technique aims to recognize dinosterol, a dinoflagellate biomarker, in both modern and fossil coral samples. The premise of this proxy is that symbiotic corals should contain the dinoflagellate biomarker, whereas those lacking symbionts should lack dinosterol. Results from this

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

Harvard Law School Proxy Access Roundtable

OpenAIRE

Bebchuk, Lucian Arye; Hirst, Scott

2010-01-01

This paper contains the proceedings of the Proxy Access Roundtable that was held by the Harvard Law School Program on Corporate Governance on October 7, 2009. The Roundtable brought together prominent participants in the debate - representing a range of perspectives and experiences - for a day of discussion on the subject. The day’s first two sessions focused on the question of whether the Securities and Exchange Commission should provide an access regime, or whether it should leave the adopt...

Proxy decision making and dementia: Using Construal Level Theory to analyse the thoughts of decision makers.

Science.gov (United States)

Convey, Helen; Holt, Janet; Summers, Barbara

2018-03-08

This study explored the feasibility of using Construal Level Theory to analyse proxy decision maker thinking about a hypothetical ethical dilemma, relating to a person who has dementia. Proxy decision makers make decisions on behalf of individuals who are living with dementia when dementia affects that individual's decision making ability. Ethical dilemmas arise because there is a need to balance the individual's past and contemporary values and views. Understanding of how proxy decision makers respond is incomplete. Construal Level Theory contends that individuals imagine reactions and make predications about the future by crossing psychological distance. This involves abstract thinking, giving meaning to decisions. There is no empirical evidence of Construal Level Theory being used to analyse proxy decision maker thinking. Exploring the feasibility of using Construal Level Theory to understand dementia carer thinking regarding proxy decisions may provide insights which inform the support given. Descriptive qualitative research with semi-structured interviews. Seven participants were interviewed using a hypothetical dementia care scenario in February 2016. Interview transcripts were analysed for themes. Construal Level Theory was applied to analyse participant responses within themes using the Linguistic Category Model. Participants travelled across psychological distance, using abstract thinking to clarify goals and provide a basis for decisions. When thinking concretely participants established boundaries regarding the ethical dilemma. Construal Level Theory gives insight into proxy decision maker thinking and the levels of abstraction used. Understanding what dementia carers think about when making proxy decisions may help nurses to understand their perspectives and to provide appropriate support. © 2018 John Wiley & Sons Ltd.

Development and psychometric characteristics of the SCI-QOL Ability to Participate and Satisfaction with Social Roles and Activities item banks and short forms.

Science.gov (United States)

Heinemann, Allen W; Kisala, Pamela A; Hahn, Elizabeth A; Tulsky, David S

2015-05-01

To develop a spinal cord injury (SCI)-focused version of PROMIS and Neuro-QOL social domain item banks; evaluate the psychometric properties of items developed for adults with SCI; and report information to facilitate clinical and research use. We used a mixed-methods design to develop and evaluate Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities items. Focus groups helped define the constructs; cognitive interviews helped revise items; and confirmatory factor analysis and item response theory methods helped calibrate item banks and evaluate differential item functioning related to demographic and injury characteristics. Five SCI Model System sites and one Veterans Administration medical center. The calibration sample consisted of 641 individuals; a reliability sample consisted of 245 individuals residing in the community. A subset of 27 Ability to Participate and 35 Satisfaction items demonstrated good measurement properties and negligible differential item functioning related to demographic and injury characteristics. The SCI-specific measures correlate strongly with the PROMIS and Neuro-QOL versions. Ten item short forms correlate >0.96 with the full banks. Variable-length CATs with a minimum of 4 items, variable-length CATs with a minimum of 8 items, fixed-length CATs of 10 items, and the 10-item short forms demonstrate construct coverage and measurement error that is comparable to the full item bank. The Ability to Participate and Satisfaction with Social Roles and Activities CATs and short forms demonstrate excellent psychometric properties and are suitable for clinical and research applications.

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

Correlates of self-reported quality of life in adults and children from the Morphea in Adults and Children cohort I

Science.gov (United States)

Das, Shinjita; Bernstein, Ira; Jacobe, Heidi

2014-01-01

Background Determining a disease's impact on life quality is important in clinical decision making, research, and resource allocation. Determinants of quality of life (QOL) in morphea are poorly understood. Objective We sought to ascertain demographic and clinical variables correlated with negative impact on self-reported QOL in morphea. Methods We conducted a cross-sectional survey of the Morphea in Adults and Children cohort. Results Symptoms (pruritus and pain) and functional impairment were correlated with decreased QOL in children and adults. This was true in both sexes and was independent of subtype and age. Patient-reported QOL correlated with physician-based measures of disease severity in adults, but not in children. Patients with linear and generalized morphea had the greatest impact on QOL. Limitations Small sample size is a limitation. Conclusion Symptoms and functional impairment were determinants of impaired life quality in both children and adults independent of morphea subtype. These results suggest that clinicians should consider suppressing the accumulation of new lesions (when rapidly accumulating) and symptoms (pain and pruritus) in the treatment of patients with morphea. PMID:24534655

Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison's disease.

Science.gov (United States)

van der Valk, Eline S; Smans, Lisanne C C J; Hofstetter, Hedwig; Stubbe, Janine H; de Vries, Marieke; Backx, Frank J G; Hermus, Ad R M M; Zelissen, Pierre M J

2016-09-01

Health-related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. The aim of this study was to investigate the quality of life in Dutch patients with Addison's disease particularly regarding the presence of fatigue and the ability to be physically active. In this cross-sectional study, a postal survey was performed among Dutch patients with Addison's disease on stable glucocorticoid replacement therapy with hydrocortisone or cortisone acetate. For quality of life and physical activity assessment, patients completed general and health-related quality of life and physical activity questionnaires, and scores were compared to Dutch controls. A total of 328 patients with Addison's disease were studied. In patients with Addison's disease, only 45·7% met the standard of physical activity (Combinorm) compared to 67·8% of Dutch controls (P < 0·01). Forty-eight per cent of patients showed abnormal fatigue, while 61% had severe fatigue. The CIS fatigue scores were significantly higher compared to controls (P < 0·01). We found reduced general subjective health-related QoL scores in both male and female patients, especially in younger patients <65 years of age. Physical activity is decreased in patients with Addison's disease, combined with a reduced subjective health-related QoL and increased fatigue. © 2016 John Wiley & Sons Ltd.

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

2018-04-01

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.

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.

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.

PROXY-BASED PATCHING STREAM TRANSMISSION STRATEGY IN MOBILE STREAMING MEDIA SYSTEM

Institute of Scientific and Technical Information of China (English)

Liao Jianxin; Lei Zhengxiong; Ma Xutao; Zhu Xiaomin

2006-01-01

A mobile transmission strategy, PMPatching (Proxy-based Mobile Patching) transmission strategy is proposed, it applies to the proxy-based mobile streaming media system in Wideband Code Division Multiple Access (WCDMA) network. Performance of the whole system can be improved by using patching stream to transmit anterior part of the suffix that had been played back, and by batching all the demands for the suffix arrived in prefix period and patching stream transmission threshold period. Experimental results show that this strategy can efficiently reduce average network transmission cost and number of channels consumed in central streaming media server.

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

Data Cleaning Methods for Client and Proxy Logs

NARCIS (Netherlands)

Weinreich, H.; Obendorf, H.; Herder, E.; Edmonds, A.; Hawkey, K.; Kellar, M.; Turnbull, D.

2006-01-01

In this paper we present our experiences with the cleaning of Web client and proxy usage logs, based on a long-term browsing study with 25 participants. A detailed clickstream log, recorded using a Web intermediary, was combined with a second log of user interface actions, which was captured by a

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…

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 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 the potential to be applicable as a palaeotemperature proxy for lacustrine environments

Construct validity of the items on the Stroke Specific Quality of Life (SS-QOL) questionnaire that evaluate the participation component of the International Classification of Functioning, Disability and Health.

Science.gov (United States)

Silva, Soraia Micaela; Corrêa, Fernanda Ishida; Pereira, Gabriela Santos; Faria, Christina Danielli Coelho de Morais; Corrêa, João Carlos Ferrari

2018-01-01

Analyze the construct validity and internal consistency of the Stroke Specific Quality of Life (SS-QOL) items that address the participation component of the ICF as well as analyze the ceiling and floor effects. One hundred subjects were analyzed: 85 community-dwelling and 15 institutionalized individuals. The analysis of construct validity was performed using classic psychometrics: (1) the comparison of known groups (individuals without restriction to participation vs. those with restriction to participation) using the Mann-Whitney test and (2) convergent validity - correlation between the scores on the SS-QOL items that address participation and the subscale scores of measures used to evaluate the similar constructs and concepts [the Short-Form Health Survey (SF-36), Functional Independence Measure (FIM) and grip strength test]. Spearman's correlation coefficients were calculated for this analysis. Cronbach's α was used for the analysis of internal consistency and both the ceiling and floor effects were analyzed. The level of significance for all analyses was α = 0.05. The a priori hypotheses regarding construct validity were partially demonstrated, as only five of the eight domains exhibited positive moderate to strong correlations (r > 0.40) with measures that address constructs similar to those addressed on the SS-QOL questionnaire. The items demonstrated adequate internal consistency and are capable of differentiating individuals with and without restriction to participation. The ceiling and floor effects were considered adequate for the total SS-QOL score, but beyond acceptable standards for some domains. The 26 items of the SS-QOL questionnaire measure a multidimensional construct and therefore do not only address participation. However, the items demonstrated adequate internal consistency and are capable of differentiating individuals with and without restriction to participation. Implications for rehabilitation The 26 items of the SS-QOL

The Association of Mindful Parenting with Glycemic Control and Quality of Life in Adolescents with Type 1 Diabetes: Results from Diabetes MILES-The Netherlands.

Science.gov (United States)

Serkel-Schrama, Inge J P; de Vries, Jolanda; Nieuwesteeg, Anke M; Pouwer, Frans; Nyklíček, Ivan; Speight, Jane; de Bruin, Esther I; Bögels, Susan M; Hartman, Esther E

The objective of this study was to examine associations between the mindful parenting style of parents of adolescents (aged 12-18) with type 1 diabetes mellitus (T1DM), and the glycaemic control and quality of life (QoL) of the adolescents. Chronic health conditions, such as T1DM, that require demanding treatment regimens, can negatively impact adolescents' quality of life. Therefore, it is important to determine whether mindful parenting may have a positive impact in these adolescents. Age, sex and duration of T1DM were examined as potential moderators. Parents ( N  = 215) reported on their own mindful parenting style (IM-P-NL) and the adolescents' glycaemic control. Parents and the adolescents with T1DM ( N  = 129) both reported on adolescents' generic and diabetes-specific QoL (PedsQL™). The results showed that a more mindful parenting style was associated with more optimal hemoglobin A 1c (HbA 1c ) values for boys. For girls, a more mindful parenting style was associated with not having been hospitalized for ketoacidosis. For both boys and girls, a more mindful parenting style was associated with better generic and diabetes-specific proxy-reported QoL. In conclusion, mindful parenting style may be a factor in helping adolescents manage their T1DM. Mindful parenting intervention studies for parents of adolescents with T1DM are needed to examine the effects on adolescents' glycaemic control and their quality of life.

Quality of life after quitting smoking and initiating aerobic exercise.

Science.gov (United States)

Bloom, Erika Litvin; Minami, Haruka; Brown, Richard A; Strong, David R; Riebe, Deborah; Abrantes, Ana M

2017-10-01

Quitting smoking and aerobic exercise each improve health. Although smokers may be concerned that quitting smoking will reduce their quality of life (QOL), recent research has shown that cessation is associated with QOL benefits. Elements of smoking cessation interventions, such as exercise, may contribute to changes in QOL. However, it is unknown whether initiating exercise in the context of smoking cessation is associated with greater or different effects on QOL than smoking cessation alone. The current study is a secondary analysis of data from a randomized trial (n = 61) of an exercise intervention for smoking cessation. We hypothesized that smoking abstinence and engagement in exercise would have positive, additive effects on QOL at end-of-treatment, 6- and, 12-month follow-ups. Sedentary adult smokers were randomized to the exercise intervention or a health education control (HEC) group. Additionally, all participants received smoking cessation counseling and nicotine patches. Data were analyzed using actual engagement in exercise, rather than group assignment as a proxy for exercise engagement, because some HEC participants also began exercising. Abstinence was positively associated with higher total and physical health QOL at follow-up. Exercise was not associated with total QOL and only marginally associated with physical health QOL, but was positively related to overall sense of well-being. Emphasizing that smoking cessation is associated with higher QOL may help motivate smokers to initiate quit attempts.

Development and Evaluation of the PROMIS® Pediatric Positive Affect Item Bank, Child-Report and Parent-Proxy Editions.

Science.gov (United States)

Forrest, Christopher B; Ravens-Sieberer, Ulrike; Devine, Janine; Becker, Brandon D; Teneralli, Rachel; Moon, JeanHee; Carle, Adam; Tucker, Carole A; Bevans, Katherine B

2018-03-01

The purpose of this study is to describe the psychometric evaluation and item response theory calibration of the PROMIS Pediatric Positive Affect item bank, child-report and parent-proxy editions. The initial item pool comprising 53 items, previously developed using qualitative methods, was administered to 1,874 children 8-17 years old and 909 parents of children 5-17 years old. Analyses included descriptive statistics, reliability, factor analysis, differential item functioning, and construct validity. A total of 14 items were deleted, because of poor psychometric performance, and an 8-item short form constructed from the remaining 39 items was administered to a national sample of 1,004 children 8-17 years old, and 1,306 parents of children 5-17 years old. The combined sample was used in item response theory (IRT) calibration analyses. The final item bank appeared unidimensional, the items appeared locally independent, and the items were free from differential item functioning. The scales showed excellent reliability and convergent and discriminant validity. Positive affect decreased with children's age and was lower for those with a special health care need. After IRT calibration, we found that 4 and 8 item short forms had a high degree of precision (reliability) across a wide range of the latent trait (>4 SD units). The PROMIS Pediatric Positive Affect item bank and its short forms provide an efficient, precise, and valid assessment of positive affect in children and youth.

Metallic stents provide better QOL than plastic stents in patients with stricture of unresectable advanced esophageal cancer

International Nuclear Information System (INIS)

Ohta, Kazuki; Nagahara, Akihito; Iijima, Katsuyori

2006-01-01

The aim of this study was to elucidate the utility and safety of treatment with esophageal stents (plastic and metallic stents) for unresectable advanced esophageal cancer. Between 1992 and 2002, 14 cases of unresectable advanced esophageal cancer were treated with esophageal stents (the plastic stent group, 7 cases; and the metallic stent group, 7 cases). Of these, 10 cases had a history of chemotherapy and or radiotherapy. An improvement in oral intake and performance status (PS), survival time, periods at home, and adverse events were compared between the two groups. After stenting, oral intake and PS were significantly improved in the metallic stent group. Follow-up at home was possible in 71.4%. There was no significant difference in survival or duration of time at home between the two groups. All adverse events were controllable and there was no difference between the two groups. Stenting not only improved oral intake and PS but also allowed a stay at home, resulting in a marked improvement in patients' quality of life (QOL). Stenting was performed safely even in cases with a history of radiotherapy. There was no difference in survival, ratios of staying at home, and safety between the two groups, but QOL was significantly improved in the metallic stent group. These outcomes indicate that placement of metallic stents should be actively considered to treat stricture due to advanced esophageal cancer. (author)

Shifty: A Weight-Shifting Dynamic Passive Haptic Proxy to Enhance Object Perception in Virtual Reality.

Science.gov (United States)

Zenner, Andre; Kruger, Antonio

2017-04-01

We define the concept of Dynamic Passive Haptic Feedback (DPHF) for virtual reality by introducing the weight-shifting physical DPHF proxy object Shifty. This concept combines actuators known from active haptics and physical proxies known from passive haptics to construct proxies that automatically adapt their passive haptic feedback. We describe the concept behind our ungrounded weight-shifting DPHF proxy Shifty and the implementation of our prototype. We then investigate how Shifty can, by automatically changing its internal weight distribution, enhance the user's perception of virtual objects interacted with in two experiments. In a first experiment, we show that Shifty can enhance the perception of virtual objects changing in shape, especially in length and thickness. Here, Shifty was shown to increase the user's fun and perceived realism significantly, compared to an equivalent passive haptic proxy. In a second experiment, Shifty is used to pick up virtual objects of different virtual weights. The results show that Shifty enhances the perception of weight and thus the perceived realism by adapting its kinesthetic feedback to the picked-up virtual object. In the same experiment, we additionally show that specific combinations of haptic, visual and auditory feedback during the pick-up interaction help to compensate for visual-haptic mismatch perceived during the shifting process.

Simple proxies for estimating the concentrations of monoterpenes and their oxidation products at a boreal forest site

Directory of Open Access Journals (Sweden)

J. Kontkanen

2016-10-01

Full Text Available The oxidation products of monoterpenes likely have a crucial role in the formation and growth of aerosol particles in boreal forests. However, the continuous measurements of monoterpene concentrations are usually not available on decadal timescales, and the direct measurements of the concentrations of monoterpene oxidation product have so far been scarce. In this study we developed proxies for the concentrations of monoterpenes and their oxidation products at a boreal forest site in Hyytiälä, southern Finland. For deriving the proxies we used the monoterpene concentration measured with a proton transfer reaction mass spectrometer (PTR-MS during 2006–2013. Our proxies for the monoterpene concentration take into account the temperature-controlled emissions from the forest ecosystem, the dilution caused by the mixing within the boundary layer and different oxidation processes. All the versions of our proxies captured the seasonal variation of the monoterpene concentration, the typical proxy-to-measurements ratios being between 0.8 and 1.3 in summer and between 0.6 and 2.6 in winter. In addition, the proxies were able to describe the diurnal variation of the monoterpene concentration rather well, especially in summer months. By utilizing one of the proxies, we calculated the concentration of oxidation products of monoterpenes by considering their production in the oxidation and their loss due to condensation on aerosol particles. The concentration of oxidation products was found to have a clear seasonal cycle, with a maximum in summer and a minimum in winter. The concentration of oxidation products was lowest in the morning or around noon and highest in the evening. In the future, our proxies for the monoterpene concentration and their oxidation products can be used, for example, in the analysis of new particle formation and growth in boreal environments.

Ocean currents generate large footprints in marine palaeoclimate proxies

NARCIS (Netherlands)

van Sebille, E.; Scussolini, P.; Durgadoo, J.V.; Peeters, F.J.C.; Biastoch, A.; Weijer, W.; Turney, C.; Paris, C.B.; Zahn, R.

2015-01-01

Fossils of marine microorganisms such as planktic foraminifera are among the cornerstones of palaeoclimatological studies. It is often assumed that the proxies derived from their shells represent ocean conditions above the location where they were deposited. Planktic foraminifera, however, are

Deuterium Values from Hydrated Volcanic Glass: A Paleoelevation Proxy for Oregon's Cascade Range

Science.gov (United States)

Carlson, T. B.; Bershaw, J. T.; Cassel, E. J.

2017-12-01

Deuterium ratios (δD) of hydrated volcanic glass have been used to reconstruct Cenozoic paleoenvironments. However, the reliability and proper sample preparation protocol have been debated. The Cascades are an excellent location to study the validity of hydrated volcanic glass as a paleoelevation proxy for several reasons. Moisture is largely 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). Additionally, past studies have inferred uplift of the Cascades since the Miocene based on changing fossil assemblages, tectonic models, and other isotopic proxies including soil carbonates and fossil teeth. In this study, hydrated volcanic ash samples from the lee of the Cascades were rinsed with hydrochloric acid and sonicated before glass shards were hand-selected and analyzed for δD and wt. % water. These preliminary results exhibited δD values becoming enriched with time, a trend opposite of other paleowater proxy studies in the area. A possible explanation for this trend is contamination due to inadequate removal of materials adhered to shard surfaces that can readily exchange with environmental water. Recent research asserts that hydrofluoric acid (HF) etching during sample preparation is necessary to accurately measure δD values of syndepositional water. Volcanic ash samples were reanalyzed after preparation using HF abrasion and heavy liquid separation. The data from these two subsets are interpreted in the context of modern water across the range, as well as other paleowater proxy and geologic studies to determine the implications of volcanic glass as a paleoelevation proxy in the Pacific Northwest.

Quercus macrocarpa annual, early- and latewood widths as hydroclimatic proxies, southeastern Saskatchewan, Canada

International Nuclear Information System (INIS)

Vanstone, Jessica R; Sauchyn, David J

2010-01-01

Fluctuations in size of annual ring-widths of Quercus species suggest that environmental factors influence the size and density of vessels within the ring, either by acting as a limiting factor for growth or through fine tuning of the wood structure to environmental factors. The purpose of this study is to assess the potential of Q. macrocarpa to provide multiple dendroclimatic proxies for the Canadian Prairies, by investigating growth responses of annual, early- and latewood widths to regional climate variability. Results indicate that ring width chronologies, from southeastern Saskatchewan capture regional signals related to moisture and drought conditions. Correlations suggest that late-wood widths are more representative of annual ring-widths, than are early-wood widths, and are the best proxy of seasonal fluctuations in climate. Thus regression models that include latewood widths were able to account for more variance in the Palmer Drought Severity Index (PDSI) than when annual ring-widths are used as the only proxy. This study demonstrates that Q. macrocarpa can provide multiple dendroclimatic proxies for investigating large scale climatic fluctuations at annual and sub-annual time scales. It is novel in terms of sub-annual analysis of tree-rings in a region that previously lacked dendrochronological research.

Assessment of parent reported quality of life in children with epilepsy from Northern India: A cross-sectional study.

Science.gov (United States)

Arya, Vandana; Gehlawat, Virender Kumar; Kaushik, Jaya Shankar; Gathwala, Geeta

2014-01-01

The objective of the following study is to assess parent reported quality of life (QOL) in children with epilepsy and to assess the demographic and clinical factors, which influence the QOL in children with epilepsy. We consecutively enrolled 40 children aged from 2 years to 14 years with active epilepsy who had undergone a comprehensive evaluation for epilepsy. Parents were enquired on baseline demographic variables including age, gender, socio-economic status and parental education. Clinical details of epilepsy including the type of epilepsy, seizure frequency were assessed. QOL was evaluated with the parent reported quality of life in childhood epilepsy (QOLCE) questionnaire. A total of 40 children were enrolled of which 55% (22/40) were males and the mean (standard deviation [SD]) age of enrolled children was 10.6 (2.7) years. The majority came from a rural background (80% [32/40]), were from lower (15 [37.5%]) or middle (23 [57.5%]) socio-economic status, with almost half (22 [55%]) of mothers being educated until high school. The overall mean (SD) QOL score was 66.7 (4.83). Lowest mean (SD) scores were observed in self-esteem (45.2 [7.3]) subscale and subscales with higher QOL scores included control/helplessness (82.1 [8.51]), anxiety (81.6 [12.55]) and social stigma (95.0 [11.6]). Parental education, socio-economic status (P = 0.96), frequency of seizure (P = 0.34) or type of epilepsy (P = 0.92) did not significantly affect the overall QOL among children with epilepsy. Our study concluded that overall QOL was compromised in Indian children with epilepsy. Demographic factors like parental education, socio-economic status and clinical factors like frequency of seizure or type of seizure did not significantly affect the QOL of epileptic children.

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.

Opportunities and limitations related to the application of plant-derived lipid molecular proxies in soil science

Directory of Open Access Journals (Sweden)

B. Jansen

2017-11-01

Full Text Available The application of lipids in soils as molecular proxies, also often referred to as biomarkers, has dramatically increased in the last decades. Applications range from inferring changes in past vegetation composition, climate, and/or human presence to unraveling the input and turnover of soil organic matter (SOM. The molecules used are extractable and non-extractable lipids, including ester-bound lipids. In addition, the carbon or hydrogen isotopic composition of such molecules is used. While holding great promise, the application of soil lipids as molecular proxies comes with several constraining factors, the most important of which are (i variability in the molecular composition of plant-derived organic matter both internally and between individual plants, (ii variability in (the relative contribution of input pathways into the soil, and (iii the transformation and/or (selective degradation of (some of the molecules once present in the soil. Unfortunately, the information about such constraining factors and their impact on the applicability of molecular proxies is fragmented and scattered. The purpose of this study is to provide a critical review of the current state of knowledge with respect to the applicability of molecular proxies in soil science, specifically focusing on the factors constraining such applicability. Variability in genetic, ontogenetic, and environmental factors influences plant n-alkane patterns in such a way that no unique compounds or specific molecular proxies pointing to, for example, plant community differences or environmental influences, exist. Other components, such as n-alcohols, n-fatty acids, and cutin- and suberin-derived monomers, have received far less attention in this respect. Furthermore, there is a high diversity of input pathways offering both opportunities and limitations for the use of molecular proxies at the same time. New modeling approaches might offer a possibility to unravel such mixed input

Work performance evaluation and QoL of adults with High Functioning Autism Spectrum Disorders (HFASD).

Science.gov (United States)

Katz, Noomi; Dejak, Ifat; Gal, Eynat

2015-01-01

Studies suggest that adults with High Functioning Autism Spectrum Disorders (HFASD) are reliant on others for support in functioning in everyday life and employment. This study followed a work placement program for people with HFASD over a nine months period. It aimed to measure the trajectory of their work performance and Quality of life on jobs in the open market. Twenty-six participants with HFASD ages 18-40 underwent extensive evaluation and based on it were placed in various jobs on the open market. Participants were followed for nine months at their work place at four different time points. QoL was self-assessed in addition to work performance (WPE) which was assessed both by first-hand and team member's accounts. Team members are health professional who accompany and support the participants in the transition to their jobs. All 26 participants were able to maintain their jobs during the nine months of follow-up. WPE was perceived as high to start with, and its scores slightly improved by both people with HFASD and team members. Self-report suggests a significant change in the quality of life of the participants, specifically in their evaluations of self-competency. This study enhances the importance of providing people with HFASD with work placing programs and following up during actual work performance.

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.

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.)

Diffie-Hellman Key Based Authentication in Proxy Mobile IPv6

Directory of Open Access Journals (Sweden)

HyunGon Kim

2010-01-01

Full Text Available Wireless communication service providers have been showing strong interest in Proxy Mobile IPv6 for providing network-based IP mobility management. This could be a prominent way to support IP mobility to mobile nodes, because Proxy Mobile IPv6 requires minimal functionalities on the mobile node. While several extensions for Proxy Mobile IPv6 are being developed in the Internet Engineering Task Force, there has been little attentions paid to developing efficient authentication mechanisms. An authentication scheme for a mobility protocol must protect signaling messages against various security threats, e.g., session stealing attack, intercept attack by redirection, replay attack, and key exposure, while minimizing authentication latency. In this paper, we propose a Diffie-Hellman key based authentication scheme that utilizes the low layer signaling to exchange Diffie-Hellman variables and allows mobility service provisioning entities to exchange mobile node's profile and ongoing sessions securely. By utilizing the low layer signaling and context transfer between relevant nodes, the proposed authentication scheme minimizes authentication latency when the mobile node moves across different networks. In addition, thanks to the use of the Diffie-Hellman key agreement, pre-established security associations between mobility service provisioning entities are not required in the proposed authentication scheme so that network scalability in an operationally efficient manner is ensured. To ascertain its feasibility, security analysis and performance analysis are presented.

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

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). 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. 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 <0.70) while discriminant validity was acceptable within each instrument. Sensitivity was satisfied in self-evaluated health status (both instruments) and average daily methadone dose (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). 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.

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.

Directory of Open Access Journals (Sweden)

Kaina Zhou

Full Text Available 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 <0.70 while discriminant validity was acceptable within each instrument. Sensitivity was satisfied in self-evaluated health status (both instruments and average daily methadone dose (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.

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.

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.

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.

Educational Attainment is not a Good Proxy for Cognitive Function in Methamphetamine Dependence

Science.gov (United States)

Dean, Andy C.; Hellemann, Gerhard; Sugar, Catherine A.; London, Edythe D.

2014-01-01

We sought to test the hypothesis that methamphetamine use interferes with both the quantity and quality of one's education, such that the years of education obtained by methamphetamine dependent individuals serves to underestimate general cognitive functioning and overestimate the quality of academic learning. Thirty-six methamphetamine-dependent participants and 42 healthy comparison subjects completed cognitive tests and self-report measures in Los Angeles, California. An overall cognitive battery score was used to assess general cognition, and vocabulary knowledge was used as a proxy for the quality of academic learning. Linear regression procedures were used for analyses. Supporting the hypothesis that methamphetamine use interferes with the quantity of education, we found that a) earlier onset of methamphetamine use was associated with fewer years of education (p battery score (p < .01); and c) greater differences between methamphetamine-dependent participants' predicted and actual educational attainment were associated with an earlier onset of MA use (p ≤ .01). Supporting the hypothesis that methamphetamine use interferes with the quality of education, years of education received prior to the onset of methamphetamine use was a better predictor of a proxy for academic learning, vocabulary knowledge, than was the total years of education obtained. Results support the hypothesis that methamphetamine use interferes with the quantity and quality of educational exposure, leading to under- and overestimation of cognitive function and academic learning, respectively. PMID:22206606

Educational attainment is not a good proxy for cognitive function in methamphetamine dependence.

Science.gov (United States)

Dean, Andy C; Hellemann, Gerhard; Sugar, Catherine A; London, Edythe D

2012-06-01

We sought to test the hypothesis that methamphetamine use interferes with both the quantity and quality of one's education, such that the years of education obtained by methamphetamine dependent individuals serves to underestimate general cognitive functioning and overestimate the quality of academic learning. Thirty-six methamphetamine-dependent participants and 42 healthy comparison subjects completed cognitive tests and self-report measures in Los Angeles, California. An overall cognitive battery score was used to assess general cognition, and vocabulary knowledge was used as a proxy for the quality of academic learning. Linear regression procedures were used for analyses. Supporting the hypothesis that methamphetamine use interferes with the quantity of education, we found that (a) earlier onset of methamphetamine use was associated with fewer years of education (pbattery score (p<.01); and (c) greater differences between methamphetamine-dependent participants' predicted and actual educational attainment were associated with an earlier onset of MA use (p≤.01). Supporting the hypothesis that methamphetamine use interferes with the quality of education, years of education received prior to the onset of methamphetamine use was a better predictor of a proxy for academic learning, vocabulary knowledge, than was the total years of education obtained. Results support the hypothesis that methamphetamine use interferes with the quantity and quality of educational exposure, leading to under- and overestimation of cognitive function and academic learning, respectively. Copyright © 2011. Published by Elsevier Ireland Ltd.

Comparison of independent proxies in the reconstruction of deep ...

African Journals Online (AJOL)

Independent proxies were assessed in two Late Quaternary sediment cores from the eastern South Atlantic to compare deep-water changes during the last 400 kyr. ... is exclusively observed during interglacials, with maximum factor loadings in ... only slightly without a significant glacial-interglacial pattern, as measured in a ...

Munchausen syndrome by proxy and child's rights

International Nuclear Information System (INIS)

Al-Haidar, Fatima A.

2008-01-01

Munchausen syndrome by proxy (MSBP) is an extreme form of child abuse in which perpetrators induce life-threatening conditions in their children. A case of MSBP is described in detail. Difficulties in diagnosis and management in this part of the world are presented. Until now, no national legal guidelines exist in the Kingdom of Saudi Arabia (KSA) to child abuse in general and MSBP in particular. Urgent guidelines, policies and legal system are required in the KSA. (author)

Measuring stigma after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Stigma item bank and short form.

Science.gov (United States)

Kisala, Pamela A; Tulsky, David S; Pace, Natalie; Victorson, David; Choi, Seung W; Heinemann, Allen W

2015-05-01

To develop a calibrated item bank and computer adaptive test (CAT) to assess the effects of stigma on health-related quality of life in individuals with spinal cord injury (SCI). Grounded-theory based qualitative item development methods, large-scale item calibration field testing, confirmatory factor analysis, and item response theory (IRT)-based psychometric analyses. Five SCI Model System centers and one Department of Veterans Affairs medical center in the United States. Adults with traumatic SCI. SCI-QOL Stigma Item Bank A sample of 611 individuals with traumatic SCI completed 30 items assessing SCI-related stigma. After 7 items were iteratively removed, factor analyses confirmed a unidimensional pool of items. Graded Response Model IRT analyses were used to estimate slopes and thresholds for the final 23 items. The SCI-QOL Stigma item bank is unique not only in the assessment of SCI-related stigma but also in the inclusion of individuals with SCI in all phases of its development. Use of confirmatory factor analytic and IRT methods provide flexibility and precision of measurement. The item bank may be administered as a CAT or as a 10-item fixed-length short form and can be used for research and clinical applications.

Development and psychometric evaluation of the PROMIS Pediatric Life Satisfaction item banks, child-report, and parent-proxy editions.

Science.gov (United States)

Forrest, Christopher B; Devine, Janine; Bevans, Katherine B; Becker, Brandon D; Carle, Adam C; Teneralli, Rachel E; Moon, JeanHee; Tucker, Carole A; Ravens-Sieberer, Ulrike

2018-01-01

To describe the psychometric evaluation and item response theory calibration of the PROMIS Pediatric Life Satisfaction item banks, child-report, and parent-proxy editions. A pool of 55 life satisfaction items was administered to 1992 children 8-17 years old and 964 parents of children 5-17 years old. Analyses included descriptive statistics, reliability, factor analysis, differential item functioning, and assessment of construct validity. Thirteen items were deleted because of poor psychometric performance. An 8-item short form was administered to a national sample of 996 children 8-17 years old, and 1294 parents of children 5-17 years old. The combined sample (2988 children and 2258 parents) was used in item response theory (IRT) calibration analyses. The final item banks were unidimensional, the items were locally independent, and the items were free from impactful differential item functioning. The 8-item and 4-item short form scales showed excellent reliability, convergent validity, and discriminant validity. Life satisfaction decreased with declining socio-economic status, presence of a special health care need, and increasing age for girls, but not boys. After IRT calibration, we found that 4- and 8-item short forms had a high degree of precision (reliability) across a wide range (>4 SD units) of the latent variable. The PROMIS Pediatric Life Satisfaction item banks and their short forms provide efficient, precise, and valid assessments of life satisfaction in children and youth.

Starspot variability as an X-ray radiation proxy

Science.gov (United States)

Arkhypov, Oleksiy V.; Khodachenko, Maxim L.; Lammer, Helmut; Güdel, Manuel; Lüftinger, Teresa; Johnstone, Colin P.

2018-05-01

Stellar X-ray emission plays an important role in the study of exoplanets as a proxy for stellar winds and as a basis for the prediction of extreme ultraviolet (EUV) flux, unavailable for direct measurements, which in their turn are important factors for the mass-loss of planetary atmospheres. Unfortunately, the detection thresholds limit the number of stars with the directly measured X-ray fluxes. At the same time, the known connection between the sunspots and X-ray sources allows using of the starspot variability as an accessible proxy for the stellar X-ray emission. To realize this approach, we analysed the light curves of 1729 main-sequence stars with rotation periods 0.5 X-ray to bolometric luminosity ratio Rx. As a result, the regressions for stellar X-ray luminosity Lx(P, Teff) and its related EUV analogue LEUV were obtained for the main-sequence stars. It was shown that these regressions allow prediction of average (over the considered stars) values of log (Lx) and log (LEUV) with typical errors of 0.26 and 0.22 dex, respectively. This, however, does not include the activity variations in particular stars related to their individual magnetic activity cycles.

On the construction of a time base and the elimination of averaging errors in proxy records

Science.gov (United States)

Beelaerts, V.; De Ridder, F.; Bauwens, M.; Schmitz, N.; Pintelon, R.

2009-04-01

Proxies are sources of climate information which are stored in natural archives (e.g. ice-cores, sediment layers on ocean floors and animals with calcareous marine skeletons). Measuring these proxies produces very short records and mostly involves sampling solid substrates, which is subject to the following two problems: Problem 1: Natural archives are equidistantly sampled at a distance grid along their accretion axis. Starting from these distance series, a time series needs to be constructed, as comparison of different data records is only meaningful on a time grid. The time series will be non-equidistant, as the accretion rate is non-constant. Problem 2: A typical example of sampling solid substrates is drilling. Because of the dimensions of the drill, the holes drilled will not be infinitesimally small. Consequently, samples are not taken at a point in distance, but rather over a volume in distance. This holds for most sampling methods in solid substrates. As a consequence, when the continuous proxy signal is sampled, it will be averaged over the volume of the sample, resulting in an underestimation of the amplitude. Whether this averaging effect is significant, depends on the volume of the sample and the variations of interest of the proxy signal. Starting from the measured signal, the continuous signal needs to be reconstructed in order eliminate these averaging errors. The aim is to provide an efficient identification algorithm to identify the non-linearities in the distance-time relationship, called time base distortions, and to correct for the averaging effects. Because this is a parametric method, an assumption about the proxy signal needs to be made: the proxy record on a time base is assumed to be harmonic, this is an obvious assumption because natural archives often exhibit a seasonal cycle. In a first approach the averaging effects are assumed to be in one direction only, i.e. the direction of the axis on which the measurements were performed. The

Stable carbon isotope fractionation in pollen of Atlas cedar: first steps towards a new palaeoecological proxy for Northwest Africa

Science.gov (United States)

Bell, Benjamin; Fletcher, William; Ryan, Peter; Grant, Helen; Ilmen, Rachid

2016-04-01

Analysis of stable carbon isotopes can provide information on climate and the environmental conditions at different growth stages of the plant, both past and present. Carbon isotope discrimination in plant tissue is already well understood, and can be used as a drought stress indicator for semi-arid regions. Stable carbon isotope ratios measured directly on pollen provides the potential for the development of long-term environmental proxies (spanning thousands of years), as pollen is well preserved in the environment. Atlas Cedar (Cedrus atlantica Endl. Manetti ex Carrière), is an ideal test case to develop a pollen stable carbon isotope proxy. The tree grows across a wide altitudinal and climatic range and is extremely sensitive to moisture availability. The pollen is abundant, and easily identifiable to the species level in pollen analysis because different cedar species are geographically confined to different regions of the world. In 2015 we sampled 76 individual cedar trees across latitudinal, altitudinal and environmental gradients, highly focused on the Middle Atlas region of Morocco, with 25 additional samples from botanical gardens across Europe and the US to extend these gradients. Here, we report new stable carbon isotope data from pollen, leaf and stem wood from these samples with a view to assessing and quantifying species-specific fractionation effects associated with pollen production. The isotopic response of individual trees at local and wider geographical scales to altitude and climatic conditions is presented. This research forms part of an ongoing PhD project working to develop and calibrate a modern carbon isotope proxy in Atlas cedar pollen, which can ultimately be applied to fossil sequences and complement existing multi-proxy records (e.g. pollen analysis in lake sediments, tree-rings).

Benefits of applying a proxy eligibility period when using electronic health records for outcomes research: a simulation study.

Science.gov (United States)

Yu, Tzy-Chyi; Zhou, Huanxue

2015-06-09

Electronic health records (EHRs) can provide valuable data for outcomes research. However, unlike administrative claims databases, EHRs lack eligibility tables or a standard way to define the benefit coverage period, which could lead to underreporting of healthcare utilization or outcomes, and could result in surveillance bias. We tested the effect of using a proxy eligibility period (eligibility proxy) when estimating a range of health resource utilization and outcomes parameters under varying degrees of missing encounter data. We applied an eligibility proxy to create a benchmark cohort of chronic obstructive pulmonary disease (COPD) patients with 12 months of follow-up, with the assumption of no missing encounter data. The benchmark cohort provided parameter estimates for comparison with 9,000 simulated datasets representing 10-90% of COPD patients (by 10th percentiles) with between 1 and 11 months of continuous missing data. Two analyses, one for datasets using an eligibility proxy and one for those without an eligibility proxy, were performed on the 9,000 datasets to assess estimator performance under increasing levels of missing data. Estimates for each study variable were compared with those from the benchmark dataset, and performance was evaluated using bias, percentage change, and root-mean-square error. The benchmark dataset contained 6,717 COPD patients, whereas the simulated datasets where the eligibility proxy was applied had between 671 and 6,045 patients depending on the percentage of missing data. Parameter estimates had better performance when an eligibility proxy based on the first and last month of observed activity was applied. This finding was consistent across a range of variables representing patient comorbidities, symptoms, outcomes, health resource utilization, and medications, regardless of the measures of performance used. Without the eligibility proxy, all evaluated parameters were consistently underestimated. In a large COPD patient

Review: Quality of Life in Children with Non-cystic Fibrosis Bronchiectasis

Directory of Open Access Journals (Sweden)

Anna Marie Nathan

2017-04-01

Full Text Available Non-cystic fibrosis bronchiectasis (NCFB has gained renewed interest, due to its increasing health-care burden. Annual mortality statistics in England and Wales showed that under 1,000 people die from bronchiectasis each year, and this number is increasing by 3% yearly. Unfortunately, there is a severe lack of well-powered, randomized controlled trials to guide clinicians how to manage NCFB effectively. Quality-of-life (QOL measures in NCFB are an important aspect of clinical care that has not been studied well. Commonly used disease-specific questionnaires in children with NCFB are the St George’s Respiratory Questionnaire, Short Form-36, the Leicester Cough Questionnaire, and the Parent Cough-Specific Quality of Life questionnaire (PC-QOL. Of these, only the PC-QOL can be used in young children, as it is a parent-proxy questionnaire. We reviewed pediatric studies looking at QOL in children with NCFB and cystic fibrosis. All types of airway clearance techniques appear to be safe and have no significant benefit over each other. Number of exacerbations and hospitalizations correlated with QOL scores, while symptom subscales correlated with lung function, worse QOL, frequent antibiotic requirements, and duration of regular follow-up in only one study. There was a correlation between QOL and age of diagnosis in children with primary ciliary dyskinesia. Other studies have shown no relationship between QOL scores and etiology of NCFB as well as CT changes. As for treatments, oral azithromycin and yoga have demonstrated some improvement in QOL scores. In conclusion, more studies are required to accurately determine important factors contributing to QOL.

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, Mirjam A. G.; Sloan, Jeff A.; Barsevick, Andrea; Chauhan, Cynthia; Dueck, Amylou C.; Raat, Hein; Shi, Quiling; van Noorden, Cornelis J. F.; Abernethy, Amy P.; Baas, Frank; Barsevick, Andrea M.; Bartels, Meike; Boomsma, Dorret I.; Bottomley, Andrew; Brundage, Michael; Cella, David; Cleeland, Charles S.; Coens, Corneel; Frost, Marlene H.; Hall, Per; Halyard, Michele Y.; Klepstad, Pål; Martin, Nicholas G.; Miaskowski, Christine; Mosing, Miriam; Movsas, Benjamin; Oliveira, Joao R.; Ordoñana, Juan; Patrick, Donald L.; Pedersen, Nancy L.; Reeve, Bryce; Ropka, Mary E.; Shinozaki, Gen; Singh, Jasvinder A.; Swaab, Dick; Veenhoven, Ruut; Wagner, Gert; Yang, Ping; Zwinderman, Ailko H.

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

A nonlinear multi-proxy model based on manifold learning to reconstruct water temperature from high resolution trace element profiles in biogenic carbonates

Directory of Open Access Journals (Sweden)

M. Bauwens

2010-11-01

Full Text Available A long standing problem in paleoceanography concerns the reconstruction of water temperature from δ¹⁸O carbonate. It is problematic in the case of freshwater influenced environments because the δ¹⁸O isotopic composition of the ambient water (related to salinity needs to be known. In this paper we argue for the use of a nonlinear multi-proxy method called Weight Determination by Manifold Regularization (WDMR to develop a temperature reconstruction model that is less sensitive to salinity variations. The motivation for using this type of model is twofold: firstly, observed nonlinear relations between specific proxies and water temperature motivate the use of nonlinear models. Secondly, the use of multi-proxy models enables salinity related variations of a given temperature proxy to be explained by salinity-related information carried by a separate proxy. Our findings confirm that Mg/Ca is a powerful paleothermometer and highlight that reconstruction performance based on this proxy is improved significantly by combining its information with the information for other trace elements in multi-proxy models. Although the models presented here are black-box models that do not use any prior knowledge about the proxies, the comparison of model reconstruction performances based on different proxy combinations do yield useful information about proxy characteristics. Using Mg/Ca, Sr/Ca, Ba/Ca and Pb/Ca the WDMR model enables a temperature reconstruction with a root mean squared error of ± 2.19 °C for a salinity range between 15 and 32.

The impact of a visual arts program on quality of life, communication, and well-being of people living with dementia: a mixed-methods longitudinal investigation.

Science.gov (United States)

Windle, Gill; Joling, Karlijn J; Howson-Griffiths, Teri; Woods, Bob; Jones, Catrin Hedd; van de Ven, Peter M; Newman, Andrew; Parkinson, Clive

2018-03-01

ABSTRACTBackground:Research reviews highlight methodological limitations and gaps in the evidence base for the arts in dementia care. In response, we developed a 12-week visual art program and evaluated the impact on people living with dementia through a mixed-methods longitudinal investigation. One hundred and twenty-five people living with mild to severe dementia were recruited across three research settings in England and Wales (residential care homes, a county hospital, and community venues). Quantitative and qualitative data on quality of life (QoL), communication and perceptions of the program were obtained through interviews and self-reports with participants and their carers. Eight domains of well-being were measured using a standardized observation tool, and data compared to an alternative activity with no art. Across all sites, scores for the well-being domains of interest, attention, pleasure, self-esteem, negative affect, and sadness were significantly better in the art program than the alternative condition. Proxy-reported QoL significantly improved between baseline and 3-month follow-up, but no improvements in QoL were reported by the participants with dementia. This was contrasted by their qualitative accounts, which described a stimulating experience important for social connectedness, well-being, and inner-strength. Communication deteriorated between baseline and follow-up in the hospital setting, but improved in the residential care setting. The findings highlight the potential for creative aging within dementia care, the benefits of art activities and the influence of the environment. We encourage dementia care providers and arts and cultural services to work toward embedding art activities within routine care provision.

gLExec and MyProxy integration in the ATLAS/OSG PanDA workload management system

International Nuclear Information System (INIS)

Caballero, J; Hover, J; Maeno, T; Potekhin, M; Wenaus, T; Zhao, X; Litmaath, M; Nilsson, P

2010-01-01

Worker nodes on the grid exhibit great diversity, making it difficult to offer uniform processing resources. A pilot job architecture, which probes the environment on the remote worker node before pulling down a payload job, can help. Pilot jobs become smart wrappers, preparing an appropriate environment for job execution and providing logging and monitoring capabilities. PanDA (Production and Distributed Analysis), an ATLAS and OSG workload management system, follows this design. However, in the simplest (and most efficient) pilot submission approach of identical pilots carrying the same identifying grid proxy, end-user accounting by the site can only be done with application-level information (PanDA maintains its own end-user accounting), and end-user jobs run with the identity and privileges of the proxy carried by the pilots, which may be seen as a security risk. To address these issues, we have enabled PanDA to use gLExec, a tool provided by EGEE which runs payload jobs under an end-user's identity. End-user proxies are pre-staged in a credential caching service, MyProxy, and the information needed by the pilots to access them is stored in the PanDA DB. gLExec then extracts from the user's proxy the proper identity under which to run. We describe the deployment, installation, and configuration of gLExec, and how PanDA components have been augmented to use it. We describe how difficulties were overcome, and how security risks have been mitigated. Results are presented from OSG and EGEE Grid environments performing ATLAS analysis using PanDA and gLExec.

A Multi-Proxy Paradigm in the Pursuit of Ocean Paleoredox

Science.gov (United States)

Anbar, A. D.; Duan, Y.; Kendall, B.; Reinhard, C.; Severmann, S.; Lyons, T. W.

2011-12-01

The geologic record provides abundant evidence for variations in ocean oxygenation throughout Earth history. Expansion of ocean anoxic zones is expected in the future as a consequence of global climate change, with attendant effects on global nutrient inventories, carbon cycling and fluxes of trace greenhouse gases to the atmosphere. Therefore, studying ancient ocean redox variations not only teaches us about the history of the Earth system, but also provides insights into how the system may respond to analogous human perturbations. However, the extent, duration, causes, and consequences of most past variations are poorly understood. This problem motivates the development of paleoredox proxies, including novel stable isotope systems such as Mo, Fe, U and Tl. Experience with these emerging isotope systems demonstrates great promise but also many challenges. The Mo isotope system is illustrative. To first order, the geochemical cycling and isotope systematics of this element are straightforward, making it a useful proxy. However, critical unresolved issues include: (a) uncertainties in the ocean inputs through time; (b) ambiguities about fractionation mechanisms; (c) inadequate understanding of how modern analogs map to ancient systems. Similar challenges confront all the novel isotope systems. The way forward requires integration of multiple isotopic proxies, as well as information gleaned from careful analyses of element concentrations. For example, an episode of Mo enrichment in the 2.5 Ga Mt. McRae Shale is generally interpreted as resulting from buildup of Mo in seawater due to oxidative weathering. This enrichment is therefore thought to indicate a "whiff" of O2 in the environment prior to the Great Oxidation Event that began at 2.4 Ga. Molybdenum isotopes are consistent with this interpretation. However, Mo enrichment due to enhanced input from low-T hydrothermal sources in an anoxic regime cannot be completely excluded given the current state of knowledge of

350 Year Cloud Reconstruction Deduced from Northeast Caribbean Coral Proxies

Science.gov (United States)

Winter, A.; Sammarco, P. W.; Mikolajewicz, U.; Jury, M.; Zanchettin, D.

2014-12-01

Clouds are a major factor influencing the global climate and its response to external forcing through their implications for the global hydrological cycle, and hence for the planetary radiative budget. Clouds also contribute to regional climates and their variability through, e.g., the changes they induce in regional precipitation patterns. There have been very few studies of decadal and longer-term changes in cloud cover in the tropics and sub-tropics, both over land and the ocean. In the tropics, there is great uncertainty regarding how global warming will affect cloud cover. Observational satellite data are too short to unambiguously discern any temporal trends in cloud cover. Corals generally live in well-mixed coastal regions and can often record environmental conditions of large areas of the upper ocean. This is particularly the case at low latitudes. Scleractinian corals are sessile, epibenthic fauna, and the type of environmental information recorded at the location where the coral has been living is dependent upon the species of coral considered and proxy index of interest. Skeletons of scleractinian corals are considered to provide among the best records of high-resolution (sub-annual) environmental variability in the tropical and sub-tropical oceans. Zooxanthellate hermatypic corals in tropical and sub-tropical seas precipitate CaCO3 skeletons as they grow. This growth is made possible through the manufacture of CaCO3crystals, facilitated by the zooxanthellae. During the process of crystallization, the holobiont binds carbon of different isotopes into the crystals. Stable carbon isotope concentrations vary with a variety of environmental conditions. In the Caribbean, d13C in corals of the species Montastraea faveolata can be used as a proxy for changes in cloud cover. In this contribution, we will demonstrate that the stable isotope 13C varies concomitantly with cloud cover for the northeastern Caribbean region. Using this proxy we have been able to

The effect of cognitive appraisal for stressors on the oral health-related QOL of dry mouth patients.

Science.gov (United States)

Matsuoka, Hirofumi; Chiba, Itsuo; Sakano, Yuji; Saito, Ichiro; Abiko, Yoshihiro

2014-01-01

Dry mouth is very common symptom, and psychological factors have an influence on this symptom. Although the influence of emotional factor related to patients with oral dryness has been examined in previous studies, the cognitive factors have not been examined thus far. The purpose of this study was to examine the influence of cognitive factors on patients with oral dryness. The participants were 106 patients complaining of oral dryness. They were required to complete a questionnaire measuring subjective oral dryness, oral-related QOL, cognition for stressors, and mood state. Correlational analyses revealed that OHIP-14 is significantly related to oral dryness, appraisal for effect, appraisal for threat, and commitment. These correlations were maintained even after controlling for the influence of depression and anxiety. Using oral dryness, appraisal for effect, appraisal for threat, and commitment, cluster analysis was done and three clusters (cluster-1, severe oral dryness; cluster-2, positive cognitive style: cluster-3, negative cognitive style) were extracted. The results of ANOVA showed that the group with severe oral dryness (cluster-1) had a significantly higher score on OHIP-14 than the other two groups. There was no significant difference between the groups with positive (cluster-2) and negative (cluster-3) cognitive style. Although the group of patients with positive cognitive style complained of more severe oral dryness than the group with negative cognitive style, no significant difference was observed between these two groups in OHIP-14. These results indicate that cognitive factors would be a useful therapeutic target for the improvement of the oral-related QOL of patients with oral dryness.

Adaptive proxy map server for efficient vector spatial data rendering

Science.gov (United States)

Sayar, Ahmet

2013-01-01

The rapid transmission of vector map data over the Internet is becoming a bottleneck of spatial data delivery and visualization in web-based environment because of increasing data amount and limited network bandwidth. In order to improve both the transmission and rendering performances of vector spatial data over the Internet, we propose a proxy map server enabling parallel vector data fetching as well as caching to improve the performance of web-based map servers in a dynamic environment. Proxy map server is placed seamlessly anywhere between the client and the final services, intercepting users' requests. It employs an efficient parallelization technique based on spatial proximity and data density in case distributed replica exists for the same spatial data. The effectiveness of the proposed technique is proved at the end of the article by the application of creating map images enriched with earthquake seismic data records.

Assessment of the Coral Temperature Proxies for Orbicella faveolata in the Southwestern Gulf of Mexico

Science.gov (United States)

Vara, M. A.; DeLong, K. L.; Herrmann, A. D.; Ouellette, G., Jr.; Richey, J. N.

2017-12-01

Coral Sr/Ca is a robust proxy of sea surface temperature (SST); however, discrepancies in the Sr/Ca-SST relationship among colonies of the same species may reduce confidence in absolute temperature reconstructions. Furthermore, terrestrial carbonate weathering can provide local sources of Sr and/or Ca to coastal waters that may disrupt the temperature-based coral Sr/Ca signal. Thus other trace metal SST proxies have been suggested to circumvent these issues (Li/Ca, Li/Mg, and Sr-U). Coral Ba/Ca has been used as a proxy for runoff and coastal upwelling, and therefore may be used to identify intervals when these processes overprint the Sr/Ca-SST signal. This study tests multiple coral SST proxies using reproducibility assessments to determine the best performing SST proxy. We conduct these assessments with cores recovered in 1991 by the U.S. Geological Survey from five Orbicella faveolata colonies from three reefs offshore of Veracruz, Mexico (19.06°N, 96.93°W) in water depths varying from 3 to 12 m. Previous studies found micromilling the complex skeletal structure of O. faveolata challenging and that monthly resolution may not recover full seasonal cycles. We use a laser ablation inductively coupled plasma mass spectrometer to simultaneously sample this coral's structure at weekly intervals spanning 8 years for Li/Ca, Li/Mg, Sr-U, Sr/Ca, and Ba/Ca. Here we found coral Li/Ca means and seasonal variations are similar among colonies thus this proxy may capture absolute temperature and SST variability. Similar to previous research with Porites corals, Li/Ca in these O. faveolata corals decreases with increases in SST with similar slopes and intercepts. During the last 10 years of these corals' lives, coral Sr/Ca analysis reveals a mean shift among colonies suggesting an external source could have disrupted the Sr/Ca signal, possibly seasonal runoff and/or winter upwelling common to Veracruz waters. Coral Ba/Ca analyses reveals elevated values in winters that coincide

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.

Quantitative use of Palaeo-Proxy Data in Global Circulation Models

Science.gov (United States)

Collins, M.

2003-04-01

It is arguably one of the ultimate aims of palaeo-modelling science to somehow "get the palaeo-proxy data into the model" i.e. to constrain the climate of the model the trajectory of the real climate recorded in the palaeo data. The traditional way of interfacing data with models is to use data assimilation. This presents a number of problems in the palaeo context as the data are more often representative of seasonal to annual or decadal climate and models have time steps of order minutes, hence the model increments are likely to be vanishingly small. Also, variational data assimilation schemes would require the adjoint of the coupled ocean-atmosphere model and the adjoint of the functions which translate model variables such as temperature and precipitation into the palaeo-proxies, both of which are hard to determine because of the high degree of non-linearity in the system and the wide range of space and time scales. An alternative is to add forward models of proxies to the model and run "many years" of simulation until an analog state is found which matches the palaeo data for each season, year, decade etc. Clearly "many years" might range from a few thousand years to almost infinity and depends on the number of degrees of freedom in the climate system and on the error characteristics of the palaeo data. The length of simulation required is probably beyond the supercomputer capacity of a single institution and hence an alternative is to use idle capacity of home and business personal computers - the climateprediction.net project.

Planktonic Foraminifera Proxies Calibration Off the NW Iberian Margin: Nutrients Approach

Science.gov (United States)

Salgueiro, E.; Castro, C. G.; Zuniga, D.; Martin, P. A.; Groeneveld, J.; de la Granda, F.; Villaceiros-Robineau, N.; Alonso-Perez, F.; Alberto, A.; Rodrigues, T.; Rufino, M. M.; Abrantes, F. F. G.; Voelker, A. H. L.

2014-12-01

Planktonic foraminifera (PF) shells preserved in marine sediments are a useful tool to reconstruct productivity conditions at different geological timescales. However, the accuracy of these paleoreconstructions depends on the data set and calibration quality. Several calibration works have been defining and improving the use of proxies for productivity and nutrient cycling parameters. Our contribution is centred on a multi-proxy calibration at a regional coastal upwelling system. To minimize the existing uncertainties affecting the use of trace elements and C stable isotopes as productivity proxy in the high productivity upwelling areas, we investigate the content and distribution of Ba/Ca and δ13C in the water column, its transference into the planktonic foraminifera shells, and, how the living planktonic foraminifera Ba/Ca and δ13C signal is related to the same planktonic foraminiferal species preserved in the sediment record. This study is based on a large data set from two stations (RAIA - 75m water depth, and CALIBERIA - 350m water depth) located off the NW Iberian margin (41.5-42.5ºN; 9-10ºW), and includes: i) two year monthly water column data (temperature, salinity, nutrients, chlorophyll a, Ba/Ca, and δ13C-DIC); ii) seasonal Ba/Ca, δ13C in several living PF species at both stations; and iii) Ba/Ca and δ13C in several PF species from a large set of core-top sediment samples in the study region. Additionally, total organic carbon and total alkenones were also measured in the sediment. Our results showed the link between productivity proxies in the surface sediment foraminifera assemblage and the processes regulating the actual phytoplankton dynamics in an upwelling area. The understanding of this relationship has special relevance since it gives fundamental information related to the past oceanic biogeochemistry and/or climate and improves the prevision of future changes against possible climate variability due to anthropogenic forcing.

New Proxies for Climate change parameters: Foram Culturing and Pteropod Potentials

Science.gov (United States)

Keul, N.; Schneider, R. R.; Langer, G.; Bijma, J.; Peijnenburg, K. T.

2017-12-01

Global climate change is one of the most pressing challenges our society is currently facing and strong efforts are made to simulate future climate conditions. To better validate models that aim at predicting global temperature rise as a consequence of anthropogenic CO2 emissions, accurate atmospheric paleo-CO2 estimates in combination with temperature reconstructions are necessary. Consequently there is a strong need for reliable proxies, allowing reconstruction of climate change. With respect to foraminifera a combination of laboratory experiments and modeling is presented, to show the isolated impact of the different parameters of the carbonate system on trace element composition of their shells. We focus on U/Ca and Sr/Ca ratios, which have recently been established as new proxies reflecting changes in the carbonate system of seawater. While U/Ca correlates with carbonate ion concentration, Sr/Ca is primarily influenced by DIC. The latter is particularly promising since the impact of additional parameters is relatively well constrained and hence, Sr/Ca ratios may allow higher accuracy in carbonate system parameter reconstructions. Furthermore, our results will be discussed on how to advance our knowledge about foraminiferal biomineralization. Pteropods, among the first responders to ocean acidification and warming, are explored as carriers of marine paleoenvironmental signals. In order to characterize the stable isotopic composition of aragonitic pteropod shells and their variation in response to climate change parameters, pteropod shells were collected along a latitudinal transect in the Atlantic Ocean. By comparing shell oxygen isotopic composition to depth changes of the calculated aragonite equilibrium oxygen isotope values, we infer shallow calcification depths for Heliconoides inflatus (75 m), rendering this species a good potential proxy carrier for past variations in surface ocean properties. Furthermore, we demonstrate that indeed, pteropod shells are

Development and psychometric testing of the Canine Owner-Reported Quality of Life questionnaire, an instrument designed to measure quality of life in dogs with cancer.

Science.gov (United States)

Giuffrida, Michelle A; Brown, Dorothy Cimino; Ellenberg, Susan S; Farrar, John T

2018-05-01

OBJECTIVE To describe development and initial psychometric testing of an owner-reported questionnaire designed to standardize measurement of general quality of life (QOL) in dogs with cancer. DESIGN Key-informant interviews, questionnaire development, and field trial. SAMPLE Owners of 25 dogs with cancer for item development and pretesting and owners of 90 dogs with cancer for reliability and validity testing. PROCEDURES Standard methods for development and testing of questionnaire instruments intended to measure subjective states were used. Items were generated, selected, scaled, and pretested for content, meaning, and readability. Response items were evaluated with exploratory factor analysis and by assessing internal consistency (Cronbach α) and convergence with global QOL as determined with a visual analog scale. Preliminary tests of stability and responsiveness were performed. RESULTS The final questionnaire-which was named the Canine Owner-Reported Quality of Life (CORQ) questionnaire-contained 17 items related to observable behaviors commonly used by owners to evaluate QOL in their dogs. Several items pertaining to physical symptoms performed poorly and were omitted. The 17 items were assigned to 4 factors-vitality, companionship, pain, and mobility-on the basis of the items they contained. The CORQ questionnaire and its factors had high internal consistency (Cronbach α = 0.68 to 0.90) and moderate to strong correlations (r = 0.49 to 0.71) with global QOL as measured on a visual analog scale. Preliminary testing indicated good test-retest reliability and responsiveness to improvements in overall QOL. CONCLUSIONS AND CLINICAL RELEVANCE The CORQ questionnaire was a valid, reliable owner-reported questionnaire that measured general QOL in dogs with cancer and showed promise as a clinical trial outcome measure for quantifying changes in individual dog QOL occurring in response to cancer treatment and progression.

Measuring psychological trauma after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Psychological Trauma item bank and short form.

Science.gov (United States)

Kisala, Pamela A; Victorson, David; Pace, Natalie; Heinemann, Allen W; Choi, Seung W; Tulsky, David S

2015-05-01

To describe the development and psychometric properties of the SCI-QOL Psychological Trauma item bank and short form. Using a mixed-methods design, we developed and tested a Psychological Trauma item bank with patient and provider focus groups, cognitive interviews, and item response theory based analytic approaches, including tests of model fit, differential item functioning (DIF) and precision. We tested a 31-item pool at several medical institutions across the United States, including the University of Michigan, Kessler Foundation, Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Veterans Administration hospital. A total of 716 individuals with SCI completed the trauma items The 31 items fit a unidimensional model (CFI=0.952; RMSEA=0.061) and demonstrated good precision (theta range between 0.6 and 2.5). Nine items demonstrated negligible DIF with little impact on score estimates. The final calibrated item bank contains 19 items The SCI-QOL Psychological Trauma item bank is a psychometrically robust measurement tool from which a short form and a computer adaptive test (CAT) version are available.

Anxiety, Depression, and Health-Related QOL in Patients Diagnosed with PAH or CTEPH.

Science.gov (United States)

Pfeuffer, Elena; Krannich, Holger; Halank, Michael; Wilkens, Heinrike; Kolb, Philipp; Jany, Berthold; Held, Matthias

2017-12-01

Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are life-threatening diseases with a high burden of symptoms. Although depression, anxiety, and reduced health related quality of life (HRQOL) have also been reported, a comparative analysis which explores these traits and their underlying factors was lacking. A retrospective analysis of depression, anxiety, and health related QOL was conducted using a Hospital anxiety and depression scale (HADS) as well as the SF-36 HRQOL questionnaire. Results from these tools were compared with haemodynamic and functional parameters in 70 PAH and 23 CTEPH outpatients from a German tertiary care center specializing in pulmonary hypertension. Although HRQOL was reduced in both cohorts of patients, individuals diagnosed with CTEPH scored lower in nearly all SF-36 parameters. Significance was noted in both "mental health" (p = 0.01) and "mental component summary score" (MCS) (p = 0.02). Depression was also more frequent in patients with CTEPH (56%) than in patients with PAH (30%), (p = 0.03). Overall, depression and anxiety correlated with most SF-36 scales in both PAH and CTEPH. In CTEPH, depression also correlated with the Borg Dyspnea Scale (r = 0.44, p = 0.01). These patients also had significantly lower pCO 2 levels than the PAH cohort reflecting more severe ventilation/perfusion mismatch. All other haemodynamic and functional parameters did not differ across the groups. While both cohorts of patients suffer from a reduced HRQOL as well as depression and anxiety, decreases in mental health parameters are more pronounced in the CTEPH cohort. This suggests a strong effort to improve early detection, especially in dyspneic patients with classical risk factors for CTEPH and PAH and argues for mental illness interventions alongside routine clinical care provided to patients diagnosed with PAH or CTEPH.

Poor-to-moderate agreement between self and proxy interviews of mobile phone use.

Science.gov (United States)

Hutter, Hans-Peter; Ehrenhöfer, Lisa; Freuis, Edith; Hartl, Patrik; Kundi, Michael

2012-10-01

In epidemiological studies, cases cannot always be interviewed due to them being too ill or already deceased. Under these circumstances, proxy interviews are often conducted; however, the veridicality of information about mobile phone use gained by proxy interviews has been doubted. The issue is undecided due to the lack of empirical data. We conducted a study of 119 heterosexual couples. Both partners answered two questionnaires about mobile phone use, one about their own use and one about their partner's use. Overall agreement assessed using Cohen's kappa, Passing and Bablok regression, and concordance coefficients between self and proxy data was poor to moderate (e.g., concordance coefficients of 0.55 for duration of use). The only item with good agreement was whether or not a prepaid phone was used (Cohen's kappa 0.78 and 0.63 for male and female estimates, respectively), and to a lesser degree, the onset of mobile phone use (concordance coefficients of 0.66 and 0.61). Poorest agreement was obtained for the side of the head the mobile phone was held during calls (kappa coefficients of 0.20 and 0.24 for female and male estimates, respectively). We conclude that the assessment of mobile phone use by proxy data cannot be relied on except for information about onset of mobile phone use, use of prepaid or contract phones, and, to a lesser degree, duration of daily use. Agreement concerning the important information about side of the head the mobile phone is held during calls was poorest and only slightly better than chance. Copyright © 2012 Wiley Periodicals, Inc.

Attribute-based proxy re-encryption with keyword search.

Science.gov (United States)

Shi, Yanfeng; Liu, Jiqiang; Han, Zhen; Zheng, Qingji; Zhang, Rui; Qiu, Shuo

2014-01-01

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.

Attribute-Based Proxy Re-Encryption with Keyword Search

Science.gov (United States)

Shi, Yanfeng; Liu, Jiqiang; Han, Zhen; Zheng, Qingji; Zhang, Rui; Qiu, Shuo

2014-01-01

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 (), 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, 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 , and propose two concrete constructions for : key-policy and ciphertext-policy . 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. PMID:25549257

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

Proxying UPnP service discovery and access to a non-IP Bluetooth network on a mobile phone

NARCIS (Netherlands)

Delphinanto, A.; Koonen, A.M.J.; Hartog, den F.T.H.; Peeters, M.E.

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 and

TEX86 paleothermometry : proxy validation and application in marine sediments

NARCIS (Netherlands)

Huguet, C.

2007-01-01

Determination of past sea surface temperature (SST) is of primary importance for the reconstruction of natural climatic changes, modelling of climate and reconstruction of ocean circulation. Recently, a new SST proxy was introduced, the TetraEther indeX of lipids with 86 carbons (TEX86), which is

TEX₈₆ paleothermometry : proxy validation and application in marine sediments

NARCIS (Netherlands)

Huguet, Carme

2007-01-01

Determination of past sea surface temperature (SST) is of primary importance for the reconstruction of natural climatic changes, modelling of climate and reconstruction of ocean circulation. Recently, a new SST proxy was introduced, the TetraEther indeX of lipids with 86 carbons (TEX₈₆), which is

POLAR NETWORK INDEX AS A MAGNETIC PROXY FOR THE SOLAR CYCLE STUDIES

International Nuclear Information System (INIS)

Priyal, Muthu; Banerjee, Dipankar; Ravindra, B.; Singh, Jagdev; Karak, Bidya Binay; Muñoz-Jaramillo, Andrés; Choudhuri, Arnab Rai

2014-01-01

The Sun has a polar magnetic field which oscillates with the 11 yr sunspot cycle. This polar magnetic field is an important component of the dynamo process which operates in the solar convection zone and produces the sunspot cycle. We have direct systematic measurements of the Sun's polar magnetic field only from about the mid-1970s. There are, however, indirect proxies which give us information about this field at earlier times. The Ca-K spectroheliograms taken at the Kodaikanal Solar Observatory during 1904-2007 have now been digitized with 4k × 4k CCD and have higher resolution (∼0.86 arcsec) than the other available historical data sets. From these Ca-K spectroheliograms, we have developed a completely new proxy (polar network index, hereafter PNI) for the Sun's polar magnetic field. We calculate PNI from the digitized images using an automated algorithm and calibrate our measured PNI against the polar field as measured by the Wilcox Solar Observatory for the period 1976-1990. This calibration allows us to estimate the polar fields for the earlier period up to 1904. The dynamo calculations performed with this proxy as input data reproduce reasonably well the Sun's magnetic behavior for the past century

POLAR NETWORK INDEX AS A MAGNETIC PROXY FOR THE SOLAR CYCLE STUDIES

Energy Technology Data Exchange (ETDEWEB)

Priyal, Muthu; Banerjee, Dipankar; Ravindra, B.; Singh, Jagdev [Indian Institute of Astrophysics,Koramangala, Bengaluru 560034 (India); Karak, Bidya Binay [Nordita, KTH Royal Institute of Technology and Stockholm University (Sweden); Muñoz-Jaramillo, Andrés [Montana State University, Bozeman, MT 59717 (United States); Choudhuri, Arnab Rai, E-mail: mpriya@iiap.res.in, E-mail: dipu@iiap.res.in [Indian Institute of Science, Bangalore (India)

2014-09-20

The Sun has a polar magnetic field which oscillates with the 11 yr sunspot cycle. This polar magnetic field is an important component of the dynamo process which operates in the solar convection zone and produces the sunspot cycle. We have direct systematic measurements of the Sun's polar magnetic field only from about the mid-1970s. There are, however, indirect proxies which give us information about this field at earlier times. The Ca-K spectroheliograms taken at the Kodaikanal Solar Observatory during 1904-2007 have now been digitized with 4k × 4k CCD and have higher resolution (∼0.86 arcsec) than the other available historical data sets. From these Ca-K spectroheliograms, we have developed a completely new proxy (polar network index, hereafter PNI) for the Sun's polar magnetic field. We calculate PNI from the digitized images using an automated algorithm and calibrate our measured PNI against the polar field as measured by the Wilcox Solar Observatory for the period 1976-1990. This calibration allows us to estimate the polar fields for the earlier period up to 1904. The dynamo calculations performed with this proxy as input data reproduce reasonably well the Sun's magnetic behavior for the past century.

Assessing 5 years of GOSAT Proxy XCH4 data and associated uncertainties

Directory of Open Access Journals (Sweden)

R. J. Parker

2015-11-01

Full Text Available We present 5 years of GOSAT XCH4 retrieved using the "proxy" approach. The Proxy XCH4 data are validated against ground-based TCCON observations and are found to be of high quality with a small bias of 4.8 ppb (∼ 0.27 % and a single-sounding precision of 13.4 ppb (∼ 0.74 %. The station-to-station bias (ameasure of the relative accuracy is found to be 4.2 ppb. For the first time the XCH4 / XCO2 ratio component of the Proxy retrieval is validated (bias of 0.014 ppb ppm−1 (∼ 0.30 %, single-sounding precision of 0.033 ppb ppm−1 (∼ 0.72 %. The uncertainty relating to the model XCO2 component of the Proxy XCH4 is assessed through the use of an ensemble of XCO2 models. While each individual XCO2 model is found to agree well with the TCCON validation data (r = 0.94–0.97, it is not possible to select one model as the best from our comparisons. The median XCO2 value of the ensemble has a smaller scatter against TCCON (a standard deviation of 0.92 ppm than any of the individual models whilst maintaining a small bias (0.15 ppm. This model median XCO2 is used to calculate the Proxy XCH4 with the maximum deviation of the ensemble from the median used as an estimate of the uncertainty. We compare this uncertainty to the a posteriori retrieval error (which is assumed to reduce with sqrt(N and find typically that the model XCO2 uncertainty becomes significant during summer months when the a posteriori error is at its lowest due to the increase in signal related to increased summertime reflected sunlight. We assess the significance of these model and retrieval uncertainties on flux inversion by comparing the GOSAT XCH4 against modelled XCH4 from TM5-4DVAR constrained by NOAA surface observations (MACC reanalysis scenario S1-NOAA. We find that for the majority of regions the differences are much larger than the estimated uncertainties. Our findings show that useful information will be provided to the inversions for the majority of regions in addition

Different Aspects of Self-Reported Quality of Life in 450 German Melanoma Survivors

Energy Technology Data Exchange (ETDEWEB)

Waldmann, Annika, E-mail: Annika.Waldmann@krebsregister-sh.de [Institute of Cancer Epidemiology (IKE e.V.), University of Luebeck, Ratzeburger Allee 160 (Haus 50), Luebeck 23562 (Germany); Nolte, Sandra [Association of Dermatological Prevention (ADP e.V.), Cremon 11, Hamburg 20457 (Germany); Deakin University, 221 Burwood Highway, Burwood, VIC 3125 (Australia); Pritzkuleit, Ron [Institute of Cancer Epidemiology (IKE e.V.), University of Luebeck, Ratzeburger Allee 160 (Haus 50), Luebeck 23562 (Germany); Breitbart, Eckhard W. [Association of Dermatological Prevention (ADP e.V.), Cremon 11, Hamburg 20457 (Germany); Center of Dermatology, Am Krankenhaus 1, Buxtehude 21614 (Germany); Katalinic, Alexander [Institute of Cancer Epidemiology (IKE e.V.), University of Luebeck, Ratzeburger Allee 160 (Haus 50), Luebeck 23562 (Germany)

2011-05-11

The present study was aimed at assessing quality of life (QoL) in a total of 450 melanoma patients who filled out the EORTC QLQ-C30 (Q1; 15 months post diagnosis) as part of the OVIS Study. Follow-up questionnaires (Q2) were administered two years after Q1. The analyses presented herein were based on the following assumptions: QoL of melanoma patients is worse than that of a German reference population. Further, both tumor location and tumor stage have an influence on self-reported QoL, with patients with tumors located on face, head, neck, and advanced tumor stage (T3/T4) reporting the worst QoL levels. Finally, patients' QoL improves over time based on the theory of disease adaptation. In contrast to the above assumptions, with the exception of global health/QoL scores, differences between OVIS and the reference population were below the minimal clinical important difference of ten points. Furthermore, no clinically meaningful differences were found between patients after stratifying our data by tumor location and tumor stage. Finally, no clinically relevant changes were seen between Q1 and Q2 across all scales of the EORTC QLQ-C30. However, when data were stratified by patients with stable disease versus those with progression, clinically relevant differences were found between Q1 and Q2 predominantly in women in the latter group regarding emotional function, insomnia, dyspnoea, and fatigue. The lack of clinically meaningful differences across strata (tumor location; tumor stage), time, and patients compared to a reference population is surprising. However, it is possible that the instrument used, a generic QoL instrument, is generally not sensitive enough to detect differences in melanoma patients. Our findings may further be explained by the fact that all patients included in our sample had been diagnosed well before Q1, i.e., main illness adaptation processes may have occurred before study entry.

Different Aspects of Self-Reported Quality of Life in 450 German Melanoma Survivors

International Nuclear Information System (INIS)

Waldmann, Annika; Nolte, Sandra; Pritzkuleit, Ron; Breitbart, Eckhard W.; Katalinic, Alexander

2011-01-01

The present study was aimed at assessing quality of life (QoL) in a total of 450 melanoma patients who filled out the EORTC QLQ-C30 (Q1; 15 months post diagnosis) as part of the OVIS Study. Follow-up questionnaires (Q2) were administered two years after Q1. The analyses presented herein were based on the following assumptions: QoL of melanoma patients is worse than that of a German reference population. Further, both tumor location and tumor stage have an influence on self-reported QoL, with patients with tumors located on face, head, neck, and advanced tumor stage (T3/T4) reporting the worst QoL levels. Finally, patients' QoL improves over time based on the theory of disease adaptation. In contrast to the above assumptions, with the exception of global health/QoL scores, differences between OVIS and the reference population were below the minimal clinical important difference of ten points. Furthermore, no clinically meaningful differences were found between patients after stratifying our data by tumor location and tumor stage. Finally, no clinically relevant changes were seen between Q1 and Q2 across all scales of the EORTC QLQ-C30. However, when data were stratified by patients with stable disease versus those with progression, clinically relevant differences were found between Q1 and Q2 predominantly in women in the latter group regarding emotional function, insomnia, dyspnoea, and fatigue. The lack of clinically meaningful differences across strata (tumor location; tumor stage), time, and patients compared to a reference population is surprising. However, it is possible that the instrument used, a generic QoL instrument, is generally not sensitive enough to detect differences in melanoma patients. Our findings may further be explained by the fact that all patients included in our sample had been diagnosed well before Q1, i.e., main illness adaptation processes may have occurred before study entry

Patient-reported symptom questionnaires in laryngeal cancer: voice, speech and swallowing.

Science.gov (United States)

Rinkel, R N P M; Verdonck-de Leeuw, I M; van den Brakel, N; de Bree, R; Eerenstein, S E J; Aaronson, N; Leemans, C R

2014-08-01

To validate questionnaires on voice, speech, and swallowing among laryngeal cancer patients, to assess the need for and use of rehabilitation services, and to determine the association between voice, speech, and swallowing problems, and quality of life and distress. Laryngeal cancer patients at least three months post-treatment completed the VHI (voice), SHI (speech), SWAL-QOL (swallowing), EORTC QLQ-C30, QLQ-HN35, HADS, and study-specific questions on rehabilitation. Eighty-eight patients and 110 healthy controls participated. Cut off scores of 15, 6, and 14 were defined for the VHI, SHI, and SWAL-QOL (sensitivity > 90%; specificity > 80%). Based on these scores, 56% of the patients reported voice, 63% speech, and 54% swallowing problems. VHI, SHI, and SWAL-QOL scores were associated significantly with quality of life (EORTC QLQ-C30 global quality of life scale) (r = .43 (VHI and SHI) and r = .46 (SWAL-QOL)) and distress (r = .50 (VHI and SHI) and r = .58 (SWAL-QOL)). In retrospect, 32% of the patients indicated the need for rehabilitation at time of treatment, and 81% of these patients availed themselves of such services. Post-treatment, 8% of the patients expressed a need for rehabilitation, and 20% of these patients actually made use of such services. Psychometric characteristics of the VHI, SHI, and SWAL-QOL in laryngeal cancer patients are good. The prevalence of voice, speech, and swallowing problems is high, and clearly related to quality of life and distress. Although higher during than after treatment, the perceived need for and use of rehabilitation services is limited. Copyright © 2014 Elsevier Ltd. All rights reserved.

Measuring the quality of life in mild to very severe dementia: testing the inter-rater and intra-rater reliability of the German version of the QUALIDEM.

Science.gov (United States)

Dichter, Martin Nikolaus; Schwab, Christian G G; Meyer, Gabriele; Bartholomeyczik, Sabine; Dortmann, Olga; Halek, Margareta

2014-05-01

Quality of life (Qol) is an increasingly used outcome measure in dementia research. The QUALIDEM is a dementia-specific and proxy-rated Qol instrument. We aimed to determine the inter-rater and intra-rater reliability in residents with dementia in German nursing homes. The QUALIDEM consists of nine subscales that were applied to a sample of 108 people with mild to severe dementia and six consecutive subscales that were applied to a sample of 53 people with very severe dementia. The proxy raters were 49 registered nurses and nursing assistants. Inter-rater and intra-rater reliability scores were calculated on the subscale and item level. None of the QUALIDEM subscales showed strong inter-rater reliability based on the single-measure Intra-Class Correlation Coefficient (ICC) for absolute agreement ≥ 0.70. Based on the average-measure ICC for four raters, eight subscales for people with mild to severe dementia (care relationship, positive affect, negative affect, restless tense behavior, social relations, social isolation, feeling at home and having something to do) and five subscales for very severe dementia (care relationship, negative affect, restless tense behavior, social relations and social isolation) yielded a strong inter-rater agreement (ICC: 0.72-0.86). All of the QUALIDEM subscales, regardless of dementia severity, showed strong intra-rater agreement. The ICC values ranged between 0.70 and 0.79 for people with mild to severe dementia and between 0.75 and 0.87 for people with very severe dementia. This study demonstrated insufficient inter-rater reliability and sufficient intra-rater reliability for all subscales of both versions of the German QUALIDEM. The degree of inter-rater reliability can be improved by collaborative Qol rating by more than one nurse. The development of a measurement manual with accurate item definitions and a standardized education program for proxy raters is recommended.

Statistical framework for evaluation of climate model simulations by use of climate proxy data from the last millennium - Part 1: Theory

Science.gov (United States)

Sundberg, R.; Moberg, A.; Hind, A.

2012-08-01

A statistical framework for comparing the output of ensemble simulations from global climate models with networks of climate proxy and instrumental records has been developed, focusing on near-surface temperatures for the last millennium. This framework includes the formulation of a joint statistical model for proxy data, instrumental data and simulation data, which is used to optimize a quadratic distance measure for ranking climate model simulations. An essential underlying assumption is that the simulations and the proxy/instrumental series have a shared component of variability that is due to temporal changes in external forcing, such as volcanic aerosol load, solar irradiance or greenhouse gas concentrations. Two statistical tests have been formulated. Firstly, a preliminary test establishes whether a significant temporal correlation exists between instrumental/proxy and simulation data. Secondly, the distance measure is expressed in the form of a test statistic of whether a forced simulation is closer to the instrumental/proxy series than unforced simulations. The proposed framework allows any number of proxy locations to be used jointly, with different seasons, record lengths and statistical precision. The goal is to objectively rank several competing climate model simulations (e.g. with alternative model parameterizations or alternative forcing histories) by means of their goodness of fit to the unobservable true past climate variations, as estimated from noisy proxy data and instrumental observations.

Lower Self-Reported Quality of Life in HIV-Infected Patients on cART and With Low Comorbidity Compared With Healthy Controls

DEFF Research Database (Denmark)

Pedersen, Karin K; Eiersted, Morten R; Gaardbo, Julie C

2015-01-01

replication and with low comorbidity, compared with healthy controls. We furthermore aimed to identify factors associated with QoL. DESIGN AND METHODS: Cross-sectional study of 52 HIV-infected patients and 23 healthy controls matched on age, gender, education, and comorbidity. HIV-infected patients...... and healthy controls had previously been examined regarding cognitive, physical, metabolic, and immunological parameters. QoL was investigated using the Medical Outcomes Study HIV Health Survey (MOS-HIV). Linear multiple regression models were created to find factors associated with mental health summary......BACKGROUND: Self-reported quality of life (QoL) has previously been found to be impaired in patients living with HIV and associated with viral replication, degree of immunodeficiency, and comorbidity. We aimed at investigating QoL in a group of HIV-infected patients with suppressed viral...

Determining the quality and effectiveness of surgical spine care: patient satisfaction is not a valid proxy.

Science.gov (United States)

Godil, Saniya S; Parker, Scott L; Zuckerman, Scott L; Mendenhall, Stephen K; Devin, Clinton J; Asher, Anthony L; McGirt, Matthew J

2013-09-01

Given the unsustainable costs of the US health-care system, health-care purchasers, payers, and hospital systems are adopting the concept of value-based purchasing by shifting care away from low-quality providers or hospitals. Legislation now allows public reporting of these quality rankings. True measures of quality, such as surgical morbidity and validated questionnaires of effectiveness, are burdensome and costly to collect. Hence, patients' satisfaction with care has emerged as a commonly used metric as a proxy for quality because of its feasibility of collection. However, patient satisfaction metrics have yet to be validated as a measure of overall quality of surgical spine care. We set out to determine whether patient satisfaction is a valid measure of safety and effectiveness of care in a prospective longitudinal spine registry. Prospective longitudinal cohort study. All patients undergoing elective spine surgery for degenerative conditions over a 6-month period at a single medical center. Patient-reported outcome instruments (numeric rating scale [NRS], Oswestry disability index [ODI], neck disability index [NDI], short-form 12-item survey [SF-12], Euro-Qol-5D [EQ-5D], Zung depression scale, and Modified Somatic Perception Questionnaire [MSPQ] anxiety scale), return to work, patient satisfaction with outcome, and patient satisfaction with provider care. All patients undergoing elective spine surgery for degenerative conditions over a 6-month period at a single medical center were enrolled into a prospective longitudinal registry. Data collected on all patients included demographics, disease characteristics, treatment variables, readmissions/reoperations, and all 90-day surgical morbidity. Patient-reported outcome instruments (NRS, ODI, NDI, SF-12, EQ-5D, Zung depression scale, and MSPQ anxiety scale), return to work, patient satisfaction with outcome, and patient satisfaction with provider care were recorded at baseline and 3 months after treatment

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

Understanding the milk-to-feed price ratio as a proxy for dairy farm profitability.

Science.gov (United States)

Wolf, C A

2010-10-01

This research examines the definition, historical pattern, and utility of the milk-to-feed price ratio (MF) as a measure of dairy farm profitability. The MF was generally an acceptable proxy of profitability in an annual sense from 1985 to 2006. The MF was steady at an average of 2.8 from 1985 to 2006 even as average annual milk price in nominal terms increased from $12 to $14/hundredweight. An alternative proxy for profitability is income over feed costs, which is measured in dollars per hundredweight. Comparison with an actual profit measure, rate of return on assets, is used to examine the appropriateness of the proxies. The volatility from 2007 to 2009 resulted in MF being a poor measure of profitability over that period. The implication is that MF is not the preferred measure of profitability when a significant change in the pattern of one or both price series occurs. Income over feed cost is a better measure of profitability in periods of volatility. Copyright © 2010 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

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 P<0.001 level for every year from 1981 to 2010. Syphilis rates were also consistently correlated with violent crime 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.

Investigating the consistency between proxy-based reconstructions and climate models using data assimilation: a mid-Holocene case study

NARCIS (Netherlands)

A. Mairesse; H. Goosse; P. Mathiot; H. Wanner; S. Dubinkina (Svetlana)

2013-01-01

htmlabstractThe mid-Holocene (6 kyr BP; thousand years before present) is a key period to study the consistency between model results and proxy-based reconstruction data as it corresponds to a standard test for models and a reasonable number of proxy-based records is available. Taking advantage of

Using paleoclimate proxy-data to select an optimal realisation in an ensemble of simulations of the past millennium.

NARCIS (Netherlands)

Goosse, H.; Renssen, H.; Timmermann, A.; Bradley, R.S.; Mann, M.E.

2006-01-01

We present and describe in detail the advantages and limitations of a technique that combines in an optimal way model results and proxy-data time series in order to obtain states of the climate system consistent with model physics, reconstruction of past radiative forcing and proxy records. To

Measuring resilience after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Resilience item bank and short form.

Science.gov (United States)

Victorson, David; Tulsky, David S; Kisala, Pamela A; Kalpakjian, Claire Z; Weiland, Brian; Choi, Seung W

2015-05-01

To describe the development and psychometric properties of the Spinal Cord Injury--Quality of Life (SCI-QOL) Resilience item bank and short form. Using a mixed-methods design, we developed and tested a resilience item bank through the use of focus groups with individuals with SCI and clinicians with expertise in SCI, cognitive interviews, and item-response theory based analytic approaches, including tests of model fit and differential item functioning (DIF). We tested a 32-item pool 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 medical center. A total of 717 individuals with SCI completed the Resilience items. A unidimensional model was observed (CFI=0.968; RMSEA=0.074) and measurement precision was good (theta range between -3.1 and 0.9). Ten items were flagged for DIF, however, after examination of effect sizes we found this to be negligible with little practical impact on score estimates. The final calibrated item bank resulted in 21 retained items. This study indicates that the SCI-QOL Resilience item bank represents a psychometrically robust measurement tool. Short form items are also suggested and computer adaptive tests are available.

Ginseng and Ganoderma lucidum use after breast cancer diagnosis and quality of life: a report from the Shanghai Breast Cancer Survival Study.

Directory of Open Access Journals (Sweden)

Ping-Ping Bao

Full Text Available To evaluate associations between quality of life (QOL and use of ginseng and Ganoderma lucidum (G. lucidum among breast cancer survivors.Included in this study were 4,149 women with breast cancer who participated in the Shanghai Breast Cancer Survival Study. Ginseng use was assessed at 6-, 18-, and 36-month post-diagnosis surveys; G. lucidum use was assessed at the 6- and 36-month surveys. QOL was evaluated at the 6- and 36-month surveys. Multiple linear regression models were used to examine associations between ginseng and G.lucidum use and QOL assessed at the 36-month survey, with adjustment for potential confounders and baseline QOL.At 6 months post-diagnosis, 14.2% of participants reported regular use of ginseng and 58.8% reported use of G. lucidum. We found no significant associations between ginseng use at 6, 18, and 36 months post-diagnosis and participants' total QOL score or individual scores for psychological, physical, or social well-being. Post-diagnosis G. lucidum use was positively associated with social well-being (adjusted mean difference: 1.26; 95% CI: 0.66, 1.86, but was inversely associated with physical well-being (adjusted mean difference: -1.16; 95% CI: -1.86, -0.47 with a dose-response pattern observed for cumulative number of times of use (P for trend <0.001 for both.We found no evidence that post-diagnosis ginseng use improved the QOL of breast cancer survivors. Post-diagnosis G. lucidum use was associated with better social well-being scores, but poorer physical well-being scores.

Linking coral river runoff proxies with climate variability, hydrology and land-use in Madagascar catchments.

Science.gov (United States)

Maina, Joseph; de Moel, Hans; Vermaat, Jan E; Bruggemann, J Henrich; Guillaume, Mireille M M; Grove, Craig A; Madin, Joshua S; Mertz-Kraus, Regina; Zinke, Jens

2012-10-01

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 catchment physical processes. To achieve these, we developed models to simulate hydrology of two watersheds in Madagascar. We examined relationships between environmental proxies derived from massive Porites spp. coral cores (spectral luminescence and barium/calcium ratios), and corresponding time-series (1950-2006) data of hydrology, climate, land use and human population growth. Results suggest regional differences in the main environmental drivers of reef sedimentation: on annual time-scales, precipitation, river flow and sediment load explained the variability in coral proxies of river discharge for the northeast region, while El Niño-Southern Oscillation (ENSO) and temperature (air and sea surface) were the best predictors in the southwest region. Copyright © 2012 Elsevier Ltd. All rights reserved.

Tracking variable sedimentation rates in orbitally forced paleoclimate proxy series

Science.gov (United States)

Li, M.; Kump, L. R.; Hinnov, L.

2017-12-01

This study addresses two fundamental issues in cyclostratigraphy: quantitative testing of orbital forcing in cyclic sedimentary sequences and tracking variable sedimentation rates. The methodology proposed here addresses these issues as an inverse problem, and estimates the product-moment correlation coefficient between the frequency spectra of orbital solutions and paleoclimate proxy series over a range of "test" sedimentation rates. It is inspired by the ASM method (1). The number of orbital parameters involved in the estimation is also considered. The method relies on the hypothesis that orbital forcing had a significant impact on the paleoclimate proxy variations, and thus is also tested. The null hypothesis of no astronomical forcing is evaluated using the Beta distribution, for which the shape parameters are estimated using a Monte Carlo simulation approach. We introduce a metric to estimate the most likely sedimentation rate using the product-moment correlation coefficient, H0 significance level, and the number of contributing orbital parameters, i.e., the CHO value. The CHO metric is applied with a sliding window to track variable sedimentation rates along the paleoclimate proxy series. Two forward models with uniform and variable sedimentation rates are evaluated to demonstrate the robustness of the method. The CHO method is applied to the classical Late Triassic Newark depth rank series; the estimated sedimentation rates match closely with previously published sedimentation rates and provide a more highly time-resolved estimate (2,3). References: (1) Meyers, S.R., Sageman, B.B., Amer. J. Sci., 307, 773-792, 2007; (2) Kent, D.V., Olsen, P.E., Muttoni, G., Earth-Sci. Rev.166, 153-180, 2017; (3) Li, M., Zhang, Y., Huang, C., Ogg, J., Hinnov, L., Wang, Y., Zou, Z., Li, L., 2017. Earth Plant. Sc. Lett. doi:10.1016/j.epsl.2017.07.015

Commentary on "Patient-reported outcomes after 3-dimensional conformal, intensity-modulated, or proton beam radiotherapy for localized prostate cancer." Gray PJ, Paly JJ, Yeap BY, Sanda MG, Sandler HM, Michalski JM, Talcott JA, Coen JJ, Hamstra DA, Shipley WU, Hahn SM, Zietman AL, Bekelman JE, Efstathiou JA. Harvard Radiation Oncology Program, Boston, MA.: Cancer 2013;119(9):1729-35. doi: 10.1002/cncr.27956. [Epub 2013 Feb 22].

Science.gov (United States)

Gottschalk, Alexander

2014-04-01

Recent studies have suggested differing toxicity patterns for patients with prostate cancer who receive treatment with 3-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), or proton beam therapy (PBT). The authors reviewed patient-reported outcomes data collected prospectively using validated instruments that assessed bowel and urinary quality of life (QOL) for patients with localized prostate cancer who received 3DCRT (n = 123), IMRT (n = 153) or PBT (n = 95). Clinically meaningful differences in mean QOL scores were defined as those exceeding half the standard deviation of the baseline mean value. Changes from baseline were compared within groups at the first post-treatment follow-up (2-3 months from the start of treatment) and at 12 months and 24 months. At the first post-treatment follow-up, patients who received 3DCRT and IMRT, but not those who received PBT, reported a clinically meaningful decrement in bowel QOL. At 12 months and 24 months, all 3 cohorts reported clinically meaningful decrements in bowel QOL. Patients who received IMRT reported clinically meaningful decrements in the domains of urinary irritation/obstruction and incontinence at the first post-treatment follow-up. At 12 months, patients who received PBT, but not those who received IMRT or 3DCRT, reported a clinically meaningful decrement in the urinary irritation/obstruction domain. At 24 months, none of the 3 cohorts reported clinically meaningful changes in urinary QOL. Patients who received 3DCRT, IMRT, or PBT reported distinct patterns of treatment-related QOL. Although the timing of toxicity varied between the cohorts, patients reported similar modest QOL decrements in the bowel domain and minimal QOL decrements in the urinary domains at 24 months. Prospective randomized trials are needed to further examine these differences. © 2013 Published by Elsevier Inc.

PROXiMATE: a database of mutant protein-protein complex thermodynamics and kinetics.

Science.gov (United States)

Jemimah, Sherlyn; Yugandhar, K; Michael Gromiha, M

2017-09-01

We have developed PROXiMATE, a database of thermodynamic data for more than 6000 missense mutations in 174 heterodimeric protein-protein complexes, supplemented with interaction network data from STRING database, solvent accessibility, sequence, structural and functional information, experimental conditions and literature information. Additional features include complex structure visualization, search and display options, download options and a provision for users to upload their data. The database is freely available at http://www.iitm.ac.in/bioinfo/PROXiMATE/ . The website is implemented in Python, and supports recent versions of major browsers such as IE10, Firefox, Chrome and Opera. gromiha@iitm.ac.in. Supplementary data are available at Bioinformatics online. © The Author (2017). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Activities of daily living and quality of life across different stages of dementia: a UK study.

Science.gov (United States)

Giebel, Clarissa M; Sutcliffe, Caroline; Challis, David

2015-01-01

People with dementia (PwD) require an increasing degree of assistance with activities of daily living (ADLs), and dependency may negatively impact on their well-being. However, it remains unclear which activities are impaired at each stage of dementia and to what extent this is associated with variations in quality of life (QoL) across the different stages, which were the two objectives of this study. The sample comprised 122 PwD, and their carers, either living at home or recently admitted to long-term care. Measures of cognition and QoL were completed by the PwD and proxy measures of psychopathology, depression, ADLs and QoL were recorded. Using frequency, correlation and multiple regression analysis, data were analysed for the number of ADL impairments across mild, moderate and severe dementia and for the factors impacting on QoL. ADL performance deteriorates differently for individual activities, with some ADLs showing impairment in mild dementia, including dressing, whereas others only deteriorate later on, including feeding. This decline may be seen in the degree to which carers perceive ADLs to explain the QoL of the PwD, with more ADLs associated with QoL in severe dementia. RESULTS of the regression analysis showed that total ADL performance however was only impacting on QoL in moderate dementia. Knowledge about performance deterioration in different ADLs has implications for designing interventions to address specific activities at different stages of the disease. Furthermore, findings suggest that different factors are important to consider when trying to improve or maintain QoL at different stages.

Bridging the spectral divide: a case study with PAGES2k, the CESM Last Millennium Ensemble and proxy system models

Science.gov (United States)

Zhu, F.; Emile-Geay, J.; Ault, T.; McKay, N.; Dee, S.

2017-12-01

A grand challenge for paleoclimatology is to constrain climate model behavior on timescales longer than the instrumental record. Of particular interest is the spectrum of temperature as sensed by climate proxies. The "continuum" of climate variability [Huybers & Curry, Nature 2006] is often characterized by its scaling exponent β , where the spectral density S and the frequency f satisfy the power law S ∝ f-β . Recent studies have voiced concern that climate models underestimate scaling behavior compared to proxies [Laepple & Huybers, PNAS 2014]. Part of this discrepancy is known to lie in the complex processes whereby proxies transform climate signals [Dee et al, EPSL in press], yet many questions remain open. Here we leverage a recent multiproxy compilation [PAGES 2k Consortium, Sci Data 2017] to characterize scaling behavior over the Common Era using an interpolation-free method [Kirchner & Neal, PNAS 2013]. Proxy spectra are compared to spectra derived from the CESM Last Millennium Ensemble [Otto-Bliesner et al, BAMS 2016], using: (a) a naive model where proxies are assumed linearly related to annual temperature vs (b) proxy system models [Evans et al, QSR 2013] of varying complexity. Scaling behavior varies considerably by archive: on average the strongest centennial slopes are observed for lake sediments (β =1.2), while the smallest are observed for glacier ice (β =0.24). Results confirm that the CESM Last Millennium simulation (LM) exhibits decadal-centennial scaling closer to proxy spectra than the pre-industrial control run (PI): the latter shows a "blue" spectrum (β 0), suggesting that forcings are essential to reduce the spectral divide. Yet, even with forcings, LM spectra are flatter than the proxy spectra. Subsequent work will investigate the roles of seasonal sensitivity (trees, foraminifera, alkenones), multivariate influences (corals, trees), detrending (trees) and post-depositional processes (ice cores, lake & marine sediments) on spectral

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.

Objective spatiotemporal proxy-model comparisons of the Asian monsoon for the last millennium

Science.gov (United States)

Anchukaitis, K. J.; Cook, E. R.; Ammann, C. M.; Buckley, B. M.; D'Arrigo, R. D.; Jacoby, G.; Wright, W. E.; Davi, N.; Li, J.

2008-12-01

The Asian monsoon system can be studied using a complementary proxy/simulation approach which evaluates climate models using estimates of past precipitation and temperature, and which subsequently applies the best understanding of the physics of the climate system as captured in general circulation models to evaluate the broad-scale dynamics behind regional paleoclimate reconstructions. Here, we use a millennial-length climate field reconstruction of monsoon season summer (JJA) drought, developed from tree- ring proxies, with coupled climate simulations from NCAR CSM1.4 and CCSM3 to evaluate the cause of large- scale persistent droughts over the last one thousand years. Direct comparisons are made between the external forced response within the climate model and the spatiotemporal field reconstruction. In order to identify patterns of drought associated with internal variability in the climate system, we use a model/proxy analog technique which objectively selects epochs in the model that most closely reproduce those observed in the reconstructions. The concomitant ocean-atmosphere dynamics are then interpreted in order to identify and understand the internal climate system forcing of low frequency monsoon variability. We examine specific periods of extensive or intensive regional drought in the 15th, 17th, and 18th centuries, many of which are coincident with major cultural changes in the region.

The Prospective and Retrospective Memory Questionnaire (PRMQ): latent structure, normative data and discrepancy analysis for proxy-ratings.

Science.gov (United States)

Crawford, John R; Henry, Julie D; Ward, Aileen L; Blake, John

2006-03-01

To evaluate the proxy-rating version of the Prospective and Retrospective Memory Questionnaire (PRMQ) and provide norms and methods for score interpretation. Cross-sectional and correlational. The PRMQ was administered to a large sample drawn from the general adult population (N=570). Confirmatory factor analysis (CFA) was used to test competing models of its latent structure. Various psychometric methods were applied to provide clinicians with tools for score interpretation. The CFA model with optimal fit specified a general memory factor together with additional prospective and retrospective factors. The reliabilities of the PRMQ were acceptable (.83 to .92), and demographic variables did not influence ratings. Tables are presented for conversion of raw scores on the Total scale and Prospective and Retrospective scales to T scores. In addition, tables are provided to allow users to assess the reliability and abnormality of differences between proxy ratings on the Prospective and Retrospective scales. Finally, tables are also provided to compare proxy-ratings with self-ratings (using data from the present sample and self-rating data from a previous study). The proxy-rating version of the PRMQ provides a useful measure of everyday memory for use in clinical research and practice.

Comparison of 2010 Census Nonresponse Follow-Up Proxy Responses with Administrative Records Using Census Coverage Measurement Results

Directory of Open Access Journals (Sweden)

Mulry Mary H.

2017-06-01

Full Text Available The U.S. Census Bureau is currently conducting research on ways to use administrative records to reduce the cost and improve the quality of the 2020 Census Nonresponse Followup (NRFU at addresses that do not self-respond electronically or by mail. Previously, when a NRFU enumerator was unable to contact residents at an address, he/she found a knowledgeable person, such as a neighbor or apartment manager, who could provide the census information for the residents. This was called a proxy response. The Census Bureau’s recent advances in merging federal and third-party databases raise the question: Are proxy responses for NRFU addresses more accurate than the administrative records available for the housing unit? Our study attempts to answer this question by comparing the quality of proxy responses and the administrative records for those housing units in the same timeframe using the results of 2010 Census Coverage Measurement (CCM Program. The assessment of the quality of the proxy responses and the administrative records in the CCM sample of block clusters takes advantage of the extensive fieldwork, processing, and clerical matching conducted for the CCM.

Improvement of a Quantum Proxy Blind Signature Scheme

Science.gov (United States)

Zhang, Jia-Lei; Zhang, Jian-Zhong; Xie, Shu-Cui

2018-06-01

Improvement of a quantum proxy blind signature scheme is proposed in this paper. Six-qubit entangled state functions as quantum channel. In our scheme, a trust party Trent is introduced so as to avoid David's dishonest behavior. The receiver David verifies the signature with the help of Trent in our scheme. The scheme uses the physical characteristics of quantum mechanics to implement message blinding, delegation, signature and verification. Security analysis proves that our scheme has the properties of undeniability, unforgeability, anonymity and can resist some common attacks.

Comparison of measurement- and proxy-based Vs30 values in California

Science.gov (United States)

Yong, Alan K.

2016-01-01

This study was prompted by the recent availability of a significant amount of openly accessible measured VS30 values and the desire to investigate the trend of using proxy-based models to predict VS30 in the absence of measurements. Comparisons between measured and model-based values were performed. The measured data included 503 VS30 values collected from various projects for 482 seismographic station sites in California. Six proxy-based models—employing geologic mapping, topographic slope, and terrain classification—were also considered. Included was a new terrain class model based on the Yong et al. (2012) approach but recalibrated with updated measured VS30 values. Using the measured VS30 data as the metric for performance, the predictive capabilities of the six models were determined to be statistically indistinguishable. This study also found three models that tend to underpredict VS30 at lower velocities (NEHRP Site Classes D–E) and overpredict at higher velocities (Site Classes B–C).

Surgery for Otitis Media in a Universal Health Care Model: Socioeconomic Status and Race/Ethnicity Effects.

Science.gov (United States)

Ambrosio, Art; Brigger, Matthew T

2014-07-01

(1) To determine the association between socioeconomic status (SES), race/ethnicity, and other demographic risk factors in surgically managed otitis media within a model of universal health care. 2) To determine quality of life (QOL) outcomes of surgically managed otitis media in this model. Tertiary academic medical center. Prospective cohort study. A prospective study was conducted between June 2011 and December 2012 with dependent children of military families. TRICARE provides equal access to care among all beneficiaries regardless of a wide range of annual incomes. Caretakers of children scheduled for bilateral myringotomy and tympanostomy tube (BMT) placement were administered a demographic survey, as well as OM-6 QOL instrument preoperatively and 6 weeks postoperatively. A control group who did not undergo BMT was also administered both the survey and OM-6 for comparison. Two hundred forty patients were enrolled (120 surgical patients and 120 controls). Logistic regression demonstrated age younger than 6 years old (P otitis media-6 (OM-6) scores after surgical management from 3.00 (95% confidence interval [CI], 2.79-3.20) to 1.35 (95% CI, 1.22-1.47). In a universal health care model serving more than 2 million children, previously reported proxies of low SES as well as minority race/ethnicity were not associated with surgically managed otitis media contrary to reported literature. Caucasian race, young age, and day care attendance were associated with surgery. Surgery improved QOL outcomes 6 weeks postoperatively. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

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

Science.gov (United States)

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

2016-08-01

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

Representativeness of single lidar stations for zonally averaged ozone profiles, their trends and attribution to proxies

Directory of Open Access Journals (Sweden)

C. Zerefos

2018-05-01

Full Text Available This paper is focusing on the representativeness of single lidar stations for zonally averaged ozone profile variations over the middle and upper stratosphere. From the lower to the upper stratosphere, ozone profiles from single or grouped lidar stations correlate well with zonal means calculated from the Solar Backscatter Ultraviolet Radiometer (SBUV satellite overpasses. The best representativeness with significant correlation coefficients is found within ±15° of latitude circles north or south of any lidar station. This paper also includes a multivariate linear regression (MLR analysis on the relative importance of proxy time series for explaining variations in the vertical ozone profiles. Studied proxies represent variability due to influences outside of the earth system (solar cycle and within the earth system, i.e. dynamic processes (the Quasi Biennial Oscillation, QBO; the Arctic Oscillation, AO; the Antarctic Oscillation, AAO; the El Niño Southern Oscillation, ENSO, those due to volcanic aerosol (aerosol optical depth, AOD, tropopause height changes (including global warming and those influences due to anthropogenic contributions to atmospheric chemistry (equivalent effective stratospheric chlorine, EESC. Ozone trends are estimated, with and without removal of proxies, from the total available 1980 to 2015 SBUV record. Except for the chemistry related proxy (EESC and its orthogonal function, the removal of the other proxies does not alter the significance of the estimated long-term trends. At heights above 15 hPa an inflection point between 1997 and 1999 marks the end of significant negative ozone trends, followed by a recent period between 1998 and 2015 with positive ozone trends. At heights between 15 and 40 hPa the pre-1998 negative ozone trends tend to become less significant as we move towards 2015, below which the lower stratosphere ozone decline continues in agreement with findings of recent literature.

Representativeness of single lidar stations for zonally averaged ozone profiles, their trends and attribution to proxies

Science.gov (United States)

Zerefos, Christos; Kapsomenakis, John; Eleftheratos, Kostas; Tourpali, Kleareti; Petropavlovskikh, Irina; Hubert, Daan; Godin-Beekmann, Sophie; Steinbrecht, Wolfgang; Frith, Stacey; Sofieva, Viktoria; Hassler, Birgit

2018-05-01

This paper is focusing on the representativeness of single lidar stations for zonally averaged ozone profile variations over the middle and upper stratosphere. From the lower to the upper stratosphere, ozone profiles from single or grouped lidar stations correlate well with zonal means calculated from the Solar Backscatter Ultraviolet Radiometer (SBUV) satellite overpasses. The best representativeness with significant correlation coefficients is found within ±15° of latitude circles north or south of any lidar station. This paper also includes a multivariate linear regression (MLR) analysis on the relative importance of proxy time series for explaining variations in the vertical ozone profiles. Studied proxies represent variability due to influences outside of the earth system (solar cycle) and within the earth system, i.e. dynamic processes (the Quasi Biennial Oscillation, QBO; the Arctic Oscillation, AO; the Antarctic Oscillation, AAO; the El Niño Southern Oscillation, ENSO), those due to volcanic aerosol (aerosol optical depth, AOD), tropopause height changes (including global warming) and those influences due to anthropogenic contributions to atmospheric chemistry (equivalent effective stratospheric chlorine, EESC). Ozone trends are estimated, with and without removal of proxies, from the total available 1980 to 2015 SBUV record. Except for the chemistry related proxy (EESC) and its orthogonal function, the removal of the other proxies does not alter the significance of the estimated long-term trends. At heights above 15 hPa an inflection point between 1997 and 1999 marks the end of significant negative ozone trends, followed by a recent period between 1998 and 2015 with positive ozone trends. At heights between 15 and 40 hPa the pre-1998 negative ozone trends tend to become less significant as we move towards 2015, below which the lower stratosphere ozone decline continues in agreement with findings of recent literature.

Assessment of parent reported quality of life in children with epilepsy from Northern India: A cross-sectional study

OpenAIRE

Arya, Vandana; Gehlawat, Virender Kumar; Kaushik, Jaya Shankar; Gathwala, Geeta

2014-01-01

Objective: The objective of the following study is to assess parent reported quality of life (QOL) in children with epilepsy and to assess the demographic and clinical factors, which influence the QOL in children with epilepsy. Study Participants: We consecutively enrolled 40 children aged from 2 years to 14 years with active epilepsy who had undergone a comprehensive evaluation for epilepsy. Materials and Methods: Parents were enquired on baseline demographic variables including age, gender,...

The effects of metamorphism on iron mineralogy and the iron speciation redox proxy

Science.gov (United States)

Slotznick, Sarah P.; Eiler, John M.; Fischer, Woodward W.

2018-03-01

As the most abundant transition metal in the Earth's crust, iron is a key player in the planetary redox budget. Observations of iron minerals in the sedimentary record have been used to describe atmospheric and aqueous redox environments over the evolution of our planet; the most common method applied is iron speciation, a geochemical sequential extraction method in which proportions of different iron minerals are compared to calibrations from modern sediments to determine water-column redox state. Less is known about how this proxy records information through post-depositional processes, including diagenesis and metamorphism. To get insight into this, we examined how the iron mineral groups/pools (silicates, oxides, sulfides, etc.) and paleoredox proxy interpretations can be affected by known metamorphic processes. Well-known metamorphic reactions occurring in sub-chlorite to kyanite rocks are able to move iron between different iron pools along a range of proxy vectors, potentially affecting paleoredox results. To quantify the effect strength of these reactions, we examined mineralogical and geochemical data from two classic localities where Silurian-Devonian shales, sandstones, and carbonates deposited in a marine sedimentary basin with oxygenated seawater (based on global and local biological constraints) have been regionally metamorphosed from lower-greenschist facies to granulite facies: Waits River and Gile Mountain Formations, Vermont, USA and the Waterville and Sangerville-Vassalboro Formations, Maine, USA. Plotting iron speciation ratios determined for samples from these localities revealed apparent paleoredox conditions of the depositional water column spanning the entire range from oxic to ferruginous (anoxic) to euxinic (anoxic and sulfidic). Pyrrhotite formation in samples highlighted problems within the proxy as iron pool assignment required assumptions about metamorphic reactions and pyrrhotite's identification depended on the extraction techniques

Model simulations and proxy-based reconstructions for the European region in the past millennium (Invited)

Science.gov (United States)

Zorita, E.

2009-12-01

One of the objectives when comparing simulations of past climates to proxy-based climate reconstructions is to asses the skill of climate models to simulate climate change. This comparison may accomplished at large spatial scales, for instance the evolution of simulated and reconstructed Northern Hemisphere annual temperature, or at regional or point scales. In both approaches a 'fair' comparison has to take into account different aspects that affect the inevitable uncertainties and biases in the simulations and in the reconstructions. These efforts face a trade-off: climate models are believed to be more skillful at large hemispheric scales, but climate reconstructions are these scales are burdened by the spatial distribution of available proxies and by methodological issues surrounding the statistical method used to translate the proxy information into large-spatial averages. Furthermore, the internal climatic noise at large hemispheric scales is low, so that the sampling uncertainty tends to be also low. On the other hand, the skill of climate models at regional scales is limited by the coarse spatial resolution, which hinders a faithful representation of aspects important for the regional climate. At small spatial scales, the reconstruction of past climate probably faces less methodological problems if information from different proxies is available. The internal climatic variability at regional scales is, however, high. In this contribution some examples of the different issues faced when comparing simulation and reconstructions at small spatial scales in the past millennium are discussed. These examples comprise reconstructions from dendrochronological data and from historical documentary data in Europe and climate simulations with global and regional models. These examples indicate that the centennial climate variations can offer a reasonable target to assess the skill of global climate models and of proxy-based reconstructions, even at small spatial scales

A Proxy Architecture to Enhance the Performance of WAP 2.0 by Data Compression

Directory of Open Access Journals (Sweden)

Yin Zhanping

2005-01-01

Full Text Available This paper presents a novel proxy architecture for wireless application protocol (WAP employing an advanced data compression scheme. Though optional in WAP , a proxy can isolate the wireless from the wired domain to prevent error propagations and to eliminate wireless session delays (WSD by enabling long-lived connections between the proxy and wireless terminals. The proposed data compression scheme combines content compression together with robust header compression (ROHC, which minimizes the air-interface traffic data, thus significantly reduces the wireless access time. By using the content compression at the transport layer, it also enables TLS tunneling, which overcomes the end-to-end security problem in WAP 1.x. Performance evaluations show that while WAP 1.x is optimized for narrowband wireless channels, WAP utilizing TCP/IP outperforms WAP 1.x over wideband wireless channels even without compression. The proposed data compression scheme reduces the wireless access time of WAP by over in CDMA2000 1XRTT channels, and in low-speed IS-95 channels, substantially reduces access time to give comparable performance to WAP 1.x. The performance enhancement is mainly contributed by the reply content compression, with ROHC offering further enhancements.

A Scalable proxy cache for Grid Data Access

International Nuclear Information System (INIS)

Cristian Cirstea, Traian; Just Keijser, Jan; Arthur Koeroo, Oscar; Starink, Ronald; Alan Templon, Jeffrey

2012-01-01

We describe a prototype grid proxy cache system developed at Nikhef, motivated by a desire to construct the first building block of a future https-based Content Delivery Network for grid infrastructures. Two goals drove the project: firstly to provide a “native view” of the grid for desktop-type users, and secondly to improve performance for physics-analysis type use cases, where multiple passes are made over the same set of data (residing on the grid). We further constrained the design by requiring that the system should be made of standard components wherever possible. The prototype that emerged from this exercise is a horizontally-scalable, cooperating system of web server / cache nodes, fronted by a customized webDAV server. The webDAV server is custom only in the sense that it supports http redirects (providing horizontal scaling) and that the authentication module has, as back end, a proxy delegation chain that can be used by the cache nodes to retrieve files from the grid. The prototype was deployed at Nikhef and tested at a scale of several terabytes of data and approximately one hundred fast cores of computing. Both small and large files were tested, in a number of scenarios, and with various numbers of cache nodes, in order to understand the scaling properties of the system. For properly-dimensioned cache-node hardware, the system showed speedup of several integer factors for the analysis-type use cases. These results and others are presented and discussed.

The conceptualization and measurement of cognitive reserve using common proxy indicators: Testing some tenable reflective and formative models.

Science.gov (United States)

Ikanga, Jean; Hill, Elizabeth M; MacDonald, Douglas A

2017-02-01

The examination of cognitive reserve (CR) literature reveals a lack of consensus regarding conceptualization and pervasive problems with its measurement. This study aimed at examining the conceptual nature of CR through the analysis of reflective and formative models using eight proxies commonly employed in the CR literature. We hypothesized that all CR proxies would significantly contribute to a one-factor reflective model and that educational and occupational attainment would produce the strongest loadings on a single CR factor. The sample consisted of 149 participants (82 male/67 female), with 18.1 average years of education and ages of 45-99 years. Participants were assessed for eight proxies of CR (parent socioeconomic status, intellectual functioning, level of education, health literacy, occupational prestige, life leisure activities, physical activities, and spiritual and religious activities). Primary statistical analyses consisted of confirmatory factor analysis (CFA) to test reflective models and structural equation modeling (SEM) to evaluate multiple indicators multiple causes (MIMIC) models. CFA did not produce compelling support for a unitary CR construct when using all eight of our CR proxy variables in a reflective model but fairly cogent evidence for a one-factor model with four variable proxies. A second three-factor reflective model based upon an exploratory principal components analysis of the eight proxies was tested using CFA. Though all eight indicators significantly loaded on their assigned factors, evidence in support of overall model fit was mixed. Based upon the results involving the three-factor reflective model, two alternative formative models were developed and evaluated. While some support was obtained for both, the model in which the formative influences were specified as latent variables appeared to best account for the contributions of all eight proxies to the CR construct. While the findings provide partial support for our

Atmospheric multidecadal variations in the North Atlantic realm: proxy data, observations, and atmospheric circulation model studies

Directory of Open Access Journals (Sweden)

K. Grosfeld

2007-01-01

Full Text Available We investigate the spatial and temporal characteristics of multidecadal climate variability in the North Atlantic realm, using observational data, proxy data and model results. The dominant pattern of multidecadal variability of SST depicts a monopolar structure in the North Atlantic during the instrumental period with cold (warm phases during 1900–1925 and 1970–1990 (1870–1890 and 1940–1960. Two atmospheric general circulation models of different complexity forced with global SST over the last century show SLP anomaly patterns from the warm and cold phases of the North Atlantic similar to the corresponding observed patterns. The analysis of a sediment core from Cariaco Basin, a coral record from the northern Red Sea, and a long-term sea level pressure (SLP reconstruction reveals that the multidecadal mode of the atmospheric circulation characterizes climate variability also in the pre-industrial era. The analyses of SLP reconstruction and proxy data depict a persistent atmospheric mode at least over the last 300 years, where SLP shows a dipolar structure in response to monopolar North Atlantic SST, in a similar way as the models' responses do. The combined analysis of observational and proxy data with model experiments provides an understanding of multidecadal climate modes during the late Holocene. The related patterns are useful for the interpretation of proxy data in the North Atlantic realm.

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.

Financial Hardship and Patient-Reported Outcomes after Hematopoietic Cell Transplantation

Science.gov (United States)

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

2016-01-01

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

Indian monsoon variability at different time scales: Marine and terrestrial proxy records

Digital Repository Service at National Institute of Oceanography (India)

Patnaik, R.; Gupta, A; Naidu, P.D.; Yadav, R.R.; Bhattacharyya, A; Kumar, M.

Here, we present a review of the work done in India during 2007-2011 on various proxy records of monsoon variability preserved in the marine (Central Indian Basin, western, northern and eastern Arabian Sea and the Bay of Bengal) and terrestrial...

PedsQLTM 4.0 Generic Core Scales for adolescents in the Yoruba language: translation and general psychometric properties.

Science.gov (United States)

Atilola, Olayinka; Stevanović, Dejan

2014-04-01

Quality of life (QOL) is a universally accepted concept for measuring the impact of different aspects of life on general well-being. Adaptation of existing QOL instruments to local cultures has been identified as a better strategy than development of new ones. To translate and adapt the Paediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales (PedsQL™) to the Yoruba language and culture and to test the psychometric properties of the adapted instrument among adolescents. Psychometric properties including internal consistency reliability, construct and factorial validity of the Yoruba version of PedsQL™ were evaluated using standard procedures. The self report and proxy scales of the Yoruba PedsQL™ were developed with good cultural relevance and semantic/conceptual equivalence. Results from 527 adolescents revealed a Cronbach's coefficient which exceeded 0.7 for internal consistency reliability for all scores. The healthy subjects reported higher PedsQL™ scores than those with mental health and physical problems, which confirmed construct validity. Confirmatory factor analysis revealed a good model fit for the Psychosocial Health score, but not for the other measures. The Yoruba PedsQL™ is culturally appropriate and with good internal consistency, reliability and construct validity. More work is needed regarding its factorial validity.

Self-reported health outcomes in patients with psoriasis and psoriatic arthritis randomized to two etanercept regimens

DEFF Research Database (Denmark)

Gniadecki, R; Robertson, David; Molta, C T

2012-01-01

the impact of skin disease on QoL; the Health Assessment Questionnaire-Disability Index (HAQ-DI), an assessment of physical function; the Hospital Anxiety and Depression Scale (HADS), which screens for anxiety and depression symptoms; and individual questions on general health, disease activity, fatigue......Background Moderate/severe psoriasis combined with psoriatic arthritis (PsA) impairs health-related quality of life (QoL). Etanercept, a fully human tumour necrosis factor-a receptor fusion protein, is approved for treatment of both diseases. Objective To compare patient-reported health outcomes...... additional weeks. PROs included: the EuroQOL-5D (EQ-5D), which measures general health status and consists of the utility index measuring five dimensions of health, and a visual analogue scale (VAS) allowing patients to assess health status; the Dermatology Life Quality Index (DLQI), which measures...

Potential of Gdgts as Temperature Proxies Along Altitudinal Transects in East Africa

Science.gov (United States)

Coffinet, Sarah; Huguet, Arnaud; Omuombo, Christine; Williamson, David; Fosse, Céline; Anquetil, Christine; Derenne, Sylvie

2014-05-01

Glycerol dialkyl glycerol tetraethers (GDGTs) are lipids of high molecular weight and include the isoprenoid GDGTs (iGDGTs) produced by Archaea and the branched GDGTs (brGDGTs) produced by unknown bacteria. Several indices were developed to describe the relationship between GDGT distribution and environmental parameters: the TEX86 (tetraether index of tetraethers consisting of 86 carbons), based on the relative abundances of iGDGTs in sediments, and the MBT (methylation index of branched tetraethers) and CBT (cyclisation ratio of branched tetraethers), based on the relative abundance of brGDGTs in soils. The TEX86 was shown to correlate well with water surface temperature, and the MBT and CBT with mean annual air temperature (MAAT) and soil pH. The GDGTs are increasingly used as temperature proxies. In this study, 41 surface soils were sampled along two altitudinal transects, from 500 to 2800 meters in Mount Rungwe (South western, Tanzania) and from 1897 to 3268 meters in Mount Kenya (Central Kenya). MAAT was reconstructed along the two transects using the MBT/CBT proxies. A linear correlation between the MBT/CBT-derived temperatures and the altitude (R2=0.83) was obtained by combining results of the two transects. The reconstructed temperature lapse rate (0.5 ° C/100 m) was consistent with the one determined from temperature measurements at six altitudes. These results show that the MBT/CBT is a suitable and robust temperature proxy in East Africa. In Mt. Rungwe soil samples, the TEX86 index, which was mainly used to reconstruct water surface temperatures until now, was found to vary linearly with altitude (R2=0.50). Such a relationship between TEX86 and altitude in organic soils has also been recently noticed in Mt. Xiangpi, China (Liu et al., 2013; R2=0.68). The adiabatic cooling of air with altitude could explain the TEX86 variation with altitude. If such a relationship is confirmed, the use of the TEX86 as a temperature proxy could be extended to soil

A randomized assessment of three quality of life (QOL) questionnaires for prostate cancer patients undergoing different radiation treatment modalities

International Nuclear Information System (INIS)

Senter, K.K.; Hardy, M.; Flynn, C.; Lewis, L.; Wallace, M.; Boyea, G.; Mitchell, C.; Fluellen, L.; Henry, C.St.; Martinez, A.

2001-01-01

Purpose: The goal of this prospective, randomized study was to assess and compare compliance of patients diagnosed with prostate cancer to completing three different validated QOL instruments pre-treatment and six months later. Materials and Methods: Between April 2000 and April 2001, 124 patients were asked to fill out only one of three randomly selected QOL questionnaires (version A, B, C). Each addressed urinary and sexual function. One also addressed patients' physical, social, family, emotional, and functional well being. Study patients received External Beam Radiation Therapy (EBRT) or Brachytherapy (BRACHY), according to departmental policy. Exclusion criteria included current/previous hormone therapy and prostatectomy. Patients were asked to return the questionnaire at their first treatment visit. The three tools were: A The Functional Assessment of Cancer Therapy for Prostate Patients (FACT-P), The Sexual Adjustments Questionnaire (SAQ), and The American Urological Association (AUA) Questionnaire. The Fact-P questionnaire elicits information about physical, social, family, emotional, and functional well being as they relate to prostate cancer. SAQ focuses on sexual function; the AUA on urinary symptoms. B SAQ and AUA only; identical to Version A, but does not address physical, social, family, emotional, and functional well-being. C The International Prostate Symptom Score (I-PSS) Questionnaire, which addresses urinary symptoms and Patient Sexual Function Questionnaire, which focuses on erectile function. Additionally, patients were asked to respond yes/no to four variables designed to evaluate these questionnaires: 1) ease of understanding, 2) too personal, 3)addresses concerns regarding urinary function and sexual potency and 4) willingness to complete questionnaire in six months. These variables were examined for any trends that may exist between the different questionnaires. Results: Fifteen (12%) of the 124 patients returned incomplete questionnaires

Risk analysis of the proxy life-cycle investments in the second pillar pension scheme in Croatia

Directory of Open Access Journals (Sweden)

Renata Kovačević

2015-03-01

Full Text Available In this article we analyze the expected risk of pension funds with different risk profiles in the proxy life-cycle model of investments for the 2nd pillar pension scheme in Croatia. The benefits of implementing proxy life-cycle investments, compared to the previous model of mandatory pension funds investments, are clearly visible in the total expected amount of accumulated savings from the risk/return perspective. However, those benefits are partially diminished by the fact that the expected risk of a pension fund with the lowest risk profile is not substantially different from the expected risk of a pension fund with a medium risk profile, due to the lack of diversification. Additionally, we analyze the robustness of the proxy life-cycle model to a sudden and severe market shock, where we determine the presence of risk for those members who choose to switch to a pension fund with a lower risk profile at an unfavorable moment.

A Quantitative Proxy for Sea-Ice Based on Diatoms: A Cautionary Tale.

Science.gov (United States)

Nesterovich, A.; Caissie, B.

2016-12-01

Sea ice in the Polar Regions supports unique and productive ecosystems, but the current decline in the Arctic sea ice extent prompts questions about previous sea ice declines and the response of ice related ecosystems. Since satellite data only extend back to 1978, the study of sea ice before this time requires a proxy. Being one of the most productive, diatom-dominated regions in the world and having a wide range of sea ice concentrations, the Bering and Chukchi seas are a perfect place to find a relationship between the presence of sea ice and diatom community composition. The aim of this work is to develop a diatom-based proxy for the sea ice extent. A total of 473 species have been identified in 104 sediment samples, most of which were collected on board the US Coast Guard Cutter Healy ice breaker (2006, 2007) and the Norseman II (2008). The study also included some of the archived diatom smear slides made from sediments collected in 1969. The assemblages were compared to satellite-derived sea ice extent data averaged over the 10 years preceding the sampling. Previous studies in the Arctic and Antarctic regions demonstrated that the Generalized Additive Model (GAM) is one of the best choices for proxy construction. It has the advantage of using only several species instead of the whole assemblage, thus including only sea ice-associated species and minimizing the noise created by species responding to other environmental factors. Our GAM on three species (Connia compita, Fragilariopsis reginae-jahniae, and Neodenticula seminae) has low standard deviation, high level of explained variation, and holds under the ten-fold cross-validation; the standard residual analysis is acceptable. However, a spatial residual analysis revealed that the model consistently over predicts in the Chukchi Sea and under predicts in the Bering Sea. Including a spatial model into the GAM didn't improve the situation. This has led us to test other methods, including a non-parametric model

Development of a Short Version of the Thyroid-Related Patient-Reported Outcome ThyPRO

DEFF Research Database (Denmark)

Watt, Torquil; Bjorner, Jakob Bue; Groenvold, Mogens

2015-01-01

BACKGROUND: Thyroid diseases affect quality of life (QoL). The Thyroid-Related Patient-Reported Outcome (ThyPRO) is an international comprehensive well-validated patient-reported outcome, measuring thyroid-related QoL. The current version is rather long-85 items. The purpose of the present study...... was to develop an abbreviated version of the ThyPRO, with conserved good measurement properties. METHODS: A cross-sectional (N = 907) and a longitudinal sample (N = 435) of thyroid patients were analyzed. A graded item response theory (IRT) model was fitted to the cross-sectional data. Short-form scales.......89-0.98), and the mean scale levels were similar. CONCLUSIONS: A 39-item version of the ThyPRO, with good measurement properties, was developed and is recommended for clinical use....

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.

Carbohydrates and phenols as quantitative molecular vegetation proxies in peats

Science.gov (United States)

Kaiser, K.; Benner, R. H.