Measuring patient knowledge of asthma: a systematic review of outcome measures.

NARCIS (Netherlands)

Pink, J.; Pink, K.; Elwyn, G.

2009-01-01

BACKGROUND: Asthma self-management education is a key component of international guidelines. No gold standard patient centred outcome measure exists for asthma knowledge. Our aim was to identify high-quality, validated, and reliable outcome measures suitable for use in either the research or

Korean Clinic Based Outcome Measure Studies

OpenAIRE

Jongbae Park

2003-01-01

Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented...

Psychometric properties of carer-reported outcome measures in palliative care: A systematic review

Science.gov (United States)

Michels, Charlotte TJ; Boulton, Mary; Adams, Astrid; Wee, Bee; Peters, Michele

2016-01-01

Background: Informal carers face many challenges in caring for patients with palliative care needs. Selecting suitable valid and reliable outcome measures to determine the impact of caring and carers’ outcomes is a common problem. Aim: To identify outcome measures used for informal carers looking after patients with palliative care needs, and to evaluate the measures’ psychometric properties. Design: A systematic review was conducted. The studies identified were evaluated by independent reviewers (C.T.J.M., M.B., M.P.). Data regarding study characteristics and psychometric properties of the measures were extracted and evaluated. Good psychometric properties indicate a high-quality measure. Data sources: The search was conducted, unrestricted to publication year, in the following electronic databases: Applied Social Sciences Index and Abstracts, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, EMBASE, PubMed, PsycINFO, Social Sciences Citation Index and Sociological Abstracts. Results: Our systematic search revealed 4505 potential relevant studies, of which 112 studies met the inclusion criteria using 38 carer measures for informal carers of patients with palliative care needs. Psychometric properties were reported in only 46% (n = 52) of the studies, in relation to 24 measures. Where psychometric data were reported, the focus was mainly on internal consistency (n = 45, 87%), construct validity (n = 27, 52%) and/or reliability (n = 14, 27%). Of these, 24 measures, only four (17%) had been formally validated in informal carers in palliative care. Conclusion: A broad range of outcome measures have been used for informal carers of patients with palliative care needs. Little formal psychometric testing has been undertaken. Furthermore, development and refinement of measures in this field is required. PMID:26407683

Staff perceptions of using outcome measures in stroke rehabilitation.

Science.gov (United States)

Burton, Louisa-Jane; Tyson, Sarah; McGovern, Alison

2013-05-01

The use of standardised outcome measures is an integral part of stroke rehabilitation and is widely recommended as good practice. However, little is known about how measures are actually used or their impact. This study aimed to identify current clinical practice; how healthcare professionals working in stroke rehabilitation use outcome measures and their perceptions of the benefits and barriers to use. Eighty-four Health Care Professionals and 12 service managers and commissioners working in stroke services across a large UK county were surveyed by postal questionnaire. Ninety-six percent of clinical respondents used at least one measure, however, less than half used measures regularly during a patient's stay. The mean number of tools used was 3.2 (SD = 1.9). Eighty-one different tools were identified; 16 of which were unpublished and unvalidated. Perceived barriers in using outcome measures in day-to-day clinical practice included lack of resources (time and training) and lack of knowledge of appropriate measures. Benefits identified were to demonstrate the effectiveness of rehabilitation interventions and monitor patients' progress. Although the use of outcome measures is prevalent in clinical practice, there is little consistency in the tools utilised. The term "outcome measures" is used, but staff rarely used the measures at appropriate time points to formally assess and evaluate outcome. The term "measurement tool" more accurately reflects the purposes to which they were put and potential benefits. Further research to overcome the barriers in using standardised measurement tools and evaluate the impact of implementation on clinical practice is needed. • Health professionals working in stroke rehabilitation should work together to agree when and how outcome measures can be most effectively used in their service. • Efforts should be made to ensure that standardised tools are used to measure outcome at set time-points during rehabilitation, in order to

Reliability and validity analysis of the open-source Chinese Foot and Ankle Outcome Score (FAOS).

Science.gov (United States)

Ling, Samuel K K; Chan, Vincent; Ho, Karen; Ling, Fona; Lui, T H

2017-12-21

Develop the first reliable and validated open-source outcome scoring system in the Chinese language for foot and ankle problems. Translation of the English FAOS into Chinese following regular protocols. First, two forward-translations were created separately, these were then combined into a preliminary version by an expert committee, and was subsequently back-translated into English. The process was repeated until the original and back translations were congruent. This version was then field tested on actual patients who provided feedback for modification. The final Chinese FAOS version was then tested for reliability and validity. Reliability analysis was performed on 20 subjects while validity analysis was performed on 50 subjects. Tools used to validate the Chinese FAOS were the SF36 and Pain Numeric Rating Scale (NRS). Internal consistency between the FAOS subgroups was measured using Cronbach's alpha. Spearman's correlation was calculated between each subgroup in the FAOS, SF36 and NRS. The Chinese FAOS passed both reliability and validity testing; meaning it is reliable, internally consistent and correlates positively with the SF36 and the NRS. The Chinese FAOS is a free, open-source scoring system that can be used to provide a relatively standardised outcome measure for foot and ankle studies. Copyright © 2017 Elsevier Ltd. All rights reserved.

Measuring Learning Outcomes in Auditing Education

DEFF Research Database (Denmark)

Holm, Claus; Steenholdt, Niels

2003-01-01

The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education, which reflects that some students taking accounting classes also are provided with on-the-job training in accounting...... firms. Hence knowledge about learning outcomes for different groups of students is essential information for educators as well as the accounting profession. This paper extends prior research on the role of declarative and procedural knowledge in performing auditing tasks. Measuring learning outcomes......). The study provides evidence, which confirms an interrelationship between declarative and procedural knowledge in auditing, and the findings also suggest that students with auditing experience perform better than students without experience on procedural questions....

Photon sources for absorptiometric measurements

International Nuclear Information System (INIS)

Witt, R.M.; Sandrik, J.M.; Cameron, J.R.

1976-01-01

Photon absorptiometry is defined and the requirements of photon sources for these measurements are described. Both x-ray tubes and radionuclide sources are discussed, including the advantages of each in absorptiometric systems

Hepatology may have problems with putative surrogate outcome measures

DEFF Research Database (Denmark)

Gluud, Christian; Brok, Jesper; Gong, Yan

2007-01-01

A surrogate outcome measure is a laboratory measurement, a physical sign, or another intermediate substitute that is able to predict an intervention's effect on a clinically meaningful outcome. A clinical outcome detects how a patient feels, functions, or survives. Surrogate outcome measures occur...... faster or more often, are cheaper, and/or are less invasively achieved than the clinical outcome. In practice, validation is surprisingly often overlooked, especially if a biologic plausible rationale is proposed. Surrogate outcomes must be validated before use. The first step in validation...... predicts the intervention's effect on the clinical outcome. In hepatology a number of putative surrogate outcomes are used both in clinical research and in clinical practice without having been properly validated. Sustained virological response to interferons and ribavirin in patients with chronic...

Measuring Conflict in a Multi-Source Environment as a Normal Measure

OpenAIRE

Wei, Pan; Ball, John E.; Anderson, Derek T.; Harsh, Archit; Archibald, Christopher

2018-01-01

In a multi-source environment, each source has its own credibility. If there is no external knowledge about credibility then we can use the information provided by the sources to assess their credibility. In this paper, we propose a way to measure conflict in a multi-source environment as a normal measure. We examine our algorithm using three simulated examples of increasing conflict and one experimental example. The results demonstrate that the proposed measure can represent conflict in a me...

Culturally Sensitive and Environment-Friendly Outcome Measures in

African Journals Online (AJOL)

Dr Olaleye

A systematic review of evidence on culturally sensitive and environment-friendly outcome measures in ..... which included manual grass cutting/hoeing, assuming the Islamic ... who opined that the starting point for any outcome measure is to ...

Radon measurements: the sources of uncertainties

International Nuclear Information System (INIS)

Zhukovsky, Michael; Onischenko, Alexandra; Bastrikov, Vladislav

2008-01-01

Full text: Radon measurements are quite complicated process and the correct estimation of uncertainties is very important. The sources of uncertainties for grab sampling, short term measurements (charcoal canisters), long term measurements (track detectors) and retrospective measurements (surface traps) are analyzed. The main sources of uncertainties for grab sampling measurements are: systematic bias of reference equipment; random Poisson and non-Poisson errors during calibration; random Poisson and non-Poisson errors during measurements. These sources are also common both for short term measurements (charcoal canisters) and long term measurements (track detectors). Usually during the calibration the high radon concentrations are used (1-5 kBq/m 3 ) and the Poisson random error rarely exceed some percents. Nevertheless the dispersion of measured values even during the calibration usually exceeds the Poisson dispersion expected on the basis of counting statistic. The origins of such non-Poisson random errors during calibration are different for different kinds of instrumental measurements. At present not all sources of non-Poisson random errors are trustworthy identified. The initial calibration accuracy of working devices rarely exceeds the value 20%. The real radon concentrations usually are in the range from some tens to some hundreds Becquerel per cubic meter and for low radon levels Poisson random error can reach up to 20%. The random non-Poisson errors and residual systematic biases are depends on the kind of measurement technique and the environmental conditions during radon measurements. For charcoal canisters there are additional sources of the measurement errors due to influence of air humidity and the variations of radon concentration during the canister exposure. The accuracy of long term measurements by track detectors will depend on the quality of chemical etching after exposure and the influence of season radon variations. The main sources of

Knee Injury and Osteoarthritis Outcome Score (KOOS)--development of a self-administered outcome measure

DEFF Research Database (Denmark)

Roos, Ewa M.; Roos, H P; Lohmander, L S

1998-01-01

There is broad consensus that good outcome measures are needed to distinguish interventions that are effective from those that are not. This task requires standardized, patient-centered measures that can be administered at a low cost. We developed a questionnaire to assess short- and long......-term patient-relevant outcomes following knee injury, based on the WOMAC Osteoarthritis Index, a literature review, an expert panel, and a pilot study. The Knee injury and Osteoarthritis Outcome Score (KOOS) is self-administered and assesses five outcomes: pain, symptoms, activities of daily living, sport...

Comparative Effectiveness of Usual Source of Care Approaches to Improve End-of-Life Outcomes for Children With Intellectual Disability.

Science.gov (United States)

Lindley, Lisa C; Cozad, Melanie J

2017-09-01

Children with intellectual disability (ID) are at risk for adverse end-of-life outcomes including high emergency room utilization and hospital readmissions, along with low hospice enrollment. The objective of this study was to compare the effectiveness of usual source of care approaches to improve end-of-life outcomes for children with ID. We used longitudinal California Medicaid claims data. Children were included who were 21 years with fee-for-service Medicaid claims, died between January 1, 2007, and December 31, 2010, and had a moderate-to-profound ID diagnosis. End-of-life outcomes (i.e., hospice enrollment, emergency room utilization, hospital readmissions) were measured via claims data. Our treatments were usual source of care (USC) only vs. usual source of care plus targeted case management (USC plus TCM). Using instrumental variable analysis, we compared the effectiveness of treatments on end-of-life outcomes. Ten percent of children with ID enrolled in hospice, 73% used the emergency room, and 20% had three or more hospital admissions in their last year of life. USC plus TCM relative to USC only had no effect on hospice enrollment; however, it significantly reduced the probability of emergency room utilization (B = -1.29, P life outcomes for children with ID. Further study of the extent of UCS and TCM involvement in reducing emergency room utilization and hospital readmissions at end of life is needed. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

EDF source term reduction project main outcomes and further developments

International Nuclear Information System (INIS)

Ranchoux, Gilles; Bonnefon, Julien; Benfarah, Moez; Wintergerst Matthieu; Gressier, Frederic; Leclercq, Stephanie

2012-09-01

The dose reduction is a strategic purpose for EDF in link with the stakes of, nuclear acceptability, respect of regulation and productivity gains. This consists not only in improving the reactor shutdown organization (time spent in control area, biological shielding,...) but also in improving the radiological state of the unit and the efficiency of the source term reduction operations. Since 2003, EDF has been running an innovative project called 'Source Term Reduction' federating the different EDF research and engineering centers in order to: - participate to the long term view about Radiological Protection issues (international feedback analyses), - develop contamination prediction tools (OSCAR software) suitable for the industrial needs (operating units and EPR design), - develop scientific models useful for the understanding of contamination mechanisms to support the strategic decision processes, - carry on with updating and analyzing of contamination measurements feedback in corrosion products (EMECC and CZT campaigns), - carry on with the operational support at short or middle term by optimizing startup and shutdown processes, pre-oxidation or and by improving purification efficiency or material characteristics. This paper will show in a first part the main 2011 results in occupational exposure (collective and individual dose, RCS index...). In a second part, an overview of the main EDF outcomes of the last 3 years in the field of source term reduction will be presented. Future developments extended to contamination issues in EDF NPPs will be also pointed out in this paper. (authors)

The Development of NOAA Education Common Outcome Performance Measures (Invited)

Science.gov (United States)

Baek, J.

2013-12-01

The National Oceanic and Atmospheric Administration (NOAA) Education Council has embarked on an ambitious Monitoring and Evaluation (M&E) project that will allow it to assess education program outcomes and impacts across the agency, line offices, and programs. The purpose of this internal effort is to link outcome measures to program efforts and to evaluate the success of the agency's education programs in meeting the strategic goals. Using an outcome-based evaluation approach, the NOAA Education Council is developing two sets of common outcome performance measures, environmental stewardship and professional development. This presentation will examine the benefits and tradeoffs of common outcome performance measures that collect program results across a portfolio of education programs focused on common outcomes. Common outcome performance measures have a few benefits to our agency and to the climate education field at large. The primary benefit is shared understanding, which comes from our process for writing common outcome performance measures. Without a shared and agreed upon set of definitions for the measure of an outcome, the reported results may not be measuring the same things and would incorrectly indicate levels of performance. Therefore, our writing process relies on a commitment to developing a shared set of definitions based on consensus. We hope that by taking the time to debate and coming to agreement across a diverse set of programs, the strength of our common measures can indicate real progress towards outcomes we care about. An additional benefit is that these common measures can be adopted and adapted by other agencies and organizations that share similar theories of change. The measures are not without their drawbacks, and we do make tradeoffs as part of our process in order to continue making progress. We know that any measure is necessarily a narrow slice of performance. A slice that may not best represent the unique and remarkable contribution

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

DEFF Research Database (Denmark)

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

2018-01-01

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

High dose rate brachytherapy source measurement intercomparison.

Science.gov (United States)

Poder, Joel; Smith, Ryan L; Shelton, Nikki; Whitaker, May; Butler, Duncan; Haworth, Annette

2017-06-01

This work presents a comparison of air kerma rate (AKR) measurements performed by multiple radiotherapy centres for a single HDR 192 Ir source. Two separate groups (consisting of 15 centres) performed AKR measurements at one of two host centres in Australia. Each group travelled to one of the host centres and measured the AKR of a single 192 Ir source using their own equipment and local protocols. Results were compared to the 192 Ir source calibration certificate provided by the manufacturer by means of a ratio of measured to certified AKR. The comparisons showed remarkably consistent results with the maximum deviation in measurement from the decay-corrected source certificate value being 1.1%. The maximum percentage difference between any two measurements was less than 2%. The comparisons demonstrated the consistency of well-chambers used for 192 Ir AKR measurements in Australia, despite the lack of a local calibration service, and served as a valuable focal point for the exchange of ideas and dosimetry methods.

Absolute measurement of LDR brachytherapy source emitted power: Instrument design and initial measurements.

Science.gov (United States)

Malin, Martha J; Palmer, Benjamin R; DeWerd, Larry A

2016-02-01

Energy-based source strength metrics may find use with model-based dose calculation algorithms, but no instruments exist that can measure the energy emitted from low-dose rate (LDR) sources. This work developed a calorimetric technique for measuring the power emitted from encapsulated low-dose rate, photon-emitting brachytherapy sources. This quantity is called emitted power (EP). The measurement methodology, instrument design and performance, and EP measurements made with the calorimeter are presented in this work. A calorimeter operating with a liquid helium thermal sink was developed to measure EP from LDR brachytherapy sources. The calorimeter employed an electrical substitution technique to determine the power emitted from the source. The calorimeter's performance and thermal system were characterized. EP measurements were made using four (125)I sources with air-kerma strengths ranging from 2.3 to 5.6 U and corresponding EPs of 0.39-0.79 μW, respectively. Three Best Medical 2301 sources and one Oncura 6711 source were measured. EP was also computed by converting measured air-kerma strengths to EPs through Monte Carlo-derived conversion factors. The measured EP and derived EPs were compared to determine the accuracy of the calorimeter measurement technique. The calorimeter had a noise floor of 1-3 nW and a repeatability of 30-60 nW. The calorimeter was stable to within 5 nW over a 12 h measurement window. All measured values agreed with derived EPs to within 10%, with three of the four sources agreeing to within 4%. Calorimeter measurements had uncertainties ranging from 2.6% to 4.5% at the k = 1 level. The values of the derived EPs had uncertainties ranging from 2.9% to 3.6% at the k = 1 level. A calorimeter capable of measuring the EP from LDR sources has been developed and validated for (125)I sources with EPs between 0.43 and 0.79 μW.

Korean Clinic Based Outcome Measure Studies

Directory of Open Access Journals (Sweden)

Jongbae Park

2003-02-01

Full Text Available Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented briefly here including 1 Quality of Life of liver cancer patients after 8 Constitutional acupuncture; 2 Developing a Korean version of Measuring yourself Medical Outcome profile (MYMOP; and 3 Survey on 5 Shu points: a pilot In the first study, we have included 4 primary or secondary liver cancer patients collecting their diagnostic X-ray film and clinical data f개m their hospital, and asked them to fill in the European Organization Research and Treatment of Cancer, Quality of Life Questionnaire before the commencement of the treatment. The acupuncture treatment is set up format but not disclosed yet. The translation and developing a Korean version of outcome measures that is Korean clinician friendly has been sought for MYMOP is one of the most appropriate one. The permission was granted, the translation into Korean was done, then back translated into English only based on the Korean translation by the researcher who is bilingual in both languages. The back translation was compared by the original developer of MYMOP and confirmed usable. In order to test the existence of acupoints and meridians through popular forms of Korean acupuncture regimes, we aim at collecting opinions from 101 Korean clinicians that have used those forms. The questions asked include most effective symptoms, 5 Shu points, points those are least likely to use due to either adverse events or the lack of effectiveness, theoretical reasons for the above proposals, proposing outcome measures

Systematic literature review of patient-reported outcome measures used in assessment and measurement of sleep disorders in chronic obstructive pulmonary disease.

Science.gov (United States)

Garrow, Adam P; Yorke, Janelle; Khan, Naimat; Vestbo, Jørgen; Singh, Dave; Tyson, Sarah

2015-01-01

Sleep problems are common in patients with chronic obstructive pulmonary disease (COPD), but the validity of patient-reported outcome measures (PROMs) that measure sleep dysfunction has not been evaluated. We have reviewed the literature to identify disease-specific and non-disease-specific sleep PROMs that have been validated for use in COPD patients. The review also examined the psychometric properties of identified sleep outcome measures and extracted point and variability estimates of sleep instruments used in COPD studies. The online EMBASE, MEDLINE, PsycINFO, and SCOPUS databases for all years to May 2014 were used to source articles for the review. The review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Criteria from the Medical Outcomes Trust Scientific Advisory Committee guidelines were used to evaluate the psychometric properties of all sleep PROMs identified. One COPD-specific and six non-COPD-specific sleep outcome measures were identified and 44 papers met the review selection criteria. We only identified one instrument, the COPD and Asthma Sleep Impact Scale, which was developed specifically for use in COPD populations. Ninety percent of the identified studies used one of two non-disease-specific sleep scales, ie, the Pittsburgh Sleep Quality Index and/or the Epworth Sleep Scale, although neither has been tested for reliability or validity in people with COPD. The results highlight a need for existing non-disease-specific instruments to be validated in COPD populations and also a need for new disease-specific measures to assess the impact of sleep problems in COPD.

Patient-reported outcome measures versus inertial performance-based outcome measures: A prospective study in patients undergoing primary total knee arthroplasty.

Science.gov (United States)

Bolink, S A A N; Grimm, B; Heyligers, I C

2015-12-01

Outcome assessment of total knee arthroplasty (TKA) by subjective patient reported outcome measures (PROMs) may not fully capture the functional (dis-)abilities of relevance. Objective performance-based outcome measures could provide distinct information. An ambulant inertial measurement unit (IMU) allows kinematic assessment of physical performance and could potentially be used for routine follow-up. To investigate the responsiveness of IMU measures in patients following TKA and compare outcomes with conventional PROMs. Patients with end stage knee OA (n=20, m/f=7/13; age=67.4 standard deviation 7.7 years) were measured preoperatively and one year postoperatively. IMU measures were derived during gait, sit-stand transfers and block step-up transfers. PROMs were assessed by using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Society Score (KSS). Responsiveness was calculated by the effect size, correlations were calculated with Spearman's rho correlation coefficient. One year after TKA, patients performed significantly better at gait, sit-to-stand transfers and block step-up transfers. Measures of time and kinematic IMU measures demonstrated significant improvements postoperatively for each performance-based test. The largest improvement was found in block step-up transfers (effect size=0.56-1.20). WOMAC function score and KSS function score demonstrated moderate correlations (Spearman's rho=0.45-0.74) with some of the physical performance-based measures pre- and postoperatively. To characterize the changes in physical function after TKA, PROMs could be supplemented by performance-based measures, assessing function during different activities and allowing kinematic characterization with an ambulant IMU. Copyright © 2015 Elsevier B.V. All rights reserved.

Disability outcome measures in multiple sclerosis clinical trials

DEFF Research Database (Denmark)

Cohen, Jeffrey A; Reingold, Stephen C; Polman, Chris H

2012-01-01

Many of the available disability outcome measures used in clinical trials of multiple sclerosis are insensitive to change over time, inadequately validated, or insensitive to patient-perceived health status or quality of life. Increasing focus on therapies that slow or reverse disability...... recommend practical refinements. Conversely, although substantial data support the multiple sclerosis functional composite as an alternative measure, changes to its component tests and scoring method are needed. Novel approaches, including the use of composite endpoints, patient-reported outcomes...... progression makes it essential to refine existing measures or to develop new tools. Major changes to the expanded disability status scale should be avoided to prevent the loss of acceptance by regulators as a measure for primary outcomes in trials that provide substantial evidence of effectiveness. Rather, we...

Accurate shear measurement with faint sources

International Nuclear Information System (INIS)

Zhang, Jun; Foucaud, Sebastien; Luo, Wentao

2015-01-01

For cosmic shear to become an accurate cosmological probe, systematic errors in the shear measurement method must be unambiguously identified and corrected for. Previous work of this series has demonstrated that cosmic shears can be measured accurately in Fourier space in the presence of background noise and finite pixel size, without assumptions on the morphologies of galaxy and PSF. The remaining major source of error is source Poisson noise, due to the finiteness of source photon number. This problem is particularly important for faint galaxies in space-based weak lensing measurements, and for ground-based images of short exposure times. In this work, we propose a simple and rigorous way of removing the shear bias from the source Poisson noise. Our noise treatment can be generalized for images made of multiple exposures through MultiDrizzle. This is demonstrated with the SDSS and COSMOS/ACS data. With a large ensemble of mock galaxy images of unrestricted morphologies, we show that our shear measurement method can achieve sub-percent level accuracy even for images of signal-to-noise ratio less than 5 in general, making it the most promising technique for cosmic shear measurement in the ongoing and upcoming large scale galaxy surveys

Measuring radon source magnitude in residential buildings

International Nuclear Information System (INIS)

Nazaroff, W.W.; Boegel, M.L.; Nero, A.V.

1981-08-01

A description is given of procedures used in residences for rapid grab-sample and time-dependent measurements of the air-exchange rate and radon concentration. The radon source magnitude is calculated from the results of simultaneous measurements of these parameters. Grab-sample measurements in three survey groups comprising 101 US houses showed the radon source magnitude to vary approximately log-normally with a geometric mean of 0.37 and a range of 0.01 to 6.0 pCi 1 -1 h -1 . Successive measurements in six houses in the northeastern United States showed considerable variability in source magnitude within a given house. In two of these houses the source magnitude showed a strong correlation with the air-exchange rate, suggesting that soil gas influx can be an important transport process for indoor radon

Outcome measurements in major trauma--results of a consensus meeting.

Science.gov (United States)

Ardolino, A; Sleat, G; Willett, K

2012-10-01

The NHS Outcomes Framework for England has identified recovery from major injury as an important clinical area. At present, there are no established outcome indicators. As more patients survive major trauma, outcomes will need to be measured in terms of morbidity and not mortality alone. To make recommendations for a selection of outcome measures that could be integrated into National Clinical Audit data collection and form part of clinical governance requirements for Regional Trauma Networks (RTNs) and measures by which RTNs are held to account by government. Specific focus was given to acute care and rehabilitation for both adults and children. A Multiprofessional, multidisciplinary expert group reviewed the current evidence on outcome measures for major trauma in the adult and children's populations, informed by a systematic review carried out jointly by the Trauma Audit and Research Network (TARN) and the Cochrane Injuries Group. A structured discussion covered functional and quality of life outcome measures as well as patient experience and indicators such as return to work, education and social dependency. For the adult population the group agreed with the in-hospital performance and hospital discharge measures recommended in the TARN and Cochrane systematic review. Concerning longer-term outcome indicators, the group suggested the use of the Glasgow Outcome Scale - Extended (GOS-E) and European Quality of Life 5D (EQ-5D) with consideration to be given to the World Health Organisation Quality of Life survey (WHO-QoL). For patients who had ongoing inpatient rehabilitation needs the group thought the measurement of the Rehabilitation Complexity Scale (RCS) and Functional Independence Measure (FIM) were important in total brain injury and, the American Spinal Injury Association Impairment Scale (ASIA) and Spinal Cord Independence Measure (SCIM) in spinal cord injury. For children the group recommended the use of the King's Outcome Scale for Childhood Head Injury

Measurements of magnetic field sources in schools

International Nuclear Information System (INIS)

Johnson, G.B.

1992-01-01

The Electrical Systems Division of the Electric Power Research Institute (EPRI) has initiated several research projects to investigate magnetic field levels, their characteristics, and their sources. This paper describes measurements of magnetic field sources in schools. Magnetic field measurements were made at four schools in the service areas of two utility companies. Magnetic field measurements included profiles of the magnetic field versus distance near power lines, around the perimeter of the school buildings, and at several locations within each school. Twenty-four hour measurements were also made to record the temporal variation of the magnetic field at several locations at each school. The instrumentation, measurement techniques, and magnetic field sources identified are discussed

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

Science.gov (United States)

Powell, J; Powell, S; Robson, A

2018-01-01

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

Factors influencing the use of outcome measures in physical therapy practice.

Science.gov (United States)

Wedge, Frances M; Braswell-Christy, Jennifer; Brown, Cynthia J; Foley, Kathleen T; Graham, Cecilia; Shaw, Sharon

2012-02-01

Use of outcome measures in physical therapy practice is central to evaluating the effectiveness of treatment interventions, providing accountability and addressing quality of physical therapy programs. There is limited discussion on barriers and facilitators to using outcome measures in physical therapy practice. The purpose of this study was to identify factors that influence a physical therapist when deciding to use outcome measures in clinical practice. Participants were 21 physical therapists, seven each from skilled nursing facilities, outpatient clinics, and inpatient rehabilitation facilities. A grounded theory approach was used for interview and data collection. Common themes were determined from the data and a theory developed to explain the rationale behind physical therapists' decisions to use or not use outcome measures in clinical practice. Three overlapping themes related to (1) concepts of time, (2) knowledge, and (3) facility culture were indentified as factors influencing the use of outcome measures. A fourth encompassing theme, professionalism, identified the value placed on the use of outcome measures in practice. Data revealed that therapists require more information on the outcome measures available, and this information needs to be easily accessible within the workplace. Therapists value information generated by using outcome measures in the clinical setting, but need information on what measures are available and psychometric properties. Information must be easily accessible and measures easy to use. Newer graduates and recent learners have a foundation in the use of outcome measures, but more needs to be done in the clinic and through continuing education to promote increased use and understanding.

The Popularity of Outcome Measures for Hip and Knee Arthroplasties.

Science.gov (United States)

Lovelock, Thomas M; Broughton, Nigel S; Williams, Cylie M

2018-01-01

The optimal methods of determining outcomes following hip and knee arthroplasty remain controversial. The objectives of this study were to determine the most frequently used outcome measures in randomized controlled trials (RCT) and study protocols registered with clinical trials registries (CTR) on hip and knee arthroplasty. A systematic search strategy was undertaken to identify the outcome measures used in RCT and CTR following joint arthroplasty. Databases searched included Embase, Ovid MEDLINE (including In-Process), Cochrane Central Register of Controlled Trials, CINAHL Plus, clinicaltrials.gov, ISRCTN registry, and ANZCTR. Differences in the use of outcome measures between RCT and CTR were assessed using logistic regression. There were 291 RCT and 113 CTR on hip arthroplasty and 452 RCT and 184 CTR on knee arthroplasty that met the inclusion criteria. The most popular outcome measures were the Harris Hip Score and the Knee Society Score. Multiple outcome measures were used in greater than 50% of the included studies. The Oxford Hip Score, Oxford Knee Score, EuroQol-5D, and Knee Injury and Osteoarthritis Outcome Score (all P < .001) were used in significantly more CTR than RCT. There is a clear preference for the use of the Harris Hip Score and Knee Society Score, contrary to existing international guidelines and reviews on the topic. Both measures require clinician input, which potentially influences their validity and increases their overall administration cost. Some patient-reported outcome measures, such as the Oxford Hip and Knee Scores, EuroQol-5D, and KOOS, appear to be increasing in popularity. Copyright © 2017 Elsevier Inc. All rights reserved.

Measuring Inclusive Education Outcomes in Alberta, Canada

Science.gov (United States)

Loreman, Tim

2014-01-01

This study details the results of a review of the academic and public sector literature on measuring inclusive education in large systems. It highlights some outcomes drawn from the international literature on inclusion that might be indicative of the presence and quality of inclusive education in an effort to develop a set of outcomes for…

Questionnaires for Measuring Refractive Surgery Outcomes.

Science.gov (United States)

Kandel, Himal; Khadka, Jyoti; Lundström, Mats; Goggin, Michael; Pesudovs, Konrad

2017-06-01

To identify the questionnaires used to assess refractive surgery outcomes, assess the available questionnaires in regard to their psychometric properties, validity, and reliability, and evaluate the performance of the available questionnaires in measuring refractive surgery outcomes. An extensive literature search was done on PubMed, MEDLINE, Scopus, CINAHL, Cochrane, and Web of Science databases to identify articles that described or used at least one questionnaire to assess refractive surgery outcomes. The information on content quality, validity, reliability, responsiveness, and psychometric properties was extracted and analyzed based on an extensive set of quality criteria. Eighty-one articles describing 27 questionnaires (12 refractive error-specific, including 4 refractive surgery-specific, 7 vision-but-non-refractive, and 8 generic) were included in the review. Most articles (56, 69.1%) described refractive error-specific questionnaires. The Quality of Life Impact of Refractive Correction (QIRC), the Quality of Vision (QoV), and the Near Activity Visual Questionnaire (NAVQ) were originally constructed using Rasch analysis; others were developed using the Classical Test Theory. The National Eye Institute Refractive Quality of Life questionnaire was the most frequently used questionnaire, but it does not provide a valid measurement. The QoV, QIRC, and NAVQ are the three best existing questionnaires to assess visual symptoms, quality of life, and activity limitations, respectively. This review identified three superior quality questionnaires for measuring different aspects of quality of life in refractive surgery. Clinicians and researchers should choose a questionnaire based on the concept being measured with superior psychometric properties. [J Refract Surg. 2017;33(6):416-424.]. Copyright 2017, SLACK Incorporated.

Data format standard for sharing light source measurements

Science.gov (United States)

Gregory, G. Groot; Ashdown, Ian; Brandenburg, Willi; Chabaud, Dominique; Dross, Oliver; Gangadhara, Sanjay; Garcia, Kevin; Gauvin, Michael; Hansen, Dirk; Haraguchi, Kei; Hasna, Günther; Jiao, Jianzhong; Kelley, Ryan; Koshel, John; Muschaweck, Julius

2013-09-01

Optical design requires accurate characterization of light sources for computer aided design (CAD) software. Various methods have been used to model sources, from accurate physical models to measurement of light output. It has become common practice for designers to include measured source data for design simulations. Typically, a measured source will contain rays which sample the output distribution of the source. The ray data must then be exported to various formats suitable for import into optical analysis or design software. Source manufacturers are also making measurements of their products and supplying CAD models along with ray data sets for designers. The increasing availability of data has been beneficial to the design community but has caused a large expansion in storage needs for the source manufacturers since each software program uses a unique format to describe the source distribution. In 2012, the Illuminating Engineering Society (IES) formed a working group to understand the data requirements for ray data and recommend a standard file format. The working group included representatives from software companies supplying the analysis and design tools, source measurement companies providing metrology, source manufacturers creating the data and users from the design community. Within one year the working group proposed a file format which was recently approved by the IES for publication as TM-25. This paper will discuss the process used to define the proposed format, highlight some of the significant decisions leading to the format and list the data to be included in the first version of the standard.

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

Science.gov (United States)

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

2018-01-29

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

Outcomes assessment in rotator cuff pathology: what are we measuring?

Science.gov (United States)

Makhni, Eric C; Steinhaus, Michael E; Morrow, Zachary S; Jobin, Charles M; Verma, Nikhil N; Cole, Brian J; Bach, Bernard R

2015-12-01

Assessments used to measure outcomes associated with rotator cuff pathology and after repair are varied. This lack of standardization leads to difficulty drawing comparisons across studies. We hypothesize that this variability in patient-reported outcome measures and objective metrics used in rotator cuff studies persists even in high-impact, peer reviewed journals. All studies assessing rotator cuff tear and repair outcomes in 6 orthopedic journals with a high impact factor from January 2010 to December 2014 were reviewed. Cadaveric and animal studies and those without outcomes were excluded. Outcome measures included range of motion (forward elevation, abduction, external rotation, and internal rotation), strength (in the same 4 planes), tendon integrity imaging, patient satisfaction, and functional assessment scores. Of the 156 included studies, 63% documented range of motion measurements, with 18% reporting range of motion in all 4 planes. Only 38% of studies reported quantitative strength measurements. In 65% of studies, tendon integrity was documented with imaging (38% magnetic resonance imaging/magnetic resonance anrhrogram, 31% ultrasound, and 8% computed tomography arthrogram). Finally, functional score reporting varied significantly, with the 5 most frequently reported scores ranging from 16% to 61% in studies, and 15 of the least reported outcomes were each reported in ≤6% of studies. Significant variability exists in outcomes reporting after rotator cuff tear and repair, making comparisons between clinical studies difficult. Creating a uniformly accepted, validated outcomes tool that assesses pain, function, patient satisfaction, and anatomic integrity would enable consistent outcomes assessment after operative and nonoperative management and allow comparisons across the literature. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Measuring Quality and Outcomes in Sports Medicine.

Science.gov (United States)

Ruzbarsky, Joseph J; Marom, Niv; Marx, Robert G

2018-07-01

Patient-reported outcome measures (PROMs) are objective metrics critical to evaluating outcomes throughout orthopedic surgery. New instruments continue to emerge, increasing the breadth of information required for those intending to use these measures for research or clinical care. Although earlier metrics were developed using the principles of classic test theory, newer instruments constructed using item response theory are amenable to computer-adaptive testing and may change the way these instruments are administered. This article aims to define the psychometric properties that are important to understand when using all PROMs and to review the most widely used instruments in sports medicine. Copyright © 2018 Elsevier Inc. All rights reserved.

Culturally Sensitive and Environment-Friendly Outcome Measures in

African Journals Online (AJOL)

Dr Olaleye

to review research studies on outcome measures that were developed for ... A systematic review of evidence on culturally sensitive and environment- ... Various databases including Google Scholar, PEDro and PubMed were accessed to search for relevant empirical ... utilization of disease-specific, patient-centered outcome.

Outcome measures for oral health based on clinical assessments and claims data: feasibility evaluation in practice.

Science.gov (United States)

Hummel, Riët; Bruers, Josef; van der Galiën, Onno; van der Sanden, Wil; van der Heijden, Geert

2017-10-05

It is well known that treatment variation exists in oral healthcare, but the consequences for oral health are unknown as the development of outcome measures is still in its infancy. The aim of this study was to identify and develop outcome measures for oral health and explore their performance using health insurance claims records and clinical data from general dental practices. The Dutch healthcare insurance company Achmea collaborated with researchers, oral health experts, and general dental practitioners (GDPs) in a proof of practice study to test the feasibility of measures in general dental practices. A literature search identified previously described outcome measures for oral healthcare. Using a structured approach, identified measures were (i) prioritized, adjusted and added to after discussion and then (ii) tested for feasibility of data collection, their face validity and discriminative validity. Data sources were claims records from Achmea, clinical records from dental practices, and prospective, pre-determined clinical assessment data obtained during routine consultations. In total eight measures (four on dental caries, one on tooth wear, two on periodontal health, one on retreatment) were identified, prioritized and tested. The retreatment measure and three measures for dental caries were found promising as data collection was feasible, they had face validity and discriminative validity. Deployment of these measures demonstrated variation in clinical practices of GDPs. Feedback of this data to GDPs led to vivid discussions on best practices and quality of care. The measure 'tooth wear' was not considered sufficiently responsive; 'changes in periodontal health score' was considered a controversial measure. The available data for the measures 'percentage of 18-year-olds with no tooth decay' and 'improvement in gingival bleeding index at reassessment' was too limited to provide accurate estimates per dental practice. The evaluated measures 'time to first

Outcome Measures for Clinical Trials in Down Syndrome.

Science.gov (United States)

Esbensen, Anna J; Hooper, Stephen R; Fidler, Deborah; Hartley, Sigan L; Edgin, Jamie; d'Ardhuy, Xavier Liogier; Capone, George; Conners, Frances A; Mervis, Carolyn B; Abbeduto, Leonard; Rafii, Michael; Krinsky-McHale, Sharon J; Urv, Tiina

2017-05-01

Increasingly individuals with intellectual and developmental disabilities, including Down syndrome, are being targeted for clinical trials. However, a challenge exists in effectively evaluating the outcomes of these new pharmacological interventions. Few empirically evaluated, psychometrically sound outcome measures appropriate for use in clinical trials with individuals with Down syndrome have been identified. To address this challenge, the National Institutes of Health (NIH) assembled leading clinicians and scientists to review existing measures and identify those that currently are appropriate for trials; those that may be appropriate after expansion of age range addition of easier items, and/or downward extension of psychometric norms; and areas where new measures need to be developed. This article focuses on measures in the areas of cognition and behavior.

Understanding paediatric rehabilitation therapists' lack of use of outcome measures.

Science.gov (United States)

King, Gillian; Wright, Virginia; Russell, Dianne J

2011-01-01

Despite widespread educational and promotional efforts, paediatric rehabilitation therapists still do not systematically or routinely use outcome measures. A review of contextual and psychosocial factors affecting therapists' use of outcome measures was performed, incorporating information from past studies of barriers to therapists' use of measures and more recent information about measure use, knowledge brokering and expert practice. This cumulative and contextual overview provided insights into how many therapists may approach practice. Therapists' beliefs in the importance of establishing effective relationships may lead them to place less value on formal measurement, to adopt a less rigorous and more pragmatic approach to ascertaining whether outcomes are achieved, and to avoid measures that may show little improvement. A relational goal-oriented approach to practice is proposed in which therapists adopt a broader facilitative and educational role with families about the importance of the measurement process.

Measuring Outcomes for Children Late Placed for Adoption.

Science.gov (United States)

Rushton, Alan

1998-01-01

Describes the selection of outcome measures used by the Maudsley Family Research team to assess outcomes--across a broad range of developmental dimensions--of permanent placement for children and adolescents. Developed a package of instruments to examine child emotional, cognitive, social, and academic development; attachment; and self-esteem, for…

Identifying an outcome measure to assess the impact of Mobility Dogs.

Science.gov (United States)

Mudge, Suzie; Rewi, Dallas; Channon, Alexis

2017-01-01

Mobility Dogs® trains dogs to work with people with physical disabilities to increase independence, confidence, self-esteem and participation. Mobility Dogs® seeks to critically evaluate and improve its services as it grows. This study aimed to identify and implement a standardised outcome measure into practice at Mobility Dogs®. Based on the Consolidated Framework for Implementation Research and guided by a steering group of key stakeholders, a three-phase approach was developed to identify and assess an outcome measure. The steering group highlighted the organisation's specific needs, selected participation as the assessment domain and identified core utility requirements of the measure. A comprehensive review of evidence was undertaken to identify and rank potential measures according to the specified needs. Of the seven participation outcome measures that met inclusion criteria, the three highest ranked measures were critically evaluated by the steering group to determine suitability against the organisation's needs. The Impact on Participation and Autonomy (IPA) was selected for implementation into practice at Mobility Dogs®. Use of the IPA is an important first step for Mobility Dogs® to test the benefits of trained service dogs. This process could be replicated by other service dog organisations to identify outcome measures to assess their own services. Implications for Rehabilitation Service dogs (such as Mobility Dogs® in New Zealand) assist people living with physical impairments by performing tasks, however there is limited evidence on outcomes. The process for selecting an appropriate outcome measure for Mobility Dogs® involving partnership between Mobility Dogs® personnel and academics was an effective way to steer the project by determining important properties of the measure, before a search of the literature was undertaken. While the IPA was selected as the most appropriate outcome measure for use at Mobility Dogs®, it was the process that

Associations between Sexually Experienced Adolescents' Sources of Information about Sex and Sexual Risk Outcomes

Science.gov (United States)

Secor-Turner, Molly; Sieving, Renee E.; Eisenberg, Marla E.; Skay, Carol

2011-01-01

The objective of this study was to describe prevalent informal sources of information about sex and examine associations between informal sources of information about sex and sexual risk outcomes among sexually experienced adolescents. Work involved the secondary analysis of data from the Minnesota Student Survey, a statewide survey to monitor…

Measuring Learning Outcomes in Auditing Education

DEFF Research Database (Denmark)

Holm, Claus; Steenholdt, Niels

The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education, which reflects that some students taking accounting classes also are provided with on-the-job training in accountin...

Improving the power of an efficacy study of a social and emotional learning program: application of generalizability theory to the measurement of classroom-level outcomes.

Science.gov (United States)

Mashburn, Andrew J; Downer, Jason T; Rivers, Susan E; Brackett, Marc A; Martinez, Andres

2014-04-01

Social and emotional learning programs are designed to improve the quality of social interactions in schools and classrooms in order to positively affect students' social, emotional, and academic development. The statistical power of group randomized trials to detect effects of social and emotional learning programs and other preventive interventions on setting-level outcomes is influenced by the reliability of the outcome measure. In this paper, we apply generalizability theory to an observational measure of the quality of classroom interactions that is an outcome in a study of the efficacy of a social and emotional learning program called The Recognizing, Understanding, Labeling, Expressing, and Regulating emotions Approach. We estimate multiple sources of error variance in the setting-level outcome and identify observation procedures to use in the efficacy study that most efficiently reduce these sources of error. We then discuss the implications of using different observation procedures on both the statistical power and the monetary costs of conducting the efficacy study.

Measuring outcomes in adult spinal deformity surgery: a systematic review to identify current strengths, weaknesses and gaps in patient-reported outcome measures.

Science.gov (United States)

Faraj, Sayf S A; van Hooff, Miranda L; Holewijn, Roderick M; Polly, David W; Haanstra, Tsjitske M; de Kleuver, Marinus

2017-08-01

Adult spinal deformity (ASD) causes severe disability, reduces overall quality of life, and results in a substantial societal burden of disease. As healthcare is becoming more value based, and to facilitate global benchmarking, it is critical to identify and standardize patient-reported outcome measures (PROMs). This study aims to identify the current strengths, weaknesses, and gaps in PROMs used for ASD. Studies were included following a systematic search in multiple bibliographic databases between 2000 and 2015. PROMs were extracted and linked to the outcome domains of WHO's International Classification of Functioning and Health (ICF) framework. Subsequently, the clinimetric quality of identified PROMs was evaluated. The literature search identified 144 papers that met the inclusion criteria, and nine frequently used PROMs were identified. These covered 29 ICF outcome domains, which could be grouped into three of the four main ICF chapters: body function (n = 7), activity and participation (n = 19), environmental factors (n = 3), and body structure (n = 0). A low quantity (n = 3) of papers was identified that studied the clinimetric quality of PROMs. The Scoliosis Research Society (SRS)-22 has the highest level of clinimetric quality for ASD. Outcome domains related to mobility and pain were well represented. We identified a gap in current outcome measures regarding neurological and pulmonary function. In addition, no outcome domains were measured in the ICF chapter body structure. These results will serve as a foundation for the process of seeking international consensus on a standard set of outcome domains, accompanied PROMs and contributing factors to be used in future clinical trials and spine registries.

Patient reported outcome measures (PROMs)

DEFF Research Database (Denmark)

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

2018-01-01

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

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

Science.gov (United States)

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

2014-12-01

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

Issues in the definition and measurement of drinking outcomes in alcoholism treatment research.

Science.gov (United States)

Babor, T F; Longabaugh, R; Zweben, A; Fuller, R K; Stout, R L; Anton, R F; Randall, C L

1994-12-01

This article reviews methodological and conceptual issues regarding the choice of drinking outcome measures in alcoholism treatment research. The following issues are discussed: Should drinking outcomes be conceptualized in terms of an underlying unitary disorder, or should provision be made for independent outcomes that cover a wide variety of dimensions? Which drinking outcomes are typically measured in treatment evaluation studies and how are they operationalized? What are the empirical associations among drinking outcome measures? If multiple outcomes are measured, which should be given primary importance? Over what period of time should treatment outcome be evaluated? What procedures can be used to detect, correct or prevent the response bias associated with verbal report methods? Because outcome measures need to fit the hypotheses and practical needs of a particular study, it is unlikely that complete standardization can be achieved across all studies. Nevertheless, given the importance of drinking outcomes and the need for economy, two primary dependent measures are recommended: (1) proportion of available drinking days abstinent; and (2) intensity of drinking, as defined by the total amount consumed (in ounces absolute alcohol) during the follow-up period divided by the number of actual drinking days. This article also proposes a strategy that may help to guide the selection of outcome measures in future research.

Redefining Outcome Measurement: A Model for Brief Psychotherapy.

Science.gov (United States)

McGuinty, Everett; Nelson, John; Carlson, Alain; Crowther, Eric; Bednar, Dina; Foroughe, Mirisse

2016-05-01

The zeitgeist for short-term psychotherapy efficacy has fundamentally shifted away from evidence-based practices to include evidence-informed practices, resulting in an equally important paradigm shift in outcome measurement designed to reflect change in this short-term modality. The present article delineates a short-term psychotherapy structure which defines four fundamental stages that all brief therapies may have in common, and are represented through Cognitive Behavioral Therapy, Solution-Focused Brief Therapy, Narrative Therapy, and Emotion-Focused Therapy. These four theoretical approaches were analyzed via a selected literature review through comparing and contrasting specific and common tasks as they relate to the process of psychotherapy and change. Once commonalities were identified within session, they were categorized or grouped into themes or general stages of change within the parameters of a four to six session model of short-term therapy. Commonalities in therapeutic stages of change may more accurately and uniformly measure outcome in short-term work, unlike the symptom-specific psychometric instruments of longer-term psychotherapy. A systematic framework for evaluating the client and clinician adherence to 20 specific tasks for these four short-term therapies is presented through the newly proposed, Brief Task Acquisition Scale (BTAS). It is further proposed that the client-clinicians' adherence to these tasks will track and ultimately increase treatment integrity. Thus, when the client-clinician relationship tracks and evaluates the three pillars of (1) stage/process change, (2) task acquisition, and (3) treatment integrity, the culmination of these efforts presents a new way of more sensitively measuring outcome in short-term psychotherapy. Data collection is suggested as a first step to empirically evaluate the testable hypotheses suggested within this current model. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message The

Procedure for measurement of anisotropy factor for neutron sources

International Nuclear Information System (INIS)

Creazolla, Prycylla Gomes

2017-01-01

Radioisotope neutron sources allow the production of reference fields for calibration of neutron detectors for radiation protection and analysis purposes. When the emission rate of these sources is isotropic, no correction is necessary. However, variations in source encapsulation and in the radioactive material concentration produce differences in its neutron emission rate, relative to the source axis, this effect is called anisotropy. In this study, is describe a procedure for measuring the anisotropy factor of neutron sources performed in the Laboratório de Metrologia de Neutrons (LN) using a Precision Long Counter (PLC) detector. A measurement procedure that takes into account the anisotropy factor of neutron sources contributes to solve some issues, particularly with respect to the high uncertainties associated with neutron dosimetry. Thus, a bibliographical review was carried out based on international standards and technical regulations specific to the area of neutron fields, and were later reproduced in practice by means of the procedure for measuring the anisotropy factor in neutron sources of the LN. The anisotropy factor is determined as a function of the angle of 90° in relation to the cylindrical axis of the source. This angle is more important due to its high use in measurements and also of its higher neutron emission rate if compared with other angles. (author)

Ancillary outcome measures for assessment of individuals with cervical spondylotic myelopathy.

Science.gov (United States)

Kalsi-Ryan, Sukhvinder; Singh, Anoushka; Massicotte, Eric M; Arnold, Paul M; Brodke, Darrel S; Norvell, Daniel C; Hermsmeyer, Jeffrey T; Fehlings, Michael G

2013-10-15

Narrative review. To identify suitable outcome measures that can be used to quantify neurological and functional impairment in the management of cervical spondylotic myelopathy (CSM). CSM is the leading cause of acquired spinal cord disability, causing varying degrees of neurological impairment which impact on independence and quality of life. Because this impairment can have a heterogeneous presentation, a single outcome measure cannot define the broad range of deficits seen in this population. Therefore, it is necessary to define outcome measures that characterize the deficits with greater validity and sensitivity. This review was conducted in 3 stages. Stage I: To evaluate the current use of outcome measures in CSM, PubMed was searched using the name of the outcome measure and the common abbreviation combined with "CSM" or "myelopathy." Stage II: Having identified a lack of appropriate outcome measures, we constructed criteria by which measures appropriate for assessing the various aspects of CSM could be identified. Stage III: A second literature search was then conducted looking at specified outcomes that met these criteria. All literature was reviewed to determine specificity and psychometric properties of outcomes for CSM. Nurick grade, modified Japanese Orthopaedic Association Scale, visual analogue scale (VAS) for pain, Short Form (36) Health Survey (SF-36), and Neck Disability Index were the most commonly cited measures. The Short-Form 36 Health Survey and Myelopathy Disability Index have been validated in the CSM population with multiple studies, whereas the modified Japanese Orthopaedic Association Scale score, Nurick grade, and European Myelopathy Scale each had only one study assessing psychometric characteristics. No validity, reliability, or responsiveness studies were found for the VAS or Neck Disability Index in the CSM population. We recommend that the modified Japanese Orthopaedic Association Scale, Nurick grade, Myelopathy Disability Index

Patient-Oriented Eczema Measure (POEM), a core instrument to measure symptoms in clinical trials: a Harmonising Outcome Measures for Eczema (HOME) statement

NARCIS (Netherlands)

Spuls, P. I.; Gerbens, L. A. A.; Simpson, E.; Apfelbacher, C. J.; Chalmers, J. R.; Thomas, K. S.; Prinsen, C. A. C.; von Kobyletzki, L. B.; Singh, J. A.; Williams, H. C.; Schmitt, J.

2017-01-01

The Harmonising Outcome Measures for Eczema (HOME) initiative has defined four core outcome domains for a core outcome set (COS) to be measured in all atopic eczema (AE) trials to ensure cross-trial comparison: clinical signs, symptoms, quality of life and long-term control. The aim of this paper is

Microflown based monopole sound sources for reciprocal measurements

NARCIS (Netherlands)

Bree, H.E. de; Basten, T.G.H.

2008-01-01

Monopole sound sources (i.e. omni directional sound sources with a known volume velocity) are essential for reciprocal measurements used in vehicle interior panel noise contribution analysis. Until recently, these monopole sound sources use a sound pressure transducer sensor as a reference sensor. A

Measuring outcomes in psychiatry: an inpatient model.

Science.gov (United States)

Davis, D E; Fong, M L

1996-02-01

This article describes a system for measuring outcomes recently implemented in the department of psychiatry of Baptist Memorial Hospital, a 78-bed inpatient and day treatment unit that represents one service line of a large, urban teaching hospital in Memphis. In June 1993 Baptist Hospital began a 15-month pilot test of PsychSentinel, a measurement tool developed by researchers in the Department of Community Medicine at the University of Connecticut. The hospital identified the following four primary goals for this pilot project: provide data for internal hospital program evaluation, provide data for external marketing in a managed care environment, satisfy requirements of the Joint Commission on Accreditation of Health Care Organizations, and generate studies that add to the literature in psychiatry and psychology. PsychSentinel is based on the standardized diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). The outcome measure assesses the change in the number of symptoms of psychopathology that occurs between admission and discharge from the hospital. Included in the nonproprietary system are risk adjustment factors, as well as access to a national reference database for comparative analysis purposes. Data collection can be done by trained ancillary staff members, with as much or as little direct physician involvement as desired. The system has proven to be both time effective and cost effective, and it provides important outcome information both at the program level and at the clinician level. After the pilot test, the staff at Baptist Memorial Hospital determined that the system met all initial objectives identified and recently adopted the system as an ongoing measure of quality patient care in the department of psychiatry.

Procedures for measurement of anisotropy factor of neutron sources

International Nuclear Information System (INIS)

Creazolla, P.G.; Camargo, A.; Astuto, A.; Silva, F.; Pereira, W.W.

2017-01-01

Radioisotope sources of neutrons allow the production of reference fields for calibration of neutron measurement devices for radioprotection and analysis purposes. When the emission rate of these sources is isotropic, no correction is necessary. However, variations in the source capsule material and variations in the concentration of the emitting material may produce differences in its neutron emission rate relative to the source axis, this effect is called anisotropy. A proposed procedure for measuring the anisotropy factor of the sources belonging to the IRD/LNMRI/LN Neutron Metrology Laboratory using a Precision Long Counter (PLC) detector will be presented

Drinking water and pregnancy outcome in central North Carolina: source, amount, and trihalomethane levels.

Science.gov (United States)

Savitz, D A; Andrews, K W; Pastore, L M

1995-01-01

In spite of the recognition of potentially toxic chemicals in chlorinated drinking water, few studies have evaluated reproductive health consequences of such exposure. Using data from a case-control study of miscarriage, preterm delivery, and low birth weight in central North Carolina, we evaluated risk associated with water source, amount, and trihalomethane (THM) concentration. Water source was not related to any of those pregnancy outcomes, but an increasing amount of ingested water was associated with decreased risks of all three outcomes (odds ratios around 1.5 for 0 glasses per day relative to 1-3 glasses per day, falling to 0.8 for 4+ glasses per day). THM concentration and dose (concentration x amount) were not related to pregnancy outcome, with the possible exception of an increased risk of miscarriage in the highest sextile of THM concentration (adjusted odds ratio = 2.8, 95% confidence interval = 1.1-2.7), which was not part of an overall dose-response gradient. These data do not indicate a strong association between chlorination by-products and adverse pregnancy outcome, but given the limited quality of our exposure assessment and the increased miscarriage risk in the highest exposure group, more refined evaluation is warranted. PMID:7556013

Does source of funding and conflict of interest influence the outcome and quality of spinal research?

Science.gov (United States)

Amiri, Amir Reza; Kanesalingam, Kavitha; Cro, Suzie; Casey, Adrian T H

2014-02-01

There has been longstanding controversy surrounding the influence of funding source on the conduct and outcome of medical research. In 2011, a systematic review of the use of recombinant bone morphogenetic protein-2 revealed underreporting of unfavorable outcomes in some industry-sponsored trials. We hypothesize that Industrial funding and the presence of potential conflict of interest will be associated with low levels of evidence (LOE) and greater proportions of favorable outcomes in spinal research. The aim of this study is to investigate the association between funding source and potential conflict of interest on the LOE and study outcome in the current spinal research. Systematic review of all the spinal publications in five leading spinal, orthopedics, neurosurgery, and general medical journals during 2010 (print and online). Supplements were included. Outcome and the LOE of research papers. Two reviewers independently assessed all publications. Commentaries, editorials, letters, open operating theatres, case reports, narrative reviews, and study protocols were excluded. The self-reported potential conflict of interest and type of funding was extracted from each paper. Funding type was classified as foundation, industry, public, intramural, multiple (including industry), multiple (without industry), and unfunded. The outcome of each study was classified as favorable, unfavorable, equivocal, or not applicable. Clinical publications were ranked using the LOE guidelines produced by the Oxford Center for Evidence-Based Medicine. Overall, 1356 papers were analyzed, out of which 864 were suitable for LOE grading. There was good interobserver reliability for assignment of LOE grade, κ=0.897 (psource of funding (psource and study outcome (p=.01). The proportion of industry-funded studies with favorable outcomes (88%) was higher than that of publicly and foundation-funded studies (73% and 74%, respectively). The associated odds ratio for reporting favorable outcomes

Populations and outcome measures used in ongoing research in sarcopenia.

Science.gov (United States)

Peña Ordóñez, Gloria Gabriela; Bustamante Montes, Lilia Patricia; Ramírez Duran, Ninfa; Sánchez Castellano, Carmen; Cruz-Jentoft, Alfonso J

2017-08-01

Sarcopenia research may be hampered by the heterogeneity of populations and outcome measures used in clinical studies. The aim of this study was to describe the inclusion/exclusion criteria and outcome measures used in ongoing research in sarcopenia. All active intervention studies registered in the World Health Organization with the keyword sarcopenia were included. Study design, type of intervention, inclusion/exclusion criteria and outcome measures were registered and classified. In April 2014, 151 studies on sarcopenia were registered in the WHO database. One hundred twenty-three were intervention studies. Most trials (94.3 %) were single centre and randomized (93.5 %), 51.2 % were double blind. Nutritional interventions (36.6 %), physical exercise (12.2 %) or both (19.5 %) were the most common interventions tested. Only 54.4 % included subjects of both genders, and 46.3 % had an upper age limit. Definition of the target populations was heterogeneous, with 57.7 % including healthy subjects and none using recent definitions of sarcopenia. Lifestyle and the degree of physical activity of subjects were not described or considered in most cases (79.7 %). Subjects with cardiovascular, neuropsychiatric or metabolic disorders and those with physical disability were usually excluded. Muscle mass and muscle strength were the primary outcome variables in 28.5 and 29.5 % of studies and physical performance in 19.5 %, but only 4.1 % used the three variables used the three of them. An additional 26.8 % used biological outcome variables. Little information and agreement existed in the way muscle and physical performance parameters were measured. We found a large heterogeneity in trial design, definition of populations and outcome measures in present research.

Inversion of Atmospheric Tracer Measurements, Localization of Sources

Science.gov (United States)

Issartel, J.-P.; Cabrit, B.; Hourdin, F.; Idelkadi, A.

When abnormal concentrations of a pollutant are observed in the atmosphere, the question of its origin arises immediately. The radioactivity from Tchernobyl was de- tected in Sweden before the accident was announced. This situation emphasizes the psychological, political and medical stakes of a rapid identification of sources. In tech- nical terms, most industrial sources can be modeled as a fixed point at ground level with undetermined duration. The classical method of identification involves the cal- culation of a backtrajectory departing from the detector with an upstream integration of the wind field. We were first involved in such questions as we evaluated the ef- ficiency of the international monitoring network planned in the frame of the Com- prehensive Test Ban Treaty. We propose a new approach of backtracking based upon the use of retroplumes associated to available measurements. Firstly the retroplume is related to inverse transport processes, describing quantitatively how the air in a sam- ple originates from regions that are all the more extended and diffuse as we go back far in the past. Secondly it clarifies the sensibility of the measurement with respect to all potential sources. It is therefore calculated by adjoint equations including of course diffusive processes. Thirdly, the statistical interpretation, valid as far as sin- gle particles are concerned, should not be used to investigate the position and date of a macroscopic source. In that case, the retroplume rather induces a straightforward constraint between the intensity of the source and its position. When more than one measurements are available, including zero valued measurements, the source satisfies the same number of linear relations tightly related to the retroplumes. This system of linear relations can be handled through the simplex algorithm in order to make the above intensity-position correlation more restrictive. This method enables to manage in a quantitative manner the

Laser driven white light source for BRDF measurement

DEFF Research Database (Denmark)

Amdemeskel, Mekbib Wubishet; Thorseth, Anders; Dam-Hansen, Carsten

2017-01-01

In this paper, we will present a setup with laser driven light source (LDLS) for measuring a 2D bidirectional reflectance distribution function (BRDF). We have carried out measurements to acquire the BRDF of different samples based on our setup: which consists of a new laser driven broadband light...... source (UV-VIS-NIR), spectroradiometer and sample holder stepper motor in a dark UV-protected environment. Here, we introduced a special kind of light source which has a bright, stable, broad spectral range and well collimated light output to give a very good angular resolution. The experimental results...

Radioactive Sources in Medicine: Impact of Additional Security Measures

International Nuclear Information System (INIS)

Classic, K. L.; Vetter, R. J.; Nelson, K. L.

2004-01-01

For many years, medical centers and hospitals have utilized appropriate security measures to prevent theft or unauthorized use of radioactive materials. Recent anxiety about orphan sources and terrorism has heightened concern about diversion of radioactive sources for purposes of constructing a radiological dispersion device. Some medical centers and hospitals may have responded by conducting threat assessments and incorporating additional measures into their security plans, but uniform recommendations or regulations have not been promulgated by regulatory agencies. The International Atomic Energy Agency drafted interim guidance for the purpose of assisting member states in deciding what security measures should be taken for various radioactive sources. The recommendations are aimed at regulators, but suppliers and users also may find the recommendations to be helpful. The purpose of this paper is to describe threat assessments and additional security actions that were taken by one large and one medium-sized medical center and the impact these measures had on operations. Both medical centers possess blood bank irradiators, low-dose-rate therapy sources, and Mo-99/Tc-99m generators that are common to many health care organizations. Other medical devices that were evaluated include high-dose-rate after loaders, intravascular brachytherapy sources, a Co-60 stereotactic surgery unit, and self-shielded irradiators used in biomedical research. This paper will discuss the impact additional security has had on practices that utilize these sources, cost of various security alternatives, and the importance of a security culture in assuring the integrity of security measures without negatively impacting beneficial use of these sources. (Author) 10 refs

Measuring treatment outcomes in gambling disorders: a systematic review.

Science.gov (United States)

Pickering, Dylan; Keen, Brittany; Entwistle, Gavin; Blaszczynski, Alex

2018-03-01

Considerable variation of outcome variables used to measure recovery in the gambling treatment literature has precluded effective cross-study evaluations and hindered the development of best-practice treatment methodologies. The aim of this systematic review was to describe current diffuse concepts of recovery in the gambling field by mapping the range of outcomes and measurement strategies used to evaluate treatments, and to identify more commonly accepted indices of recovery. A systematic search of six academic databases for studies evaluating treatments (psychological and pharmacological) for gambling disorders with a minimum 6-month follow-up. Data from eligible studies were tabulated and analysis conducted using a narrative approach. Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were adhered to. Thirty-four studies were reviewed systematically (RCTs = 17, comparative designs = 17). Sixty-three different outcome measures were identified: 25 (39.7%) assessed gambling-specific constructs, 36 (57.1%) assessed non-gambling specific constructs, and two instruments were used across both categories (3.2%). Self-report instruments ranged from psychometrically validated to ad-hoc author-designed questionnaires. Units of measurement were inconsistent, particularly in the assessment of gambling behaviour. All studies assessed indices of gambling behaviour and/or symptoms of gambling disorder. Almost all studies (n = 30; 88.2%) included secondary measures relating to psychiatric comorbidities, psychological processes linked to treatment approach, or global functioning and wellbeing. In research on gambling disorders, the incorporation of broader outcome domains that extend beyond disorder-specific symptoms and behaviours suggests a multi-dimensional conceptualization of recovery. Development of a single comprehensive scale to measure all aspects of gambling recovery could help to facilitate uniform reporting practices

Measuring device for strong gamma-ray sources; Dispositif de mesure des fortes sources emettrices {gamma}

Energy Technology Data Exchange (ETDEWEB)

Engelman, J; Vagner, J [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1956-07-01

We are given the description of a hollow argon-filled cylindrical ionisation chamber which is to be used to measure gamma-emitting sources. The instrument is currently used at the Measures Department in routine gauging of some radioelements. Sources are introduced into the central part of the chamber through a remote handling device. Measures are directly registered, it is not worth while removing the source from the container; a deviation of the source has little effect on the ionization current. The chamber was gauged to test such elements as: {sup 198}Au, {sup 60}Co, {sup 192}Ir, {sup 24}Na, {sup 137}Cs. Its measuring power approximately ranges from 100 micro-curies to 5 curies. (author) [French] On decrit une chambre d'ionisation cylindrique creuse, a remplissage d'argon, destinee a la mesure des sources emettrices {gamma}. Cet appareil est utilise couramment par la Section Mesures pour l'etalonnage de routine d'un certain nombre de radioelements. Les sources sont mises en place au centre de la chambre par un dispositif de manipulation a distance. La mesure est faite directement, sans qu'il soit necessaire d'extraire la source de son container; un decentrement de la source n'a en effet pas d'influence sensible sur le courant d'ionisation. Cette chambre d'ionisation a ete etalonnee pour divers radioelements: {sup 198}Au, {sup 60}Co, {sup 192}Ir, {sup 24}Na, {sup 137}Cs. La flamme d'activite mesurable s'etend de 100 microcuries a 5 curies, environ. (auteur)

Health-related quality-of-life outcome measures in paediatric palliative care: A systematic review of psychometric properties and feasibility of use

Science.gov (United States)

Coombes, Lucy H; Wiseman, Theresa; Lucas, Grace; Sangha, Amrit; Murtagh, Fliss EM

2016-01-01

Background: The number of children worldwide requiring palliative care services is increasing due to advances in medical care and technology. The use of outcome measures is important to improve the quality and effectiveness of care. Aim: To systematically identify health-related quality-of-life outcome measures that could be used in paediatric palliative care and examine their feasibility of use and psychometric properties. Design: A systematic literature review and analysis of psychometric properties. Data sources: PsychInfo, Medline and EMBASE were searched from 1 January 1990 to 10 December 2014. Hand searches of the reference list of included studies and relevant reviews were also performed. Results: From 3460 articles, 125 papers were selected for full-text assessment. A total of 41 articles met the eligibility criteria and examined the psychometric properties of 22 health-related quality-of-life measures. Evidence was limited as at least half of the information on psychometric properties per instrument was missing. Measurement error was not analysed in any of the included articles and responsiveness was only analysed in one study. The methodological quality of included studies varied greatly. Conclusion: There is currently no ‘ideal’ outcome assessment measure for use in paediatric palliative care. The domains of generic health-related quality-of-life measures are not relevant to all children receiving palliative care and some domains within disease-specific measures are only relevant for that specific population. Potential solutions include adapting an existing measure or developing more individualized patient-centred outcome and experience measures. Either way, it is important to continue work on outcome measurement in this field. PMID:27247087

Measuring Population Health Outcomes

OpenAIRE

Parrish, R. Gibson

2010-01-01

An ideal population health outcome metric should reflect a population's dynamic state of physical, mental, and social well-being. Positive health outcomes include being alive; functioning well mentally, physically, and socially; and having a sense of well-being. Negative outcomes include death, loss of function, and lack of well-being. In contrast to these health outcomes, diseases and injuries are intermediate factors that influence the likelihood of achieving a state of health. On the basis...

Psychometric evaluation of self-report outcome measures for prosthetic applications

OpenAIRE

Hafner, Brian J.; Morgan, Sara J.; Askew, Robert L.; Salem, Rana

2016-01-01

Documentation of clinical outcomes is increasingly expected in delivery of prosthetic services and devices. However, many outcome measures suitable for use in clinical care and research have not been psychometrically tested with prosthesis users. The aim of this study was to determine test-retest reliability, mode-of-administration (MoA) equivalence, standard error of measurement (SEM), and minimal detectable change (MDC) of standardized, self-report instruments that assess constructs of impo...

The International Dermatology Outcome Measures initiative as applied to psoriatic disease outcomes

DEFF Research Database (Denmark)

Gottlieb, Alice B; Armstrong, April W; Christensen, Robin

2014-01-01

In the United States, access to care is the number one issue facing our patients with dermatological conditions. In part, this is because we do not have outcome measures that are useful in clinical practice and available in databases where payers and governmental agencies can compare the performa...

Spectroscopic measurements of an H- ion source discharge

International Nuclear Information System (INIS)

Keller, R.; Smith, H.V. Jr.

1985-01-01

Spectral emission lines from an H - Penning surface-plasma source (SPS), the 4X source, are examined in the visible and near ultraviolet. Electron distribution temperatures are deduced from integral line-strength measurements. These temperatures are surprisingly low, about 0.5 eV. Electron density values of about 1.5 x 10 14 cm -3 and H-atom energies between 2 and 2.6 eV are determined from the measured Balmer-line profiles. Assuming the H - energy is identical to the H-atom energy, an emittance limit of 0.006 π x cm x mrad is deduced for this source with a 5.4-mm aperture

Measuring and communicating meaningful outcomes in neonatology: A family perspective.

Science.gov (United States)

Janvier, Annie; Farlow, Barbara; Baardsnes, Jason; Pearce, Rebecca; Barrington, Keith J

2016-12-01

Medium- and long-term outcomes have been collected and described among survivors of neonatal intensive care units for decades, for a number of purposes: (1) quality control within units, (2) comparisons of outcomes between NICUs, (3) clinical trials (whether an intervention improves outcomes), (4) end-of-life decision-making, (5) to better understand the effects of neonatal conditions and/or interventions on organs and/or long-term health, and finally (6) to better prepare parents for the future. However, the outcomes evaluated have been selected by investigators, based on feasibility, availability, cost, stability, and on what investigators consider to be important. Many of the routinely measured outcomes have major limitations: they may not correlate well with long-term difficulties, they may artificially divide continuous outcomes into dichotomous ones, and may have no clear relationship with quality of life and functioning of children and their families. Several investigations, such as routine term cerebral resonance imaging for preterm infants, have also not yet been shown to improve the outcome of children nor their families. In this article, the most common variables used in neonatology as well as some variables which are rarely measured but may be of equal importance for families are presented. The manner in which these outcomes are communicated to families will be examined, as well as recommendations to optimize communication with parents. Copyright © 2016 Elsevier Inc. All rights reserved.

Relationship outcomes as measurement criteria to assist communication strategists to manage organisational relationships

Directory of Open Access Journals (Sweden)

E. Botha

2011-06-01

Full Text Available Nonfinancial assets like relationships are increasingly important to managers. Communication managers in particular are focusing on measuring and managing organisational relationships as a means to quantify the return on investment (ROI of public relations and communication strategies. Measuring relationships offers communication managers a way to evaluate its contribution to the organisation. A commonly agreed upon definition of these relationships, however, does not exist. If we consider communication management is a managerial function, it must first refine its instruments of measurement. This study looks at the three-stage model of organisational relationships (relationship antecedents, maintenance strategies and relationship outcomes proposed by Grunig & Huang (2000 to firstly review the development of the model. Secondly, the study takes an in-depth look at each relationship outcomes of trust, commitment, satisfaction and control mutuality. Lastly, we assess the reliability and validity of the use of current relationship outcome measures through a survey of 154 organisational relationships. Previous studies that have utilized these outcomes in the measurement of organisational relationships do not discuss the possible interaction (or relationship among these outcomes. This study contributes to current literature by both providing an improved framework for the measurement of relationship outcomes and hypothesizing about how these outcomes interact with one another. It also discusses the managerial implications of managing relationships through the constant measurement of trust, commitment, satisfaction and control mutuality

Outcome measures for adult critical care: a systematic review.

Science.gov (United States)

Hayes, J A; Black, N A; Jenkinson, C; Young, J D; Rowan, K M; Daly, K; Ridley, S

2000-01-01

1. To identify generic and disease specific measures of impairment, functional status and health-related quality of life that have been used in adult critical care (intensive and high-dependency care) survivors. 2. To review the validity, reliability and responsiveness of the measures in adult critical care survivors. 3. To consider the implications for future policy and to make recommendations for further methodological research. 4. To review what is currently known of the outcome of adult critical care. Searches of electronic databases (MEDLINE, EMBASE, CINAHL, PsycLIT, The Cochrane Library and SIGLE) from 1970 to August 1998. Manual searches of five journals (1985-98) not indexed in electronic databases and relevant conference proceedings (1993-98). Reference lists of six existing reviews, plus snowballing from reference lists of all relevant articles identified. Randomised trials, non-randomised trials (cohort studies) and case series that included data on outcomes after discharge from adult (16 years and over) critical care. If reported, the following data were extracted from each paper: patient characteristics (age, gender, severity of illness, diagnostic category) number of patients eligible for study, follow-up period, number of deaths before follow-up, number and proportion of survivors included in follow-up method of presentation of outcome data - proportion normal as defined by reference values, or aggregate value (e.g. mean or median), or aggregate values plus an indication of variance (e.g. standard deviation or inter-quartile range). Evidence for three measurement properties was sought for each outcome measure that had been used in at least two studies - their validity, reliability and responsiveness in adult critical care. If the authors did not report these aspects explicitly, an attempt was made to use the data provided to provide these measurement properties. For measures that were used in at least ten studies, information on actual reported

Patient-reported outcome measures in arthroplasty registries

DEFF Research Database (Denmark)

Rolfson, Ola; Eresian Chenok, Kate; Bohm, Eric

2016-01-01

survey (SF-12) or the similar Veterans RAND 12-item health survey (VR-12). The most common specific PROMs were the Hip disability and Osteoarthritis Outcome Score (HOOS), the Knee injury and Osteoarthritis Outcome Score (KOOS), the Oxford Hip Score (OHS), the Oxford Knee Score (OKS), the Western Ontario...... of PROMs for hip and knee arthroplasty in registries worldwide. The 2 main types of PROMs include generic (general health) PROMs, which provide a measure of general health for any health state, and specific PROMs, which focus on specific symptoms, diseases, organs, body regions, or body functions...... all elective hip or knee arthroplasty patients and 6 registries collected PROMs for sample populations; 1 other registry had planned but had not started collection of PROMs. The most common generic instruments used were the EuroQol 5 dimension health outcome survey (EQ-5D) and the Short Form 12 health...

A tool for evaluating the potential for cost-effective outcomes measurement

Directory of Open Access Journals (Sweden)

Somasekhar MM

2012-04-01

Full Text Available Melinda M Somasekhar1, Alfred Bove2, Chris Rausch1, James Degnan3, Cathy T King1, Arnold Meyer11The Albert J Finestone, MD, Office for Continuing Medical Education, 2Section of Cardiology, Temple University School of Medicine, Philadelphia, PA, USA; 3Measurement and Research Center, Temple University, Philadelphia, PA, USAAbstract: Cost related to higher-level outcomes measurement is often very high. However, the cost burden is felt even more by smaller, less well-funded continuing medical education (CME programs. It is possible to overcome financial and participant-related barriers to measuring Level 6 outcomes, which are patient health outcomes. The Temple University School of Medicine’s Office for Continuing Medical Education developed a sequential tool for attaining cost-effective outcomes measurement for determining the likelihood of a CME intervention to produce significant changes in physician performance. The appropriate selection of the CME topic and specific practice change indictors drive this tool. This tool walks providers through a simple YES or NO decision-making list that guides them toward an accurate prediction of potential programmatic outcomes. Factors considered during the decision-making process include whether: (a the intended change(s will have a substantial impact on current practice; (b the intended practice change(s are well supported by clinical data, specialty organization/government recommendations, expert opinion, etc; (c the potential change(s affects a large population; (d external factors, such as system pressures, media pressures, financial pressures, patient pressures, safety pressures, etc, are driving this intended change in performance; (e there is a strong motivation on the part of physicians to implement the intended change(s; and (f the intended change(s is relatively easy to implement within any system of practice. If each of these questions can be responded to positively, there is a higher likelihood

Cost-effectiveness analysis in severe mental illness : Outcome measures selection

NARCIS (Netherlands)

Stant, A. Dennis; Buskens, Erik; Jenner, Jack A.; Wiersma, Durk; TenVergert, Elisabeth M.

Background: Most economic evaluations conducted in mental healthcare did not include widely recommended preference-based health outcomes like the QALY (Quality-Adjusted Life Years). Instead, studies have mainly been designed as cost-effectiveness analyses that include single outcome measures aimed

Patient-reported outcome measures for patients with meniscal tears: a systematic review of measurement properties and evaluation with the COSMIN checklist

Science.gov (United States)

Middleton, Robert; Beard, David J; Price, Andrew J; Hopewell, Sally

2017-01-01

Objective Meniscal tears occur frequently in the population and the most common surgical treatment, arthroscopic partial meniscectomy, is performed in approximately two million cases worldwide each year. The purpose of this systematic review is to summarise and critically appraise the evidence for the use of patient-reported outcome measures (PROMs) in patients with meniscal tears. Design A systematic review was undertaken. Data on reported measurement properties were extracted and the quality of the studies appraised according to Consensus-based Standards for the Selection of Health Measurement Instruments. Data sources A search of MEDLINE, Embase, AMED and PsycINFO, unlimited by language or publication date (last search 20 February 2017). Eligibility criteria for selecting studies Development and validation studies reporting the measurement properties of PROMs in patients with meniscal tears were included. Results 11 studies and 10 PROMs were included. The overall quality of studies was poor. For measurement of symptoms and functional status, there is only very limited evidence supporting the selection of either the Lysholm Knee Scale, International Knee Documentation Committee Subjective Knee Form or the Dutch version of the Knee injury and Osteoarthritis Outcome Score. For measuring health-related quality of life, only limited evidence supports the selection of the Western Ontario Meniscal Evaluation Tool (WOMET). Of all the PROMs evaluated, WOMET has the strongest evidence for content validity. Conclusion For patients with meniscal tears, there is poor quality and incomplete evidence regarding the validity of the currently available PROMs. Further research is required to ensure these PROMs truly reflect the symptoms, function and quality of life of patients with meniscal tears. PROSPERO registration number CRD42017056847. PMID:29030413

A Binomial Test of Group Differences with Correlated Outcome Measures

Science.gov (United States)

Onwuegbuzie, Anthony J.; Levin, Joel R.; Ferron, John M.

2011-01-01

Building on previous arguments for why educational researchers should not provide effect-size estimates in the face of statistically nonsignificant outcomes (Robinson & Levin, 1997), Onwuegbuzie and Levin (2005) proposed a 3-step statistical approach for assessing group differences when multiple outcome measures are individually analyzed…

Measuring Learning Outcomes. A Learner Perspective in Auditing Education

DEFF Research Database (Denmark)

Holm, Claus; Steenholdt, Niels

2000-01-01

The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education which reflects that some students taking accounting classes also are provided with on-the-job training in accounting...... for students taking a graduate auditing course reflect prior accounting work experience for some students and undergraduate accounting coursework experience for all students. This paper extends prior research on the role of declarative and procedural knowledge in performing auditing tasks. Measuring learning...... suggested by Robert M. Gagné. An instrument was developed to measure differences regarding learning outcomes in the context of an auditing course by posing a broad set of questions testing declarative knowledge and the full range of intellectual skills from discrimination to the use of higher...

Measurement of Impairment among Children with Attention Deficit Hyperactivity Disorder as Part of Evaluating Treatment Outcome.

Science.gov (United States)

Al-Ansari, Ahmed M

2013-05-01

This study assesses the impairment and treatment outcome of children with attention deficit hyperactivity disorder (ADHD) in an outpatient child psychiatry clinic, using multiple sources, including the Children Global Assessment Scale (C-GAS). A total of 20 children, aged 4 to 16 years, were recruited serially in 2010 from the Child Psychiatric Unit of the Psychiatric Hospital, Manama, Bahrain. The children received a diagnosis of ADHD using the Diagnostic and Statistical Manual of Mental Disorders Text Revision (DSM-IV-TR). The children were assessed with the C-GAS by a blinded investigator, initially at the beginning of the treatment and then one year later. The parents of the patients reported improvement in all cases; the improvement in impairment after one year, assessed using the C-GAS, was significant for all of the cases (P = 0.001) and low for those with comorbidity (P = 0.07). Measurement of improvement using the C-GAS was a suitable method of collecting data, and hence should be included in routine clinical practice for both ADHD diagnosis and outcome measurement.

Outcome Measurement in the Treatment of Spasmodic Dysphonia: A Systematic Review of the Literature.

Science.gov (United States)

Rumbach, Anna; Aiken, Patrick; Novakovic, Daniel

2018-04-11

The aim of this review was to systematically identify all available studies reporting outcomes measures to assess treatment outcomes for people with spasmodic dysphonia (SD). Full-text journal articles were identified through searches of PubMed, Embase, CINAHL, and Cochrane databases and hand searching of journals. A total of 4,714 articles were retrieved from searching databases; 1,165 were duplicates. Titles and abstracts of 3,549 were screened, with 171 being selected for full-text review. During full-text review, 101 articles were deemed suitable for inclusion. An additional 24 articles were identified as suitable for inclusion through a hand search of reference lists. Data were extracted from 125 studies. A total of 220 outcome measures were identified. Considered in reference to the World Health Organization International Classification of Functioning, Disability and Health (ICF), the majority of outcomes were measured at a Body Function level (n = 212, 96%). Outcomes that explored communication and participation in everyday life and attitudes toward communication (ie, activity and participation domains) were infrequent (n = 8; 4%). Quality of life, a construct not measured within the ICF, was also captured by four outcome measures. No instruments evaluating communication partners' perspectives or burden/disability were identified. The outcome measures used in SD treatment studies are many and varied. The outcome measures identified predominately measure constructs within the Body Functions component of the ICF. In order to facilitate data synthesis across trials, the development of a core outcome set is recommended. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Patient-Oriented Eczema Measure (POEM), a core instrument to measure symptoms in clinical trials: a Harmonising Outcome Measures for Eczema (HOME) statement

OpenAIRE

Spuls, Ph.I.; Gerbens, L.A.A.; Simpson, E.; Apfelbacher, C.J.; Chalmers, J.R.; Thomas, K.S.; Prinsen, C.A.C.; Kobyletzki, L.B. von; Singh, J.A.; Williams, Hywel C.; Schmitt, J.

2017-01-01

Background: The Harmonising Outcome Measures for Eczema (HOME) initiative has defined four core outcome domains for a core outcome set (COS) to be measured in all atopic eczema (AE) trials to ensure cross-trial comparison: clinical signs, symptoms, quality of life and longterm control.\\ud Objectives: The aim of this paper is to report on the consensus process that was used to select the core instrument to consistently assess symptoms in all future AE trials.\\ud Methods: Following the HOME roa...

Source term determination from subcritical multiplication measurements at Koral-1 reactor

International Nuclear Information System (INIS)

Blazquez, J.B.; Barrado, J.M.

1978-01-01

By using an AmBe neutron source two independent procedures have been settled for the zero-power experimental fast-reactor Coral-1 in order to measure the source term which appears in the point kinetical equations. In the first one, the source term is measured when the reactor is just critical with source by taking advantage of the wide range of the linear approach to critical for Coral-1. In the second one, the measurement is made in subcritical state by making use of the previous calibrated control rods. Several applications are also included such as the measurement of the detector dead time, the determinations of the reactivity of small samples and the shape of the neutron importance of the source. (author)

Associations between nine family dinner frequency measures and child weight, dietary and psychosocial outcomes

Science.gov (United States)

Fulkerson, Jayne A.; Friend, Sarah E.; Neumark-Sztainer, Dianne

2015-01-01

Background Family meal frequency has been consistently and significantly associated with positive youth dietary and psychosocial outcomes but less consistently associated with weight outcomes. Family meal frequency measurement has varied widely and it is unclear how this variation may impact relationships with youth weight, dietary, and psychosocial outcomes. Objective This study assesses how five parent/caregiver-reported and four child-reported family dinner frequency measures correlate with each other and are associated with health-related outcomes. Design/Participants This secondary, cross-sectional analysis uses baseline, parent/caregiver (n=160) and 8–12 year old child (n=160) data from the Healthy Home Offerings via the Mealtime Environment (HOME) Plus trial (collected 2011–2012). Data were obtained from objective measurements, dietary recall interviews, and psychosocial surveys. Outcome measures Outcomes included child body mass index z-scores (BMIz), fruit, vegetable and sugar-sweetened beverage intake, dietary quality (Healthy Eating Index-2010 [HEI-2010]), family connectedness, and meal conversations. Statistical analyses performed Pearson correlations and general linear models were used to assess associations between family dinner frequency measures and outcomes. Results All family dinner frequency measures had comparable means and were correlated within and across parent/caregiver- and child-reporters (r=0.17–0.94, pdinner frequency measures were significantly associated with BMIz scores and 100% were significantly associated with fruit/vegetable intake and HEI-2010. In adjusted models, most significant associations with dietary and psychosocial outcomes remained but associations with child BMIz remained significant only for parent/caregiver- (β±SE= −0.07±0.03; pdinner frequency measures asking about ‘sitting and eating’ dinner. Conclusions In spite of phrasing variations in family dinner frequency measures (e.g., which family members

Network meta-analysis of multiple outcome measures accounting for borrowing of information across outcomes.

Science.gov (United States)

Achana, Felix A; Cooper, Nicola J; Bujkiewicz, Sylwia; Hubbard, Stephanie J; Kendrick, Denise; Jones, David R; Sutton, Alex J

2014-07-21

Network meta-analysis (NMA) enables simultaneous comparison of multiple treatments while preserving randomisation. When summarising evidence to inform an economic evaluation, it is important that the analysis accurately reflects the dependency structure within the data, as correlations between outcomes may have implication for estimating the net benefit associated with treatment. A multivariate NMA offers a framework for evaluating multiple treatments across multiple outcome measures while accounting for the correlation structure between outcomes. The standard NMA model is extended to multiple outcome settings in two stages. In the first stage, information is borrowed across outcomes as well across studies through modelling the within-study and between-study correlation structure. In the second stage, we make use of the additional assumption that intervention effects are exchangeable between outcomes to predict effect estimates for all outcomes, including effect estimates on outcomes where evidence is either sparse or the treatment had not been considered by any one of the studies included in the analysis. We apply the methods to binary outcome data from a systematic review evaluating the effectiveness of nine home safety interventions on uptake of three poisoning prevention practices (safe storage of medicines, safe storage of other household products, and possession of poison centre control telephone number) in households with children. Analyses are conducted in WinBUGS using Markov Chain Monte Carlo (MCMC) simulations. Univariate and the first stage multivariate models produced broadly similar point estimates of intervention effects but the uncertainty around the multivariate estimates varied depending on the prior distribution specified for the between-study covariance structure. The second stage multivariate analyses produced more precise effect estimates while enabling intervention effects to be predicted for all outcomes, including intervention effects on

Surrogacy assessment using principal stratification when surrogate and outcome measures are multivariate normal.

Science.gov (United States)

Conlon, Anna S C; Taylor, Jeremy M G; Elliott, Michael R

2014-04-01

In clinical trials, a surrogate outcome variable (S) can be measured before the outcome of interest (T) and may provide early information regarding the treatment (Z) effect on T. Using the principal surrogacy framework introduced by Frangakis and Rubin (2002. Principal stratification in causal inference. Biometrics 58, 21-29), we consider an approach that has a causal interpretation and develop a Bayesian estimation strategy for surrogate validation when the joint distribution of potential surrogate and outcome measures is multivariate normal. From the joint conditional distribution of the potential outcomes of T, given the potential outcomes of S, we propose surrogacy validation measures from this model. As the model is not fully identifiable from the data, we propose some reasonable prior distributions and assumptions that can be placed on weakly identified parameters to aid in estimation. We explore the relationship between our surrogacy measures and the surrogacy measures proposed by Prentice (1989. Surrogate endpoints in clinical trials: definition and operational criteria. Statistics in Medicine 8, 431-440). The method is applied to data from a macular degeneration study and an ovarian cancer study.

Psychometric validation of patient-reported outcome measures assessing chronic constipation

Directory of Open Access Journals (Sweden)

Nelson LM

2014-09-01

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

Physical outcome measures for conductive and mixed hearing loss treatment: A systematic review.

Science.gov (United States)

Johansson, M L; Tysome, J R; Hill-Feltham, P; Hodgetts, W E; Ostevik, A; McKinnon, B J; Monksfield, P; Sockalingam, R; Wright, T

2018-05-07

The number of potential options for rehabilitation of patients with conductive or mixed hearing loss is continually expanding. To be able to inform patients and other stakeholders there is a need to identify and develop patient-centred outcomes for treatment of hearing loss. To identify outcome measures in the physical core area used when reporting the outcome after treatment of conductive and mixed hearing loss in adult patients. Systematic review. Systematic review of literature related to reported physical outcome measures after treatment of mixed or conductive hearing loss without restrictions regarding type of intervention, treatment or device. Any measure reporting the physical outcome after treatment or intervention of mixed or conductive hearing loss was sought and categorised. The physical outcomes measures that had been extracted were then grouped into domains. The literature search resulted in the identification of 1,434 studies, of which 153 were selected for inclusion in the review. The majority (57%) of papers reported results from middle ear surgery, with the remainder reporting results from either bone conduction hearing devices or middle ear implants. Outcomes related to complications were categorised into 17 domains, whereas outcomes related to treatment success was categorised in 22 domains. The importance of these domains to patients and other stakeholders needs to be further explored in order to establish which of these domains are most relevant to interventions for conductive or mixed hearing loss. This will allow us to then assess which outcomes measures are most suitable for inclusion in the core set This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The Aphasia Communication Outcome Measure (ACOM): Dimensionality, Item Bank Calibration, and Initial Validation

Science.gov (United States)

Hula, William D.; Doyle, Patrick J.; Stone, Clement A.; Hula, Shannon N. Austermann; Kellough, Stacey; Wambaugh, Julie L.; Ross, Katherine B.; Schumacher, James G.; St. Jacque, Ann

2015-01-01

Purpose: The purpose of this study is to investigate the structure and measurement properties of the Aphasia Communication Outcome Measure (ACOM), a patient-reported outcome measure of communicative functioning for persons with aphasia. Method: Three hundred twenty-nine participants with aphasia responded to 177 items asking about communicative…

Measuring Outcome in the Treatment of Cocaine Dependence

Science.gov (United States)

Crits-Christoph, Paul; Gallop, Robert; Gibbons, Mary Beth Connolly; Sadicario, Jaclyn S.; Woody, George

2015-01-01

Background Little in known about the extent to which outcome measures used in studies of the treatment of cocaine dependence are associated with longer-term use and with broader measures of clinical improvement. The current study examined reductions in use, and abstinence-oriented measures, in relation to functioning and longer-term clinical benefits in the treatment of cocaine dependence. Methods Overall drug use, cocaine use, and functioning in a number of addiction-related domains for 487 patients diagnosed with DSM-IV cocaine dependence and treated with one of four psychosocial interventions in the NIDA Cocaine Collaborative Treatment Study were assessed monthly during 6 months of treatment and at 9, 12, 15, and 18 month follow-up. Results Measures of during-treatment reduction in use were moderately correlated with drug and cocaine use measures 12 months, but showed non-significant or small correlations with measures of functioning at 12 months. Highest correlations were evident for abstinence measures (maximum consecutive days abstinence and completely abstinent) during treatment in relation to sustained (3 month) abstinence at 12 months. Latent class analysis of patterns of change over time revealed that most patients initially (months 1 to 4 of treatment) either became abstinent immediately or continued to use every month. Over the couse of follow-up, patients either maintained abstinence or used regularly – intermittent use was less common. Conclusions There were generally small associations between various measures of cocaine use and longer-term clinical benefits, other than abstinence was associated with continued abstinence. No one method of measuring outcome of treatment of cocaine dependence appears superior to others. PMID:26366427

Using Patient Reported Outcomes Measures to Promote Integrated Care

Directory of Open Access Journals (Sweden)

Marcel G. M. Olde Rikkert

2018-04-01

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

Use of standardized outcome measures in physical therapist practice: perceptions and applications.

Science.gov (United States)

Jette, Diane U; Halbert, James; Iverson, Courtney; Miceli, Erin; Shah, Palak

2009-02-01

Standardized instruments for measuring patients' activity limitations and participation restrictions have been advocated for use by rehabilitation professionals for many years. The available literature provides few recent reports of the use of these measures by physical therapists in the United States. The primary purpose of this study was to determine: (1) the extent of the use of standardized outcome measures and (2) perceptions regarding their benefits and barriers to their use. A secondary purpose was to examine factors associated with their use among physical therapists in clinical practice. The study used an observational design. A survey questionnaire comprising items regarding the use and perceived benefits and barriers of standardized outcome measures was sent to 1,000 randomly selected members of the American Physical Therapy Association (APTA). Forty-eight percent of participants used standardized outcome measures. The majority of participants (>90%) who used such measures believed that they enhanced communication with patients and helped direct the plan of care. The most frequently reported reasons for not using such measures included length of time for patients to complete them, length of time for clinicians to analyze the data, and difficulty for patients in completing them independently. Use of standardized outcome measures was related to specialty certification status, practice setting, and the age of the majority of patients treated. The limitations included an unvalidated survey for data collection and a sample limited to APTA members. Despite more than a decade of development and testing of standardized outcome measures appropriate for various conditions and practice settings, physical therapists have some distance to go in implementing their use routinely in most clinical settings. Based on the perceived barriers, alterations in practice management strategies and the instruments themselves may be necessary to increase their use.

Are current psychometric tools suitable for measuring outcomes of diabetes education?

DEFF Research Database (Denmark)

Eigenmann, C. A.; Colagiuri, R.; Skinner, T. C.

2009-01-01

Aims To critically appraise the suitability, validity, reliability, feasibility and sensitivity to change of available psychometric tools for measuring the education outcomes identified in the (Australian) National Consensus on Outcomes and Indicators for Diabetes Patient Education. Methods Poten...

Miniature electron bombardment evaporation source: evaporation rate measurement

International Nuclear Information System (INIS)

Nehasil, V.; Masek, K.; Matolin, V.; Moreau, O.

1997-01-01

Miniature electron beam evaporation sources which operate on the principle of vaporization of source material, in the form of a tip, by electron bombardment are produced by several companies specialized in UHV equipment. These sources are used primarily for materials that are normally difficult to deposit due to their high evaporation temperature. They are appropriate for special applications such as heteroepitaxial thin film growth requiring a very low and well controlled deposition rate. A simple and easily applicable method of evaporation rate control is proposed. The method is based on the measurement of ion current produced by electron bombardment of evaporated atoms. The absolute evaporation flux values were measured by means of the Bayard-Alpert ion gauge, which enabled the ion current vs evaporation flux calibration curves to be plotted. (author). 1 tab., 4 figs., 6 refs

Evaluation of Sources of Uncertainties in Solar Resource Measurement

Energy Technology Data Exchange (ETDEWEB)

Habte, Aron M [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Sengupta, Manajit [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

2017-09-25

This poster presents a high-level overview of sources of uncertainties in solar resource measurement, demonstrating the impact of various sources of uncertainties -- such as cosine response, thermal offset, spectral response, and others -- on the accuracy of data from several radiometers. The study provides insight on how to reduce the impact of some of the sources of uncertainties.

Beam emittance measurements on multicusp ion sources

Energy Technology Data Exchange (ETDEWEB)

Sarstedt, M.; Lee, Y.; Leung, K.N. [and others

1995-08-01

Multicusp ion sources are used for various applications. Presently, the implementation of this type of ion source planned for the development of an ion beam lithography machine, which will be used for the projection of sub-0.2 {mu}m patterns onto a wafer substrate. Since, for this application, a very good beam quality and a small ion energy spread are required, emittance measurements have been performed on a multicusp ion source for various source conditions. It is shown that the installation of proper capacitors between the extraction electrodes is necessary to avoid rf-pickup, which otherwise leads to a distortion of the beam emittance. The influence of the magnetic filter field on the beam emittance has been investigated, and the beam emittance of a dc filament-discharge plasma has also been compared to that of an rf-generated plasma.

Beam emittance measurements on multicusp ion sources

International Nuclear Information System (INIS)

Sarstedt, M.; Lee, Y.; Leung, K.N.

1995-08-01

Multicusp ion sources are used for various applications. Presently, the implementation of this type of ion source planned for the development of an ion beam lithography machine, which will be used for the projection of sub-0.2 μm patterns onto a wafer substrate. Since, for this application, a very good beam quality and a small ion energy spread are required, emittance measurements have been performed on a multicusp ion source for various source conditions. It is shown that the installation of proper capacitors between the extraction electrodes is necessary to avoid rf-pickup, which otherwise leads to a distortion of the beam emittance. The influence of the magnetic filter field on the beam emittance has been investigated, and the beam emittance of a dc filament-discharge plasma has also been compared to that of an rf-generated plasma

Measurement of radiation skyshine with D-T neutron source

Energy Technology Data Exchange (ETDEWEB)

Yoshida, S.; Nishitani, T. E-mail: nisitani@naka.jaeri.go.jp; Ochiai, K.; Kaneko, J.; Hori, J.; Sato, S.; Yamauchi, M.; Tanaka, R.; Nakao, M.; Wada, M.; Wakisaka, M.; Murata, I.; Kutsukake, C.; Tanaka, S.; Sawamura, T.; Takahashi, A

2003-09-01

The D-T neutron skyshine experiments have been carried out at the Fusion Neutronics Source (FNS) of JAERI with the neutron yield of {approx}1.7x10{sup 11} n/s. The concrete thickness of the roof and the wall of a FNS target room are 1.15 and 2 m, respectively. The FNS skyshine port with a size of 0.9x0.9 m{sup 2} was open during the experimental period. The radiation dose rate outside the target room was measured a maximum distance of 550 m from the D-T target point with a spherical rem-counter. Secondary gamma-rays were measured with high purity Ge detectors and NaI scintillation counters. The highest neutron dose was about 9x10{sup -22} Sv/(source neutron) at a distance of 30 m from the D-T target point and the dose rate was attenuated to 4x10{sup -24} Sv/(source neutron) at a distance of 550 m. The measured neutron dose distribution was analyzed with Monte Carlo code MCNP-4B and a simple line source model. The MCNP calculation overestimates the neutron dose in the distance range larger than 230 m. The line source model agrees well with the experimental results within the distance of 350 m.

Psychometric evaluation of self-report outcome measures for prosthetic applications.

Science.gov (United States)

Hafner, Brian J; Morgan, Sara J; Askew, Robert L; Salem, Rana

2016-01-01

Documentation of clinical outcomes is increasingly expected in delivery of prosthetic services and devices. However, many outcome measures suitable for use in clinical care and research have not been psychometrically tested with prosthesis users. The aim of this study was to determine test-retest reliability, mode-of-administration (MoA) equivalence, standard error of measurement (SEM), and minimal detectable change (MDC) of standardized, self-report instruments that assess constructs of importance to people with lower limb loss. Prosthesis users (n = 201) were randomly assigned to groups based on MoA (i.e., paper, electronic, or mixed-mode). Participants completed two surveys 2 to 3 d apart. Instruments included the Prosthetic Limb Users Survey of Mobility, Prosthesis Evaluation Questionnaire-Mobility Subscale, Activities-Specific Balance Confidence Scale, Quality of Life in Neurological Conditions-Applied Cognition/General Concerns, Patient-Reported Outcomes Measurement Information System Profile, and Socket Comfort Score. Intraclass correlation coefficients indicated all instruments are appropriate for group-level comparisons and select instruments are suitable for individual-level applications. Several instruments showed evidence of possible floor and ceiling effects. All were equivalent across MoAs. SEM and MDC were quantified to facilitate interpretation of outcomes and change scores. These results can enhance clinicians' and researchers' ability to select, apply, and interpret scores from instruments administered to prosthesis users.

Measuring social inclusion--a key outcome in global mental health.

Science.gov (United States)

Baumgartner, Joy Noel; Burns, Jonathan K

2014-04-01

Social inclusion is increasingly recognized as a key outcome for evaluating global mental health programmes and interventions. Whereas social inclusion as an outcome is not a new concept in the field of mental health, its measurement has been hampered by varying definitions, concepts and instruments. To move the field forward, this paper reviews the currently available instruments which measure social inclusion and are reported in the literature, realizing that no single measure will be appropriate for all studies or contexts. A systematic literature search of English language peer-reviewed articles published through February 2013 was undertaken to identify scales specifically developed to measure social inclusion or social/community integration among populations with mental disorders. Five instruments were identified through the search criteria. The scales are discussed in terms of their theoretical underpinnings, domains and/or key items and their potential for use in global settings. Whereas numerous reviewed abstracts discussed mental health and social inclusion or social integration, very few were concerned with direct measurement of the construct. All identified scales were developed in high-income countries with limited attention paid to how the scale could be adapted for cross-cultural use. Social inclusion is increasingly highlighted as a key outcome for global mental health policies and programmes, yet its measurement is underdeveloped. There is need for a global cross-cultural measure that has been developed and tested in diverse settings. However, until that need is met, some of the scales presented here may be amenable to adaptation.

Use of β-ray source for measurement of adsorption

International Nuclear Information System (INIS)

Kawakami, Hirokane; Nishimura, Keigo; Oshima, Takayoshi

1987-01-01

A research project has been carried out with the goal of determining the mass of a neutrino from β-decay measurements. During a study seeking the development of a β-ray source for this purpose, it was found that the amount of residual gas adsorbed on a cooled β-ray source can be measured successfully. Electrons emitted from a β-ray source is measured by an electron spectrometer. A sharp, nearly symmetric peak is obtained if all electrons have the same energy. If gas is adsorbed on the surface of the source, on the other hand, the resultant spectrum has a rather different profile due to energy loss caused by the gas. The difference between the energy loss spectrum and the original spectrum must be proportional to the amount of the adsorbed gas. In this study, a 109 Cd source with an electron energy peak at 18 keV is selected and the number of molecules adsorbed on the source, cooled to -35 deg C at 5 x 10 -7 Torr, is determined. Assuming that the gas is water vapor, it is shown that the adsorbed layer is of a two-molecular thickness on the average. It is also found that the thickness is reversible at varrying temperatures and does not change for two days. This gas amount is 7,500 time as large as that in the case of physical adsorption of water. (Nogami, K.)

The magnet measurement facility for the Advanced Photon Source

International Nuclear Information System (INIS)

Kim, S.H.; Doose, C.; Hogrefe, R.; Kim, K.; Merl, R.

1993-01-01

A magnet measurement facility has been developed to measure the prototype and production magnets for the Advance Photon Source. The measurement facility is semi-automatic in measurement control and data analysis. One dipole system and three rotating coil measurement systems for quadrupole and sextupole magnets and corresponding probe coils are described

The OpenPMU Platform for Open Source Phasor Measurements

OpenAIRE

Laverty, David M.; Best, Robert J.; Brogan, Paul; Al-Khatib, Iyad; Vanfretti, Luigi; Morrow, D John

2013-01-01

OpenPMU is an open platform for the development of phasor measurement unit (PMU) technology. A need has been identified for an open-source alternative to commercial PMU devices tailored to the needs of the university researcher and for enabling the development of new synchrophasor instruments from this foundation. OpenPMU achieves this through open-source hardware design specifications and software source code, allowing duplicates of the OpenPMU to be fabricated under open-source licenses. Th...

CONSIDER - Core Outcome Set in IAD Research: study protocol for establishing a core set of outcomes and measurements in incontinence-associated dermatitis research.

Science.gov (United States)

Van den Bussche, Karen; De Meyer, Dorien; Van Damme, Nele; Kottner, Jan; Beeckman, Dimitri

2017-10-01

This study protocol describes the methodology for the development of a core set of outcomes and a core set of measurements for incontinence-associated dermatitis. Incontinence is a widespread disorder with an important impact on quality of life. One of the most common complications is incontinence-associated dermatitis, resulting from chemical and physical irritation of the skin barrier, triggering inflammation and skin damage. Managing incontinence-associated dermatitis is an important challenge for nurses. Several interventions have been assessed in clinical trials, but heterogeneity in study outcomes complicates the comparability and standardization. To overcome this challenge, the development of a core outcome set, a minimum set of outcomes and measurements to be assessed in clinical research, is needed. A project team, International Steering Committee and panelists will be involved to guide the development of the core outcome set. The framework of the Harmonizing Outcomes Measures for Eczema roadmap endorsed by Cochrane Skin Group Core Outcomes Set Initiative, is used to inform the project design. A systematic literature review, interviews to integrate the patients' perspective and a consensus study with healthcare researchers and providers using the Delphi procedure will be performed. The project was approved by the Ethics review Committee (April 2016). This is the first project that will identify a core outcome set of outcomes and measurements for incontinence-associated dermatitis research. A core outcome set will reduce possible reporting bias, allow results comparisons and statistical pooling across trials and strengthen evidence-based practice and decision-making. This project has been registered in the Core Outcome Measures in Effectiveness Trials (COMET) database and is part of the Cochrane Skin Group Core Outcomes Set Initiative (CSG-COUSIN). © 2016 John Wiley & Sons Ltd.

Dosimetric measurements of an 192Ir HDR source with a diamond detector

International Nuclear Information System (INIS)

Rustgi, Surendra N.

1996-01-01

Purpose: To study the feasibility of using a diamond detector for the dosimetry of a high dose rate (HDR) 192 Ir source and to compare the measurement results with published data and calculations from a commercial treatment planning system. Materials and methods: The sensitive volume of the diamond detector consists of a disk of 0.26 mm thickness and 3 mm diameter. The detector was applied an external bias of +100 V and was preirradiated to a dose of 500 cGy to stabilize its response. The 192 Ir source from the Nucletron microSelectron unit has an active diameter of 0.6 mm and a length of 3.5 mm. Photon fluence anisotropy factors in air were measured at distances of 5 and 10 cm from two sources and compared with TLD measurements. Dose profiles and isodose distributions were measured at several distances from the source and compared with calculations from a Nucletron treatment planning system. These dose calculations in water use a point source approximation with the anisotropy factors independent of the radial distance from the source. Results: The photon fluence around the 192 Ir HDR source, measured with a diamond detector at distances of 5 and 10 cm from the source, is very anisotropic. Compared to the source transverse direction, the photon fluence intensity along the source axis reduces to approximately 60%. Measurements performed on two sources indicate that the photon anisotropy does not change with distance in air. Within experimental uncertainty, similar results were obtained with TLD rods and are in excellent agreement with published anisotropy factors 1 . Dose profiles, measured with the diamond detector in a water phantom, at distances of 1,2,3 and 5 cm from the source, are found to be in excellent agreement with the Nucletron planning system calculations. Similar excellent agreement is observed between the measured and calculated isodose curves in planes parallel to the source plane. Conclusion: The diamond detector has been demonstrated to be suitable

Calculated and measured brachytherapy dosimetry parameters in water for the Xoft Axxent X-Ray Source: an electronic brachytherapy source.

Science.gov (United States)

Rivard, Mark J; Davis, Stephen D; DeWerd, Larry A; Rusch, Thomas W; Axelrod, Steve

2006-11-01

A new x-ray source, the model S700 Axxent X-Ray Source (Source), has been developed by Xoft Inc. for electronic brachytherapy. Unlike brachytherapy sources containing radionuclides, this Source may be turned on and off at will and may be operated at variable currents and voltages to change the dose rate and penetration properties. The in-water dosimetry parameters for this electronic brachytherapy source have been determined from measurements and calculations at 40, 45, and 50 kV settings. Monte Carlo simulations of radiation transport utilized the MCNP5 code and the EPDL97-based mcplib04 cross-section library. Inter-tube consistency was assessed for 20 different Sources, measured with a PTW 34013 ionization chamber. As the Source is intended to be used for a maximum of ten treatment fractions, tube stability was also assessed. Photon spectra were measured using a high-purity germanium (HPGe) detector, and calculated using MCNP. Parameters used in the two-dimensional (2D) brachytherapy dosimetry formalism were determined. While the Source was characterized as a point due to the small anode size, S700 Source exhibited depth dose behavior similar to low-energy photon-emitting low dose rate sources 125I and l03Pd, yet with capability for variable and much higher dose rates and subsequently adjustable penetration capabilities. This paper presents the calculated and measured in-water brachytherapy dosimetry parameters for the model S700 Source at the aforementioned three operating voltages.

Calorimetric measurement of strong γ emitting sources

International Nuclear Information System (INIS)

Brangier, B.; Herczeg, C.; Henry, R.

1968-01-01

This publication gives the principle and a description of an adiabatic calorimeter for measuring the real activity of strong gamma-emitting sources by absorbing the emitted energy in a mass of copper. Because of the difficulty of evaluating the amount self- absorption, we have built a calorimeter for measuring the self- absorption, and a description of it is given.The results of these three measurements are fairly satisfactory. The calibration and the actual measurements obtained are given with a few corrections made necessary by the design of the apparatus. The correlation of the various results is discussed. (author) [fr

Measuring Modularity in Open Source Code Bases

Directory of Open Access Journals (Sweden)

Roberto Milev

2009-03-01

Full Text Available Modularity of an open source software code base has been associated with growth of the software development community, the incentives for voluntary code contribution, and a reduction in the number of users who take code without contributing back to the community. As a theoretical construct, modularity links OSS to other domains of research, including organization theory, the economics of industry structure, and new product development. However, measuring the modularity of an OSS design has proven difficult, especially for large and complex systems. In this article, we describe some preliminary results of recent research at Carleton University that examines the evolving modularity of large-scale software systems. We describe a measurement method and a new modularity metric for comparing code bases of different size, introduce an open source toolkit that implements this method and metric, and provide an analysis of the evolution of the Apache Tomcat application server as an illustrative example of the insights gained from this approach. Although these results are preliminary, they open the door to further cross-discipline research that quantitatively links the concerns of business managers, entrepreneurs, policy-makers, and open source software developers.

Use of the measure your medical outcome profile (MYMOP2 and W-BQ12 (Well-Being outcomes measures to evaluate chiropractic treatment: an observational study

Directory of Open Access Journals (Sweden)

Polus Barbara I

2011-03-01

Full Text Available Abstract Background The objective was to assess the use of the Measure Yourself Medical Outcome Profile (MYMOP2 and W-BQ12 well-being questionnaire for measuring clinical change associated with a course of chiropractic treatment. Methods Chiropractic care of the patients involved spinal manipulative therapy (SMT, mechanically assisted techniques, soft tissue therapy, and physiological therapeutic devices. Outcome measures used were MYMOP2 and the Well-Being Questionnaire 12 (W-BQ12. Results Statistical and clinical significant changes were demonstrated with W-BQ12 and MYMOP2. Conclusions The study demonstrated that MYMOP2 was responsive to change and may be a useful instrument for assessing clinical changes among chiropractic patients who present with a variety of symptoms and clinical conditions.

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

OpenAIRE

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

2016-01-01

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

Measuring Student Learning Outcomes Using the SALG Instrument

Science.gov (United States)

Scholl, Kathleen; Olsen, Heather M.

2014-01-01

U.S. higher education institutions are being called to question their central nature, priorities, and functions, with prominent and unprecedented attention being given to accountability and the measurement of student learning outcomes. As higher education evolves in how it assesses student learning and leisure studies and recreation departments…

[Improving care for cleft lip and palate patients: uniform and patient-orientated outcome measures].

Science.gov (United States)

Haj, M; de Gier, H H W; van Veen-van der Hoek, M; Versnel, S L; van Adrichem, L N; Wolvius, E B; Hazelzet, J A; Koudstaal, M J

2018-02-01

The quality of care for patients with cleft lip and palate is extremely variable across the world. Treatment protocols differ and methods of data registration are not uniform. Improving this care by means of comparative research is challenging. The best treatment programmes can be identified by uniformly registering patient-orientated outcomes and comparing the outcomes with those of other treatment centres. That knowledge can be used to improve one's own care. An international team consisting of specialists and cleft lip and palate patients has developed a set of outcome measures that are considered by patients to be most important. This team is coordinated by the International Consortium of Health Outcomes Measurement (ICHOM). The cleft lip and palate outcome set can be used by all centres worldwide in following up on cleft lip and palate patients. In the Erasmus Medical Centre in Rotterdam, the 'Zorgmonitor Schisis' (Care Monitor Cleft Lip and Palate) has been built, an application in which these outcome measures are collected at fixed times. Implementing this set of outcome measures in other cleft lip and palate treatment centres and using the outcomes as (inter)national benchmarks will result in transparency and the improvement of the treatment of cleft lip and palate worldwide.

Residual stress measurement using the pulsed neutron source at LANSCE

International Nuclear Information System (INIS)

Bourke, M.A.M.; Goldstone, J.A.; Holden, T.M.

1991-01-01

The presence of residual stress in engineering components can effect their mechanical properties and structural integrity. Neutron diffraction is the only measuring technique which can make spatially resolved non-destructive strain measurements in the interior of components. By recording the change in the crystalline interplanar spacing, elastic strains can be measured for individual lattice reflections. Using a pulsed neutron source, all the lattice reflections are recorded in each measurement which allows anisotropic effects to be studied. Measurements made at the Manuel Lujan Jr Neutron Scattering Centre (LANSCE) demonstrate the potential for stress measurements on a pulsed source and indicate the advantages and disadvantages over measurements made on a reactor. 15 refs., 7 figs

Implementation of learning outcome attainment measurement system in aviation engineering higher education

Science.gov (United States)

Salleh, I. Mohd; Mat Rani, M.

2017-12-01

This paper aims to discuss the effectiveness of the Learning Outcome Attainment Measurement System in assisting Outcome Based Education (OBE) for Aviation Engineering Higher Education in Malaysia. Direct assessments are discussed to show the implementation processes that become a key role in the successful outcome measurement system. A case study presented in this paper involves investigation on the implementation of the system in Aircraft Structure course for Bachelor in Aircraft Engineering Technology program in UniKL-MIAT. The data has been collected for five semesters, starting from July 2014 until July 2016. The study instruments used include the report generated in Learning Outcomes Measurements System (LOAMS) that contains information on the course learning outcomes (CLO) individual and course average performance reports. The report derived from LOAMS is analyzed and the data analysis has revealed that there is a positive significant correlation between the individual performance and the average performance reports. The results for analysis of variance has further revealed that there is a significant difference in OBE grade score among the report. Independent samples F-test results, on the other hand, indicate that the variances of the two populations are unequal.

Stable source reconstruction from a finite number of measurements in the multi-frequency inverse source problem

DEFF Research Database (Denmark)

Karamehmedovic, Mirza; Kirkeby, Adrian; Knudsen, Kim

2018-01-01

setting: From measurements made at a finite set of frequencies we uniquely determine and reconstruct sources in a subspace spanned by finitely many Fourier-Bessel functions. Further, we obtain a constructive criterion for identifying a minimal set of measurement frequencies sufficient for reconstruction......, and under an additional, mild assumption, the reconstruction method is shown to be stable." Our analysis is based on a singular value decomposition of the source-to-measurement forward operators and the distribution of positive zeros of the Bessel functions of the first kind. The reconstruction method...

A new mini-extrapolation chamber for beta source uniformity measurements

International Nuclear Information System (INIS)

Oliveira, M.L.; Caldas, L.V.E.

2006-01-01

According to recent international recommendations, beta particle sources should be specified in terms of absorbed dose rates to water at the reference point. However, because of the clinical use of these sources, additional information should be supplied in the calibration reports. This additional information include the source uniformity. A new small volume extrapolation chamber was designed and constructed at the Calibration Laboratory at Instituto de Pesquisas Energeticas e Nucleares, IPEN, Brazil, for the calibration of 90 Sr+ 90 Y ophthalmic plaques. This chamber can be used as a primary standard for the calibration of this type of source. Recent additional studies showed the feasibility of the utilization of this chamber to perform source uniformity measurements. Because of the small effective electrode area, it is possible to perform independent measurements by varying the chamber position by small steps. The aim of the present work was to study the uniformity of a 90 Sr+ 90 Y plane ophthalmic plaque utilizing the mini extrapolation chamber developed at IPEN. The uniformity measurements were performed by varying the chamber position by steps of 2 mm in the source central axis (x-and y-directions) and by varying the chamber position off-axis by 3 mm steps. The results obtained showed that this small volume chamber can be used for this purpose with a great advantage: it is a direct method, being unnecessary a previously calibration of the measurement device in relation to a reference instrument, and it provides real -time results, reducing the time necessary for the study and the determination of the uncertainties related to the measurements. (authors)

A tool for evaluating the potential for cost-effective outcomes measurement.

Science.gov (United States)

Somasekhar, Melinda M; Bove, Alfred; Rausch, Chris; Degnan, James; King, Cathy T; Meyer, Arnold

2012-01-01

Cost related to higher-level outcomes measurement is often very high. However, the cost burden is felt even more by smaller, less well-funded continuing medical education (CME) programs. It is possible to overcome financial and participant-related barriers to measuring Level 6 outcomes, which are patient health outcomes. The Temple University School of Medicine's Office for Continuing Medical Education developed a sequential tool for attaining cost-effective outcomes measurement for determining the likelihood of a CME intervention to produce significant changes in physician performance. The appropriate selection of the CME topic and specific practice change indictors drive this tool. This tool walks providers through a simple YES or NO decision-making list that guides them toward an accurate prediction of potential programmatic outcomes. Factors considered during the decision-making process include whether: (a) the intended change(s) will have a substantial impact on current practice; (b) the intended practice change(s) are well supported by clinical data, specialty organization/government recommendations, expert opinion, etc; (c) the potential change(s) affects a large population; (d) external factors, such as system pressures, media pressures, financial pressures, patient pressures, safety pressures, etc, are driving this intended change in performance; (e) there is a strong motivation on the part of physicians to implement the intended change(s); and (f) the intended change(s) is relatively easy to implement within any system of practice. If each of these questions can be responded to positively, there is a higher likelihood that the intended practice-related change(s) will occur. Such change can be measured using a simpler and less costly methodology.

Quantifying sources of bias in longitudinal data linkage studies of child abuse and neglect: measuring impact of outcome specification, linkage error, and partial cohort follow-up.

Science.gov (United States)

Parrish, Jared W; Shanahan, Meghan E; Schnitzer, Patricia G; Lanier, Paul; Daniels, Julie L; Marshall, Stephen W

2017-12-01

Health informatics projects combining statewide birth populations with child welfare records have emerged as a valuable approach to conducting longitudinal research of child maltreatment. The potential bias resulting from linkage misspecification, partial cohort follow-up, and outcome misclassification in these studies has been largely unexplored. This study integrated epidemiological survey and novel administrative data sources to establish the Alaska Longitudinal Child Abuse and Neglect Linkage (ALCANLink) project. Using these data we evaluated and quantified the impact of non-linkage misspecification and single source maltreatment ascertainment use on reported maltreatment risk and effect estimates. The ALCANLink project integrates the 2009-2011 Alaska Pregnancy Risk Assessment Monitoring System (PRAMS) sample with multiple administrative databases through 2014, including one novel administrative source to track out-of-state emigration. For this project we limited our analysis to the 2009 PRAMS sample. We report on the impact of linkage quality, cohort follow-up, and multisource outcome ascertainment on the incidence proportion of reported maltreatment before age 6 and hazard ratios of selected characteristics that are often available in birth cohort linkage studies of maltreatment. Failure to account for out-of-state emigration biased the incidence proportion by 12% (from 28.3% w to 25.2% w ), and the hazard ratio (HR) by as much as 33% for some risk factors. Overly restrictive linkage parameters biased the incidence proportion downwards by 43% and the HR by as much as 27% for some factors. Multi-source linkages, on the other hand, were of little benefit for improving reported maltreatment ascertainment. Using the ALCANLink data which included a novel administrative data source, we were able to observe and quantify bias to both the incidence proportion and HR in a birth cohort linkage study of reported child maltreatment. Failure to account for out

The art and science of using routine outcome measurement in mental health benchmarking.

Science.gov (United States)

McKay, Roderick; Coombs, Tim; Duerden, David

2014-02-01

To report and critique the application of routine outcome measurement data when benchmarking Australian mental health services. The experience of the authors as participants and facilitators of benchmarking activities is augmented by a review of the literature regarding mental health benchmarking in Australia. Although the published literature is limited, in practice, routine outcome measures, in particular the Health of the National Outcomes Scales (HoNOS) family of measures, are used in a variety of benchmarking activities. Use in exploring similarities and differences in consumers between services and the outcomes of care are illustrated. This requires the rigour of science in data management and interpretation, supplemented by the art that comes from clinical experience, a desire to reflect on clinical practice and the flexibility to use incomplete data to explore clinical practice. Routine outcome measurement data can be used in a variety of ways to support mental health benchmarking. With the increasing sophistication of information development in mental health, the opportunity to become involved in benchmarking will continue to increase. The techniques used during benchmarking and the insights gathered may prove useful to support reflection on practice by psychiatrists and other senior mental health clinicians.

Prosthetists' perceptions and use of outcome measures in clinical practice: Long-term effects of focused continuing education.

Science.gov (United States)

Hafner, Brian J; Spaulding, Susan E; Salem, Rana; Morgan, Sara J; Gaunaurd, Ignacio; Gailey, Robert

2017-06-01

Continuing education is intended to facilitate clinicians' skills and knowledge in areas of practice, such as administration and interpretation of outcome measures. To evaluate the long-term effect of continuing education on prosthetists' confidence in administering outcome measures and their perceptions of outcomes measurement in clinical practice. Pretest-posttest survey methods. A total of 66 prosthetists were surveyed before, immediately after, and 2 years after outcomes measurement education and training. Prosthetists were grouped as routine or non-routine outcome measures users, based on experience reported prior to training. On average, prosthetists were just as confident administering measures 1-2 years after continuing education as they were immediately after continuing education. In all, 20% of prosthetists, initially classified as non-routine users, were subsequently classified as routine users at follow-up. Routine and non-routine users' opinions differed on whether outcome measures contributed to efficient patient evaluations (79.3% and 32.4%, respectively). Both routine and non-routine users reported challenges integrating outcome measures into normal clinical routines (20.7% and 45.9%, respectively). Continuing education had a long-term impact on prosthetists' confidence in administering outcome measures and may influence their clinical practices. However, remaining barriers to using standardized measures need to be addressed to keep practitioners current with evolving practice expectations. Clinical relevance Continuing education (CE) had a significant long-term impact on prosthetists' confidence in administering outcome measures and influenced their clinical practices. In all, approximately 20% of prosthetists, who previously were non-routine outcome measure users, became routine users after CE. There remains a need to develop strategies to integrate outcome measurement into routine clinical practice.

Dignity Impact as a Primary Outcome Measure for Dignity Therapy.

Science.gov (United States)

Scarton, Lisa; Oh, Sungho; Sylvera, Ashley; Lamonge, Ralph; Yao, Yingwei; Chochinov, Harvey; Fitchett, George; Handzo, George; Emanuel, Linda; Wilkie, Diana

2018-01-01

Feasibility of dignity therapy (DT) is well established in palliative care. Evidence of its efficacy, however, has been inconsistent and may stem from DT's primary effects differing from the outcomes measured in previous studies. We proposed that DT effects were in the spiritual domain and created a new outcome measure, Dignity Impact Scale (DIS), from items previously used in a large randomized controlled trial (RCT). The purpose of this secondary analysis study was to examine properties of a new measure of dignity impact. Using the DIS, we conducted reanalysis of posttest data from a large 3-arm, multi-site RCT study. Participants were receiving hospice/palliative care (n = 326, 50.6% female, mean age = 65.1 years, 89.3% white, all with a terminal illness with 6 months or less life expectancy). They had been randomized to standard palliative care (n = 111), client-centered care (n = 107), or DT (n = 108). The 7-item DIS was derived from selected items in a posttest DT Patient Feedback Questionnaire. The DIS had strong internal consistency (α = 0.85). The DT group mean DIS score (21.4 ± 5.0) was significantly higher than the usual care group mean score (17.7 ± 5.5; t = 5.2, df = 216, P death, and life completion tasks. We propose that the DIS be used as the primary outcome measure in evaluating the effects of DT.

Systematic review of tools to measure outcomes for young children with autism spectrum disorder.

Science.gov (United States)

McConachie, Helen; Parr, Jeremy R; Glod, Magdalena; Hanratty, Jennifer; Livingstone, Nuala; Oono, Inalegwu P; Robalino, Shannon; Baird, Gillian; Beresford, Bryony; Charman, Tony; Garland, Deborah; Green, Jonathan; Gringras, Paul; Jones, Glenys; Law, James; Le Couteur, Ann S; Macdonald, Geraldine; McColl, Elaine M; Morris, Christopher; Rodgers, Jacqueline; Simonoff, Emily; Terwee, Caroline B; Williams, Katrina

2015-06-01

The needs of children with autism spectrum disorder (ASD) are complex and this is reflected in the number and diversity of outcomes assessed and measurement tools used to collect evidence about children's progress. Relevant outcomes include improvement in core ASD impairments, such as communication, social awareness, sensory sensitivities and repetitiveness; skills such as social functioning and play; participation outcomes such as social inclusion; and parent and family impact. To examine the measurement properties of tools used to measure progress and outcomes in children with ASD up to the age of 6 years. To identify outcome areas regarded as important by people with ASD and parents. The MeASURe (Measurement in Autism Spectrum disorder Under Review) research collaboration included ASD experts and review methodologists. We undertook systematic review of tools used in ASD early intervention and observational studies from 1992 to 2013; systematic review, using the COSMIN checklist (Consensus-based Standards for the selection of health Measurement Instruments) of papers addressing the measurement properties of identified tools in children with ASD; and synthesis of evidence and gaps. The review design and process was informed throughout by consultation with stakeholders including parents, young people with ASD, clinicians and researchers. The conceptual framework developed for the review was drawn from the International Classification of Functioning, Disability and Health, including the domains 'Impairments', 'Activity Level Indicators', 'Participation', and 'Family Measures'. In review 1, 10,154 papers were sifted - 3091 by full text - and data extracted from 184; in total, 131 tools were identified, excluding observational coding, study-specific measures and those not in English. In review 2, 2665 papers were sifted and data concerning measurement properties of 57 (43%) tools were extracted from 128 papers. Evidence for the measurement properties of the reviewed

Directivity of Spherical Polyhedron Sound Source Used in Near-Field HRTF Measurements

International Nuclear Information System (INIS)

Yu Guang-Zheng; Xie Bo-Sun; Rao Dan

2010-01-01

The omnidirectional character is one of important requirements for the sound source used in near-field head-related transfer function (HRTF) measurements. Based on the analysis on the radiation sound pressure and directivity character of various spherical polyhedron sound sources, a spherical dodecahedral sound source with radius of 0.035m is proposed and manufactured. Theoretical and measured results indicate that the sound source is approximately omnidirectional below the frequency of 8 kHz. In addition, the sound source has reasonable magnitude response from 350Hz to 20kHz and linear phase characteristics. Therefore, it is suitable for the near-field HRTF measurements. (fundamental areas of phenomenology(including applications))

Measure of functional independence dominates discharge outcome prediction after inpatient rehabilitation for stroke.

Science.gov (United States)

Brown, Allen W; Therneau, Terry M; Schultz, Billie A; Niewczyk, Paulette M; Granger, Carl V

2015-04-01

Identifying clinical data acquired at inpatient rehabilitation admission for stroke that accurately predict key outcomes at discharge could inform the development of customized plans of care to achieve favorable outcomes. The purpose of this analysis was to use a large comprehensive national data set to consider a wide range of clinical elements known at admission to identify those that predict key outcomes at rehabilitation discharge. Sample data were obtained from the Uniform Data System for Medical Rehabilitation data set with the diagnosis of stroke for the years 2005 through 2007. This data set includes demographic, administrative, and medical variables collected at admission and discharge and uses the FIM (functional independence measure) instrument to assess functional independence. Primary outcomes of interest were functional independence measure gain, length of stay, and discharge to home. The sample included 148,367 people (75% white; mean age, 70.6±13.1 years; 97% with ischemic stroke) admitted to inpatient rehabilitation a mean of 8.2±12 days after symptom onset. The total functional independence measure score, the functional independence measure motor subscore, and the case-mix group were equally the strongest predictors for any of the primary outcomes. The most clinically relevant 3-variable model used the functional independence measure motor subscore, age, and walking distance at admission (r(2)=0.107). No important additional effect for any other variable was detected when added to this model. This analysis shows that a measure of functional independence in motor performance and age at rehabilitation hospital admission for stroke are predominant predictors of outcome at discharge in a uniquely large US national data set. © 2015 American Heart Association, Inc.

Thinking about online sources: Exploring students' epistemic cognition in internet-based chemistry learning

Science.gov (United States)

Dai, Ting

This dissertation investigated the relation between epistemic cognition---epistemic aims and source beliefs---and learning outcome in an Internet--based research context. Based on a framework of epistemic cognition (Chinn, Buckland, & Samarapungavan, 2011), a context--specific epistemic aims and source beliefs questionnaire (CEASBQ) was developed and administered to 354 students from college--level introductory chemistry courses. A series of multitrait--multimethod model comparisons provided evidence for construct convergent and discriminant validity for three epistemic aims--- true beliefs, justified beliefs, explanatory connection, which were all distinguished from, yet correlated with, mastery goals. Students' epistemic aims were specific to the chemistry topics in research. Multidimensional scaling results indicated that students' source evaluation was based on two dimensions--- professional expertise and first--hand knowledge, suggesting a multidimensional structure of source beliefs. Most importantly, online learning outcome was found to be significantly associated with two epistemic aims---justified beliefs and explanatory connection: The more students sought justifications in the online research, the lower they tended to score on the learning outcome measure, whereas the more students sought explanatory connections between information, the higher they scored on the outcome measure. There was a significant but small positive association between source beliefs and learning outcome. The influences of epistemic aims and source beliefs on learning outcome were found to be above and beyond the effects of a number of covariates, including prior knowledge and perceived ability with online sources.

Lunar occultations for gamma-ray source measurements

Science.gov (United States)

Koch, David G.; Hughes, E. B.; Nolan, Patrick L.

1990-01-01

The unambiguous association of discrete gamma-ray sources with objects radiating at other wavelengths, the separation of discrete sources from the extended emission within the Galaxy, the mapping of gamma-ray emission from nearby galaxies and the measurement of structure within a discrete source cannot presently be accomplished at gamma-ray energies. In the past, the detection processes used in high-energy gamma-ray astronomy have not allowed for good angular resolution. This problem can be overcome by placing gamma-ray detectors on the moon and using the horizon as an occulting edge to achieve arcsec resolution. For purposes of discussion, this concept is examined for gamma rays above 100 MeV for which pair production dominates the detection process and locally-generated nuclear gamma rays do not contribute to the background.

Measuring what matters to rare disease patients - reflections on the work by the IRDiRC taskforce on patient-centered outcome measures.

Science.gov (United States)

Morel, Thomas; Cano, Stefan J

2017-11-02

Our ability to evaluate outcomes which genuinely reflect patients' unmet needs, hopes and concerns is of pivotal importance. However, much current clinical research and practice falls short of this objective by selecting outcome measures which do not capture patient value to the fullest. In this Opinion, we discuss Patient-Centered Outcomes Measures (PCOMs), which have the potential to systematically incorporate patient perspectives to measure those outcomes that matter most to patients. We argue for greater multi-stakeholder collaboration to develop PCOMs, with rare disease patients and families at the center. Beyond advancing the science of patient input, PCOMs are powerful tools to translate care or observed treatment benefit into an 'interpretable' measure of patient benefit, and thereby help demonstrate clinical effectiveness. We propose mixed methods psychometric research as the best route to deliver fit-for-purpose PCOMs in rare diseases, as this methodology brings together qualitative and quantitative research methods in tandem with the explicit aim to efficiently utilise data from small samples. And, whether one opts to develop a brand-new PCOM or to select or adapt an existing outcome measure for use in a rare disease, the anchors remain the same: patients, their daily experience of the rare disease, their preferences, core concepts and values. Ultimately, existing value frameworks, registries, and outcomes-based contracts largely fall short of consistently measuring the full range of outcomes that matter to patients. We argue that greater use of PCOMs in rare diseases would enable a fast track to Patient-Centered Care.

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

DEFF Research Database (Denmark)

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

2010-01-01

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

Flux density measurements of radio sources at 2.14 millimeter wavelength

International Nuclear Information System (INIS)

Cogdell, J.R.; Davis, J.H.; Ulrich, B.T.; Wills, B.J.

1975-01-01

Flux densities of galactic and extragalactic sources, and planetary temperatures, have been measured at 2.14 mm wavelength (140 GHz). Results are presented for OJ 287; the galactic sources DR 21, W3, and Orion A; the extragalactic sources PKS 0106plus-or-minus01, 3C 84, 3C 120, BL Lac, 3C 216, 3C 273, 3C 279, and NGC 4151; and the Sun, Venus, Mars, and Jupiter. Also presented is the first measurement of the 2.14-mm temperature of Uranus. The spectra of some of these sources are discussed. The flux density scale was calibrated absolutely. The measurements were made with a new continuum receiver on the 4.88-m radio telescope of The University of Texas

Quality measures for nurse practitioner practice evaluation.

Science.gov (United States)

Kleinpell, Ruth; Kapu, April N

2017-08-01

Evaluating the impact of nurse practitioner (NP) practice has become a priority area of focus for demonstrating outcomes. A number of quality measures are available to enable practice-specific evaluation of NP roles and initiatives. This article reviews sources of quality measures that can be used to facilitate quantifying the outcomes of NP practice as part of an overall evaluation agenda. National resources and published literature on NP quality measures were reviewed. Various resources and toolkits exist to assist NPs in identifying outcomes of practice using quality measures. The need to demonstrate outcomes of NP practice remains an ongoing priority area regardless of the clinical practice setting. A variety of sources of quality measures exist that can be used to showcase the effect of NP care. The use of quality measures can be effectively integrated into evaluation of NP role and NP-directed initiatives to demonstrate impact, and enhance the conduct of an NP outcomes assessment. The use of organizational, NP-specific, and national-related quality measures can help to showcase how NP care improves the quality, safety, and costs of health care. ©2017 American Association of Nurse Practitioners.

Functional outcome measures in a surgical model of hip osteoarthritis in dogs.

Science.gov (United States)

Little, Dianne; Johnson, Stephen; Hash, Jonathan; Olson, Steven A; Estes, Bradley T; Moutos, Franklin T; Lascelles, B Duncan X; Guilak, Farshid

2016-12-01

The hip is one of the most common sites of osteoarthritis in the body, second only to the knee in prevalence. However, current animal models of hip osteoarthritis have not been assessed using many of the functional outcome measures used in orthopaedics, a characteristic that could increase their utility in the evaluation of therapeutic interventions. The canine hip shares similarities with the human hip, and functional outcome measures are well documented in veterinary medicine, providing a baseline for pre-clinical evaluation of therapeutic strategies for the treatment of hip osteoarthritis. The purpose of this study was to evaluate a surgical model of hip osteoarthritis in a large laboratory animal model and to evaluate functional and end-point outcome measures. Seven dogs were subjected to partial surgical debridement of cartilage from one femoral head. Pre- and postoperative pain and functional scores, gait analysis, radiographs, accelerometry, goniometry and limb circumference were evaluated through a 20-week recovery period, followed by histological evaluation of cartilage and synovium. Animals developed histological and radiographic evidence of osteoarthritis, which was correlated with measurable functional impairment. For example, Mankin scores in operated limbs were positively correlated to radiographic scores but negatively correlated to range of motion, limb circumference and 20-week peak vertical force. This study demonstrates that multiple relevant functional outcome measures can be used successfully in a large laboratory animal model of hip osteoarthritis. These measures could be used to evaluate relative efficacy of therapeutic interventions relevant to human clinical care.

Stability check source measurements with a secondary standard dosimeter in SSDL-Pakistan

International Nuclear Information System (INIS)

Salman, S.; Mahmoud, K.; Orfi, S.D.

1988-01-01

The stability check source is an integral part of a Secondary Standard Dosimetry System. The purpose of the stability check source is to confirm that the overall response of the dosimeter has not changed significantly since the instrument was calibrated. In case any change in the sensitivity of the ionization chamber or measuring assembly occurs the same is reflected in the reference check source measurements. Stability check source measurements are taken in a Primary Standard Dosimetry Laboratory (PSDL) at the time of calibration of secondary standard dosimeter and mean time (in seconds) to the reference setting of 50 scale divisions with ambient conditions of air at 20 deg. C, 101.3 kPa and 50% RH is quoted in a calibration certificate. This quoted stability check source time figure is the basis for future confirmation of overall response of the secondary standard dosimeter system. This note presents the results of stability check source measurements carried out in SSDL Pakistan over a period of five years

Treatment of Phonological Disorder: A Feasibility Study With Focus on Outcome Measures.

Science.gov (United States)

Smit, Ann Bosma; Brumbaugh, Klaire Mann; Weltsch, Barbara; Hilgers, Melanie

2018-02-20

In a feasibility study for a randomized controlled trial of treatments for phonological disorders conducted over a period of 8 months, we examined 6 clinically relevant outcome measures. We took steps to reduce error variance and to maximize systematic variance. Six children received traditional treatment (Van Riper, 1939), and 7 received expansion points (Smit, 2000), a treatment program with both phonological and traditional elements. Outcome measures, which were applied to both word list and conversational samples, included percentage of consonants correct (PCC; Shriberg & Kwiatkowski, 1982), PCC for late and/or difficult (L/D) consonants and number of L/D consonants acquired. In repeated-measures analyses of variance, all measures showed significant differences from pretreatment to posttreatment, and the word list measures were associated with very high power values. In analyses of covariance for between-groups contrasts, the adjusted expansion points mean exceeded the adjusted traditional treatment mean for every measure; however, no differences reached significance. For the L/D PCC (conversation) measure, the contrast between groups was associated with a large effect size. We recommend that practitioners use outcome measures related to a word list. We recommend that researchers consider using L/D PCC on the basis of conversational samples to detect differences among treatment groups. https://doi.org/10.23641/asha.5872677.

Low noise constant current source for bias dependent noise measurements

International Nuclear Information System (INIS)

Talukdar, D.; Bose, Suvendu; Bardhan, K. K.; Chakraborty, R. K.

2011-01-01

A low noise constant current source used for measuring the 1/f noise in disordered systems in ohmic as well as nonohmic regime is described. The source can supply low noise constant current starting from as low as 1 μA to a few tens of milliampere with a high voltage compliance limit of around 20 V. The constant current source has several stages, which can work in a standalone manner or together to supply the desired value of load current. The noise contributed by the current source is very low in the entire current range. The fabrication of a low noise voltage preamplifier modified for bias dependent noise measurements and based on the existing design available in the MAT04 data sheet is also described.

A gamma-source method of measuring soil moisture

International Nuclear Information System (INIS)

Al-Jeboori, M.A.; Ameen, I.A.

1986-01-01

Water content in soil column was measured using NaI scintillation detector 5 mci Cs-137 as a gamma source. The measurements were done with a back scatter gauge, restricted with scattering angle less to than /2 overcome the effect of soil type. A 3 cm air gap was maintained between the front of the detector and the wall of the soil container in order to increase the counting rate. The distance between the center of the source and the center of the back scattering detector was 14 cm. The accuracy of the measurements was 0.63. For comparision, a direct rays method was used to measure the soil moisture. The results gave an error of 0.65. Results of the two methods were compared with the gravimetric method which gave an error of 0.18 g/g and 0.17 g/g for direct and back method respectively. The quick direct method was used to determine the gravimetric and volumetric percentage constants, and were found to be 1.62 and 0.865 respectively. The method then used to measure the water content in the layers of soil column.(6 tabs., 4 figs., 12 refs.)

Proposed outcome measures for prospective clinical trials in juvenile idiopathic arthritis-associated uveitis

DEFF Research Database (Denmark)

Heiligenhaus, Arnd; Foeldvari, Ivan; Edelsten, Clive

2012-01-01

To develop a set of core outcome measures for use in randomized controlled trials (RCTs) and longitudinal observational studies in juvenile idiopathic arthritis (JIA)-associated uveitis.......To develop a set of core outcome measures for use in randomized controlled trials (RCTs) and longitudinal observational studies in juvenile idiopathic arthritis (JIA)-associated uveitis....

Calculated and measured brachytherapy dosimetry parameters in water for the Xoft Axxent X-Ray Source: An electronic brachytherapy source

International Nuclear Information System (INIS)

Rivard, Mark J.; Davis, Stephen D.; DeWerd, Larry A.; Rusch, Thomas W.; Axelrod, Steve

2006-01-01

A new x-ray source, the model S700 Axxent trade mark sign X-Ray Source (Source), has been developed by Xoft Inc. for electronic brachytherapy. Unlike brachytherapy sources containing radionuclides, this Source may be turned on and off at will and may be operated at variable currents and voltages to change the dose rate and penetration properties. The in-water dosimetry parameters for this electronic brachytherapy source have been determined from measurements and calculations at 40, 45, and 50 kV settings. Monte Carlo simulations of radiation transport utilized the MCNP5 code and the EPDL97-based mcplib04 cross-section library. Inter-tube consistency was assessed for 20 different Sources, measured with a PTW 34013 ionization chamber. As the Source is intended to be used for a maximum of ten treatment fractions, tube stability was also assessed. Photon spectra were measured using a high-purity germanium (HPGe) detector, and calculated using MCNP. Parameters used in the two-dimensional (2D) brachytherapy dosimetry formalism were determined. While the Source was characterized as a point due to the small anode size, P (5) were 0.20, 0.24, and 0.29 for the 40, 45, and 50 kV voltage settings, respectively. For 1 125 I and 103 Pd, yet with capability for variable and much higher dose rates and subsequently adjustable penetration capabilities. This paper presents the calculated and measured in-water brachytherapy dosimetry parameters for the model S700 Source at the aforementioned three operating voltages

Security measures in transport of radiation source in Jordan

Energy Technology Data Exchange (ETDEWEB)

Mohammad, Alslman [Korea Advanced Institute of Science and Technology, Kaist Daejeon (Korea, Republic of); Choi, Kwang Sik [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

2011-05-15

Radioactive materials are used in Jordan for peaceful applications in medicine, industry, agriculture, environmental science, education and research and military applications. Most of these radioactive sources used are imported, therefore trans-boundary movement is a significant factor in consideration of security measures during movement of these sources. After 11/9 2001 event, IAEA efforts began to focus and concentrate on security in transport of radioactive materials, after the emergence of risks of using these sources in terrorist activities. In 2002, Efforts were initiated by the IAEA to provide additional guidance for security in the transport of radioactive materials, based upon the new security requirements in the Recommendations on the Transport of Dangerous Goods. This paper reviews some of the measures relating to the transport of radioactive materials in Jordan

Retail price as an outcome measure for the effectiveness of drug law enforcement.

Science.gov (United States)

Bright, David A; Ritter, Alison

2010-09-01

One outcome measure of law enforcement effectiveness is the reduction in drug consumption which occurs as a result of law enforcement interventions. A theoretical relationship between drug consumption and retail price has promoted the use of retail price as a surrogate measure for consumption. In the current article, retail price is examined as a potential outcome measure for the effectiveness of law enforcement. The predictions regarding the relationship between law enforcement intensity and price are only partially supported by research. Explanations for the disconnect between the drug law enforcement activity and retail price include: rapid adaptation by market players, enforcement swamping, assumptions of rational actors, short-run versus long-run effects, structure of the illicit market, simultaneous changes that affect price in perverse ways, the role of violence in markets, and data limitations. Researchers who use retail price as an outcome measure need to take into account the complex relationship between drug law enforcement interventions and the retail price of illicit drugs. Viable outcome measures which can be used as complements to retail price are worth investigation. Copyright 2009 Elsevier B.V. All rights reserved.

Measuring quality of life in cleft lip and palate patients: currently available patient-reported outcomes measures.

Science.gov (United States)

Eckstein, Donna A; Wu, Rebecca L; Akinbiyi, Takintope; Silver, Lester; Taub, Peter J

2011-11-01

Patient-reported outcomes in cleft lip and palate treatment are critical for patient care. Traditional surgical outcomes focused on objective measures, such as photographs, anatomic measurements, morbidity, and mortality. Although these remain important, they leave many questions unanswered. Surveys that include aesthetics, speech, functionality, self-image, and quality of life provide more thorough outcomes assessment. It is vital that reliable, valid, and comprehensive questionnaires are available to craniofacial surgeons. The authors performed a literature review to identify questionnaires validated in cleft lip and palate patients. Qualifying instruments were assessed for adherence to guidelines for development and validation by the scientific advisory committee and for content. The authors identified 44 measures used in cleft lip and palate studies. After 15 ad hoc questionnaires, eight generic instruments, 11 psychiatric instruments, and one non-English language questionnaire were excluded, nine measures remained. Of these, four were never validated in the cleft population. Analysis revealed one craniofacial-specific measure (Youth Quality of Life-Facial Differences), two voice-related measures (Patient Voice-Related Quality of Life and Cleft Audit Protocol for Speech-Augmented), and two oral health-related measures (Child Oral Health Impact Profile and Child Oral Health Quality of Life). The Youth Quality of Life-Facial Differences, Child Oral Health Impact Profile, and Child Oral Health Quality of Life questionnaires were sufficiently validated. None was created specifically for clefts, resulting in content limitations. There is a lack of comprehensive, valid, and reliable questionnaires for cleft lip and palate surgery. For thorough assessment of satisfaction, further research to develop and validate cleft lip and palate surgery-specific instruments is needed.

A systematic review of measurement properties of patient reported outcome measures in psoriatic arthritis: A GRAPPA-OMERACT initiative.

Science.gov (United States)

Højgaard, Pil; Klokker, Louise; Orbai, Ana-Maria; Holmsted, Kim; Bartels, Else M; Leung, Ying Ying; Goel, Niti; de Wit, Maarten; Gladman, Dafna D; Mease, Philip; Dreyer, Lene; Kristensen, Lars E; FitzGerald, Oliver; Tillett, William; Gossec, Laure; Helliwell, Philip; Strand, Vibeke; Ogdie, Alexis; Terwee, Caroline B; Christensen, Robin

2018-04-01

An updated psoriatic arthritis (PsA) core outcome set (COS) for randomized controlled trials (RCTs) was endorsed at the Outcome Measures in Rheumatology (OMERACT) meeting in 2016. To synthesize the evidence on measurement properties of patient reported outcome measures (PROMs) for PsA and thereby contribute to development of a PsA core outcome measurement set (COMS) as described by the OMERACT Filter 2.0. A systematic literature search was performed in EMBASE, MEDLINE and PsycINFO on Jan 1, 2017 to identify full-text articles with an aim of assessing the measurement properties of PROMs in PsA. Two independent reviewers rated the quality of studies using the COnsensus based standards for the Selection of health Measurement INstruments (COSMIN) checklist, and performed a qualitative evidence synthesis. Fifty-five studies were included in the systematic review. Forty-four instruments and a total of 89 scales were analyzed. PROMs measuring COS domains with at least fair quality evidence for good validity and reliability (and no evidence for poor properties) included the Stockerau Activity Score for PsA (German), Psoriasis Symptom Inventory, visual analogue scale for Patient Global, 36 Item Short Form Health Survey Physical Function subscale, Health Assessment Questionnaire Disability Index, Bath Ankylosing Spondylitis Functional Index, PsA Impact of Disease questionnaire, PsA Quality of Life questionnaire, VITACORA-19, Functional Assessment of Chronic Illness Therapy Fatigue scale and Social Role Participation Questionnaire. At least one PROM with some evidence for aspects of validity and reliability was available for six of the eight mandatory domains of the PsA COS. Copyright © 2018 Elsevier Inc. All rights reserved.

Outcome measures and definition of cure in female stress urinary incontinence surgery: a survey of recent publications.

Science.gov (United States)

Castillo, Peter A; Espaillat-Rijo, Luis M; Davila, G Willy

2010-03-01

Much variability exists in outcome measures used to report success of SUI surgery. We set out to evaluate outcome measures and definitions of cure in SUI surgery studies. Outcome measures, success rates, and definition of cure were analyzed from published series and compared to recommendations by leading authorities. Ninety-one publications were analyzed. Thirty (33%) utilized solely subjective measures, four (4%) utilized only objective measures, and 57 (63%) included both. Sixty-one (67%) used symptom questionnaires, 56 (60%) QOL questionnaires, and six (7%) visual analog scale. Twelve (13%) used voiding diaries and 52 (56%) used self-reporting as an outcome measure. Objective measures: 52 (57%) cough stress test, 37 (41%) urodynamic evaluation, 28 (31%) pad testing and a combination in 33 (36%). Few studies adhered to one set of outcome recommendations. Outcome measures used to evaluate success of anti-incontinence procedures lack consensus and comparability.

Developing a General Outcome Measure Off Growth in Social Skills for Infants and Toddlers

Science.gov (United States)

Carta, Judith; Greenwood, Charles; Luze, Gayle; Cline, Gabriel; Kuntz, Susan

2004-01-01

Proficiency in social interaction with adults and peers is an important outcome in early childhood. The development of an experimental measure for assessing growth in social skills in children birth to 3 years is described. Based on the general outcome measurement (GOM) approach (e.g., Deno, 1997), the measure is intended for use by early…

Developing a General Outcome Measure of Growth in Social Skills for Infants and Toddlers

Science.gov (United States)

Carta, Judith; Greenwood, Charles; Luze, Gayle; Cline, Gabriel; Kuntz, Susan

2004-01-01

Proficiency in social interaction with adults and peers is an important outcome in early childhood. The development of an experimental measure for assessing growth in social skills in children birth to 3 years is described. Based on the general outcome measurement (GOM) approach (e.g., Deno, 1997), the measure is intended for use by early…

Development of the FOCUS (Focus on the Outcomes of Communication under Six), a Communication Outcome Measure for Preschool Children

Science.gov (United States)

Thomas-Stonell, Nancy L.; Oddson, Bruce; Robertson, Bernadette; Rosenbaum, Peter L.

2010-01-01

Aim: Our aim was to develop an outcome measure, called Focus on the Outcomes of Communication Under Six (FOCUS), that captures real-world changes in preschool children's communication. Conceptually grounded in the World Health Organization International Classification of Functioning, Disability and Health framework, the FOCUS items were derived…

Using Cross-Cultural Dimensions Exercises to Improve and Measure Learning Outcomes in International Business Courses

Science.gov (United States)

Zainuba, Mohamed; Rahal, Ahmad

2012-01-01

This article proposes an approach for using cross-cultural dimensions exercises to improve and measure learning outcomes in international business courses. The following key issues are highlighted: (a) what are the targeted learning outcomes to be assessed, (b) how to measure the accomplishment of these learning outcomes, (c) the input measures…

Measure for measure. Outcome assessment of arthritis treatment in clinical practice

OpenAIRE

Gülfe, Anders

2009-01-01

Objective: To investigate (i) the performance and agreement between various activity indices and response criteria in TNF-blockade of RA; (ii) the predictive ability of different response criteria and disease activity states regarding continuation of anti-TNF treatment of RA; (iii) Euro-QoL-5-dimensions utility development during TNF blockade of RA, PsA and SpA. Also, (iv) to develop a simple, utility-based outcome measure, the number needed to treat per quality adjusted life year gained (NN...

Orphan Sources and Fresh Fallout: Virtual Exercise in Mobile Measurement (ORPEX)

International Nuclear Information System (INIS)

Dowdall, M.; Smethurst, M.A.; Andersson, K.; Aage, H.K.; Palsson, S.E.

2011-10-01

In recent years carborne gamma spectrometry has expanded from its role as a geological survey platform to serving as a useful asset in the field of emergency response to radiological and nuclear situations. Its two main applications are searching for orphan sources and for surveying in the aftermath of an accident involving the release of radioactive materials. Despite this expansion, the opportunities for gaining practical experience in the field are limited by cost considerations and practicability. These limitations are exacerbated by the fact that data generated and displayed in the field differ significantly from gamma spectral data generated in a laboratory environment. As a means of exercising existing emergency measuring/surveying capability and introducing carborne measurements to a larger group, a virtual exercise was devised. The exercise ORPEX (Orphan Sources and Fresh Fallout Virtual Exercise in Mobile Measurement) featured two typical emergency scenarios in which carborne measuring systems might be deployed: firstly a search for multiple orphan sources and secondly surveying to delineate patchy fallout from a local release point. In the first scenario, synthetic spectral data were generated for imaginary point sources and inserted into genuine carborne measurements from in the Trondheim area of Norway. Participants were presented with a typical software tool and data in a range of typical formats and asked to report the source locations and isotopes within a time limit. In the second scenario, synthetic spectral data representing fallout from a local fire involving radioactive material were added to real carborne data from the Trondheim area. Participants were asked to produce maps that identify and characterise the regions of contamination within the same time limit. Fourteen individual organisations from seven different countries supplied results. Results from participants indicate that for strong sources of isotopes with simple spectra featuring

Orphan Sources and Fresh Fallout: Virtual Exercise in Mobile Measurement (ORPEX)

Energy Technology Data Exchange (ETDEWEB)

Dowdall, M. (Norwegian Radiation Protection Authority, OEsteraas (Norway)); Smethurst, M.A. (Univ. of Exeter and Avalonia Geophysics, Cornwall Campus, Penryn (United Kingdom)); Andersson, K. (Technical Univ. of Denmark. Risoe National Lab. for Sustainable Energy, Roskilde (Denmark)); Aage, H.K. (Danish Emergency Management Agency, Birkeroed (Denmark)); Palsson, S.E. (Icelandic Radiation Protection Institute, Reykjavik (Iceland))

2011-10-15

In recent years carborne gamma spectrometry has expanded from its role as a geological survey platform to serving as a useful asset in the field of emergency response to radiological and nuclear situations. Its two main applications are searching for orphan sources and for surveying in the aftermath of an accident involving the release of radioactive materials. Despite this expansion, the opportunities for gaining practical experience in the field are limited by cost considerations and practicability. These limitations are exacerbated by the fact that data generated and displayed in the field differ significantly from gamma spectral data generated in a laboratory environment. As a means of exercising existing emergency measuring/surveying capability and introducing carborne measurements to a larger group, a virtual exercise was devised. The exercise ORPEX (Orphan Sources and Fresh Fallout Virtual Exercise in Mobile Measurement) featured two typical emergency scenarios in which carborne measuring systems might be deployed: firstly a search for multiple orphan sources and secondly surveying to delineate patchy fallout from a local release point. In the first scenario, synthetic spectral data were generated for imaginary point sources and inserted into genuine carborne measurements from in the Trondheim area of Norway. Participants were presented with a typical software tool and data in a range of typical formats and asked to report the source locations and isotopes within a time limit. In the second scenario, synthetic spectral data representing fallout from a local fire involving radioactive material were added to real carborne data from the Trondheim area. Participants were asked to produce maps that identify and characterise the regions of contamination within the same time limit. Fourteen individual organisations from seven different countries supplied results. Results from participants indicate that for strong sources of isotopes with simple spectra featuring

On-line measurement of microwave power in ECR ion source

International Nuclear Information System (INIS)

Zhou Changgeng; Kang Wu; Hu Yonghong; Li Yan; Lou Benchao; Zu Xiulan; Xiong Riheng; Chen Junguang; Li Xiaoyun

2005-01-01

It is a new technology to apply an ECR ion source to the neutron generator. Because of the structure limitation, working state of the ECR ion source could not be judged by the color of gas discharging in discharge chamber. Therefore, it was hard to estimate if the ECR ion source was working properly in the neutron generator. The method to resolve the problem was described in this paper. The microwave power was measured on-line by a directional coupler and a small microwave power meter. The ion beam current could be educed from the measured incidence microwave power, and discharge state in discharge chamber could be determined. (authors)

The uses of outcome measures within multidisciplinary early childhood intervention services: a systematic review.

Science.gov (United States)

Calder, Samuel; Ward, Roslyn; Jones, Megan; Johnston, Jenelle; Claessen, Mary

2017-07-18

Purpose of the article: To review the use of outcome measures, across the domains of activity, participation, and environment, within multidisciplinary early childhood intervention services. A systematic literature search was undertaken that included four electronic databases: Medline, CINAHL, EMBASE, and the Cochrane Library and Cochrane Database of Systematic Review. Inclusion criteria were age 0-24 months, having or at risk of a developmental disability, in receipt of multidisciplinary early childhood intervention services, and included outcome measures across all domains of the International Classification of Functioning-Child & Youth (ICF-CY). Only peer-reviewed journal articles were considered. Eligible studies were coded using the Oxford Levels of Evidence. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) Scale for randomised controlled trials and the QualSyst for non-randomised control trials. Of the total of 5764 records identified, 10 were considered to meet inclusion criteria. Fourteen outcome measures were identified, addressing the domains of activity, participation, and environment. Of these, eight have been recommended in the early intervention literature. While the methodological quality of the 10 studies varied, these papers make a contribution to the body of research that acknowledges the role of routine and enriched environments. Implications for Rehabilitation Core practice elements of multidisciplinary early childhood intervention services indicate it is necessary to select outcome measures framed within the International Classification of Functioning-Child & Youth to inform clinical decision-making for measuring intervention effectiveness across the domains of activity, participation and environment. Of the identified measures, three (Canadian Occupational Performance Measure, Pediatric Evaluation of Disability Inventory, and Goal Attainment Scaling) are well-established and identified in the literature as

Preparation of protactinium measurement source by electroplating method

International Nuclear Information System (INIS)

Li Zongwei; Yang Weifan; Fang Keming; Yuan Shuanggui; Guo Junsheng; Pan Qiangyan

1998-01-01

An electroplating method for the preparation of Pa sources is described, and the main factors (such as pH value of solution, electroplating time and current density) influencing the electroplating of Pa are tested and discussed with 233 Pa as a tracer. A thin and uniform electroplating Pa-Layer of 1 mg/cm 2 thick on thin stainless steel disk was obtained. The Pa source was measured by a HPGe detector to determine the chemical efficiency

Evaluating measurements of carbon dioxide emissions using a precision source--A natural gas burner.

Science.gov (United States)

Bryant, Rodney; Bundy, Matthew; Zong, Ruowen

2015-07-01

A natural gas burner has been used as a precise and accurate source for generating large quantities of carbon dioxide (CO2) to evaluate emissions measurements at near-industrial scale. Two methods for determining carbon dioxide emissions from stationary sources are considered here: predicting emissions based on fuel consumption measurements-predicted emissions measurements, and direct measurement of emissions quantities in the flue gas-direct emissions measurements. Uncertainty for the predicted emissions measurement was estimated at less than 1%. Uncertainty estimates for the direct emissions measurement of carbon dioxide were on the order of ±4%. The relative difference between the direct emissions measurements and the predicted emissions measurements was within the range of the measurement uncertainty, therefore demonstrating good agreement. The study demonstrates how independent methods are used to validate source emissions measurements, while also demonstrating how a fire research facility can be used as a precision test-bed to evaluate and improve carbon dioxide emissions measurements from stationary sources. Fossil-fuel-consuming stationary sources such as electric power plants and industrial facilities account for more than half of the CO2 emissions in the United States. Therefore, accurate emissions measurements from these sources are critical for evaluating efforts to reduce greenhouse gas emissions. This study demonstrates how a surrogate for a stationary source, a fire research facility, can be used to evaluate the accuracy of measurements of CO2 emissions.

Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting.

Science.gov (United States)

Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

2012-09-01

The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes research. In June 2011, the HOME initiative conducted a consensus study involving 43 individuals from 10 countries, representing different stakeholders (patients, clinicians, methodologists, pharmaceutical industry) to determine core outcome domains for atopic eczema trials, to define quality criteria for atopic eczema outcome measures and to prioritize topics for atopic eczema outcomes research. Delegates were given evidence-based information, followed by structured group discussion and anonymous consensus voting. Consensus was achieved to include clinical signs, symptoms, long-term control of flares and quality of life into the core set of outcome domains for atopic eczema trials. The HOME initiative strongly recommends including and reporting these core outcome domains as primary or secondary endpoints in all future atopic eczema trials. Measures of these core outcome domains need to be valid, sensitive to change and feasible. Prioritized topics of the HOME initiative are the identification/development of the most appropriate instruments for the four core outcome domains. HOME is open to anyone with an interest in atopic eczema outcomes research. © 2012 John Wiley & Sons A/S.

Heterogeneity of wound outcome measures in RCTs of treatments for VLUs: a systematic review.

Science.gov (United States)

Gethin, G; Killeen, F; Devane, D

2015-05-01

Venous leg ulcers (VLUs) affect up to 4% of the population aged over 65 years. Outcomes of randomised controlled trials (RCTs) in VLUs are important to guide clinical and resource decision making. Our objective was to identify what endpoints and wound bed outcomes were assessed in RCTs in VLUs; how these were assessed and what reference was made to validity and reliability of methods used. A systematic review of all full text RCTs, published in English, from 1998-2013. Our criteria were met by 102 studies. There were 78 different endpoints recorded, the majority (n=34) related to healing and were evaluated at 12 different times points. Size was the most frequently reported outcome measure (n=99), with photographs, tissue type, exudate, odour and pain also recorded. There was poor reporting of methods used to assess outcomes. Visual analogue scales predominated as a method of assessment, but 95% of studies made no reference to the validity or reliability of assessment methods. Future research in VLUs requires standards for measuring outcomes with acceptable inter-rater reliability and validated measures of patient-reported outcomes.

Functional outcome measures in a surgical model of hip osteoarthritis in dogs

OpenAIRE

Little, Dianne; Johnson, Stephen; Hash, Jonathan; Olson, Steven A.; Estes, Bradley T.; Moutos, Franklin T.; Lascelles, B. Duncan X.; Guilak, Farshid

2016-01-01

Background The hip is one of the most common sites of osteoarthritis in the body, second only to the knee in prevalence. However, current animal models of hip osteoarthritis have not been assessed using many of the functional outcome measures used in orthopaedics, a characteristic that could increase their utility in the evaluation of therapeutic interventions. The canine hip shares similarities with the human hip, and functional outcome measures are well documented in veterinary medicine, pr...

Psychometric properties of the Spanish version of the Clinical Outcomes in Routine Evaluation – Outcome Measure

Directory of Open Access Journals (Sweden)

Trujillo A

2016-06-01

Full Text Available Adriana Trujillo,1,2 Guillem Feixas,1,2 Arturo Bados,1 Eugeni García-Grau,1 Marta Salla,1 Joan Carles Medina,1 Adrián Montesano,1,2 José Soriano,3 Leticia Medeiros-Ferreira,4 Josep Cañete,5 Sergi Corbella,6 Antoni Grau,7 Fernando Lana,8 Chris Evans9 1Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology, 2Institute for Brain, Cognition and Behaviour, University of Barcelona, 3Hospital of the Holy Cross and Saint Paul, 4Nou Barris Mental Health Center, Barcelona, 5Hospital of Mataró, Sanitary Consortium of Maresme, Mataró, 6FPCEE, Blanquerna, Universitat Ramon Llull, 7Institute of Eating Disorders, Barcelona, 8MAR Health Park, CAEMIL, Santa Coloma de Gramenet, Spain; 9East London NHS Foundation Trust, NPDDNet, London, UK Objective: The objective of this paper is to assess the reliability and validity of the Spanish translation of the Clinical Outcomes in Routine Evaluation – Outcome Measure, a 34-item self-report questionnaire that measures the client’s status in the domains of Subjective well-being, Problems/Symptoms, Life functioning, and Risk.Method: Six hundred and forty-four adult participants were included in two samples: the clinical sample (n=192 from different mental health and primary care centers; and the nonclinical sample (n=452, which included a student and a community sample.Results: The questionnaire showed good acceptability and internal consistency, appropriate test–retest reliability, and acceptable convergent validity. Strong differentiation between clinical and nonclinical samples was found. As expected, the Risk domain had different characteristics than other domains, but all findings were comparable with the UK referential data. Cutoff scores were calculated for clinical significant change assessment.Conclusion: The Spanish version of the Clinical Outcomes in Routine Evaluation – Outcome Measure showed acceptable psychometric properties, providing support for using the

Psychometrics of the Personal Questionnaire: A client-generated outcome measure.

Science.gov (United States)

Elliott, Robert; Wagner, John; Sales, Célia M D; Rodgers, Brian; Alves, Paula; Café, Maria J

2016-03-01

We present a range of evidence for the reliability and validity of data generated by the Personal Questionnaire (PQ), a client-generated individualized outcome measure, using 5 data sets from 3 countries. Overall pretherapy mean internal consistency (alpha) across clients was .80, and within-client alphas averaged .77; clients typically had 1 or 2 items that did not vary with the other items. Analyses of temporal structure indicated high levels of between-clients variance (58%), moderate pretherapy test-retest correlation (r = .57), and high session-to-session Lag-1 autocorrelation (.82). Scores on the PQ provided clear evidence of convergence with a range of outcome measures (within-client r = .41). Mean pre-post effects were large (d = 1.25). The results support a revised caseness cutoff of 3.25 and a reliable change index interval of 1.67. We conclude that PQ data meet criteria for evidence-based, norm-referenced measurement of client psychological distress for supporting psychotherapy practice and research. (c) 2016 APA, all rights reserved).

Comparison of reliability and responsiveness of patient-reported clinical outcome measures in knee osteoarthritis rehabilitation.

Science.gov (United States)

Williams, Valerie J; Piva, Sara R; Irrgang, James J; Crossley, Chad; Fitzgerald, G Kelley

2012-08-01

Secondary analysis, pretreatment-posttreatment observational study. To compare the reliability and responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Knee Outcome Survey activities of daily living subscale (KOS-ADL), and the Lower Extremity Functional Scale (LEFS) in individuals with knee osteoarthritis (OA). The WOMAC is the current standard in patient-reported measures of function in patients with knee OA. The KOS-ADL and LEFS were designed for potential use in patients with knee OA. If the KOS-ADL and LEFS are to be considered viable alternatives to the WOMAC for measuring patient-reported function in individuals with knee OA, they should have measurement properties comparable to the WOMAC. It would also be important to determine whether either of these instruments may be superior to the WOMAC in terms of reliability or responsiveness in this population. Data from 168 subjects with knee OA, who participated in a rehabilitation program, were used in the analyses. Reliability and responsiveness of each outcome measure were estimated at follow-ups of 2, 6, and 12 months. Reliability was estimated by calculating the intraclass correlation coefficient (ICC2,1) for subjects who were unchanged in status from baseline at each follow-up time, based on a global rating of change score. To examine responsiveness, the standard error of the measurement, minimal detectable change, minimal clinically important difference, and the Guyatt responsiveness index were calculated for each outcome measure at each follow-up time. All 3 outcome measures demonstrated reasonable reliability and responsiveness to change. Reliability and responsiveness tended to decrease somewhat with increasing follow-up time. There were no substantial differences between outcome measures for reliability or any of the 3 measures of responsiveness at any follow-up time. The results do not indicate that one outcome measure is more reliable or responsive than

Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting

NARCIS (Netherlands)

Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F.; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

2012-01-01

The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes

Towards global consensus on outcome measures for atopic eczema research : Results of the HOME II meeting

NARCIS (Netherlands)

Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes

Comparative study of outcome measures and analysis methods for traumatic brain injury trials.

Science.gov (United States)

Alali, Aziz S; Vavrek, Darcy; Barber, Jason; Dikmen, Sureyya; Nathens, Avery B; Temkin, Nancy R

2015-04-15

Batteries of functional and cognitive measures have been proposed as alternatives to the Extended Glasgow Outcome Scale (GOSE) as the primary outcome for traumatic brain injury (TBI) trials. We evaluated several approaches to analyzing GOSE and a battery of four functional and cognitive measures. Using data from a randomized trial, we created a "super" dataset of 16,550 subjects from patients with complete data (n=331) and then simulated multiple treatment effects across multiple outcome measures. Patients were sampled with replacement (bootstrapping) to generate 10,000 samples for each treatment effect (n=400 patients/group). The percentage of samples where the null hypothesis was rejected estimates the power. All analytic techniques had appropriate rates of type I error (≤5%). Accounting for baseline prognosis either by using sliding dichotomy for GOSE or using regression-based methods substantially increased the power over the corresponding analysis without accounting for prognosis. Analyzing GOSE using multivariate proportional odds regression or analyzing the four-outcome battery with regression-based adjustments had the highest power, assuming equal treatment effect across all components. Analyzing GOSE using a fixed dichotomy provided the lowest power for both unadjusted and regression-adjusted analyses. We assumed an equal treatment effect for all measures. This may not be true in an actual clinical trial. Accounting for baseline prognosis is critical to attaining high power in Phase III TBI trials. The choice of primary outcome for future trials should be guided by power, the domain of brain function that an intervention is likely to impact, and the feasibility of collecting outcome data.

Methane source identification in Boston, Massachusetts using isotopic and ethane measurements

Science.gov (United States)

Down, A.; Jackson, R. B.; Plata, D.; McKain, K.; Wofsy, S. C.; Rella, C.; Crosson, E.; Phillips, N. G.

2012-12-01

Methane has substantial greenhouse warming potential and is the principle component of natural gas. Fugitive natural gas emissions could be a significant source of methane to the atmosphere. However, the cumulative magnitude of natural gas leaks is not yet well constrained. We used a combination of point source measurements and ambient monitoring to characterize the methane sources in the Boston urban area. We developed distinct fingerprints for natural gas and multiple biogenic methane sources based on hydrocarbon concentration and isotopic composition. We combine these data with periodic measurements of atmospheric methane and ethane concentration to estimate the fractional contribution of natural gas and biogenic methane sources to the cumulative urban methane flux in Boston. These results are used to inform an inverse model of urban methane concentration and emissions.

Positive psychology outcome measures for family caregivers of people living with dementia: a systematic review.

Science.gov (United States)

Stansfeld, Jacki; Stoner, Charlotte R; Wenborn, Jennifer; Vernooij-Dassen, Myrra; Moniz-Cook, Esme; Orrell, Martin

2017-08-01

Family caregivers of people living with dementia can have both positive and negative experiences of caregiving. Despite this, existing outcome measures predominately focus on negative aspects of caregiving such as burden and depression. This review aimed to evaluate the development and psychometric properties of existing positive psychology measures for family caregivers of people living with dementia to determine their potential utility in research and practice. A systematic review of positive psychology outcome measures for family caregivers of people with dementia was conducted. The databases searched were as follows: PsychINFO, CINAHL, MEDLINE, EMBASE, and PubMed. Scale development papers were subject to a quality assessment to appraise psychometric properties. Twelve positive outcome measures and six validation papers of these scales were identified. The emerging constructs of self-efficacy, spirituality, resilience, rewards, gain, and meaning are in line with positive psychology theory. There are some robust positive measures in existence for family caregivers of people living with dementia. However, lack of reporting of the psychometric properties hindered the quality assessment of some outcome measures identified in this review. Future research should aim to include positive outcome measures in interventional research to facilitate a greater understanding of the positive aspects of caregiving and how these contribute to well-being.

The quality of systematic reviews of health-related outcome measurement instruments.

Science.gov (United States)

Terwee, C B; Prinsen, C A C; Ricci Garotti, M G; Suman, A; de Vet, H C W; Mokkink, L B

2016-04-01

Systematic reviews of outcome measurement instruments are important tools for the selection of instruments for research and clinical practice. Our aim was to assess the quality of systematic reviews of health-related outcome measurement instruments and to determine whether the quality has improved since our previous study in 2007. A systematic literature search was performed in MEDLINE and EMBASE between July 1, 2013, and June 19, 2014. The quality of the reviews was rated using a study-specific checklist. A total of 102 reviews were included. In many reviews the search strategy was considered not comprehensive; in only 59 % of the reviews a search was performed in EMBASE and in about half of the reviews there was doubt about the comprehensiveness of the search terms used for type of measurement instruments and measurement properties. In 41 % of the reviews, compared to 30 % in our previous study, the methodological quality of the included studies was assessed. In 58 %, compared to 55 %, the quality of the included instruments was assessed. In 42 %, compared to 7 %, a data synthesis was performed in which the results from multiple studies on the same instrument were somehow combined. Despite a clear improvement in the quality of systematic reviews of outcome measurement instruments in comparison with our previous study in 2007, there is still room for improvement with regard to the search strategy, and especially the quality assessment of the included studies and the included instruments, and the data synthesis.

Measuring mental health and wellbeing outcomes for children and adolescents to inform practice and policy: a review of child self-report measures.

Science.gov (United States)

Deighton, Jessica; Croudace, Tim; Fonagy, Peter; Brown, Jeb; Patalay, Praveetha; Wolpert, Miranda

2014-01-01

There is a growing appetite for mental health and wellbeing outcome measures that can inform clinical practice at individual and service levels, including use for local and national benchmarking. Despite a varied literature on child mental health and wellbeing outcome measures that focus on psychometric properties alone, no reviews exist that appraise the availability of psychometric evidence and suitability for use in routine practice in child and adolescent mental health services (CAMHS) including key implementation issues. This paper aimed to present the findings of the first review that evaluates existing broadband measures of mental health and wellbeing outcomes in terms of these criteria. The following steps were implemented in order to select measures suitable for use in routine practice: literature database searches, consultation with stakeholders, application of inclusion and exclusion criteria, secondary searches and filtering. Subsequently, detailed reviews of the retained measures' psychometric properties and implementation features were carried out. 11 measures were identified as having potential for use in routine practice and meeting most of the key criteria: 1) Achenbach System of Empirically Based Assessment, 2) Beck Youth Inventories, 3) Behavior Assessment System for Children, 4) Behavioral and Emotional Rating Scale, 5) Child Health Questionnaire, 6) Child Symptom Inventories, 7) Health of the National Outcome Scale for Children and Adolescents, 8) Kidscreen, 9) Pediatric Symptom Checklist, 10) Strengths and Difficulties Questionnaire, 11) Youth Outcome Questionnaire. However, all existing measures identified had limitations as well as strengths. Furthermore, none had sufficient psychometric evidence available to demonstrate that they could reliably measure both severity and change over time in key groups. The review suggests a way of rigorously evaluating the growing number of broadband self-report mental health outcome measures against

[Patient evaluation and outcome measures].

Science.gov (United States)

Nieto Pol, Enrique

2014-01-01

Both the initial evaluation and follow-up of patients with osteoarthritis require systematic evaluation of the indicators that provide information on the degree of involvement of the disease and allow its quantification. Reliable measures of disease progression help decision-making by clinicians and provide valid information on treatment response and the effectiveness of the distinct therapeutic interventions. The instruments recommended in research, as outcome measures in osteoarthritis, are pain evaluation, assessment of physical function, and self-reported global evaluation. In studies lasting more than 1 year, structural changes are evaluated through simple X-ray. Self-reported quality of life assessment and physician global assessment are also recommended as options. These indicators should be incorporated into routine clinical practice for adequate evaluation and correct follow-up of patients with osteoarthritis. The recommended pain evaluation method for use in clinical practice is the visual analog scale (VAS). The best instrument to evaluate physical function in patients with hip or knee osteoarthritis is the WOMAC scale (Western Ontario and McMaster Universities Osteoarthritis Index). For patient-reported global assessment in routine practice, the recommended scales are VAS or the SF-12 (12-item short-form health survey). Copyright © 2014 Elsevier España, S.L. All rights reserved.

Development and validation of MyLifeTracker: a routine outcome measure for youth mental health

Directory of Open Access Journals (Sweden)

Kwan B

2018-04-01

Full Text Available Benjamin Kwan,1 Debra J Rickwood,1,2 Nic R Telford2 1Faculty of Health, University of Canberra, Bruce, ACT, 2headspace National Youth Mental Health Foundation, Melbourne, VIC, Australia Purpose: Routine outcome measures are now being designed for session-by-session use, with emphasis on clinically meaningful items and sensitivity to change. Despite an increasing mental health service focus for young people aged 12–25 years, there is a lack of outcome measures that are designed to be used across this age group. Consequently, MyLifeTracker (MLT was developed as a brief mental health outcome measure designed for young people for routine use. It consists of the following five items targeting areas of importance to young people: general well-being, day-to-day activities, relationships with friends, relationships with family, and general coping. Participants and methods: The measure was tested with 75,893 young people aged 12–25 years attending headspace centers across Australia for mental health-related issues. Results: MLT showed a robust unidimensional factor structure and appropriate reliability. It exhibited good concurrent validity against well-validated measures of psychological distress, well-being, functioning, and life satisfaction. The measure was further demonstrated to be sensitive to change. Conclusion: MLT provides a psychometrically sound mental health outcome measure for young people. The measure taps into items that are meaningful to young people and provides an additional clinical support tool for clinicians and clients during therapy. The measure is brief and easy to use and has been incorporated into an electronic system that routinely tracks session-by-session change and produces time-series charts for the ease of use and interpretation. Keywords: MyLifeTracker, youth mental health, routine outcome measure, routine outcome monitoring, adolescent and young adult

Engaging the hearts and minds of clinicians in outcome measurement - the UK Rehabilitation Outcomes Collaborative approach.

Science.gov (United States)

Turner-Stokes, Lynne; Williams, Heather; Sephton, Keith; Rose, Hilary; Harris, Sarah; Thu, Aung

2012-01-01

This article explores the rationale for choosing the instruments included within the UK Rehabilitation Outcomes Collaborative (UKROC) data set. Using one specialist neuro-rehabilitation unit as an exemplar service, it describes an approach to engaging the hearts and minds of clinicians in recording the data. Measures included within a national data set for rehabilitation should be psychometrically robust and feasible to use in routine clinical practice; they should also support clinical decision-making so that clinicians actually want to use them. Learning from other international casemix models and benchmarking data sets, the UKROC team has developed a cluster of measures to inform the development of effective and cost-efficient rehabilitation services. These include measures of (1) "needs" for rehabilitation (complexity), (2) inputs provided to meet those needs (nursing and therapy intervention), and (3) outcome, including the attainment of personal goals as well as gains in functional independence. By integrating the use of the data set measures in everyday clinical practice, we have achieved a very high rate of compliance with data collection. However, staff training and ongoing commitment from senior staff and managers are critical to the maintenance of effort required to provide assurance of data quality in the longer term.

Distributed 3D Source Localization from 2D DOA Measurements Using Multiple Linear Arrays

Directory of Open Access Journals (Sweden)

Antonio Canclini

2017-01-01

Full Text Available This manuscript addresses the problem of 3D source localization from direction of arrivals (DOAs in wireless acoustic sensor networks. In this context, multiple sensors measure the DOA of the source, and a central node combines the measurements to yield the source location estimate. Traditional approaches require 3D DOA measurements; that is, each sensor estimates the azimuth and elevation of the source by means of a microphone array, typically in a planar or spherical configuration. The proposed methodology aims at reducing the hardware and computational costs by combining measurements related to 2D DOAs estimated from linear arrays arbitrarily displaced in the 3D space. Each sensor measures the DOA in the plane containing the array and the source. Measurements are then translated into an equivalent planar geometry, in which a set of coplanar equivalent arrays observe the source preserving the original DOAs. This formulation is exploited to define a cost function, whose minimization leads to the source location estimation. An extensive simulation campaign validates the proposed approach and compares its accuracy with state-of-the-art methodologies.

Patient-reported outcome measures in arthroplasty registries

DEFF Research Database (Denmark)

Rolfson, Ola; Bohm, Eric; Franklin, Patricia

2016-01-01

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

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

Science.gov (United States)

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

2018-05-09

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

Use of continuous glucose monitoring as an outcome measure in clinical trials.

Science.gov (United States)

Beck, Roy W; Calhoun, Peter; Kollman, Craig

2012-10-01

Although developed to be a management tool for individuals with diabetes, continuous glucose monitoring (CGM) also has potential value for the assessment of outcomes in clinical studies. We evaluated using CGM as such an outcome measure. Data were analyzed from six previously completed inpatient studies in which both CGM (Freestyle Navigator™ [Abbott Diabetes Care, Alameda, CA] or Guardian(®) [Medtronic, Northridge, CA]) and reference glucose measurements were available. The analyses included 97 days of data from 93 participants with type 1 diabetes (age range, 5-57 years; mean, 18 ± 12 years). Mean glucose levels per day were similar for the CGM and reference measurements (median, 148 mg/dL vs. 143 mg/dL, respectively; P = 0.92), and the correlation of the two was high (r = 0.89). Similarly, most glycemia metrics showed no significant differences comparing CGM and reference values, except that the nadir glucose tended to be slightly lower and peak glucose slightly higher with reference measurements than CGM measurements (respective median, 59 mg/dL vs. 66 mg/dL [P = 0.05] and 262 mg/dL vs. 257 mg/dL [P = 0.003]) and glucose variability as measured with the coefficient of variation was slightly lower with CGM than reference measurements (respective median, 31% vs. 35%; Pblood glucose measurements. CGM inaccuracy and underestimation of the extremes of hyperglycemia and hypoglycemia can be accounted for in a clinical trial's study design. Thus, in appropriate settings, CGM can be a very meaningful and feasible outcome measure for clinical trials.

a locally adapted functional outcome measurement score for total

African Journals Online (AJOL)

Results and success of total hip arthroplasty are often measured using a functional outcome scoring system. Most current scores were developed in Europe and. North America (1-3). During the evaluation of a Total. Hip Replacement (THR) project in Ouagadougou,. Burkina Faso (4) it was felt that these scores were not.

Ion implanted Na22 source for positron lifetime measurements

International Nuclear Information System (INIS)

Fluss, M.J.; Smedeskjaer, L.C.

1979-04-01

A new positron source-sample fabrication technique, intended for high temperature positron annihilation measurements, was developed. The method makes use of a mass separator to implant pure Na 22 into the sample surface. The application of this technique to Cu is described. A brief discussion of the origin of the source component is given, and different possibilities of correcting for it are pointed out. 3 references

Framework of outcome measures recommended for use in the evaluation of childhood obesity treatment interventions: the CoOR framework.

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Bryant, M; Ashton, L; Nixon, J; Jebb, S; Wright, J; Roberts, K; Brown, J

2014-12-01

Consensus is lacking in determining appropriate outcome measures for assessment of childhood obesity treatments. Inconsistency in the use and reporting of such measures impedes comparisons between treatments and limits consideration of effectiveness. This study aimed to produce a framework of recommended outcome measures: the Childhood obesity treatment evaluation Outcomes Review (CoOR) framework. A systematic review including two searches was conducted to identify (1) existing trial outcome measures and (2) manuscripts describing development/evaluation of outcome measures. Outcomes included anthropometry, diet, eating behaviours, physical activity, sedentary time/behaviour, fitness, physiology, environment, psychological well-being and health-related quality of life. Eligible measures were appraised by the internal team using a system developed from international guidelines, followed by appraisal from national external expert collaborators. A total of 25,486 papers were identified through both searches. Eligible search 1 trial papers cited 417 additional papers linked to outcome measures, of which 56 were eligible. A further 297 outcome development/evaluation papers met eligibility criteria from search 2. Combined, these described 191 outcome measures. After internal and external appraisal, 52 measures across 10 outcomes were recommended for inclusion in the CoOR framework. Application of the CoOR framework will ensure greater consistency in choosing robust outcome measures that are appropriate to population characteristics. © 2014 The Authors. Pediatric Obesity © 2014 International Association for the Study of Obesity.

Total luminous flux measurement for flexible surface sources with an integrating sphere photometer

International Nuclear Information System (INIS)

Yu, Hsueh-Ling; Liu, Wen-Chun

2014-01-01

Applying an integrating sphere photometer for total luminous flux measurement is a widely used method. However, the measurement accuracy depends on the spatial uniformity of the integrating sphere, especially when the test sample has a different light distribution from that of the standard source. Therefore, spatial correction is needed to eliminate the effect caused by non-uniformity. To reduce the inconvenience of spatial correction but retain the measurement accuracy, a new type of working standard is designed for flexible and curved surface sources. Applying this new type standard source, the measurement deviation due to different orientations is reduced by an order of magnitude compared with using a naked incandescent lamp as the standard source. (paper)

Goal specificity: a proxy measure for improvements in environmental outcomes in collaborative governance.

Science.gov (United States)

Biddle, Jennifer C; Koontz, Tomas M

2014-12-01

Collaborative governance critics continually call for evidence to support its prevalent use. As is often the case in environmental policy, environmental outcomes occur at a rate incompatible with political agendas. In addition, a multitude of possibly confounding variables makes it difficult to correlate collaborative governance processes with environmental outcomes. The findings of this study offer empirical evidence that collaborative processes have a measurable, beneficial effect on environmental outcomes. Through the use of a unique paired-waterbody design, our dataset reduced the potential for confounding variables to impact our environmental outcome measurements. The results of a path analysis indicate that the output of setting specific pollutant reduction goals is significantly related to watershed partnerships' level of attainment of their environmental improvement goals. The action of setting specific goals (e.g. percentage of load reductions in pollutant levels) is fostered by sustained participation from partnership members throughout the lifecycle of the collaborative. In addition, this study demonstrates the utility of logic modeling for environmental planning and management, and suggests that the process of setting specific pollutant reduction goals is a useful proxy measure for reporting progress towards improvements in environmental outcomes when long-term environmental data are not available. Copyright © 2014 Elsevier Ltd. All rights reserved.

Ultrasound as an Outcome Measure in Gout. A Validation Process by the OMERACT Ultrasound Working Group

DEFF Research Database (Denmark)

Terslev, Lene; Gutierrez, Marwin; Schmidt, Wolfgang A

2015-01-01

OBJECTIVE: To summarize the work performed by the Outcome Measures in Rheumatology (OMERACT) Ultrasound (US) Working Group on the validation of US as a potential outcome measure in gout. METHODS: Based on the lack of definitions, highlighted in a recent literature review on US as an outcome tool...

Conservation covenants on private land: issues with measuring and achieving biodiversity outcomes in Australia.

Science.gov (United States)

Fitzsimons, James A; Carr, C Ben

2014-09-01

Conservation covenants and easements have become essential tools to secure biodiversity outcomes on private land, and to assist in meeting international protection targets. In Australia, the number and spatial area of conservation covenants has grown significantly in the past decade. Yet there has been little research or detailed policy analysis of conservation covenanting in Australia. We sought to determine how conservation covenanting agencies were measuring the biodiversity conservation outcomes achieved on covenanted properties, and factors inhibiting or contributing to measuring these outcomes. In addition, we also investigated the drivers and constraints associated with actually delivering the biodiversity outcomes, drawing on detailed input from covenanting programs. Although all conservation covenanting programs had the broad aim of maintaining or improving biodiversity in their covenants in the long term, the specific stated objectives of conservation covenanting programs varied. Programs undertook monitoring and evaluation in different ways and at different spatial and temporal scales. Thus, it was difficult to determine the extent Australian conservation covenanting agencies were measuring the biodiversity conservation outcomes achieved on covenanted properties on a national scale. Lack of time available to covenantors to undertake management was one of the biggest impediments to achieving biodiversity conservation outcomes. A lack of financial resources and human capital to monitor, knowing what to monitor, inconsistent monitoring methodologies, a lack of benchmark data, and length of time to achieve outcomes were all considered potential barriers to monitoring the biodiversity conservation outcomes of conservation covenants.

Translation of the Ibadan Knee/Hip Osteoarthritis Outcome Measure

African Journals Online (AJOL)

Dr Olaleye

rated by the clinician on five and six (0-5) point ordinal scales. IKHOAM has been ... Igbo translation of Ibadan osteoarthritis outcome measure. 176 .... encourage the use of scales and questionnaires in an .... Validation of a Yoruba translation of the World Health ... Scales: A practical guide to their development and use (1st.

Finite element approximation for time-dependent diffusion with measure-valued source

Czech Academy of Sciences Publication Activity Database

Seidman, T.; Gobbert, M.; Trott, D.; Kružík, Martin

2012-01-01

Roč. 122, č. 4 (2012), s. 709-723 ISSN 0029-599X R&D Projects: GA AV ČR IAA100750802 Institutional support: RVO:67985556 Keywords : measure-valued source * diffusion equation Subject RIV: BA - General Mathematics Impact factor: 1.329, year: 2012 http://library.utia.cas.cz/separaty/2012/MTR/kruzik-finite element approximation for time - dependent diffusion with measure-valued source.pdf

Measuring the Effects of Self-Awareness: Construction of the Self-Awareness Outcomes Questionnaire

Directory of Open Access Journals (Sweden)

Anna Sutton

2016-11-01

Full Text Available Dispositional self-awareness is conceptualized in several different ways, including insight, reflection, rumination and mindfulness, with the latter in particular attracting extensive attention in recent research. While self-awareness is generally associated with positive psychological well-being, these different conceptualizations are also each associated with a range of unique outcomes. This two part, mixed methods study aimed to advance understanding of dispositional self-awareness by developing a questionnaire to measure its outcomes. In Study 1, expert focus groups categorized and extended an initial pool of potential items from previous research. In Study 2, these items were reduced to a 38 item self-report questionnaire with four factors representing three beneficial outcomes (reflective self-development, acceptance and proactivity and one negative outcome (costs. Regression of these outcomes against self-awareness measures revealed that self-reflection and insight predicted beneficial outcomes, rumination predicted reduced benefits and increased costs, and mindfulness predicted both increased proactivity and costs. These studies help to refine the self-awareness concept by identifying the unique outcomes associated with the concepts of self-reflection, insight, reflection, rumination and mindfulness. It can be used in future studies to evaluate and develop awareness-raising techniques to maximize self-awareness benefits while minimizing related costs.

Comparison of Physician-Predicted to Measured Low Vision Outcomes

Science.gov (United States)

Chan, Tiffany L.; Goldstein, Judith E.; Massof, Robert W.

2013-01-01

Purpose To compare low vision rehabilitation (LVR) physicians’ predictions of the probability of success of LVR to patients’ self-reported outcomes after provision of usual outpatient LVR services; and to determine if patients’ traits influence physician ratings. Methods The Activity Inventory (AI), a self-report visual function questionnaire, was administered pre and post-LVR to 316 low vision patients served by 28 LVR centers that participated in a collaborative observational study. The physical component of the Short Form-36, Geriatric Depression Scale, and Telephone Interview for Cognitive Status were also administered pre-LVR to measure physical capability, depression and cognitive status. Following patient evaluation, 38 LVR physicians estimated the probability of outcome success (POS), using their own criteria. The POS ratings and change in functional ability were used to assess the effects of patients’ baseline traits on predicted outcomes. Results A regression analysis with a hierarchical random effects model showed no relationship between LVR physician POS estimates and AI-based outcomes. In another analysis, Kappa statistics were calculated to determine the probability of agreement between POS and AI-based outcomes for different outcome criteria. Across all comparisons, none of the kappa values were significantly different from 0, which indicates the rate of agreement is equivalent to chance. In an exploratory analysis, hierarchical mixed effects regression models show that POS ratings are associated with information about the patient’s cognitive functioning and the combination of visual acuity and functional ability, as opposed to visual acuity or functional ability alone. Conclusions Physicians’ predictions of LVR outcomes appear to be influenced by knowledge of patients’ cognitive functioning and the combination of visual acuity and functional ability - information physicians acquire from the patient’s history and examination. However

Comparing the responsiveness of functional outcome assessment measures for trauma registries.

Science.gov (United States)

Williamson, Owen D; Gabbe, Belinda J; Sutherland, Ann M; Wolfe, Rory; Forbes, Andrew B; Cameron, Peter A

2011-07-01

Measuring long-term disability and functional outcomes after major trauma is not standardized across trauma registries. An ideal measure would be responsive to change but not have significant ceiling effects. The aim of this study was to compare the responsiveness of the Glasgow Outcome Scale (GOS), GOS-Extended (GOSE), Functional Independence Measure (FIM), and modified FIM in major trauma patients, with and without significant head injuries. Patients admitted to two adult Level I trauma centers in Victoria, Australia, who survived to discharge from hospital, were aged 15 years to 80 years with a blunt mechanism of injury, and had an estimated Injury Severity Score >15 on admission, were recruited for this prospective study. The instruments were administered at baseline (hospital discharge) and by telephone interview 6 months after injury. Measures of responsiveness, including effect sizes, were calculated. Bootstrapping techniques, and floor and ceiling effects, were used to compare the measures. Two hundred forty-three patients participated, of which 234 patients (96%) completed the study. The GOSE and GOS were the most responsive instruments in this major trauma population with effect sizes of 5.3 and 4.4, respectively. The GOSE had the lowest ceiling effect (17%). The GOSE was the instrument with greatest responsiveness and the lowest ceiling effect in a major trauma population with and without significant head injuries and is recommended for use by trauma registries for monitoring functional outcomes and benchmarking care. The results of this study do not support the use of the modified FIM for this purpose.

Measures of outcome for stimulant trials: ACTTION recommendations and research agenda.

Science.gov (United States)

Kiluk, Brian D; Carroll, Kathleen M; Duhig, Amy; Falk, Daniel E; Kampman, Kyle; Lai, Shengan; Litten, Raye Z; McCann, David J; Montoya, Ivan D; Preston, Kenzie L; Skolnick, Phil; Weisner, Constance; Woody, George; Chandler, Redonna; Detke, Michael J; Dunn, Kelly; Dworkin, Robert H; Fertig, Joanne; Gewandter, Jennifer; Moeller, F Gerard; Ramey, Tatiana; Ryan, Megan; Silverman, Kenneth; Strain, Eric C

2016-01-01

The development and approval of an efficacious pharmacotherapy for stimulant use disorders has been limited by the lack of a meaningful indicator of treatment success, other than sustained abstinence. In March, 2015, a meeting sponsored by Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) was convened to discuss the current state of the evidence regarding meaningful outcome measures in clinical trials for stimulant use disorders. Attendees included members of academia, funding and regulatory agencies, pharmaceutical companies, and healthcare organizations. The goal was to establish a research agenda for the development of a meaningful outcome measure that may be used as an endpoint in clinical trials for stimulant use disorders. Based on guidelines for the selection of clinical trial endpoints, the lessons learned from prior addiction clinical trials, and the process that led to identification of a meaningful indicator of treatment success for alcohol use disorders, several recommendations for future research were generated. These include a focus on the validation of patient reported outcome measures of functioning, the exploration of patterns of stimulant abstinence that may be associated with physical and/or psychosocial benefits, the role of urine testing for validating self-reported measures of stimulant abstinence, and the operational definitions for reduction-based measures in terms of frequency rather than quantity of stimulant use. These recommendations may be useful for secondary analyses of clinical trial data, and in the design of future clinical trials that may help establish a meaningful indicator of treatment success. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The barriers and facilitators to routine outcome measurement by allied health professionals in practice: a systematic review

Directory of Open Access Journals (Sweden)

Duncan Edward AS

2012-05-01

Full Text Available Abstract Background Allied Health Professionals today are required, more than ever before, to demonstrate their impact. However, despite at least 20 years of expectation, many services fail to deliver routine outcome measurement in practice. This systematic review investigates what helps and hinders routine outcome measurement of allied health professionals practice. Methods A systematic review protocol was developed comprising: a defined search strategy for PsycINFO, MEDLINE and CINHAL databases and inclusion criteria and systematic procedures for data extraction and quality appraisal. Studies were included if they were published in English and investigated facilitators and/or barriers to routine outcome measurement by allied health professionals. No restrictions were placed on publication type, design, country, or year of publication. Reference lists of included publications were searched to identify additional papers. Descriptive methods were used to synthesise the findings. Results 960 papers were retrieved; 15 met the inclusion criteria. Professional groups represented were Physiotherapy, Occupational Therapy, and Speech and Language Therapy. The included literature varied in quality and design. Facilitators and barriers to routine outcome measurement exist at individual, managerial and organisational levels. Key factors affecting professionals’ use of routine outcome measurement include: professionals’ level of knowledge and confidence about using outcome measures, and the degree of organisational and peer-support professionals received with a view to promoting their work in practice. Conclusions Whilst the importance of routinely measuring outcomes within the allied health professions is well recognised, it has largely failed to be delivered in practice. Factors that influence clinicians’ ability and desire to undertake routine outcome measurement are bi-directional: they can act as either facilitators or barriers. Routine outcome

The patient-specific functional scale: psychometrics, clinimetrics, and application as a clinical outcome measure.

Science.gov (United States)

Horn, Katyana Kowalchuk; Jennings, Sophie; Richardson, Gillian; Vliet, Ditte Van; Hefford, Cheryl; Abbott, J Haxby

2012-01-01

Systematic review of the literature. To summarize peer-reviewed literature on the reliability, validity, and responsiveness of the Patient-Specific Functional Scale (PSFS), and to identify its use as an outcome measure. Searches were performed of several electronic databases from 1995 to May 2010. Studies included were published articles containing (1) primary research investigating the psychometric and clinimetrics of the PSFS or (2) the implementation of the PSFS as an outcome measure. We assessed the methodological quality of studies included in the first category. Two hundred forty-two articles published from 1994 to May 2010 were identified. Of these, 66 met the inclusion criteria for this review, with 13 reporting the measurement properties of the PSFS, 55 implementing the PSFS as an outcome measure, and 2 doing both of the above. The PSFS was reported to be valid, reliable, and responsive in populations with knee dysfunction, cervical radiculopathy, acute low back pain, mechanical low back pain, and neck dysfunction. The PSFS was found to be reliable and responsive in populations with chronic low back pain. The PSFS was also reported to be valid, reliable, or responsive in individuals with a limited number of acute, subacute, and chronic conditions. This review found that the PSFS is also being used as an outcome measure in many other conditions, despite a lack of published evidence supporting its validity in these conditions. Although the use of the PSFS as an outcome measure is increasing in physiotherapy practice, there are gaps in the research literature regarding its validity, reliability, and responsiveness in many health conditions.

Galvanically Decoupled Current Source Modules for Multi-Channel Bioimpedance Measurement Systems

Directory of Open Access Journals (Sweden)

Roman Kusche

2017-10-01

Full Text Available Bioimpedance measurements have become a useful technique in the past several years in biomedical engineering. Especially, multi-channel measurements facilitate new imaging and patient monitoring techniques. While most instrumentation research has focused on signal acquisition and signal processing, this work proposes the design of an excitation current source module that can be easily implemented in existing or upcoming bioimpedance measurement systems. It is galvanically isolated to enable simultaneous multi-channel bioimpedance measurements with a very low channel-coupling. The system is based on a microcontroller in combination with a voltage-controlled current source circuit. It generates selectable sinusoidal excitation signals between 0.12 and 1.5 mA in a frequency range from 12 to 250 kHz, whereas the voltage compliance range is ±3.2 V. The coupling factor between two current sources, experimentally galvanically connected with each other, is measured to be less than −48 dB over the entire intended frequency range. Finally, suggestions for developments in the future are made.

Broadband light source for fiber-optic measurement system in spaceborne applications

Science.gov (United States)

Rößner, Max R.; Müller, Mathias S.; Buck, Thorbjörn C.; Koch, Alexander W.

2012-01-01

Measuring temperatures, mechanical loads and derived quantities precisely and reliably play an important role in spaceflight. With spacecraft becoming increasingly complex, upscaling of present telemetry techniques can become cumbersome. Additionally, there are entirely new sensory requirements, resulting from emerging technologies such as smart structures, active vibration damping and composite material health monitoring. It has been demonstrated in preceding studies that these measurements can be advantageously and efficiently carried out by means of fiber-optic systems. The most prominent fiber-optic strain and temperature sensor is the fiber Bragg grating. Typically, multiple fiber Bragg gratings are used to translate entire temperature and strain fields into an optical wavelength information. For the interrogation of these sensors, a broadband or scanning light source is required. Additional requirements with respect to the light source are high intensity and unpolarized illumination of the gratings. These constraints can be met by a light source that is based on amplified spontaneous emission in a rare-earth-doped fiber. In the presented work, a compact light source, adapted for measurement applications and targeted towards space applications, has been developed. The design of this light source is presented, as well as its implementation. The light source has been designed and tested for selected core aspects of space robustness and the results of these tests are summarized.

Bayesian source term determination with unknown covariance of measurements

Science.gov (United States)

Belal, Alkomiet; Tichý, Ondřej; Šmídl, Václav

2017-04-01

Determination of a source term of release of a hazardous material into the atmosphere is a very important task for emergency response. We are concerned with the problem of estimation of the source term in the conventional linear inverse problem, y = Mx, where the relationship between the vector of observations y is described using the source-receptor-sensitivity (SRS) matrix M and the unknown source term x. Since the system is typically ill-conditioned, the problem is recast as an optimization problem minR,B(y - Mx)TR-1(y - Mx) + xTB-1x. The first term minimizes the error of the measurements with covariance matrix R, and the second term is a regularization of the source term. There are different types of regularization arising for different choices of matrices R and B, for example, Tikhonov regularization assumes covariance matrix B as the identity matrix multiplied by scalar parameter. In this contribution, we adopt a Bayesian approach to make inference on the unknown source term x as well as unknown R and B. We assume prior on x to be a Gaussian with zero mean and unknown diagonal covariance matrix B. The covariance matrix of the likelihood R is also unknown. We consider two potential choices of the structure of the matrix R. First is the diagonal matrix and the second is a locally correlated structure using information on topology of the measuring network. Since the inference of the model is intractable, iterative variational Bayes algorithm is used for simultaneous estimation of all model parameters. The practical usefulness of our contribution is demonstrated on an application of the resulting algorithm to real data from the European Tracer Experiment (ETEX). This research is supported by EEA/Norwegian Financial Mechanism under project MSMT-28477/2014 Source-Term Determination of Radionuclide Releases by Inverse Atmospheric Dispersion Modelling (STRADI).

Multiple Measures of Outcome in Assessing a Prison-Based Drug Treatment Program

Science.gov (United States)

Prendergast, Michael L.; Hall, Elizabeth A.; Wexler, Harry K.

2003-01-01

Evaluations of prison-based drug treatment programs typically focus on one or two dichotomous outcome variables related to recidivism. In contrast, this paper uses multiple measures of outcomes related to crime and drug use to examine the impact of prison treatment. Crime variables included self-report data of time to first illegal activity,…

Do energy efficiency measures promote the use of renewable sources?

International Nuclear Information System (INIS)

Marques, Antonio C.; Fuinhas, Jose A.

2011-01-01

This paper analyses the factors behind the deployment of renewable energy, focusing particularly on the effect of energy efficiency policies and measures. The impact of these factors is appraised within the context of several phases of the use of renewable sources. We therefore apply the quantile regression technique to a set of 21 European Countries in two time spans: from 1990 to 1998, and from 1999 to 2006. We control variables of policy, environment, socioeconomic characteristics, and electricity generation. For the second period, energy efficiency policies and measures concerning renewable sources effectively promote renewables, namely in the take-off phase. We shed light on the lobbying effect of traditional energy industries, showing that it depends both on the period under analysis, and on the kind of traditional energy source.

CT-angiography source images indicate less fatal outcome despite coma of patients in the Basilar Artery International Cooperation Study.

Science.gov (United States)

Pallesen, Lars P; Khomenko, Andrei; Dzialowski, Imanuel; Barlinn, Jessica; Barlinn, Kristian; Zerna, Charlotte; van der Hoeven, Erik Jrj; Algra, Ale; Kapelle, L Jaap; Michel, Patrik; Bodechtel, Ulf; Demchuk, Andrew M; Schonewille, Wouter; Puetz, Volker

2017-02-01

Background Coma is associated with poor outcome in patients with basilar artery occlusion. Aims We sought to assess whether the posterior circulation Acute Stroke Prognosis Early CT Score and the Pons-Midbrain Index applied to CT angiography source images predict the outcome of comatose patients in the Basilar Artery International Cooperation Study. Methods Basilar Artery International Cooperation Study was a prospective, observational registry of patients with acute basilar artery occlusion with 48 recruiting centers worldwide. We applied posterior circulation Acute Stroke Prognosis Early CT Score and Pons-Midbrain Index to CT angiography source images of Basilar Artery International Cooperation Study patients who presented with coma. We calculated adjusted risk ratios to assess the association of dichotomized posterior circulation Acute Stroke Prognosis Early CT Score (≥8 vs. International Cooperation Study registry, CT angiography source images were available for review in 158 patients. Among these, 78 patients (49%) presented with coma. Compared to non-comatose patients, comatose patients were more likely to die (risk ratios 2.34; CI 95% 1.56-3.52) and less likely to have a favourable outcome (risk ratios 0.44; CI 95% 0.24-0.80). Among comatose patients, a Pons-Midbrain Index < 3 was related to reduced mortality (adjusted RR 0.66; 95% CI 0.46-0.96), but not to favourable outcome (adjusted RR 1.19; 95% CI 0.39-3.62). Posterior circulation Acute Stroke Prognosis Early CT Score dichotomized at ≥ 8 vs. <8 was not significantly associated with death (adjusted RR 0.70; 95% CI 0.46-1.05). Conclusion In comatose patients with basilar artery occlusion, the extent of brainstem ischemia appears to be related to mortality but not to favourable outcome.

Implementation of 252Cf-source-driven power spectrum density measurement system

International Nuclear Information System (INIS)

Ren Yong; Wei Biao; Feng Peng; Li Jiansheng; Ye Cenming

2012-01-01

The principle of 252 Cf-source-driven power spectrum density measurement method is introduced. A measurement system and platform is realized accordingly, which is a combination of hardware and software, for measuring nuclear parameters. The detection method of neutron pulses based on an ultra-high-speed data acquisition card (three channels, 1 GHz sampling rate, 1 ns synchronization) is described, and the data processing process and the power spectrum density algorithm on PC are designed. This 252 Cf-source-driven power spectrum density measurement system can effectively obtain the nuclear tag parameters of nuclear random processes, such as correlation function and power spectrum density. (authors)

On-line measurement of the microwave power in ECR ion source

International Nuclear Information System (INIS)

Zhou Changgeng; Kang Wu; Hu Yonghong; Li Yan; Lou Benchao; Zu Xiulan; Xiong Riheng; Chen Junguang

2005-01-01

It is a new technology that ECR ion source is applied in the neutron generator. Because of effect of the structure, working state of ECR ion source could not be judged by the color of gas discharging in discharging chamber as doing in high frequency ion source. Therefore, state adjusting of ECR ion source was difficult in running of the neutron generator. The method to resolve the question is described in this paper. The micro-wave power was measured in case of running by using the method of directional coupler adding small microwave power meter. Because both were in the direct proportion, the ion beam current could be educed from microwave incidence power measured, and discharge state in discharge chamber could be judged. Finally, the neutron generator might be operated in best running state. (authors)

Measuring public health practice and outcomes in chronic disease: a call for coordination.

Science.gov (United States)

Porterfield, Deborah S; Rogers, Todd; Glasgow, LaShawn M; Beitsch, Leslie M

2015-04-01

A strategic opportunity exists to coordinate public health systems and services researchers' efforts to develop local health department service delivery measures and the efforts of divisions within the Centers for Disease Control and Prevention's National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) to establish outcome indicators for public health practice in chronic disease. Several sets of outcome indicators developed by divisions within NCCDPHP and intended for use by state programs can be tailored to assess outcomes of interventions within smaller geographic areas or intervention settings. Coordination of measurement efforts could potentially allow information to flow from the local to the state to the federal level, enhancing program planning, accountability, and even subsequent funding for public health practice.

The error sources appearing for the gamma radioactive source measurement in dynamic condition

International Nuclear Information System (INIS)

Sirbu, M.

1977-01-01

The error analysis for the measurement of the gamma radioactive sources, placed on the soil, with the help of the helicopter are presented. The analysis is based on a new formula that takes account of the attenuation gamma ray factor in the helicopter walls. They give a complete error formula and an error diagram. (author)

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

Science.gov (United States)

Ni Riordain, R; McCreary, C

2013-04-01

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

Exploring Outcome Measures for Exercise Intervention in People with Parkinson’s Disease

Directory of Open Access Journals (Sweden)

L. A. King

2013-01-01

Full Text Available Background. It is widely believed that exercise improves mobility in people with Parkinson’s disease (PD. However, it is difficult to determine whether a specific type of exercise is the most effective. The purpose of this study was to determine which outcome measures were sensitive to exercise intervention and to explore the effects of two different exercise programs for improving mobility in patients with PD. Methods. Participants were randomized into either the Agility Boot Camp (ABC or treadmill training; 4x/week for 4 weeks. Outcome measures were grouped by the International Classification of Function/Disability (ICF. To determine the responsiveness to exercise, we calculated the standardized response means. t-tests were used to compare the relative benefits of each exercise program. Results. Four of five variables at the structure/function level changed after exercise: turn duration (P=0.03, stride velocity (P=0.001, peak arm speed (P=0.001, and horizontal trunk ROM during gait (P=0.02. Most measures improved similarly for both interventions. The only variable that detected a difference between groups was postural sway in ABC group (F=4.95; P=0.03. Conclusion. Outcome measures at ICF body structure/function level were most effective at detecting change after exercise and revealing differences in improvement between interventions.

Do Activity Level Outcome Measures Commonly Used in Neurological Practice Assess Upper-Limb Movement Quality?

Science.gov (United States)

Demers, Marika; Levin, Mindy F

2017-07-01

Movement is described in terms of task-related end point characteristics in external space and movement quality (joint rotations in body space). Assessment of upper-limb (UL) movement quality can assist therapists in designing effective treatment approaches for retraining lost motor elements and provide more detailed measurements of UL motor improvements over time. To determine the extent to which current activity level outcome measures used in neurological practice assess UL movement quality. Outcome measures assessing arm/hand function at the International Classification of Function activity level recommended by neurological clinical practice guidelines were reviewed. Measures assessing the UL as part of a general mobility assessment, those strictly evaluating body function/structure or participation, and paediatric measures were excluded. In all, 15 activity level outcome measures were identified; 9 measures assess how movement is performed by measuring either end point characteristics or movement quality. However, except for the Reaching Performance Scale for Stroke and the Motor Evaluation Scale for Upper Extremity in Stroke Patients, these measures only account for deficits indirectly by giving a partial score if movements are slower or if the person experiences difficulties. Six outcome measures neither assess any parameters related to movement quality, nor distinguish between improvements resulting from motor compensation or recovery of desired movement strategies. Current activity measures may not distinguish recovery from compensation and adequately track changes in movement quality over time. Movement quality may be incorporated into clinical assessment using observational kinematics with or without low-cost motion tracking technology.

CT Measured Psoas Density Predicts Outcomes After Enterocutaneous Fistula Repair

Science.gov (United States)

Lo, Wilson D.; Evans, David C.; Yoo, Taehwan

2018-01-01

Background Low muscle mass and quality are associated with poor surgical outcomes. We evaluated CT measured psoas muscle density as a marker of muscle quality and physiologic reserve, and hypothesized that it would predict outcomes after enterocutaneous fistula repair (ECF). Methods We conducted a retrospective cohort study of patients 18 – 90 years old with ECF failing non-operative management requiring elective operative repair at Ohio State University from 2005 – 2016 that received a pre-operative abdomen/pelvis CT with intravenous contrast within 3 months of their operation. Psoas Hounsfield Unit average calculation (HUAC) were measured at the L3 level. 1 year leak rate, 90 day, 1 year, and 3 year mortality, complication risk, length of stay, dependent discharge, and 30 day readmission were compared to HUAC. Results 100 patients met inclusion criteria. Patients were stratified into interquartile (IQR) ranges based on HUAC. The lowest HUAC IQR was our low muscle quality (LMQ) cutoff, and was associated with 1 year leak (OR 3.50, p < 0.01), 1 year (OR 2.95, p < 0.04) and 3 year mortality (OR 3.76, p < 0.01), complication risk (OR 14.61, p < 0.01), and dependent discharge (OR 4.07, p < 0.01) compared to non-LMQ patients. Conclusions Psoas muscle density is a significant predictor of poor outcomes in ECF repair. This readily available measure of physiologic reserve can identify patients with ECF on pre-operative evaluation that have significantly increased risk that may benefit from additional interventions and recovery time to mitigate risk before operative repair. PMID:29505144

Radio weak lensing shear measurement in the visibility domain - II. Source extraction

Science.gov (United States)

Rivi, M.; Miller, L.

2018-05-01

This paper extends the method introduced in Rivi et al. (2016b) to measure galaxy ellipticities in the visibility domain for radio weak lensing surveys. In that paper, we focused on the development and testing of the method for the simple case of individual galaxies located at the phase centre, and proposed to extend it to the realistic case of many sources in the field of view by isolating visibilities of each source with a faceting technique. In this second paper, we present a detailed algorithm for source extraction in the visibility domain and show its effectiveness as a function of the source number density by running simulations of SKA1-MID observations in the band 950-1150 MHz and comparing original and measured values of galaxies' ellipticities. Shear measurements from a realistic population of 104 galaxies randomly located in a field of view of 1 \\deg ^2 (i.e. the source density expected for the current radio weak lensing survey proposal with SKA1) are also performed. At SNR ≥ 10, the multiplicative bias is only a factor 1.5 worse than what found when analysing individual sources, and is still comparable to the bias values reported for similar measurement methods at optical wavelengths. The additive bias is unchanged from the case of individual sources, but it is significantly larger than typically found in optical surveys. This bias depends on the shape of the uv coverage and we suggest that a uv-plane weighting scheme to produce a more isotropic shape could reduce and control additive bias.

Development of negative heavy ion sources for plasma potential measurement

International Nuclear Information System (INIS)

Sasao, M.; Okabe, Y.; Fujisawa, A.; Iguchi, H.; Fujita, J.; Yamaoka, H.; Wada, M.

1991-10-01

A plasma sputter negative ion source was studied for its applicability to the potential measurement of a fusion plasma. Both the beam current density and the beam energy spread are key issues. Energy spectra of a self extracted Au - beam from the source were measured under the condition of a constant work function of the production surface. The full width of half maximum (FWHM) increases from 3 eV to 9 eV monotonically as the target voltage increases from 50 V to 300 V, independently from the target surface work function of 2.2 - 3 eV. (author)

Outcome-driven thresholds for home blood pressure measurement: international database of home blood pressure in relation to cardiovascular outcome.

Science.gov (United States)

Niiranen, Teemu J; Asayama, Kei; Thijs, Lutgarde; Johansson, Jouni K; Ohkubo, Takayoshi; Kikuya, Masahiro; Boggia, José; Hozawa, Atsushi; Sandoya, Edgardo; Stergiou, George S; Tsuji, Ichiro; Jula, Antti M; Imai, Yutaka; Staessen, Jan A

2013-01-01

The lack of outcome-driven operational thresholds limits the clinical application of home blood pressure (BP) measurement. Our objective was to determine an outcome-driven reference frame for home BP measurement. We measured home and clinic BP in 6470 participants (mean age, 59.3 years; 56.9% women; 22.4% on antihypertensive treatment) recruited in Ohasama, Japan (n=2520); Montevideo, Uruguay (n=399); Tsurugaya, Japan (n=811); Didima, Greece (n=665); and nationwide in Finland (n=2075). In multivariable-adjusted analyses of individual subject data, we determined home BP thresholds, which yielded 10-year cardiovascular risks similar to those associated with stages 1 (120/80 mm Hg) and 2 (130/85 mm Hg) prehypertension, and stages 1 (140/90 mm Hg) and 2 (160/100 mm Hg) hypertension on clinic measurement. During 8.3 years of follow-up (median), 716 cardiovascular end points, 294 cardiovascular deaths, 393 strokes, and 336 cardiac events occurred in the whole cohort; in untreated participants these numbers were 414, 158, 225, and 194, respectively. In the whole cohort, outcome-driven systolic/diastolic thresholds for the home BP corresponding with stages 1 and 2 prehypertension and stages 1 and 2 hypertension were 121.4/77.7, 127.4/79.9, 133.4/82.2, and 145.4/86.8 mm Hg; in 5018 untreated participants, these thresholds were 118.5/76.9, 125.2/79.7, 131.9/82.4, and 145.3/87.9 mm Hg, respectively. Rounded thresholds for stages 1 and 2 prehypertension and stages 1 and 2 hypertension amounted to 120/75, 125/80, 130/85, and 145/90 mm Hg, respectively. Population-based outcome-driven thresholds for home BP are slightly lower than those currently proposed in hypertension guidelines. Our current findings could inform guidelines and help clinicians in diagnosing and managing patients.

Development of source range measurement instrument in Xi'an pulsed reactor

CERN Document Server

Wang Li

2002-01-01

Source range measurement instrument in Xi'an pulsed reactor is key equipment of low-side measuring in source range. At the same time, it is also weighty component of out-of-pile neutron-flux level observation system. The authors have done some researching and renovating based on the similar type devices used in nuclear reactor to improve the meter sensitivity, measuring range, noise proof features, reliability in running and maintainability which belong to the main performance index of the instrument. The design ideas, configurations, working principle, performance indexes, technique features and effect in utilizing are introduced briefly

A portable measurement system for subcriticality measurements by the CF-source-driven neutron noise analysis method

International Nuclear Information System (INIS)

Mihalczo, J.T.; Ragan, G.E.; Blakeman, E.D.

1988-01-01

A portable measurement system consisting of a personal computer used as a Fourier analyzer and three detection channels (with associated electronics that provide the signals to analog-to-digital (A/D) convertors) has been assembled to measure subcriticality by the /sup 252/Cf-source-driven neutron noise analysis method. The /sup 252/Cf-source-driven neutron noise analysis method for obtaining the subcritical neutron multiplication factor of a configuration of fissile material requires measurement of the frequency-dependent cross-power spectral density (CPSD), G/sub 23/(ω), between a pair of detectors (Nos. 2 and 3) located in or near the fissile material and CPSDs G/sub 12/(ω) and G/sub 13/(ω) between these same detectors and a source of neutrons emanating from an ionization chamber (No. 1) containing /sup 252/Cf, also positioned in or near the fissile material. The auto-power spectral density (APSD), G/sub 11/(ω), of the source is also required. A particular ratio of spectral densities, G/sub 12//sup */G/sub 13//G/sub 11/G/sub 23/ (/sup */ denotes complex conjugation), is then formed. This ratio is related to the subcritical neutron multiplication factor and is independent of detector efficiencies

Spatial cluster detection for repeatedly measured outcomes while accounting for residential history.

Science.gov (United States)

Cook, Andrea J; Gold, Diane R; Li, Yi

2009-10-01

Spatial cluster detection has become an important methodology in quantifying the effect of hazardous exposures. Previous methods have focused on cross-sectional outcomes that are binary or continuous. There are virtually no spatial cluster detection methods proposed for longitudinal outcomes. This paper proposes a new spatial cluster detection method for repeated outcomes using cumulative geographic residuals. A major advantage of this method is its ability to readily incorporate information on study participants relocation, which most cluster detection statistics cannot. Application of these methods will be illustrated by the Home Allergens and Asthma prospective cohort study analyzing the relationship between environmental exposures and repeated measured outcome, occurrence of wheeze in the last 6 months, while taking into account mobile locations.

Engaging the hearts and minds of clinicians in outcome measurement – the UK rehabilitation outcomes collaborative approach

Science.gov (United States)

2012-01-01

Purpose This article explores the rationale for choosing the instruments included within the UK Rehabilitation Outcomes Collaborative (UKROC) data set. Using one specialist neuro-rehabilitation unit as an exemplar service, it describes an approach to engaging the hearts and minds of clinicians in recording the data. Key messages and implications Measures included within a national data set for rehabilitation should be psychometrically robust and feasible to use in routine clinical practice; they should also support clinical decision-making so that clinicians actually want to use them. Learning from other international casemix models and benchmarking data sets, the UKROC team has developed a cluster of measures to inform the development of effective and cost-efficient rehabilitation services. These include measures of (1) “needs” for rehabilitation (complexity), (2) inputs provided to meet those needs (nursing and therapy intervention), and (3) outcome, including the attainment of personal goals as well as gains in functional independence. Conclusions By integrating the use of the data set measures in everyday clinical practice, we have achieved a very high rate of compliance with data collection. However, staff training and ongoing commitment from senior staff and managers are critical to the maintenance of effort required to provide assurance of data quality in the longer term. PMID:22506959

Measurements on Pb27+ Sources for the CERN Heavy Ion Injection Chain

CERN Document Server

Chamings, J A

2004-01-01

CERN, the world's largest particle physics laboratory near Geneva, is currently in the process of building the Large Hadron Collider (LHC). Lead-208 will be used in this accelerator and to meet the injection requirements much work is required to find a suitable and reliable heavy ion source. The work in this report covers two ion sources, the Laser Ion Source (LIS), and the Electron Cyclotron Resonance Ion Source (ECRIS). An emittance measurement, using a pepper pot and CCD camera, was completed on the recently re-installed LIS, measured and analysed to be 140mm.mrad un-normalised and 0.8mm.mrad normalised 4rms for the maximum intensity charge state, Pb27+. A Visual Basic Program was modified to allow Charge State Distribution (CSD) and other scans of the ECRIS at CERN to be taken. Chapter 5 presents the results of the CSD scans taken. This program provided a new method to take 1 dimensional transverse beam profiles. From this a direct emittance measurement was formed for the first time since the source was o...

Application research of tune measurement system in Hefei light source

International Nuclear Information System (INIS)

Sun Baogen; He Duohui; Xu Hongliang; Lu Ping; Wang Junhua; Gao Yunfeng; Wang Lin; Liu Jinying

2002-01-01

The author introduces the measurement and research of some beam parameters using tune measurement system for Hefei Light Source (HLS), which include the betatron tune, beta function, natural chromaticity, corrected chromaticity, and central frequency. Additionally, it also describes the measurement of the influence of DC clearing electrodes on the betatron tune shift and gives some measurement results. The measurement results are compared with the theoretical values and they are in good agreement

Absorptivity Measurements and Heat Source Modeling to Simulate Laser Cladding

Science.gov (United States)

Wirth, Florian; Eisenbarth, Daniel; Wegener, Konrad

The laser cladding process gains importance, as it does not only allow the application of surface coatings, but also additive manufacturing of three-dimensional parts. In both cases, process simulation can contribute to process optimization. Heat source modeling is one of the main issues for an accurate model and simulation of the laser cladding process. While the laser beam intensity distribution is readily known, the other two main effects on the process' heat input are non-trivial. Namely the measurement of the absorptivity of the applied materials as well as the powder attenuation. Therefore, calorimetry measurements were carried out. The measurement method and the measurement results for laser cladding of Stellite 6 on structural steel S 235 and for the processing of Inconel 625 are presented both using a CO2 laser as well as a high power diode laser (HPDL). Additionally, a heat source model is deduced.

Treatment of patients with hand osteoarthritis : outcome measures, patient satisfaction, and economic evaluation

NARCIS (Netherlands)

Marks, Miriam

2014-01-01

The aim of this thesis was to investigate the limitations in daily life, outcome measures, clinical outcomes with the emphasis on patient satisfaction, and economic aspects of the treatment of hand osteoarthritis (OA). Patients with hand OA report severe restrictions in daily life, in particular in

Progress Towards a Core Set of Outcome Measures in Small-vessel Vasculitis. Report from OMERACT 9

Science.gov (United States)

MERKEL, PETER A.; HERLYN, KAREN; MAHR, ALFRED D.; NEOGI, TUHINA; SEO, PHILIP; WALSH, MICHAEL; BOERS, MAARTEN; LUQMANI, RAASHID

2011-01-01

The past decade has seen a substantial increase in the number and quality of clinical trials of new therapies for vasculitis, including randomized, controlled, multicenter trials that have successfully incorporated measures of disease activity and toxicity. However, because current treatment regimens for severe disease effectively induce initial remission and reduce mortality, future trials will focus on any of several goals including: (a) treatment of mild—moderate disease; (b) prevention of chronic damage; (c) reduction in treatment toxicity; or (d) more subtle differences in remission induction or maintenance. Thus, new trials will require outcome measure instruments that are more precise and are better able to detect effective treatments for different disease states and measure chronic manifestations of disease. The OMERACT Vasculitis Working Group comprises international clinical investigators with expertise in vasculitis who, since 2002, have worked collaboratively to advance the refinement of outcome measures in vasculitis, create new measures to address domains of illness not covered by current research approaches, and harmonize outcome assessment in vasculitis. The focus of the OMERACT group to date has been on outcome measures in small-vessel vasculitis with an overall goal of creating a core set of outcome measures for vasculitis, each of which fulfills the OMERACT filter of truth, discrimination, feasibility, and identifying additional domains requiring further research. This process has been informed by several ongoing projects providing data on outcomes of disease activity, disease-related damage, multidimensional health-related quality of life, and patient-reported ratings of the burden of vasculitis. PMID:19820226

Dynamic Aperture Measurements at the Advanced Light Source

International Nuclear Information System (INIS)

Decking, W.; Robin, D.

1999-01-01

A large dynamic aperture for a storage ring is of importance for long lifetimes and a high injection efficiency. Measurements of the dynamic aperture of the third generation synchrotron light source Advanced Light Source (ALS) using beam excitation with kicker magnets are presented. The experiments were done for various accelerator conditions, allowing us to investigate the influence of different working points, chromaticities, insertion devices, etc.. The results are compared both with tracking calculations and a simple model for the dynamic aperture yielding good agreements. This gives us confidence in the predictability of the nonlinear accelerator model. This is especially important for future ALS upgrades as well as new storage ring designs

Measuring light spectrum as a main indicator of artificial sources quality

Directory of Open Access Journals (Sweden)

Piotr Dąbrowski

2015-05-01

Full Text Available Objective: To compare different artificial light sources in different places where plant breeding is conduced. Methods: Measurements were conducted outdoor, in room, in greenhouse, under four panels with light emitting diodes, in phytotron, in dark room with various light sources and inside Sanyo versatile environmental chamber. The measurements were made by using SpectraPen SP100 (PSI, Czech Republic device. Results: Our result showed that spectrum measured outdoor during sunny day had only one peak at the wavelength of 485 nm (ca. 60000 relative units. On cloudy day, the trend of light spectrum curve was similar, but with lower values. At room conditions, the curve was more flat than outdoor. Under greenhouse conditions, the curve was similar to that measured outdoor. A few additional peaks on the curve appeared by adding high pressure sodium lamp. There were changes of curve under LED panels. Conclusions: It must be underlined that the most similar spectrum curve to daylight light has incandescent bulb and this light source should be preferred as support of daylight in greenhouses and as main source in phytotrons. Using high pressure sodium lamp in greenhouses as support of daylight cause increase in the red/far-red ratio and occurrence of a new peak on spectrum curve. The new possibilities are creating by LED panels with red and blue diodes.

Measurement and correction of chromaticity in Hefei light source

International Nuclear Information System (INIS)

Sun Baogen; Xu Hongliang; He Duohui; Wang Junhua; Lu Ping

2001-01-01

The measurement and correction of chromaticity for Hefei light source is introduced. The natural chromaticity is obtained by detecting the variation of the betatron tune with the main dipole field strength. The correction chromaticity is obtained by detecting the variation of the betatron tune with the RF frequency. The theoretic analysis and formula for the two methods is given. The measurement results of chromaticity are given

No common denominator: a review of outcome measures in IVF RCTs.

Science.gov (United States)

Wilkinson, Jack; Roberts, Stephen A; Showell, Marian; Brison, Daniel R; Vail, Andy

2016-12-01

Which outcome measures are reported in RCTs for IVF? Many combinations of numerator and denominator are in use, and are often employed in a manner that compromises the validity of the study. The choice of numerator and denominator governs the meaning, relevance and statistical integrity of a study's results. RCTs only provide reliable evidence when outcomes are assessed in the cohort of randomised participants, rather than in the subgroup of patients who completed treatment. Review of outcome measures reported in 142 IVF RCTs published in 2013 or 2014. Trials were identified by searching the Cochrane Gynaecology and Fertility Specialised Register. English-language publications of RCTs reporting clinical or preclinical outcomes in peer-reviewed journals in the period 1 January 2013 to 31 December 2014 were eligible. Reported numerators and denominators were extracted. Where they were reported, we checked to see if live birth rates were calculated correctly using the entire randomised cohort or a later denominator. Over 800 combinations of numerator and denominator were identified (613 in no more than one study). No single outcome measure appeared in the majority of trials. Only 22 (43%) studies reporting live birth presented a calculation including all randomised participants or only excluding protocol violators. A variety of definitions were used for key clinical numerators: for example, a consensus regarding what should constitute an ongoing pregnancy does not appear to exist at present. Several of the included articles may have been secondary publications. Our categorisation scheme was essentially arbitrary, so the frequencies we present should be interpreted with this in mind. The analysis of live birth denominators was post hoc. There is massive diversity in numerator and denominator selection in IVF trials due to its multistage nature, and this causes methodological frailty in the evidence base. The twin spectres of outcome reporting bias and analysis of non

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

Science.gov (United States)

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

2017-01-01

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

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

NARCIS (Netherlands)

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

2015-01-01

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

A measurement-based generalized source model for Monte Carlo dose simulations of CT scans.

Science.gov (United States)

Ming, Xin; Feng, Yuanming; Liu, Ransheng; Yang, Chengwen; Zhou, Li; Zhai, Hezheng; Deng, Jun

2017-03-07

The goal of this study is to develop a generalized source model for accurate Monte Carlo dose simulations of CT scans based solely on the measurement data without a priori knowledge of scanner specifications. The proposed generalized source model consists of an extended circular source located at x-ray target level with its energy spectrum, source distribution and fluence distribution derived from a set of measurement data conveniently available in the clinic. Specifically, the central axis percent depth dose (PDD) curves measured in water and the cone output factors measured in air were used to derive the energy spectrum and the source distribution respectively with a Levenberg-Marquardt algorithm. The in-air film measurement of fan-beam dose profiles at fixed gantry was back-projected to generate the fluence distribution of the source model. A benchmarked Monte Carlo user code was used to simulate the dose distributions in water with the developed source model as beam input. The feasibility and accuracy of the proposed source model was tested on a GE LightSpeed and a Philips Brilliance Big Bore multi-detector CT (MDCT) scanners available in our clinic. In general, the Monte Carlo simulations of the PDDs in water and dose profiles along lateral and longitudinal directions agreed with the measurements within 4%/1 mm for both CT scanners. The absolute dose comparison using two CTDI phantoms (16 cm and 32 cm in diameters) indicated a better than 5% agreement between the Monte Carlo-simulated and the ion chamber-measured doses at a variety of locations for the two scanners. Overall, this study demonstrated that a generalized source model can be constructed based only on a set of measurement data and used for accurate Monte Carlo dose simulations of patients' CT scans, which would facilitate patient-specific CT organ dose estimation and cancer risk management in the diagnostic and therapeutic radiology.

A measurement-based generalized source model for Monte Carlo dose simulations of CT scans

Science.gov (United States)

Ming, Xin; Feng, Yuanming; Liu, Ransheng; Yang, Chengwen; Zhou, Li; Zhai, Hezheng; Deng, Jun

2017-03-01

The goal of this study is to develop a generalized source model for accurate Monte Carlo dose simulations of CT scans based solely on the measurement data without a priori knowledge of scanner specifications. The proposed generalized source model consists of an extended circular source located at x-ray target level with its energy spectrum, source distribution and fluence distribution derived from a set of measurement data conveniently available in the clinic. Specifically, the central axis percent depth dose (PDD) curves measured in water and the cone output factors measured in air were used to derive the energy spectrum and the source distribution respectively with a Levenberg-Marquardt algorithm. The in-air film measurement of fan-beam dose profiles at fixed gantry was back-projected to generate the fluence distribution of the source model. A benchmarked Monte Carlo user code was used to simulate the dose distributions in water with the developed source model as beam input. The feasibility and accuracy of the proposed source model was tested on a GE LightSpeed and a Philips Brilliance Big Bore multi-detector CT (MDCT) scanners available in our clinic. In general, the Monte Carlo simulations of the PDDs in water and dose profiles along lateral and longitudinal directions agreed with the measurements within 4%/1 mm for both CT scanners. The absolute dose comparison using two CTDI phantoms (16 cm and 32 cm in diameters) indicated a better than 5% agreement between the Monte Carlo-simulated and the ion chamber-measured doses at a variety of locations for the two scanners. Overall, this study demonstrated that a generalized source model can be constructed based only on a set of measurement data and used for accurate Monte Carlo dose simulations of patients’ CT scans, which would facilitate patient-specific CT organ dose estimation and cancer risk management in the diagnostic and therapeutic radiology.

Directly measured secondhand smoke exposure and COPD health outcomes

Directory of Open Access Journals (Sweden)

Balmes John

2006-06-01

Full Text Available Abstract Background Although personal cigarette smoking is the most important cause and modulator of chronic obstructive pulmonary disease (COPD, secondhand smoke (SHS exposure could influence the course of the disease. Despite the importance of this question, the impact of SHS exposure on COPD health outcomes remains unknown. Methods We used data from two waves of a population-based multiwave U.S. cohort study of adults with COPD. 77 non-smoking respondents with a diagnosis of COPD completed direct SHS monitoring based on urine cotinine and a personal badge that measures nicotine. We evaluated the longitudinal impact of SHS exposure on validated measures of COPD severity, physical health status, quality of life (QOL, and dyspnea measured at one year follow-up. Results The highest level of SHS exposure, as measured by urine cotinine, was cross-sectionally associated with poorer COPD severity (mean score increment 4.7 pts; 95% CI 0.6 to 8.9 and dyspnea (1.0 pts; 95% CI 0.4 to 1.7 after controlling for covariates. In longitudinal analysis, the highest level of baseline cotinine was associated with worse COPD severity (4.7 points; 95% CI -0.1 to 9.4; p = 0.054, disease-specific QOL (2.9 pts; -0.16 to 5.9; p = 0.063, and dyspnea (0.9 pts; 95% CI 0.2 to 1.6 pts; p Conclusion Directly measured SHS exposure appears to adversely influence health outcomes in COPD, independent of personal smoking. Because SHS is a modifiable risk factor, clinicians should assess SHS exposure in their patients and counsel its avoidance. In public health terms, the effects of SHS exposure on this vulnerable subpopulation provide a further rationale for laws prohibiting public smoking.

Patient-reported outcomes (PROs): the significance of using humanistic measures in clinical trial and clinical practice.

Science.gov (United States)

Refolo, P; Minacori, R; Mele, V; Sacchini, D; Spagnolo, A G

2012-10-01

Patient-reported outcome (PRO) is an "umbrella term" that covers a whole range of potential types of measurement but it is used specifically to refer to all measures quantifying the state of health through the evaluation of outcomes reported by the patient himself/herself. PROs are increasingly seen as complementary to biomedical measures and they are being incorporated more frequently into clinical trials and clinical practice. After considering the cultural background of PROs - that is the well known patient-centered model of medicine -, their historical profile (since 1914, the year of the first outcome measure) and typologies, the paper aims at debating their methodological complexity and implementation into practice. Some clinical trials and therapeutic managements utilizing patient-centered measures will be also analyzed.

Measurement properties of the Health of the Nation Outcome Scales (HoNOS) family of measures: protocol for a systematic review

Science.gov (United States)

Harris, Meredith G; Sparti, Claudia; Scheurer, Roman; Coombs, Tim; Pirkis, Jane; Ruud, Torleif; Kisely, Steve; Hanssen-Bauer, Ketil; Siqveland, Johan; Burgess, Philip M

2018-01-01

Introduction The Health of the Nation Outcome Scales (HoNOS) for adults, and equivalent measures for children and adolescents and older people, are widely used in clinical practice and research contexts to measure mental health and functional outcomes. Additional HoNOS measures have been developed for special populations and applications. Stakeholders require synthesised information about the measurement properties of these measures to assess whether they are fit for use with intended service settings and populations and to establish performance benchmarks. This planned systematic review will critically appraise evidence on the measurement properties of the HoNOS family of measures. Methods and analysis Journal articles meeting inclusion criteria will be identified via a search of seven electronic databases: MEDLINE via EBSCOhost, PsycINFO via APA PsycNET, Embase via Elsevier, Cumulative Index to Nursing and Allied Health Literature via EBSCOhost, Web of Science via Thomson Reuters, Google Scholar and the Cochrane Library. Variants of ‘Health of the Nation Outcome Scales’ or ‘HoNOS’ will be searched as text words. No restrictions will be placed on setting or language of publication. Reference lists of relevant studies and reviews will be scanned for additional eligible studies. Appraisal of reliability, validity, responsiveness and interpretability will be guided by the COnsensus-based Standards for the selection of health Measurement INstruments checklist. Feasibility/utility will be appraised using definitions and criteria derived from previous reviews. For reliability studies, we will also apply the Guidelines for Reporting Reliability and Agreement Studies to assess quality of reporting. Results will be synthesised narratively, separately for each measure, and by subgroup (eg, treatment setting, rater profession/experience or training) where possible. Meta-analyses will be undertaken where data are adequate. Ethics and dissemination Ethics approval is

Measurement properties of the Health of the Nation Outcome Scales (HoNOS) family of measures: protocol for a systematic review.

Science.gov (United States)

Harris, Meredith G; Sparti, Claudia; Scheurer, Roman; Coombs, Tim; Pirkis, Jane; Ruud, Torleif; Kisely, Steve; Hanssen-Bauer, Ketil; Siqveland, Johan; Burgess, Philip M

2018-04-20

The Health of the Nation Outcome Scales (HoNOS) for adults, and equivalent measures for children and adolescents and older people, are widely used in clinical practice and research contexts to measure mental health and functional outcomes. Additional HoNOS measures have been developed for special populations and applications. Stakeholders require synthesised information about the measurement properties of these measures to assess whether they are fit for use with intended service settings and populations and to establish performance benchmarks. This planned systematic review will critically appraise evidence on the measurement properties of the HoNOS family of measures. Journal articles meeting inclusion criteria will be identified via a search of seven electronic databases: MEDLINE via EBSCOhost, PsycINFO via APA PsycNET, Embase via Elsevier, Cumulative Index to Nursing and Allied Health Literature via EBSCOhost, Web of Science via Thomson Reuters, Google Scholar and the Cochrane Library. Variants of 'Health of the Nation Outcome Scales' or 'HoNOS' will be searched as text words. No restrictions will be placed on setting or language of publication. Reference lists of relevant studies and reviews will be scanned for additional eligible studies. Appraisal of reliability, validity, responsiveness and interpretability will be guided by the COnsensus-based Standards for the selection of health Measurement INstruments checklist. Feasibility/utility will be appraised using definitions and criteria derived from previous reviews. For reliability studies, we will also apply the Guidelines for Reporting Reliability and Agreement Studies to assess quality of reporting. Results will be synthesised narratively, separately for each measure, and by subgroup (eg, treatment setting, rater profession/experience or training) where possible. Meta-analyses will be undertaken where data are adequate. Ethics approval is not required as no primary data will be collected. Outcomes will be

Measurements of bremsstrahlung spectra of Lanzhou ECR Ion Source No. 3 (LECR3)

International Nuclear Information System (INIS)

Zhao, H.Y.; Zhao, H.W.; Ma, X.W.; Zhang, S.F.; Feng, W.T.; Zhu, X.L.; Zhang, Z.M.; He, W.; Sun, L.T.; Feng, Y.C.; Cao, Y.; Li, J.Y.; Li, X.X.; Wang, H.; Ma, B.H.

2006-01-01

In order to diagnose the electron cyclotron resonance (ECR) plasma, electron bremsstrahlung spectra were measured by a HPGe detector on Lanzhou ECR Ion Source No. 3 at IMP. The ion source was operated with argon under various working conditions, including different microwave power, mixing gas, extraction high voltage (HV), and so on. Some of the measured spectra are presented in this article. The dependence of energetic electron population on mixing gas and extraction HV is also described. Additionally, we are looking forward to further measurements on SECRAL (Superconducting ECR Ion Source with Advanced design at Lanzhou)

Radio measurements in the fields of gamma-ray sources. Pt. 1

International Nuclear Information System (INIS)

Sieber, W.; Schlickeiser, R.

1982-01-01

The γ-ray source CG 195+04 has been searched for radio counterparts at wavelengths between 2.8 cm and 18 cm with the 100-m telescope of the Max-Planck-Institut fuer Radioastronomie, Bonn. We have detected a number of sources and measured their spectra. Our positions may form the basis for future surveys in other frequency ranges. Different physical emission models suggest compactness of the γ-ray source. (orig.)

Study of localized photon source in space of measures

International Nuclear Information System (INIS)

Lisi, M.

2010-01-01

In this paper we study a three-dimensional photon transport problem in an interstellar cloud, with a localized photon source inside. The problem is solved indirectly, by defining the adjoint of an operator acting on an appropriate space of continuous functions. By means of sun-adjoint semi groups theory of operators in a Banach space of regular Borel measures, we prove existence and uniqueness of the solution of the problem. A possible approach to identify the localization of the photon source is finally proposed.

Alzheimer Disease Biomarkers as Outcome Measures for Clinical Trials in MCI.

Science.gov (United States)

Caroli, Anna; Prestia, Annapaola; Wade, Sara; Chen, Kewei; Ayutyanont, Napatkamon; Landau, Susan M; Madison, Cindee M; Haense, Cathleen; Herholz, Karl; Reiman, Eric M; Jagust, William J; Frisoni, Giovanni B

2015-01-01

The aim of this study was to compare the performance and power of the best-established diagnostic biological markers as outcome measures for clinical trials in patients with mild cognitive impairment (MCI). Magnetic resonance imaging, F-18 fluorodeoxyglucose positron emission tomography markers, and Alzheimer's Disease Assessment Scale-cognitive subscale were compared in terms of effect size and statistical power over different follow-up periods in 2 MCI groups, selected from Alzheimer's Disease Neuroimaging Initiative data set based on cerebrospinal fluid (abnormal cerebrospinal fluid Aβ1-42 concentration-ABETA+) or magnetic resonance imaging evidence of Alzheimer disease (positivity to hippocampal atrophy-HIPPO+). Biomarkers progression was modeled through mixed effect models. Scaled slope was chosen as measure of effect size. Biomarkers power was estimated using simulation algorithms. Seventy-four ABETA+ and 51 HIPPO+ MCI patients were included in the study. Imaging biomarkers of neurodegeneration, especially MR measurements, showed highest performance. For all biomarkers and both MCI groups, power increased with increasing follow-up time, irrespective of biomarker assessment frequency. These findings provide information about biomarker enrichment and outcome measurements that could be employed to reduce MCI patient samples and treatment duration in future clinical trials.

Recommendations for a first Core Outcome Measurement set for complex regional PAin syndrome Clinical sTudies (COMPACT)

Science.gov (United States)

Grieve, Sharon; Perez, Roberto SGM; Birklein, Frank; Brunner, Florian; Bruehl, Stephen; Harden R, Norman; Packham, Tara; Gobeil, Francois; Haigh, Richard; Holly, Janet; Terkelsen, Astrid; Davies, Lindsay; Lewis, Jennifer; Thomassen, Ilona; Connett, Robyn; Worth, Tina; Vatine, Jean-Jacques; McCabe, Candida S

2017-01-01

Complex Regional Pain Syndrome (CRPS) is a persistent pain condition that remains incompletely understood and challenging to treat. Historically, a wide range of different outcome measures have been used to capture the multidimensional nature of CRPS. This has been a significant limiting factor in the advancement of our understanding of the mechanisms and management of CRPS. In 2013, an international consortium of patients, clinicians, researchers and industry representatives was established, to develop and agree on a minimum core set of standardised outcome measures for use in future CRPS clinical research, including but not limited to clinical trials within adult populations The development of a core measurement set was informed through workshops and supplementary work, using an iterative consensus process. ‘What is the clinical presentation and course of CRPS, and what factors influence it?’ was agreed as the most pertinent research question that our standardised set of patient-reported outcome measures should be selected to answer. The domains encompassing the key concepts necessary to answer the research question were agreed as: pain, disease severity, participation and physical function, emotional and psychological function, self efficacy, catastrophizing and patient's global impression of change. The final core measurement set included the optimum generic or condition-specific patient-reported questionnaire outcome measures, which captured the essence of each domain, and one clinician reported outcome measure to capture the degree of severity of CRPS. The next step is to test the feasibility and acceptability of collecting outcome measure data using the core measurement set in the CRPS population internationally. PMID:28178071

Performance measurement of the gas tax and public transit funds : final report

International Nuclear Information System (INIS)

2007-01-01

Federal funding for the gas tax fund and public transit fund are provided through Infrastructure Canada for municipal infrastructure across Canada in a broad range of municipal service projects. In order to identify appropriate outcomes that would meet reporting requirements for the gas tax fund and public transit fund, this report outlined a performance measurement approach that would allow for the reporting of projects under both funds and provide a structured methodology for multiple year analysis of benefits. The report discussed the performance measures process review and outcomes approach logic model. It also provided an outline of information sourcing strategies including an overview of the project types and expenditures; information sourcing strategy; typical municipal information sources by project type; performance measurement framework assumptions and limitations; and modeling of outcomes from outputs. Conclusions and recommendations were also offered. It was concluded that based on a comprehensive review of ancillary benefits and outcomes of various historic funding programs, there are 3 foundational outcomes that should be considered to assess all initial program outcomes. These include cleaner air, cleaner water and reduced greenhouse gas emissions. tabs., figs

Evaluation of outcome measures for use in clinical practice for adults with musculoskeletal conditions of the knee: a systematic review.

Science.gov (United States)

Howe, Tracey E; Dawson, Lesley J; Syme, Grant; Duncan, Louise; Reid, Judith

2012-04-01

This systematic review reported on the clinimetric properties of outcome measures for use in clinical practice for adults with musculoskeletal conditions of the knee. A systematic search was performed in Medline, EMBASE, Cinahl and AMED to identify studies examining the clinimetric properties of outcome measures for adults undergoing conservative treatment of ligament injuries, meniscal lesions, patellofemoral pain and osteoarthritis of the knee. Outcomes measures taking less than 20 min to administer and requiring minimal equipment and space were included. Pairs of authors used a checklist to record the characteristics of the outcome measures, their reported clinimetric properties and the demographics of the study populations. The OMERACT filters of 'truth' and 'discrimination' were applied to the data for each outcome measure by an expert panel. Forty-seven studies were included evaluating 37 outcome measures. Ten outcome measures had adequate supporting evidence for 'truth' and 'discrimination': AAOS, AKPS, goniometer measurement, IKDC, KOOS, LEFS, Lysholm, Tegner, WOMAC and WOMET. However none of the outcome measures had been comprehensively tested across all clinimetric properties. Despite the widespread use of some outcome measures in clinical practice and primary research, data on the clinimetric properties were available for only 37 and of these only 10 had adequate supporting evidence for use in this population. However, before a core set of outcome measures can be recommended use in clinical practice, for adults with musculoskeletal conditions of the knee, consensus should be obtained on 'feasibility' in terms of burden on the clinician and the participant. Copyright © 2011 Elsevier Ltd. All rights reserved.

Measurement and simulation of the time-dependent behavior of the UMER source

International Nuclear Information System (INIS)

Haber, I.; Feldman, D.; Fiorito, R.; Friedman, A.; Grote, D.P.; Kishek, R.A.; Quinn, B.; Reiser, M.; Rodgers, J.; O'Shea, P.G.; Stratakis, D.; Tian, K.; Vay, J.-L.; Walter, M.

2007-01-01

Control of the time-dependent characteristics of the beam pulse, beginning when it is born from the source, is important for obtaining adequate beam intensity on a target. Recent experimental measurements combined with the new mesh-refinement capability in WARP have improved the understanding of time-dependent beam characteristics beginning at the source, as well as the predictive ability of the simulation codes. The University of Maryland Electron Ring (UMER), because of its ease of operation and flexible diagnostics has proved particularly useful for benchmarking WARP by comparing simulation to measurement. One source of significant agreement has been in the ability of three-dimensional WARP simulations to predict the onset of virtual cathode oscillations in the vicinity of the cathode grid in the UMER gun, and the subsequent measurement of the predicted oscillations

2π absolute measurement research for α-electroplating source covering ZnS(Ag)

International Nuclear Information System (INIS)

Zhu Tianxia

1999-01-01

2π absolute measurement can be completed after the quantitative deposit (5 +- 1) mg/cm 2 with ZnS(Ag) on surface of the alpha electroplating source. The measuring efficiency is 100%. This method is suitable for both of electroplating ordinary sample and electroplating standard (of reference) source

Fatigue is a reliable, sensitive and unique outcome measure in rheumatoid arthritis.

LENUS (Irish Health Repository)

Minnock, Patricia

2009-12-01

Fatigue is an important symptom in patients with RA. Measurement of fatigue in clinical trials and in clinical practice requires scales that are reproducible, sensitive to change and practical. This study examined the reliability and sensitivity to change of fatigue and its relative independence as an outcome measure in RA.

Effects of neutron source type on soil moisture measurement

Science.gov (United States)

Irving Goldberg; Norman A. MacGillivray; Robert R. Ziemer

1967-01-01

A number of radioisotopes have recently become commercially available as alternatives to radium-225 in moisture gauging devices using alpha-neutron sources for determining soil moisture, for well logging, and for other industrial applications in which hydrogenous materials are measured.

Measurement of the activity of an artificial neutrino source based on 37Ar

International Nuclear Information System (INIS)

Abdurashitov, D. N.; Veretenkin, E. P.; Gavrin, V. N.; Gorbachev, V. V.; Ibragimova, T. V.; Kalikhov, A. V.; Mirmov, I. N.; Shikhin, A. A.; Yants, V. E.; Barsanov, V. I.; Dzhanelidze, A. A.; Zlokazov, S. B.; Markov, S. Yu.; Shakirov, Z. N.; Cleveland, B. T.

2007-01-01

The activity of an artificial neutrino source based on 37 Ar was measured by a specially developed method of directly counting 37 Ar decays in a proportional counter. This source was used to irradiate the target of the SAGE radiochemical gallium-germanium neutrino telescope at the Baksan Neutrino Observatory (Institute for Nuclear Research, Russian Academy of Sciences, Moscow), whereupon the measurements were performed at the Institute of Reactor Materials (Zarechny, Sverdlovsk oblast, Russia). The method used to prepare gaseous samples for measurements in proportional counters and the counting procedure are described. The measured activity of the 37 Ar neutrino source is 405.1 ± 3.7 kCi (corrected for decays that occurred within the period between the instant of activity measurement and the commencement of the irradiation of Ga target at 04:00 Moscow time, 30.04.2004)

Patient Reported Outcome Measure of Spiritual Care as Delivered by Chaplains.

Science.gov (United States)

Snowden, Austyn; Telfer, Iain

2017-01-01

Chaplains are employed by health organizations around the world to support patients in recognizing and addressing their spiritual needs. There is currently no generalizable measure of the impact of these interventions and so the clinical and strategic worth of chaplaincy is difficult to articulate. This article introduces the Scottish PROM, an original five-item patient reported outcome measure constructed specifically to address this gap. It describes the validation process from its conceptual grounding in the spiritual care literature through face and content validity cycles. It shows that the Scottish PROM is internally consistent and unidimensional. Responses to the Scottish PROM show strong convergent validity with responses to the Warwick and Edinburgh Mental Well-Being Scale, a generic well-being scale often used as a proxy for spiritual well-being. In summary, the Scottish PROM is fit for purpose. It measures the outcomes of spiritual care as delivered by chaplains in this study. This novel project introduces an essential and original breakthrough; the possibility of generalizable international chaplaincy research.

Measurement-device-independent quantum communication with an untrusted source

Science.gov (United States)

Xu, Feihu

2015-07-01

Measurement-device-independent quantum key distribution (MDI-QKD) can provide enhanced security compared to traditional QKD, and it constitutes an important framework for a quantum network with an untrusted network server. Still, a key assumption in MDI-QKD is that the sources are trusted. We propose here a MDI quantum network with a single untrusted source. We have derived a complete proof of the unconditional security of MDI-QKD with an untrusted source. Using simulations, we have considered various real-life imperfections in its implementation, and the simulation results show that MDI-QKD with an untrusted source provides a key generation rate that is close to the rate of initial MDI-QKD in the asymptotic setting. Our work proves the feasibility of the realization of a quantum network. The network users need only low-cost modulation devices, and they can share both an expensive detector and a complicated laser provided by an untrusted network server.

Optimized spectroscopic scheme for enhanced precision CO measurements with applications to urban source attribution

Science.gov (United States)

Nottrott, A.; Hoffnagle, J.; Farinas, A.; Rella, C.

2014-12-01

Carbon monoxide (CO) is an urban pollutant generated by internal combustion engines which contributes to the formation of ground level ozone (smog). CO is also an excellent tracer for emissions from mobile combustion sources. In this work we present an optimized spectroscopic sampling scheme that enables enhanced precision CO measurements. The scheme was implemented on the Picarro G2401 Cavity Ring-Down Spectroscopy (CRDS) analyzer which measures CO2, CO, CH4 and H2O at 0.2 Hz. The optimized scheme improved the raw precision of CO measurements by 40% from 5 ppb to 3 ppb. Correlations of measured CO2, CO, CH4 and H2O from an urban tower were partitioned by wind direction and combined with a concentration footprint model for source attribution. The application of a concentration footprint for source attribution has several advantages. The upwind extent of the concentration footprint for a given sensor is much larger than the flux footprint. Measurements of mean concentration at the sensor location can be used to estimate source strength from a concentration footprint, while measurements of the vertical concentration flux are necessary to determine source strength from the flux footprint. Direct measurement of vertical concentration flux requires high frequency temporal sampling and increases the cost and complexity of the measurement system.

Clinical Outcomes Measures for Assessment of Longevity in the Dental Implant Literature : ORONet Approach

NARCIS (Netherlands)

Bassi, Francesco; Carr, Alan B.; Chang, Ting-Ling; Estafanous, Emad; Garrett, Neal R.; Happonen, Risto-Pekka; Koka, Sreenivas; Laine, Juhani; Osswald, Martin; Reintsema, Harry; Rieger, Jana; Roumanas, Eleni; Salinas, Thomas J.; Stanford, Clark M.; Wolfaardt, Johan

2013-01-01

The Oral Rehabilitation Outcomes Network (ORONet) Longevity Working Group undertook a search of the literature from 1995 to 2009 on randomized controlled trials related to longevity of osseointegrated implants. Outcomes measures used in these studies were identified and subjected to the OMERACT

Experience and problems of the automated measuring and sorting of sealed radiation sources

International Nuclear Information System (INIS)

Shmidt, G.

1979-01-01

It has been shown that with the help of a serial device for samples changing and a mini-computer with a suitable software it is possible to organize the radioactivity measuring and sorting of sealed gamma-sources with activity in the microcuri region. Application of the computer permits to rise accuracy of the data on the radiation sources radioactivity, sorted according to the preset activity level groups and, in the casa of necessity, to perform the activity measurements with lower error. The method listed, gives the working-time economy of nearly 4 hours in measuring and sorting of some 500 sealed radiation sources [ru

Presurgery resting-state local graph-theory measures predict neurocognitive outcomes after brain surgery in temporal lobe epilepsy.

Science.gov (United States)

Doucet, Gaelle E; Rider, Robert; Taylor, Nathan; Skidmore, Christopher; Sharan, Ashwini; Sperling, Michael; Tracy, Joseph I

2015-04-01

This study determined the ability of resting-state functional connectivity (rsFC) graph-theory measures to predict neurocognitive status postsurgery in patients with temporal lobe epilepsy (TLE) who underwent anterior temporal lobectomy (ATL). A presurgical resting-state functional magnetic resonance imaging (fMRI) condition was collected in 16 left and 16 right TLE patients who underwent ATL. In addition, patients received neuropsychological testing pre- and postsurgery in verbal and nonverbal episodic memory, language, working memory, and attention domains. Regarding the functional data, we investigated three graph-theory properties (local efficiency, distance, and participation), measuring segregation, integration and centrality, respectively. These measures were only computed in regions of functional relevance to the ictal pathology, or the cognitive domain. Linear regression analyses were computed to predict the change in each neurocognitive domain. Our analyses revealed that cognitive outcome was successfully predicted with at least 68% of the variance explained in each model, for both TLE groups. The only model not significantly predictive involved nonverbal episodic memory outcome in right TLE. Measures involving the healthy hippocampus were the most common among the predictors, suggesting that enhanced integration of this structure with the rest of the brain may improve cognitive outcomes. Regardless of TLE group, left inferior frontal regions were the best predictors of language outcome. Working memory outcome was predicted mostly by right-sided regions, in both groups. Overall, the results indicated our integration measure was the most predictive of neurocognitive outcome. In contrast, our segregation measure was the least predictive. This study provides evidence that presurgery rsFC measures may help determine neurocognitive outcomes following ATL. The results have implications for refining our understanding of compensatory reorganization and predicting

Vision and vision-related outcome measures in multiple sclerosis

DEFF Research Database (Denmark)

Balcer, Laura J; Miller, David H; Reingold, Stephen C

2015-01-01

Visual impairment is a key manifestation of multiple sclerosis. Acute optic neuritis is a common, often presenting manifestation, but visual deficits and structural loss of retinal axonal and neuronal integrity can occur even without a history of optic neuritis. Interest in vision in multiple...... sclerosis is growing, partially in response to the development of sensitive visual function tests, structural markers such as optical coherence tomography and magnetic resonance imaging, and quality of life measures that give clinical meaning to the structure-function correlations that are unique...... of investigators involved in the development and study of visual outcomes in multiple sclerosis, which had, as its overriding goals, to review the state of the field and identify areas for future research. We review data and principles to help us understand the importance of vision as a model for outcomes...

Development of a core outcome set for clinical trials in facial aging: study protocol for a systematic review of the literature and identification of a core outcome set using a Delphi survey.

Science.gov (United States)

Schlessinger, Daniel I; Iyengar, Sanjana; Yanes, Arianna F; Henley, Jill K; Ashchyan, Hovik J; Kurta, Anastasia O; Patel, Payal M; Sheikh, Umar A; Franklin, Matthew J; Hanna, Courtney C; Chen, Brian R; Chiren, Sarah G; Schmitt, Jochen; Deckert, Stefanie; Furlan, Karina C; Poon, Emily; Maher, Ian A; Cartee, Todd V; Sobanko, Joseph F; Alam, Murad

2017-08-01

Facial aging is a concern for many patients. Wrinkles, loss of volume, and discoloration are common physical manifestations of aging skin. Genetic heritage, prior ultraviolet light exposure, and Fitzpatrick skin type may be associated with the rate and type of facial aging. Although many clinical trials assess the correlates of skin aging, there is heterogeneity in the outcomes assessed, which limits the quality of evaluation and comparison of treatment modalities. To address the inconsistency in outcomes, in this project we will develop a core set of outcomes that are to be evaluated in all clinical trials relevant to facial aging. A long list of measureable outcomes will be created from four sources: (1) systematic medical literature review, (2) patient interviews, (3) other published sources, and (4) stakeholder involvement. Two rounds of Delphi processes with homogeneous groups of physicians and patients will be performed to prioritize and condense the list. At a consensus meeting attended by physicians, patients, and stakeholders, outcomes will be further condensed on the basis of participant scores. By the end of the meeting, members will vote and decide on a final recommended set of core outcomes. Subsequent to this, specific measures will be selected or created to assess these outcomes. The aim of this study is to develop a core outcome set and relevant measures for clinical trials relevant to facial aging. We hope to improve the reliability and consistency of outcome reporting of skin aging, thereby enabling improved evaluation of treatment efficacy and patient satisfaction. Core Outcome Measures in Effectiveness Trials (COMET) Initiative, accessible at http://www.comet-initiative.org/studies/details/737 . Core Outcomes Set Initiative, (CSG-COUSIN) accessible at https://www.uniklinikum-dresden.de/de/das-klinikum/universitaetscentren/zegv/cousin/meet-the-teams/project-groups/core-outcome-set-for-the-appearance-of-facial-aging . Protocol version date is 28

Initial constructs for patient-centered outcome measures to evaluate brain-computer interfaces.

Science.gov (United States)

Andresen, Elena M; Fried-Oken, Melanie; Peters, Betts; Patrick, Donald L

2016-10-01

The authors describe preliminary work toward the creation of patient-centered outcome (PCO) measures to evaluate brain-computer interface (BCI) as an assistive technology (AT) for individuals with severe speech and physical impairments (SSPI). In Phase 1, 591 items from 15 existing measures were mapped to the International Classification of Functioning, Disability and Health (ICF). In Phase 2, qualitative interviews were conducted with eight people with SSPI and seven caregivers. Resulting text data were coded in an iterative analysis. Most items (79%) were mapped to the ICF environmental domain; over half (53%) were mapped to more than one domain. The ICF framework was well suited for mapping items related to body functions and structures, but less so for items in other areas, including personal factors. Two constructs emerged from qualitative data: quality of life (QOL) and AT. Component domains and themes were identified for each. Preliminary constructs, domains and themes were generated for future PCO measures relevant to BCI. Existing instruments are sufficient for initial items but do not adequately match the values of people with SSPI and their caregivers. Field methods for interviewing people with SSPI were successful, and support the inclusion of these individuals in PCO research. Implications for Rehabilitation Adapted interview methods allow people with severe speech and physical impairments to participate in patient-centered outcomes research. Patient-centered outcome measures are needed to evaluate the clinical implementation of brain-computer interface as an assistive technology.

Faustmann and the forestry tradition of outcome-based performance measures

Science.gov (United States)

Peter J. Ince

1999-01-01

The concept of land expectation value developed by Martin Faustmann may serve as a paradigm for outcome-based performance measures in public forest management if the concept of forest equity value is broadened to include social and environmental benefits and costs, and sustainability. However, anticipation and accurate evaluation of all benefits and costs appears to...

The importance of patient-reported outcome measures in reconstructive urology.

Science.gov (United States)

Jackson, Matthew J; N'Dow, James; Pickard, Rob

2010-11-01

Patient-reported outcome measures (PROMs) are now recognised as the most appropriate instruments to assess the effectiveness of healthcare interventions from the patient's perspective. The purpose of this review was to identify recent publications describing the use of PROMs following reconstructive urological surgery. A wide systematic search identified only three original articles published in the last 2 years that prospectively assessed effectiveness using a patient-completed condition-specific or generic health-related quality of life (HRQoL) instrument. These publications illustrate the need to administer PROMs at a postoperative interval relevant to the anticipated recovery phase of individual procedures. They also highlight the difference in responsiveness of generic HRQoL instruments to symptomatic improvement between straightforward conditions such as pelviureteric junction obstruction and complex multidimensional conditions such as meningomyelocele. PROMs uptake and awareness is increasing in reconstructive urology but more work is required to demonstrate the effectiveness of surgical procedures for patients and healthcare funders alike. Healthcare policy-makers now rely on these measures to determine whether specific treatments are worth financing and to compare outcomes between institutions.

Systematic review of tools to measure outcomes for young children with autism spectrum disorder

NARCIS (Netherlands)

McConachie, H.; Parr, J.R.; Glod, M.; Hanratty, J.; Livingstone, N.; Oono, I.P.; Robalino, S.; Baird, G.; Beresford, B.; Charman, T.; Garland, D.; Green, J.; Gringras, P.; Jones, G.; Law, J.; Le Couteur, A.S.; Macdonald, G.; McColl, E.M.; Morris, C.; Rodgers, J.; Simonoff, E.; Terwee, C.B.; Williams, K.

2015-01-01

Background: The needs of children with autism spectrum disorder (ASD) are complex and this is reflected in the number and diversity of outcomes assessed and measurement tools used to collect evidence about children�s progress. Relevant outcomes include improvement in core ASD impairments, such as

Timing jitter measurements at the SLC electron source

International Nuclear Information System (INIS)

Sodja, J.; Browne, M.J.; Clendenin, J.E.

1989-03-01

The SLC thermionic gun and electron source produce a beam of up to 15 /times/ 10 10 /sub e//minus/ in a single S-band bunch. A 170 keV, 2 ns FWHM pulse out of the gun is compressed by means of two subharmonic buncher cavities followed by an S-band buncher and a standard SLAC accelerating section. Ceramic gaps in the beam pipe at the output of the gun allow a measure of the beam intensity and timing. A measurement at these gaps of the timing jitter, with a resolution of <10 ps, is described. 3 refs., 5 figs

Developing a General Outcome Measure of Growth in Movement for Infants and Toddlers.

Science.gov (United States)

Greenwood, Charles R.; Luze, Gayle J.; Cline, Gabriel; Kuntz, Susan; Leitschuh, Carol

2002-01-01

The development of an experimental measure for assessing growth in movement in children (ages birth-3) is described. Results from the use of the Movement General Outcome Measurement with 29 infants and toddlers demonstrated the feasibility of the measure. The 6-minute assessment was found reliable in terms of inter-observer agreement. (Contains…

Can community change be measured for an outcomes-based initiative? A comparative case study of the success by 6 initiative.

Science.gov (United States)

Minich, Lisa; Howe, Steven; Langmeyer, Daniel; Corcoran, Kevin

2006-12-01

One of the challenges facing nonprofit organizations today is the demand for measurable results. Increasingly, these organizations are focusing less on program outputs and program outcomes in favor of community outcomes or changes demonstrated in the larger community. Success by 6(R) is a popular United Way initiative that emphasizes defining and measuring community outcomes. In this paper, we describe our work with 24 Success by 6(R) initiatives around the country. It is clear that not all of these initiatives are measuring community outcomes. Of those initiatives that are experiencing some success measuring community outcomes, similar measurement strategies are reported. Additionally, our experience suggests several United Way employees express dissatisfaction with the logic model as a framework for defining and measuring community outcomes although no preferred alternative model is identified. Evaluators working with community-wide initiatives must find ways to communicate the differences between program and community outcomes to key stakeholders and funders.

Interferometry with flexible point source array for measuring complex freeform surface and its design algorithm

Science.gov (United States)

Li, Jia; Shen, Hua; Zhu, Rihong; Gao, Jinming; Sun, Yue; Wang, Jinsong; Li, Bo

2018-06-01

The precision of the measurements of aspheric and freeform surfaces remains the primary factor restrict their manufacture and application. One effective means of measuring such surfaces involves using reference or probe beams with angle modulation, such as tilted-wave-interferometer (TWI). It is necessary to improve the measurement efficiency by obtaining the optimum point source array for different pieces before TWI measurements. For purpose of forming a point source array based on the gradients of different surfaces under test, we established a mathematical model describing the relationship between the point source array and the test surface. However, the optimal point sources are irregularly distributed. In order to achieve a flexible point source array according to the gradient of test surface, a novel interference setup using fiber array is proposed in which every point source can be independently controlled on and off. Simulations and the actual measurement examples of two different surfaces are given in this paper to verify the mathematical model. Finally, we performed an experiment of testing an off-axis ellipsoidal surface that proved the validity of the proposed interference system.

Source profiles of volatile organic compounds (VOCs) measured in China: Part I

Science.gov (United States)

Liu, Ying; Shao, Min; Fu, Linlin; Lu, Sihua; Zeng, Limin; Tang, Dagang

The profiles of major volatile organic compound (VOC) sources in China, including vehicle exhaust, gasoline vapor, paint, asphalt, industrial and residential coal burning, biomass burning, and the petrochemical industry, were experimentally determined. Source samples were taken using a dilution chamber for mobile and stationary sources, biomass burning in an actual Chinese farmer's house, and ambient air in a petrochemical industrial area. The concentrations of 92 VOC species were quantified using canister sampling and a gas chromatography-flame ionization detection/mass spectrometry system, and VOC source profiles were developed for source apportionment of VOCs in the Pearl River Delta region. Based on the measurement of source profiles, possible tracers for various emission sources were identified; e.g., 2-methylpentane and 1,3-butadiene could be used as tracers for vehicle exhaust; the characteristic compounds of architectural coating were aromatics such as toluene and m, p-xylene; the light hydrocarbons, namely n-butane, trans-2-butene, and n-pentane, dominated the composition of gasoline vapor; and n-nonane, n-decane, and n-undecane were found to be typical of diesel vapor and asphalt application processes. As different emission sources are characterized by overlapping VOC species, the ratio of possible VOC tracers could be used to assess the contribution of various sources. The ratios between n-butane and isobutane, 1,3-butadiene and isoprene, and the ratios of aromatics (e.g., toluene to benzene and ethylbenzene to m, p-xylene) in the measured sources were compared.

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

DEFF Research Database (Denmark)

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

2016-01-01

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

An International Standard Set of Patient-Centered Outcome Measures After Stroke

NARCIS (Netherlands)

Salinas, J. (Joel); Sprinkhuizen, S.M. (Sara M.); Ackerson, T. (Teri); Bernhardt, J. (Julie); Davie, C. (Charlie); George, M.G. (Mary G.); Gething, S. (Stephanie); Kelly, A.G. (Adam G.); Lindsay, P. (Patrice); Liu, L. (Liping); Martins, S.C.O. (Sheila C.O.); Morgan, L. (Louise); B. Norrving (Bo); Ribbers, G.M. (Gerard M.); Silver, F.L. (Frank L.); Smith, E.E. (Eric E.); Williams, L.S. (Linda S.); Schwamm, L.H. (Lee H.)

2015-01-01

markdownabstract__BACKGROUND AND PURPOSE:__ Value-based health care aims to bring together patients and health systems to maximize the ratio of quality over cost. To enable assessment of healthcare value in stroke management, an international standard set of patient-centered stroke outcome measures

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

DEFF Research Database (Denmark)

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

2017-01-01

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

Considerations for analysis of time-to-event outcomes measured with error: Bias and correction with SIMEX.

Science.gov (United States)

Oh, Eric J; Shepherd, Bryan E; Lumley, Thomas; Shaw, Pamela A

2018-04-15

For time-to-event outcomes, a rich literature exists on the bias introduced by covariate measurement error in regression models, such as the Cox model, and methods of analysis to address this bias. By comparison, less attention has been given to understanding the impact or addressing errors in the failure time outcome. For many diseases, the timing of an event of interest (such as progression-free survival or time to AIDS progression) can be difficult to assess or reliant on self-report and therefore prone to measurement error. For linear models, it is well known that random errors in the outcome variable do not bias regression estimates. With nonlinear models, however, even random error or misclassification can introduce bias into estimated parameters. We compare the performance of 2 common regression models, the Cox and Weibull models, in the setting of measurement error in the failure time outcome. We introduce an extension of the SIMEX method to correct for bias in hazard ratio estimates from the Cox model and discuss other analysis options to address measurement error in the response. A formula to estimate the bias induced into the hazard ratio by classical measurement error in the event time for a log-linear survival model is presented. Detailed numerical studies are presented to examine the performance of the proposed SIMEX method under varying levels and parametric forms of the error in the outcome. We further illustrate the method with observational data on HIV outcomes from the Vanderbilt Comprehensive Care Clinic. Copyright © 2017 John Wiley & Sons, Ltd.

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

Science.gov (United States)

Oates, Matthew; Davidson, Megan

2015-04-01

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

A portable measurement system for subcriticality measurements by the Cf-source-driven neutron noise analysis method

International Nuclear Information System (INIS)

Mihalczo, J.T.; Ragan, G.E.; Blakeman, E.D.

1987-01-01

A portable measurement system consisting of a personal computer used as a Fourier analyzer and three detection channels (with associated electronics that provide the signals to analog-to-digital (A/D) convertors) has been assembled to measure subcriticality by the 252 Cf-source-driven neutron noise analysis method. 8 refs

Use of and confidence in administering outcome measures among clinical prosthetists: Results from a national survey and mixed-methods training program.

Science.gov (United States)

Gaunaurd, Ignacio; Spaulding, Susan E; Amtmann, Dagmar; Salem, Rana; Gailey, Robert; Morgan, Sara J; Hafner, Brian J

2015-08-01

Outcome measures can be used in prosthetic practices to evaluate interventions, inform decision making, monitor progress, document outcomes, and justify services. Strategies to enhance prosthetists' ability to use outcome measures are needed to facilitate their adoption in routine practice. To assess prosthetists' use of outcome measures and evaluate the effects of training on their confidence in administering performance-based measures. Cross-sectional and single-group pretest-posttest survey. Seventy-nine certified prosthetists (mean of 16.0 years of clinical experience) were surveyed about their experiences with 20 standardized outcome measures. Prosthetists were formally trained by the investigators to administer the Timed Up and Go and Amputee Mobility Predictor. Prosthetists' confidence in administering the Timed Up and Go and Amputee Mobility Predictor was measured before and after training. The majority of prosthetists (62%) were classified as non-routine outcome measure users. Confidence administering the Timed Up and Go and Amputee Mobility Predictor prior to training was low-to-moderate across the study sample. Training significantly (p measures. Interactive training resulted in a statistically significant increase of prosthetists' confidence in administering the Timed Up and Go and Amputee Mobility Predictor and may facilitate use of outcome measures in clinical practice. Frequency of outcome measure use in the care of persons with limb loss has not been studied. Study results suggest that prosthetists may not regularly use standardized outcome measures and report limited confidence in administering them. Training enhances confidence and may encourage use of outcome measures in clinical practice. © The International Society for Prosthetics and Orthotics 2014.

Complementarity between innovation knowledge sources: Does the innovation performance measure matter?

Directory of Open Access Journals (Sweden)

Ana Mª Serrano-Bedia

2018-01-01

Full Text Available We analyse complementarity between different knowledge sources (internal, external and/or cooperation employing a wide range of innovation performance measures (product, process, organizational, and commercial. The empirical study uses 2014 Spanish CIS data and studies complementarities by performing conditional complementarity/substitutability tests. The results show evidence of conditional complementarity in product innovation performance between external and internal knowledge sources in absence of cooperation and of conditional substitute relationship between external and cooperation knowledge sources in presence of internal source. In product and process innovation performance we found a conditional substitute relationship between internal and cooperation sources when external source is used and not used, respectively. This relationship turns to conditional complementarity in organisational innovation in absence of external knowledge source. Therefore, when designing innovation strategy, managers must consider their objectives on a priority basis, since not all the strategies have the same effects on innovation performance.

Birth outcome measures and prenatal exposure to 4-tert-octylphenol

International Nuclear Information System (INIS)

Lv, Shenliang; Wu, Chunhua; Lu, Dasheng; Qi, Xiaojuan; Xu, Hao; Guo, Jianqiu; Liang, Weijiu; Chang, XiuLi

2016-01-01

Exposure to 4-tert-octylphenol (tOP) has been linked with adverse health outcomes in animals and humans, while epidemiological studies about associations between prenatal exposure to tOP and fetal growth are extremely limited. We measured urinary tOP concentrations in 1100 pregnant women before their delivery, and examined whether tOP levels were associated with birth outcomes, including weight, length, head circumference and ponderal index at birth. tOP could be detected in all samples, and the median uncorrected and creatinine-corrected tOP concentrations were 0.90 μg/L (range from 0.25 to 20.05 μg/L) and 1.33 μg/g creatinine (range from 0.15 to 42.49 μg/g creatinine), respectively. Maternal urinary log-transformed tOP concentrations were significantly negatively associated with adjusted birth weight [β (g) = −126; 95% confidence interval (CI): −197, −55], birth length [β (cm) = −0.53; 95% CI:−0.93, −0.14], and head circumference [β (cm) = −0.30; 95% CI: −0.54, −0.07], respectively. Additionally, considering sex difference, these significant negative associations were also found among male neonates, while only higher maternal tOP concentrations were associated with a significant decrease in birth weight among female neonates. This study suggested significant negative associations between maternal urinary tOP concentrations and neonatal sizes at birth, and they differed by neonatal sex. Further epidemiological studies are required to more fully elaborate the associations between prenatal tOP exposure and birth outcomes. - Highlights: • We measured 4-tert-octylphenol (tOP) in urine from 1100 Chinese pregnant women. • The associations between maternal tOP levels and birth outcomes were investigated. • Prenatal exposure to tOP in the selected area was widespread at higher levels. • Maternal tOP levels were significantly negatively associated with birth sizes. • The associations between tOP and birth outcomes might

Funding source and primary outcome changes in clinical trials registered on ClinicalTrials.gov are associated with the reporting of a statistically significant primary outcome: a cross-sectional study [v2; ref status: indexed, http://f1000r.es/5bj

Directory of Open Access Journals (Sweden)

Sreeram V Ramagopalan

2015-04-01

Full Text Available Background: We and others have shown a significant proportion of interventional trials registered on ClinicalTrials.gov have their primary outcomes altered after the listed study start and completion dates. The objectives of this study were to investigate whether changes made to primary outcomes are associated with the likelihood of reporting a statistically significant primary outcome on ClinicalTrials.gov. Methods: A cross-sectional analysis of all interventional clinical trials registered on ClinicalTrials.gov as of 20 November 2014 was performed. The main outcome was any change made to the initially listed primary outcome and the time of the change in relation to the trial start and end date. Findings: 13,238 completed interventional trials were registered with ClinicalTrials.gov that also had study results posted on the website. 2555 (19.3% had one or more statistically significant primary outcomes. Statistical analysis showed that registration year, funding source and primary outcome change after trial completion were associated with reporting a statistically significant primary outcome. Conclusions: Funding source and primary outcome change after trial completion are associated with a statistically significant primary outcome report on clinicaltrials.gov.

Single-case synthesis tools II: Comparing quantitative outcome measures.

Science.gov (United States)

Zimmerman, Kathleen N; Pustejovsky, James E; Ledford, Jennifer R; Barton, Erin E; Severini, Katherine E; Lloyd, Blair P

2018-03-07

Varying methods for evaluating the outcomes of single case research designs (SCD) are currently used in reviews and meta-analyses of interventions. Quantitative effect size measures are often presented alongside visual analysis conclusions. Six measures across two classes-overlap measures (percentage non-overlapping data, improvement rate difference, and Tau) and parametric within-case effect sizes (standardized mean difference and log response ratio [increasing and decreasing])-were compared to determine if choice of synthesis method within and across classes impacts conclusions regarding effectiveness. The effectiveness of sensory-based interventions (SBI), a commonly used class of treatments for young children, was evaluated. Separately from evaluations of rigor and quality, authors evaluated behavior change between baseline and SBI conditions. SBI were unlikely to result in positive behavior change across all measures except IRD. However, subgroup analyses resulted in variable conclusions, indicating that the choice of measures for SCD meta-analyses can impact conclusions. Suggestions for using the log response ratio in SCD meta-analyses and considerations for understanding variability in SCD meta-analysis conclusions are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

THE Q/U IMAGING EXPERIMENT: POLARIZATION MEASUREMENTS OF RADIO SOURCES AT 43 AND 95 GHz

Energy Technology Data Exchange (ETDEWEB)

Huffenberger, K. M. [Department of Physics, Florida State University, P.O. Box 3064350, Tallahassee, FL 32306-4350 (United States); Araujo, D.; Zwart, J. T. L. [Department of Physics and Columbia Astrophysics Laboratory, Columbia University, New York, NY 10027 (United States); Bischoff, C.; Buder, I. [Kavli Institute for Cosmological Physics, Department of Physics, Enrico Fermi Institute, The University of Chicago, Chicago, IL 60637 (United States); Chinone, Y.; Hasegawa, M. [High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba, Ibaraki 305-0801 (Japan); Cleary, K. [Cahill Center for Astronomy and Astrophysics, California Institute of Technology, 1200 E. California Blvd M/C 249-17, Pasadena, CA 91125 (United States); Kusaka, A. [Physics Division, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA 94720 (United States); Monsalve, R. [School of Earth and Space Exploration, Arizona State University, 781 E. Terrace Road, Tempe, AZ 85287 (United States); Næss, S. K. [Department of Astrophysics, University of Oxford, Keble Road, Oxford, OX1 3RH (United Kingdom); Newburgh, L. B. [Dunlap Institute, University of Toronto, 50 St. George Street, Toronto, ON M5S 3H4 (Canada); Reeves, R. [CePIA, Departamento de Astronomía, Universidad de Concepción (Chile); Ruud, T. M.; Eriksen, H. K. [Institute of Theoretical Astrophysics, University of Oslo, P.O. Box 1029 Blindern, NO-0315 Oslo (Norway); Wehus, I. K.; Gaier, T. [Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, CA 91109 (United States); Dickinson, C. [Jodrell Bank Centre for Astrophysics, Alan Turing Building, School of Physics and Astronomy, The University of Manchester, Oxford Road, Manchester M13 9PL (United Kingdom); Gundersen, J. O., E-mail: huffenbe@physics.fsu.edu [Department of Physics, University of Miami, 1320 Campo Sano Drive, Coral Gables, FL 33146 (United States); Collaboration: QUIET Collaboration; and others

2015-06-10

We present polarization measurements of extragalactic radio sources observed during the cosmic microwave background polarization survey of the Q/U Imaging Experiment (QUIET), operating at 43 GHz (Q-band) and 95 GHz (W-band). We examine sources selected at 20 GHz from the public, >40 mJy catalog of the Australia Telescope (AT20G) survey. There are ∼480 such sources within QUIET’s four low-foreground survey patches, including the nearby radio galaxies Centaurus A and Pictor A. The median error on our polarized flux density measurements is 30–40 mJy per Stokes parameter. At signal-to-noise ratio > 3 significance, we detect linear polarization for seven sources in Q-band and six in W-band; only 1.3 ± 1.1 detections per frequency band are expected by chance. For sources without a detection of polarized emission, we find that half of the sources have polarization amplitudes below 90 mJy (Q-band) and 106 mJy (W-band), at 95% confidence. Finally, we compare our polarization measurements to intensity and polarization measurements of the same sources from the literature. For the four sources with WMAP and Planck intensity measurements >1 Jy, the polarization fractions are above 1% in both QUIET bands. At high significance, we compute polarization fractions as much as 10%–20% for some sources, but the effects of source variability may cut that level in half for contemporaneous comparisons. Our results indicate that simple models—ones that scale a fixed polarization fraction with frequency—are inadequate to model the behavior of these sources and their contributions to polarization maps.

Monte Carlo calculations and measurements of spectra from a C-14 source

International Nuclear Information System (INIS)

Borg, J.

1996-05-01

To perform Monte Carlo simulations it is necessary to model the physical geometries i.e., the source and detector geometry. However, a complete model of the physical geometry may not be possible or may result in a very low calculation efficiency. Substituting the complete source model with a simplified model is one way of increasing the calculation efficiency. In this report, the study of a simplified model of a 14 C source is described. Results of Monte Carlo calculations with the EGS4 code are compared with measurements with a β spectrometer consisting of two coaxial Si detectors, and a low-energy photon spectrometer being a Si(Li) detector. Calculations and measurements show generally good agreement. However, the difference (a factor of 4) between calculated and measured response to electrons for the Si(Li) detector indicates that this detector has a dead layer about 12 μm thick instead of 0.2 μm as reported by the manufacturer. The efficiency of the calculations is increased by a factor of 10, when the complete source model is replaced by the simplified source model. This reduces the calculation time of detector responses to a few days instead of weeks on the NRC SGI R4400 computers. Good agreement between measured and calculated data also verifies that the MC code EGS4 is a reliable and useful tool for simulating coupled electron and photon transport for particles with energies down to a few keV. (au) 3 tabs., 15 ills., 11 refs

76 FR 53897 - EPA Seeking Input Materials Measurement; Municipal Solid Waste (MSW), Recycling, and Source...

Science.gov (United States)

2011-08-30

... Measurement; Municipal Solid Waste (MSW), Recycling, and Source Reduction Measurement in the U.S. AGENCY... Subjects Environmental protection, municipal solid waste (MSW) characterization, MSW management, recycling, measurement, data, data collection, construction and demolition (C&D) recycling, source reduction, life cycle...

Relationships between Student, Staff, and Administrative Measures of School Climate and Student Health and Academic Outcomes

Science.gov (United States)

Gase, Lauren Nichol; Gomez, Louis M.; Kuo, Tony; Glenn, Beth A.; Inkelas, Moira; Ponce, Ninez A.

2018-01-01

BACKGROUND School climate is an integral part of a comprehensive approach to improving the wellbeing of students; however, little is known about the relationships between its different domains and measures. This study examined the relationships between student, staff, and administrative measures of school climate in order to understand the extent to which they were related to each other and student outcomes. METHODS The sample included 33,572 secondary school students from 121 schools in Los Angeles County during the 2014–2015 academic year. A multilevel regression model was constructed to examine the association between the domains and measures of school climate and five outcomes of student wellbeing: depressive symptoms or suicidal ideation, tobacco use, alcohol use, marijuana use, and grades. RESULTS Student, staff, and administrative measures of school climate were weakly correlated. Strong associations were found between student outcomes and student reports of engagement and safety, while school staff reports and administrative measures of school climate showed limited associations with student outcomes. CONCLUSIONS As schools seek to measure and implement interventions aimed at improving school climate, consideration should be given to grounding these efforts in a multi-dimensional conceptualization of climate that values student perspectives and includes elements of both engagement and safety. PMID:28382671

Relationships Among Student, Staff, and Administrative Measures of School Climate and Student Health and Academic Outcomes.

Science.gov (United States)

Gase, Lauren N; Gomez, Louis M; Kuo, Tony; Glenn, Beth A; Inkelas, Moira; Ponce, Ninez A

2017-05-01

School climate is an integral part of a comprehensive approach to improving the well-being of students; however, little is known about the relationships between its different domains and measures. We examined the relationships between student, staff, and administrative measures of school climate to understand the extent to which they were related to each other and student outcomes. The sample included 33,572 secondary school students from 121 schools in Los Angeles County during the 2014-2015 academic year. A multilevel regression model was constructed to examine the association between the domains and measures of school climate and 5 outcomes of student well-being: depressive symptoms or suicidal ideation, tobacco use, alcohol use, marijuana use, and grades. Student, staff, and administrative measures of school climate were weakly correlated. Strong associations were found between student outcomes and student reports of engagement and safety, while school staff reports and administrative measures of school climate showed limited associations with student outcomes. As schools seek to measure and implement interventions aimed at improving school climate, consideration should be given to grounding these efforts in a multidimensional conceptualization of climate that values student perspectives and includes elements of both engagement and safety. © 2017, American School Health Association.

Measurement and diagnosis system for 1.2 MV repetitive pulsed power source

International Nuclear Information System (INIS)

Li Yawei; Deng Jianjun; Xie Min; Feng Zongming; Liu Yuntao; Ma Chenggang

2010-01-01

In order to analyze the discharge performance and improve the design of the power system, a set of measurement and diagnosis system for the 1.2 MV repetitive pulsed power source, which supplies the drive power for a high power microwave source, has been designed by studying the high-voltage, high-current testing technology, data acquisition, signal processing, fault diagnosis, virtual instruments and electromagnetic compatibility technology, etc. A resistive-capacitive divider and a Rogowski coil are adopted in measurement; ADLINK corporation's PXI chips are used in data acquisition; data transmission system, condition monitoring and data analysis are developed by LabVIEW. This system can realize on-line monitoring and data analysis for the repetitive pulsed power source. (authors)

Test-Retest Reliability of Dual-Task Outcome Measures in People With Parkinson Disease

NARCIS (Netherlands)

Strouwen, C.; Molenaar, E.A.; Keus, S.H.; Munks, L.; Bloem, B.R.; Nieuwboer, A.

2016-01-01

BACKGROUND: Dual-task (DT) training is gaining ground as a physical therapy intervention in people with Parkinson disease (PD). Future studies evaluating the effect of such interventions need reliable outcome measures. To date, the test-retest reliability of DT measures in patients with PD remains

Health economics research into supporting carers of people with dementia: A systematic review of outcome measures

Science.gov (United States)

2012-01-01

Advisory bodies, such as the National Institute for Health and Clinical Excellence (NICE) in the UK, advocate using preference based instruments to measure the quality of life (QoL) component of the quality-adjusted life year (QALY). Cost per QALY is used to determine cost-effectiveness, and hence funding, of interventions. QALYs allow policy makers to compare the effects of different interventions across different patient groups. Generic measures may not be sensitive enough to fully capture the QoL effects for certain populations, such as carers, so there is a need to consider additional outcome measures, which are preference based where possible to enable cost-effectiveness analysis to be undertaken. This paper reviews outcome measures commonly used in health services research and health economics research involving carers of people with dementia. An electronic database search was conducted in PubMed, Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, the National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment database. Studies were eligible for inclusion if they included an outcome measure for carers of people with dementia. 2262 articles were identified. 455 articles describing 361 studies remained after exclusion criteria were applied. 228 outcome measures were extracted from the studies. Measures were categorised into 44 burden measures, 43 mastery measures, 61 mood measures, 32 QoL measures, 27 social support and relationships measures and 21 staff competency and morale measures. The choice of instrument has implications on funding decisions; therefore, researchers need to choose appropriate instruments for the population being measured and the type of intervention undertaken. If an instrument is not sensitive enough to detect changes in certain populations, the effect of an intervention may be underestimated, and hence

Regularity of the wear control of radioactive sources from the nuclear measurers

International Nuclear Information System (INIS)

Ferreira L, M.

2006-01-01

The control of radioactive sources in Brazil is regulated by the CNEN (National Comissao of Nuclear Energy). The Laboratory of Descontaminacao of the IPEN (Institute of Energy Y Nuclear Investigations) it offers to the companies that work with nuclear measurers, essays for control of the source wear according to the ISO 9978/1992 through the smear tests Y of leakage. The analyses are taken in alpha Y beta detectors of low bottom radiation with annual detection limits around 1 Bq. Certificates of the accepted analyses by the CNEN for sources that already passed its time of validity assured by the makers, but its continue operational are emitted. The smear test is repeated the whole year, while the leakage test repeats to every two years. A balance of the last two years of the activities of the laboratory shows the regularity of the clients Y the growth of companies specialized in radioprotection with official of radioprotection, credited by the regulatory authority that its act as intermediaries in the process, contacting the clients, gathering the samples next to the proprietors of sources Y hiring our services. Overalls, proves that the inspection activities by part of the regulatory authority are fulfil. In 2004, 192 sources were analyzed by the smear method Y 86 sources by leakage. In 2005, 232 sources were analyzed by the smear method Y 60 sources by leakage. All the leakage tests was made in sources of Americium of oneself Y only client that brings the sources so that they dismantle them to him in the Sources production laboratory of the IPEN. By the quantity Y age of the sources that were analyzed in those two years, it is proven that the number of sources without use conditions (total activity measured by the two added methods smaller than 180Bq) it doesn't arrive to 2%. (Author)

PROMIS GH (Patient-Reported Outcomes Measurement Information System Global Health) Scale in Stroke: A Validation Study.

Science.gov (United States)

Katzan, Irene L; Lapin, Brittany

2018-01-01

The International Consortium for Health Outcomes Measurement recently included the 10-item PROMIS GH (Patient-Reported Outcomes Measurement Information System Global Health) scale as part of their recommended Standard Set of Stroke Outcome Measures. Before collection of PROMIS GH is broadly implemented, it is necessary to assess its performance in the stroke population. The objective of this study was to evaluate the psychometric properties of PROMIS GH in patients with ischemic stroke and intracerebral hemorrhage. PROMIS GH and 6 PROMIS domain scales measuring same/similar constructs were electronically collected on 1102 patients with ischemic and hemorrhagic strokes at various stages of recovery from their stroke who were seen in a cerebrovascular clinic from October 12, 2015, through June 2, 2017. Confirmatory factor analysis was performed to evaluate the adequacy of 2-factor structure of component scores. Test-retest reliability and convergent validity of PROMIS GH items and component scores were assessed. Discriminant validity and responsiveness were compared between PROMIS GH and PROMIS domain scales measuring the same or related constructs. Analyses were repeated stratified by stroke subtype and modified Rankin Scale score validity was good with significant correlations between all PROMIS GH items and PROMIS domain scales ( P 0.5) was demonstrated for 8 of the 10 PROMIS GH items. Reliability and validity remained consistent across stroke subtype and disability level (modified Rankin Scale, <2 versus ≥2). PROMIS GH exhibits acceptable performance in patients with stroke. Our findings support International Consortium for Health Outcomes Measurement recommendation to use PROMIS GH as part of the standard set of outcome measures in stroke. © 2017 American Heart Association, Inc.

Report from the third international consensus meeting to harmonise core outcome measures for atopic eczema/dermatitis clinical trials (HOME)

Science.gov (United States)

Chalmers, JR; Schmitt, J; Apfelbacher, C; Dohil, M; Eichenfield, LF; Simpson, EL; Singh, J; Spuls, P; Thomas, KS; Admani, S; Aoki, V; Ardeleanu, M; Barbarot, S; Berger, T; Bergman, JN; Block, J; Borok, N; Burton, T; Chamlin, SL; Deckert, S; DeKlotz, CC; Graff, LB; Hanifin, JM; Hebert, AA; Humphreys, R; Katoh, N; Kisa, RM; Margolis, DJ; Merhand, S; Minnillo, R; Mizutani, H; Nankervis, H; Ohya, Y; Rodgers, P; Schram, ME; Stalder, JF; Svensson, A; Takaoka, R; Teper, A; Tom, WL; von Kobyletzki, L; Weisshaar, E; Zelt, S; Williams, HC

2014-01-01

Summary This report provides a summary of the third meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in San Diego, CA, U.S.A., 6–7 April 2013 (HOME III). The meeting addressed the four domains that had previously been agreed should be measured in every eczema clinical trial: clinical signs, patient-reported symptoms, long-term control and quality of life. Formal presentations and nominal group techniques were used at this working meeting, attended by 56 voting participants (31 of whom were dermatologists). Significant progress was made on the domain of clinical signs. Without reference to any named scales, it was agreed that the intensity and extent of erythema, excoriation, oedema/papulation and lichenification should be included in the core outcome measure for the scale to have content validity. The group then discussed a systematic review of all scales measuring the clinical signs of eczema and their measurement properties, followed by a consensus vote on which scale to recommend for inclusion in the core outcome set. Research into the remaining three domains was presented, followed by discussions. The symptoms group and quality of life groups need to systematically identify all available tools and rate the quality of the tools. A definition of long-term control is needed before progress can be made towards recommending a core outcome measure. What's already known about this topic? Many different scales have been used to measure eczema, making it difficult to compare trials in meta-analyses and hampering improvements in clinical practice. HOME core outcome measures must pass the OMERACT (Outcome Measures in Rheumatology) filter of truth (validity), discrimination (sensitivity to change and responsiveness) and feasibility (ease of use, costs, time to perform and interpret). It has been previously agreed as part of the consensus process that four domains should be measured by the core outcomes: clinical signs, patient

Radioactivity measurements of metallic 192Ir sources by calorimetric methods

International Nuclear Information System (INIS)

Genka, Tsuguo; Iwamoto, Seikichi; Takeuchi, Norio

1992-01-01

The necessity of establishing the traceability of dose measurement in brachytherapy 192 Ir sources is realized by physicians and researchers in the medical field. Standard sources of various shapes such as open-quotes hairpin,close quotes open-quotes single pin,close quotes open-quotes thin wire,close quotes and open-quotes seedclose quotes for calibrating ionization chambers in hospitals are being demanded. Nominal activities of not only these source products but also the standard sources have been so far specified by open-quotes apparentclose quotes values. Determination of open-quotes absoluteclose quotes activity by an established means such as 4pi-beta-gamma coincidence counting is not practical because quantitative dissolution of metallic iridium is very difficult. We tried to determine the open-quotes absoluteclose quotes activity by a calorimetric method in a fully nondestructive way

Statistical measurement of the gamma-ray source-count distribution as a function of energy

Science.gov (United States)

Zechlin, H.-S.; Cuoco, A.; Donato, F.; Fornengo, N.; Regis, M.

2017-01-01

Photon counts statistics have recently been proven to provide a sensitive observable for characterizing gamma-ray source populations and for measuring the composition of the gamma-ray sky. In this work, we generalize the use of the standard 1-point probability distribution function (1pPDF) to decompose the high-latitude gamma-ray emission observed with Fermi-LAT into: (i) point-source contributions, (ii) the Galactic foreground contribution, and (iii) a diffuse isotropic background contribution. We analyze gamma-ray data in five adjacent energy bands between 1 and 171 GeV. We measure the source-count distribution dN/dS as a function of energy, and demonstrate that our results extend current measurements from source catalogs to the regime of so far undetected sources. Our method improves the sensitivity for resolving point-source populations by about one order of magnitude in flux. The dN/dS distribution as a function of flux is found to be compatible with a broken power law. We derive upper limits on further possible breaks as well as the angular power of unresolved sources. We discuss the composition of the gamma-ray sky and capabilities of the 1pPDF method.

Assessment of COPD-related outcomes via a national electronic medical record database.

Science.gov (United States)

Asche, Carl; Said, Quayyim; Joish, Vijay; Hall, Charles Oaxaca; Brixner, Diana

2008-01-01

The technology and sophistication of healthcare utilization databases have expanded over the last decade to include results of lab tests, vital signs, and other clinical information. This review provides an assessment of the methodological and analytical challenges of conducting chronic obstructive pulmonary disease (COPD) outcomes research in a national electronic medical records (EMR) dataset and its potential application towards the assessment of national health policy issues, as well as a description of the challenges or limitations. An EMR database and its application to measuring outcomes for COPD are described. The ability to measure adherence to the COPD evidence-based practice guidelines, generated by the NIH and HEDIS quality indicators, in this database was examined. Case studies, before and after their publication, were used to assess the adherence to guidelines and gauge the conformity to quality indicators. EMR was the only source of information for pulmonary function tests, but low frequency in ordering by primary care was an issue. The EMR data can be used to explore impact of variation in healthcare provision on clinical outcomes. The EMR database permits access to specific lab data and biometric information. The richness and depth of information on "real world" use of health services for large population-based analytical studies at relatively low cost render such databases an attractive resource for outcomes research. Various sources of information exist to perform outcomes research. It is important to understand the desired endpoints of such research and choose the appropriate database source.

Measuring Learning Outcomes. Evolution of Cognitive Skills among Graduate Students in Auditing

DEFF Research Database (Denmark)

Holm, Claus; Steenholdt, Niels

with the knowledge provided in a graduate course the student learns from his prior experiences and stores the important aspects of each experience in memory in accordance with such schemas. The schemas available for students taking a graduate auditing course reflects prior accounting work experience for some...... students and undergraduate accounting coursework experience for all students. This paper extends prior research on the role of declarative and procedural knowledge in performing auditing tasks. Measuring learning outcomes is a complex matter requiring sensible measures for both declarative knowledge...... outcomes in the context of an auditing course by posing a broad set of questions testing declarative knowledge and the full range of intellectual skills from discrimination to the use of higher-order-rules . The paper presents data collected in September 1999 including 34 graduate students representing...

Historical perspective: The pros and cons of conventional outcome measures in Parkinson's disease.

Science.gov (United States)

Lim, Shen-Yang; Tan, Ai Huey

2018-01-01

Conventional outcome measures (COMs) in Parkinson's disease (PD) refer to rating scales, questionnaires, patient diaries and clinically-based tests that do not require specialized equipment. It is timely at this juncture - as clinicians and researchers begin to grapple with the "invasion" of digital technologies - to review the strengths and weaknesses of these outcome measures. This paper discusses advances (including an enhanced understanding of PD itself, and the development of clinimetrics as a field) that have led to improvements in the COMs used in PD; their strengths and limitations; and factors to consider when selecting and using a measuring instrument. It is envisaged that in the future, a combination of COMs and technology-based objective measures will be utilized, with different methods having their own strengths and weaknesses. Judgement is required on the part of the clinician and researcher in terms of which instrument(s) are appropriate to use, depending on the particular clinical or research setting or question. Copyright © 2017 Elsevier Ltd. All rights reserved.

Assessing methods for measurement of clinical outcomes and quality of care in primary care practices

Directory of Open Access Journals (Sweden)

Green Michael E

2012-07-01

Full Text Available Abstract Purpose To evaluate the appropriateness of potential data sources for the population of performance indicators for primary care (PC practices. Methods This project was a cross sectional study of 7 multidisciplinary primary care teams in Ontario, Canada. Practices were recruited and 5-7 physicians per practice agreed to participate in the study. Patients of participating physicians (20-30 were recruited sequentially as they presented to attend a visit. Data collection included patient, provider and practice surveys, chart abstraction and linkage to administrative data sets. Matched pairs analysis was used to examine the differences in the observed results for each indicator obtained using multiple data sources. Results Seven teams, 41 physicians, 94 associated staff and 998 patients were recruited. The survey response rate was 81% for patients, 93% for physicians and 83% for associated staff. Chart audits were successfully completed on all but 1 patient and linkage to administrative data was successful for all subjects. There were significant differences noted between the data collection methods for many measures. No single method of data collection was best for all outcomes. For most measures of technical quality of care chart audit was the most accurate method of data collection. Patient surveys were more accurate for immunizations, chronic disease advice/information dispensed, some general health promotion items and possibly for medication use. Administrative data appears useful for indicators including chronic disease diagnosis and osteoporosis/ breast screening. Conclusions Multiple data collection methods are required for a comprehensive assessment of performance in primary care practices. The choice of which methods are best for any one particular study or quality improvement initiative requires careful consideration of the biases that each method might introduce into the results. In this study, both patients and providers were

Source modelling of train noise - Literature review and some initial measurements

Energy Technology Data Exchange (ETDEWEB)

Zhang Xuetao; Jonasson, Hans; Holmberg, Kjell

2000-07-01

A literature review of source modelling of railway noise is reported. Measurements on a special test rig at Surahammar and on the new railway line between Arlanda and Stockholm City are reported and analyzed. In the analysis the train is modelled as a number of point sources with or without directivity and each source is combined with analytical sound propagation theory to predict the sound propagation pattern best fitting the measured data. Wheel/rail rolling noise is considered to be the most important noise source. The rolling noise can be modelled as an array of moving point sources, which have a dipole-like horizontal directivity and some kind of vertical directivity. In general it is necessary to distribute the point sources on several heights. Based on our model analysis the source heights for the rolling noise should be below the wheel axles and the most important height is about a quarter of wheel diameter above the railheads. When train speeds are greater than 250 km/h aerodynamic noise will become important and even dominant. It may be important for low frequency components only if the train speed is less than 220 km/h. Little data are available for these cases. It is believed that aerodynamic noise has dipole-like directivity. Its spectrum depends on many factors: speed, railway system, type of train, bogies, wheels, pantograph, presence of barriers and even weather conditions. Other sources such as fans, engine, transmission and carriage bodies are at most second order noise sources, but for trains with a diesel locomotive engine the engine noise will be dominant if train speeds are less than about 100 km/h. The Nord 2000 comprehensive model for sound propagation outdoors, together with the source model that is based on the understandings above, can suitably handle the problems of railway noise propagation in one-third octave bands although there are still problems left to be solved.

Validating criticality calculations for spent fuel with 252Cf-source-driven noise measurements

International Nuclear Information System (INIS)

Mihalczo, J.T.; Krass, A.W.; Valentine, T.E.

1992-01-01

The 252 Cf-Source-driven noise analysis method can be used for measuring the subcritical neutron multiplication factor k of arrays of spent light water reactor (LWR) fuel. This type of measurement provides a parameter that is directly related to the criticality state of arrays of LWR fuel. Measurements of this parameter can verify the criticality safety margins of spent LWR fuel configurations and thus could be a means of obtaining the information to justify burnup credit for spent LWR transportation/storage casks. The practicality of a measurement depends on the ability to install the hardware required to perform the measurement. Source chambers containing the 252 Cf at the required source intensity for this application have been constructed and have operated successfully for ∼10 years and can be fabricated to fit into control rod guide tubes of PWR fuel elements. Fission counters especially developed for spent-fuel measurements are available that would allow measurements of a special 3 x 3 spent fuel array and a typical burnup credit rail cask with spent fuel in unborated water. Adding a moderator around these fission counters would allow measurements with the typical burnup credit rail cask with borated water and the special 3 x 3 array with borated water. The recent work of Ficaro on modifying the KENO Va code to calculate by the Monte Carlo method the time sequences of pulses at two detectors near a fissile assembly from the fission chain multiplication process, initiated by a 252 Cf source in the assembly allows a direct computer calculation of the noise analysis data from this measurement method

Dispersion Measure Variation of Repeating Fast Radio Burst Sources

Energy Technology Data Exchange (ETDEWEB)

Yang, Yuan-Pei; Zhang, Bing, E-mail: yypspore@gmail.com, E-mail: zhang@physics.unlv.edu [Kavli Institute for Astronomy and Astrophysics, Peking University, Beijing 100871 (China)

2017-09-20

The repeating fast radio burst (FRB) 121102 was recently localized in a dwarf galaxy at a cosmological distance. The dispersion measure (DM) derived for each burst from FRB 121102 so far has not shown significant evolution, even though an apparent increase was recently seen with newly detected VLA bursts. It is expected that more repeating FRB sources may be detected in the future. In this work, we investigate a list of possible astrophysical processes that might cause DM variation of a particular FRB source. The processes include (1) cosmological scale effects such as Hubble expansion and large-scale structure fluctuations; (2) FRB local effects such as gas density fluctuation, expansion of a supernova remnant (SNR), a pulsar wind nebula, and an H ii region; and (3) the propagation effect due to plasma lensing. We find that the DM variations contributed by the large-scale structure are extremely small, and any observable DM variation is likely caused by the plasma local to the FRB source. In addition to mechanisms that decrease DM over time, we suggest that an FRB source in an expanding SNR around a nearly neutral ambient medium during the deceleration (Sedov–Taylor and snowplow) phases or in a growing H ii region can increase DM. Some effects (e.g., an FRB source moving in an H ii region or plasma lensing) can produce either positive or negative DM variations. Future observations of DM variations of FRB 121102 and other repeating FRB sources can provide important clues regarding the physical origin of these sources.

Dispersion Measure Variation of Repeating Fast Radio Burst Sources

International Nuclear Information System (INIS)

Yang, Yuan-Pei; Zhang, Bing

2017-01-01

The repeating fast radio burst (FRB) 121102 was recently localized in a dwarf galaxy at a cosmological distance. The dispersion measure (DM) derived for each burst from FRB 121102 so far has not shown significant evolution, even though an apparent increase was recently seen with newly detected VLA bursts. It is expected that more repeating FRB sources may be detected in the future. In this work, we investigate a list of possible astrophysical processes that might cause DM variation of a particular FRB source. The processes include (1) cosmological scale effects such as Hubble expansion and large-scale structure fluctuations; (2) FRB local effects such as gas density fluctuation, expansion of a supernova remnant (SNR), a pulsar wind nebula, and an H ii region; and (3) the propagation effect due to plasma lensing. We find that the DM variations contributed by the large-scale structure are extremely small, and any observable DM variation is likely caused by the plasma local to the FRB source. In addition to mechanisms that decrease DM over time, we suggest that an FRB source in an expanding SNR around a nearly neutral ambient medium during the deceleration (Sedov–Taylor and snowplow) phases or in a growing H ii region can increase DM. Some effects (e.g., an FRB source moving in an H ii region or plasma lensing) can produce either positive or negative DM variations. Future observations of DM variations of FRB 121102 and other repeating FRB sources can provide important clues regarding the physical origin of these sources.

Interpretation of UV radiometric measurements of spectrally non-uniform sources

International Nuclear Information System (INIS)

Murphy, P.J.; Gardner, D.G.

1988-01-01

Narrow bandpass UV radiometers are used in a variety of high-temperature measurement applications. Significant systematic errors, in the form of an apparent wavelength shift in the system response curve, may be introduced when interpreting data obtained from spectrally nonuniform sources. Theoretical calculations, using transmission curves from commercially available narrow bandpass filters, show that the apparent shift in the system spectral response is a function of temperature for a blackbody source. A brief comparison between the theoretical analysis and experimentaal data is presented

Questioning the Use of Outcome Measures to Evaluate Principal Preparation Programs

Science.gov (United States)

Fuller, Ed; Hollingworth, Liz

2018-01-01

Policymakers are proposing the use of outcome measures as indicators of effective principal preparation programs. The three most common metrics recommended are: (1) graduates' effectiveness in improving student achievement test scores, (2) graduate job placement rates, and (3) principal job retention once employed. This article explores the use of…

X-ray stress measurement by use of synchrotron radiation source

International Nuclear Information System (INIS)

Yoshioka, Yasuo; Matsui, Hisaaki; Moro-oka, Toshimasa; Hasegawa, Ken-ichi; Nakajima, Tetsuo.

1986-01-01

In the field of X-ray stress measurement of polycrystalline materials, a diffraction plane at higher Bragg angle has to be selected in order to obtain the precise value of stress. However, the stress measurement on an optional (hkl) plane desired is not always possible because the X-ray beam exited from a metal target has a dispersive wave length. Recently, we have been able to use the synchrotron radiation source (SR) as an excellent X-ray source. In Japan, the facility of synchrotron radiation (Photon Factory, PF) was constructed in the National Laboratory for High Energy Physics (KEK) at Tsukuba academic city. The use of this SR enables the stress measurements on many (hkl) planes with high accuracy in the higher Bragg angle region by providing an X-ray beam having an optional wave length. We have started the X-ray stress analysis by use of the synchrotron radiation source. This paper reports the system of measurement and some results of preliminaly experiments. Since a monochromatic X-ray beam is required for the stress measurement, we used a beam line which consists of a double crystal monochrometer and a focusing mirror. X-rays between 4 KeV (λ = 0.31 nm) and 10 KeV (λ = 0.12 nm) are available with this optical system. We adopted a constant Bragg angle of 2θ = 154 deg for all the diffraction planes. A PSPC having a carbon fiber anode is made and used as a detector with the use of a fast digital signal processor. We could observe the diffraction profiles from (200), (211), (220), (310) and (321) crystal plane of alpha iron, respectively, and the residual stresses in these planes except the (200) plane were measured with high accuracy in a short time. Such feature especially suits the stress analysis of the material which has preferred orientation or stress gradient. (author)

Measuring outcomes of communication partner training of health care professionals:

DEFF Research Database (Denmark)

Isaksen, Jytte; Jensen, Lise Randrup

health care, and other communicative exchanges associated with appropriate health care [3]. As a consequence of these challenges in patient-provider communication, implementation of evidence- based methods of communication partner training is becoming increasingly frequent in different health care...... with large groups of trainees, e.g. all staff from a ward. Self-rating questionnaires, however, present another set of issues when used as outcome measures, including the need to examine their content validity, reliability and sensitivity to change [9]. This work appears to be lacking for most...... of the available questionnaires. However, it is important in order to lay the groundwork for future studies, which compare the efficacy and outcome of different methods of implementing conversation partner training in clinical practice. Aims: The overall purpose of this round table is to: 1. provide an overview...

Routine outcome measurement in mental health service consumers: who should provide support for the self-assessments?

Science.gov (United States)

Gelkopf, Marc; Pagorek-Eshel, Shira; Trauer, Tom; Roe, David

2015-06-01

This study examined whether mental health community service users completed outcome self-reports differently when assessments were supervised by internal vs. external staff. The examination of potential differences between the two has useful implications for mental health systems that take upon themselves the challenge of Routine Outcome Measurement (ROM), as it might impact allocation of public resources and managed care program planning. 73 consumers completed the Manchester Short Assessment of Quality of Life (MANSA), a shortened version of the Recovery Assessment Scale (RAS), and a functioning questionnaire. Questionnaires were administered, once using support provided by internal staff and once using support provided by external professional staff, with a one-month time interval and in random order. A MANOVA Repeated Measures showed no differences in outcomes of quality of life and recovery between internal and external support. Functioning scores were higher for the internal support when the internal assessments were performed first. Overall, except for the differences in functioning assessment, outcome scores were not determined by the supporting agency. This might indicate that when measuring quality of life and recovery, different supporting methods can be used to gather outcome measures and internal staff might be a good default agency to do this. Differences found in functioning assessment are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sources and protective measures of indoor radon

International Nuclear Information System (INIS)

Gou Quanlu; Wang Hengde

1993-01-01

This paper presents the relative contribution to indoor radon 222 Rn of various sources in twenty three rooms of three kinds in Taiyuan area. The results show that the major sources in this area are radon emanation from surfaces of soil and building materials and that from outdoor air, while the contribution of water and gas consumed in the rooms is less important. These results suggest a basis for taking suitable protective measures against indoor radon. Some materials are also recommended which are effective in restraining radon exhalation and low in price, by testing more than ten kinds of materials and comparing them using cost-effectiveness analysis technique, such as painting materials, polyvinyl alcohol (CH 2 :CHOH)n, etc. Their sealing effects on radon exhalation were examined with home-made REM-89 Radon Exhalation Monitor. The deposition effects of negative ion generator and humidifier on radon progeny were also tested. The maximum deposition may reach 70-90%, which proves they are also effective and economical in radon protection. (2 tabs., 3 figs.)

Core outcome measurement instruments for clinical trials in nonspecific low back pain

Science.gov (United States)

Chiarotto, Alessandro; Boers, Maarten; Deyo, Richard A.; Buchbinder, Rachelle; Corbin, Terry P.; Costa, Leonardo O.P.; Foster, Nadine E.; Grotle, Margreth; Koes, Bart W.; Kovacs, Francisco M.; Lin, C.-W. Christine; Maher, Chris G.; Pearson, Adam M.; Peul, Wilco C.; Schoene, Mark L.; Turk, Dennis C.; van Tulder, Maurits W.; Terwee, Caroline B.; Ostelo, Raymond W.

2018-01-01

Abstract To standardize outcome reporting in clinical trials of patients with nonspecific low back pain, an international multidisciplinary panel recommended physical functioning, pain intensity, and health-related quality of life (HRQoL) as core outcome domains. Given the lack of a consensus on measurement instruments for these 3 domains in patients with low back pain, this study aimed to generate such consensus. The measurement properties of 17 patient-reported outcome measures for physical functioning, 3 for pain intensity, and 5 for HRQoL were appraised in 3 systematic reviews following the COSMIN methodology. Researchers, clinicians, and patients (n = 207) were invited in a 2-round Delphi survey to generate consensus (≥67% agreement among participants) on which instruments to endorse. Response rates were 44% and 41%, respectively. In round 1, consensus was achieved on the Oswestry Disability Index version 2.1a for physical functioning (78% agreement) and the Numeric Rating Scale (NRS) for pain intensity (75% agreement). No consensus was achieved on any HRQoL instrument, although the Short Form 12 (SF12) approached the consensus threshold (64% agreement). In round 2, a consensus was reached on an NRS version with a 1-week recall period (96% agreement). Various participants requested 1 free-to-use instrument per domain. Considering all issues together, recommendations on core instruments were formulated: Oswestry Disability Index version 2.1a or 24-item Roland-Morris Disability Questionnaire for physical functioning, NRS for pain intensity, and SF12 or 10-item PROMIS Global Health form for HRQoL. Further studies need to fill the evidence gaps on the measurement properties of these and other instruments. PMID:29194127

Using Generalizability Theory to Disattenuate Correlation Coefficients for Multiple Sources of Measurement Error.

Science.gov (United States)

Vispoel, Walter P; Morris, Carrie A; Kilinc, Murat

2018-05-02

Over the years, research in the social sciences has been dominated by reporting of reliability coefficients that fail to account for key sources of measurement error. Use of these coefficients, in turn, to correct for measurement error can hinder scientific progress by misrepresenting true relationships among the underlying constructs being investigated. In the research reported here, we addressed these issues using generalizability theory (G-theory) in both traditional and new ways to account for the three key sources of measurement error (random-response, specific-factor, and transient) that affect scores from objectively scored measures. Results from 20 widely used measures of personality, self-concept, and socially desirable responding showed that conventional indices consistently misrepresented reliability and relationships among psychological constructs by failing to account for key sources of measurement error and correlated transient errors within occasions. The results further revealed that G-theory served as an effective framework for remedying these problems. We discuss possible extensions in future research and provide code from the computer package R in an online supplement to enable readers to apply the procedures we demonstrate to their own research.

Bayesian statistics in radionuclide metrology: measurement of a decaying source

International Nuclear Information System (INIS)

Bochud, F. O.; Bailat, C.J.; Laedermann, J.P.

2007-01-01

The most intuitive way of defining a probability is perhaps through the frequency at which it appears when a large number of trials are realized in identical conditions. The probability derived from the obtained histogram characterizes the so-called frequentist or conventional statistical approach. In this sense, probability is defined as a physical property of the observed system. By contrast, in Bayesian statistics, a probability is not a physical property or a directly observable quantity, but a degree of belief or an element of inference. The goal of this paper is to show how Bayesian statistics can be used in radionuclide metrology and what its advantages and disadvantages are compared with conventional statistics. This is performed through the example of an yttrium-90 source typically encountered in environmental surveillance measurement. Because of the very low activity of this kind of source and the small half-life of the radionuclide, this measurement takes several days, during which the source decays significantly. Several methods are proposed to compute simultaneously the number of unstable nuclei at a given reference time, the decay constant and the background. Asymptotically, all approaches give the same result. However, Bayesian statistics produces coherent estimates and confidence intervals in a much smaller number of measurements. Apart from the conceptual understanding of statistics, the main difficulty that could deter radionuclide metrologists from using Bayesian statistics is the complexity of the computation. (authors)

Response of a BGO detector to photon and neutron sources simulations and measurements

CERN Document Server

Vincke, H H; Fabjan, Christian Wolfgang; Otto, T

2002-01-01

In this paper Monte Carlo simulations (FLUKA) and measurements of the response of a BGO detector are reported. %For the measurements different radioactive sources were used to irradiate the BGO crystal. For the measurements three low-energy photon emitters $\\left({}^{60}\\rm{Co},\\right.$ ${}^{54}\\rm{Mn},$ $\\left. {}^{137}\\rm{Cs}\\right)$ were used to irradiate the BGO from various distances and angles. The neutron response was measured with an Am--Be neutron source. Simulations of the experimental irradiations were carried out. Our study can also be considered as a benchmark for FLUKA in terms of its reliability to predict the detector response of a BGO scintillator.

Brightness measurement of an electron impact gas ion source for proton beam writing applications

Energy Technology Data Exchange (ETDEWEB)

Liu, N.; Santhana Raman, P. [Centre for Ion Beam Applications, Department of Physics, National University of Singapore, Singapore 117542 (Singapore); Department of Electrical and Computer Engineering, National University of Singapore, Singapore 117583 (Singapore); Xu, X.; Pang, R.; Kan, J. A. van, E-mail: phyjavk@nus.edu.sg [Centre for Ion Beam Applications, Department of Physics, National University of Singapore, Singapore 117542 (Singapore); Khursheed, A. [Department of Electrical and Computer Engineering, National University of Singapore, Singapore 117583 (Singapore)

2016-02-15

We are developing a high brightness nano-aperture electron impact gas ion source, which can create ion beams from a miniature ionization chamber with relatively small virtual source sizes, typically around 100 nm. A prototype source of this kind was designed and successively micro-fabricated using integrated circuit technology. Experiments to measure source brightness were performed inside a field emission scanning electron microscope. The total output current was measured to be between 200 and 300 pA. The highest estimated reduced brightness was found to be comparable to the injecting focused electron beam reduced brightness. This translates into an ion reduced brightness that is significantly better than that of conventional radio frequency ion sources, currently used in single-ended MeV accelerators.

Magnetic measurements of the injector synchrotron magnets for the Advanced Photon Source

International Nuclear Information System (INIS)

Kim, S.H.; Carnegie, D.W.; Doose, C.L.; Hogrefe, R.; Kim, K.; Merl, R.; Turner, L.R.

1993-01-01

The magnetic measurement data of the dipole, quadrupole, and sextupole magnets for the Advanced Photon Source injector synchrotron are summarized. Magnet design and magnetic measurements of the field strength, field shape, and multipole coefficients are described

Magnetic measurements of the injector synchrotron magnets for the advanced photon source

Science.gov (United States)

Kim, S. H.; Carnegie, D. W.; Doose, C. L.; Hogrefe, R.; Kim, K.; Merl, R.; Turner, L. R.

1994-07-01

The magnetic measurement data of the dipole, quadrupole, and sextupole magnets for the Advanced Photon Source injector synchrotron are summarized. Magnet design and magnetic measurements of the field strength, field shape, and multipole coefficients are described.

Measuring Longitudinal Student Performance on Student Learning Outcomes in Sustainability Education

Science.gov (United States)

Jarchow, Meghann E.; Formisano, Paul; Nordyke, Shane; Sayre, Matthew

2018-01-01

Purpose: The purpose of this paper is to describe the student learning outcomes (SLOs) for a sustainability major, evaluate faculty incorporation of the SLOs into the courses in the sustainability major curriculum and measure student performance on the SLOs from entry into the major to the senior capstone course. Design/methodology/approach:…

Measurement-device-independent quantum key distribution with correlated source-light-intensity errors

Science.gov (United States)

Jiang, Cong; Yu, Zong-Wen; Wang, Xiang-Bin

2018-04-01

We present an analysis for measurement-device-independent quantum key distribution with correlated source-light-intensity errors. Numerical results show that the results here can greatly improve the key rate especially with large intensity fluctuations and channel attenuation compared with prior results if the intensity fluctuations of different sources are correlated.

Development and evaluation of an Individualized Outcome Measure (IOM) for randomized controlled trials in mental health.

Science.gov (United States)

Pesola, Francesca; Williams, Julie; Bird, Victoria; Freidl, Marion; Le Boutillier, Clair; Leamy, Mary; Macpherson, Rob; Slade, Mike

2015-12-01

Pre-defined, researcher-selected outcomes are routinely used as the clinical end-point in randomized controlled trials (RCTs); however, individualized approaches may be an effective way to assess outcome in mental health research. The present study describes the development and evaluation of the Individualized Outcome Measure (IOM), which is a patient-specific outcome measure to be used for RCTs of complex interventions. IOM was developed using a narrative review, expert consultation and piloting with mental health service users (n = 20). The final version of IOM comprises two components: Goal Attainment (GA) and Personalized Primary Outcome (PPO). For GA, patients identify one relevant goal at baseline and rate its attainment at follow-up. For PPO, patients choose an outcome domain related to their goal from a pre-defined list at baseline, and complete a standardized questionnaire assessing the chosen outcome domain at baseline and follow-up. A feasibility study indicated that IOM had adequate completion (89%) and acceptability (96%) rates in a clinical sample (n = 84). IOM was then evaluated in a RCT (ISRCTN02507940). GA and PPO components were associated with each other and with the trial primary outcome. The use of the PPO component of IOM as the primary outcome could be considered in future RCTs. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Ground motion measurements at the LBL Light Source site, the Bevatron and at SLAC

International Nuclear Information System (INIS)

Green, M.A.; Majer, E.I.; More, V.D.; O'Connell, D.R.; Shilling, R.C.

1986-12-01

This report describes the technique for measuring ground motion at the site of the 1.0 to 2.0 GeV Synchrotron Radiation Facility which was known as the Advanced Light Source (in 1983 when the measurements were taken). The results of ground motion measurements at the Light Source site at Building 6 at LBL are presented. As comparison, ground motion measurements were made at the Byerly Tunnel, the Bevatron, Blackberry Canyon, and SLAC at the Spear Ring. Ground Motion at the Light Source site was measured in a band from 4 to 100 Hz. The measured noise is primarily local in origin and is not easily transported through LBL soils. The background ground motion is for the most part less than 0.1 microns. Localized truck traffic near Building 6 and the operation of the cranes in the building can result in local ground motions of a micron or more for short periods of time. The background motion at Building 6 is between 1 and 2 orders of magnitude higher than ground motion in a quiet seismic tunnel, which is representative of quiet sites worldwide. The magnitude of the ground motions at SLAC and the Bevatron are comparable to ground motions measured at the Building 6 Light Source site. However, the frequency signature of each site is very different

Back-trajectory modeling of high time-resolution air measurement data to separate nearby sources

Science.gov (United States)

Strategies to isolate air pollution contributions from sources is of interest as voluntary or regulatory measures are undertaken to reduce air pollution. When different sources are located in close proximity to one another and have similar emissions, separating source emissions ...

Quantitative outcome measures for systemic sclerosis-related Microangiopathy - Reliability of image acquisition in Nailfold Capillaroscopy.

Science.gov (United States)

Dinsdale, Graham; Moore, Tonia; O'Leary, Neil; Berks, Michael; Roberts, Christopher; Manning, Joanne; Allen, John; Anderson, Marina; Cutolo, Maurizio; Hesselstrand, Roger; Howell, Kevin; Pizzorni, Carmen; Smith, Vanessa; Sulli, Alberto; Wildt, Marie; Taylor, Christopher; Murray, Andrea; Herrick, Ariane L

2017-09-01

Nailfold capillaroscopic parameters hold increasing promise as outcome measures for clinical trials in systemic sclerosis (SSc). Their inclusion as outcomes would often naturally require capillaroscopy images to be captured at several time points during any one study. Our objective was to assess repeatability of image acquisition (which has been little studied), as well as of measurement. 41 patients (26 with SSc, 15 with primary Raynaud's phenomenon) and 10 healthy controls returned for repeat high-magnification (300×) videocapillaroscopy mosaic imaging of 10 digits one week after initial imaging (as part of a larger study of reliability). Images were assessed in a random order by an expert blinded observer and 4 outcome measures extracted: (1) overall image grade and then (where possible) distal vessel locations were marked, allowing (2) vessel density (across the whole nailfold) to be calculated (3) apex width measurement and (4) giant vessel count. Intra-rater, intra-visit and intra-rater inter-visit (baseline vs. 1week) reliability were examined in 475 and 392 images respectively. A linear, mixed-effects model was used to estimate variance components, from which intra-class correlation coefficients (ICCs) were determined. Intra-visit and inter-visit reliability estimates (ICCs) were (respectively): overall image grade, 0.97 and 0.90; vessel density, 0.92 and 0.65; mean vessel width, 0.91 and 0.79; presence of giant capillary, 0.68 and 0.56. These estimates were conditional on each parameter being measurable. Within-operator image analysis and acquisition are reproducible. Quantitative nailfold capillaroscopy, at least with a single observer, provides reliable outcome measures for clinical studies including randomised controlled trials. Copyright © 2017 Elsevier Inc. All rights reserved.

Measuring intangibles: Managing intangibles for tangible outcomes in research and innovation

International Nuclear Information System (INIS)

Carayannis, E.G.

2004-01-01

Knowledge sharing is critical to the success and survival of companies in knowledge intensive industries. It is essential to effectively measure knowledge creation and sharing to facilitate good investment decision making in knowledge management initiatives. This paper will focus on the identification of intangible benefits, the cause and effect relationships, and the applicability of existing metrics to these intangibles. The premise is that existing measurements may not apply. The development of new metrics for managing intangible assets to obtain tangible outcomes is a necessity. (author)

Validation of Patient-Reported Outcomes Measurement Information System Computerized Adaptive Tests Against the Foot and Ankle Outcome Score for 6 Common Foot and Ankle Pathologies.

Science.gov (United States)

Koltsov, Jayme C B; Greenfield, Stephen T; Soukup, Dylan; Do, Huong T; Ellis, Scott J

2017-08-01

The field of foot and ankle surgery lacks a widely accepted gold-standard patient-reported outcome instrument. With the changing infrastructure of the medical profession, more efficient patient-reported outcome tools are needed to reduce respondent burden and increase participation while providing consistent and reliable measurement across multiple pathologies and disciplines. The primary purpose of the present study was to validate 3 Patient-Reported Outcomes Measurement Information System computer adaptive tests (CATs) most relevant to the foot and ankle discipline against the Foot and Ankle Outcome Score (FAOS) and the Short Form 12 general health status survey in patients with 6 common foot and ankle pathologies. Patients (n = 240) indicated for operative treatment for 1 of 6 common foot and ankle pathologies completed the CATs, FAOS, and Short Form 12 at their preoperative surgical visits, 1 week subsequently (before surgery), and at 6 months postoperatively. The psychometric properties of the instruments were assessed and compared. The Patient-Reported Outcomes Measurement Information System CATs each took less than 1 minute to complete, whereas the FAOS took 6.5 minutes, and the Short Form 12 took 3 minutes. CAT scores were more normally distributed and had fewer floor and ceiling effects than those on the FAOS, which reached as high as 24%. The CATs were more precise than the FAOS and had similar responsiveness and test-retest reliability. The physical function and mobility CATs correlated strongly with the activities subscale of the FAOS, and the pain interference CAT correlated strongly with the pain subscale of the FAOS. The CATs and FAOS were responsive to changes with operative treatment for 6 common foot and ankle pathologies. The CATs performed as well as or better than the FAOS in all aspects of psychometric validity. The Patient-Reported Outcomes Measurement Information System CATs show tremendous potential for improving the study of patient

Measures Against-Illicit Trafficking of Nuclear Materials and Other Radioactive Sources

International Nuclear Information System (INIS)

Barakat, M.B.; Nassef, M.H.; El Mongy, S.A.

2008-01-01

Since the early nineties, illicit trafficking (IT) of nuclear materials and radioactive sources appeared as a new trend which raised the concern of the international community due to the grave consequences that would merge if these materials or radioactive sources fell into the hands of terrorist groups. However, by the end of the last century illicit trafficking of nuclear materials and radioactive sources lost its considerable salience, in spite of seizure of considerable amounts of 2 '3'5U (76% enrichment) in Bulgaria (May 1999) and also 235 U (30% enrichment) in Georgia (April 2000). Nevertheless, IT should be always considered as a continued and viable threat to the international community. Awareness of the problem should be developed and maintained among concerned circles as the first step towards combating illicit trafficking of nuclear materials and radioactive sources. Illicit trafficking of nuclear and radioactive materials needs serious consideration and proper attention by the governmental law enforcement authorities. Measures to combat with IT of nuclear material or radioactive sources should be effective in recovery, of stolen, removed or lost nuclear materials or radioactive sources due to the failure of the physical protection system or the State System Accounting and Control (SSAC) system which are normally applied for protecting these materials against illegal actions. Measures such as use of modern and efficient radiation monitoring equipment at the borders inspection points, is an important step in preventing the illicit trafficking of nuclear and radioactive materials across the borders. Also providing radiological training to specific personnel and workers in this field will minimize the consequences of a radiological attack in case of its occurrence. There is a real need to start to enter into cooperative agreements to strengthen borders security under the umbrella of IAEA to faster as an international cooperation in the illicit trafficking

Emissions & Measurements - Black Carbon | Science ...

Science.gov (United States)

Emissions and Measurement (EM) research activities performed within the National Risk Management Research Lab NRMRL) of EPA's Office of Research and Development (ORD) support measurement and laboratory analysis approaches to accurately characterize source emissions, and near source concentrations of air pollutants. They also support integrated Agency research programs (e.g., source to health outcomes) and the development of databases and inventories that assist Federal, state, and local air quality managers and industry implement and comply with air pollution standards. EM research underway in NRMRL supports the Agency's efforts to accurately characterize, analyze, measure and manage sources of air pollution. This pamphlet focuses on the EM research that NRMRL researchers conduct related to black carbon (BC). Black Carbon is a pollutant of concern to EPA due to its potential impact on human health and climate change. There are extensive uncertainties in emissions of BC from stationary and mobile sources. Emissions and Measurement (EM) research activities performed within the National Risk Management Research Lab NRMRL) of EPA's Office of Research and Development (ORD)

Outcomes Measurement in Voice Disorders: Application of an Acoustic Index of Dysphonia Severity

Science.gov (United States)

Awan, Shaheen N.; Roy, Nelson

2009-01-01

Purpose: The purpose of this experiment was to assess the ability of an acoustic model composed of both time-based and spectral-based measures to track change following voice disorder treatment and to serve as a possible treatment outcomes measure. Method: A weighted, four-factor acoustic algorithm consisting of shimmer, pitch sigma, the ratio of…

Monte Carlo calculations and experimental measurements of dosimetric parameters of the IRA-103Pd source

International Nuclear Information System (INIS)

Sadeghi, Mahdi; Hosseini, Hamed; Raisali, Gholamreza

2008-01-01

Full text: The use of 103 Pd seed sources for permanent prostate implantation has become a popular brachytherapy application. As recommended by AAPM the dosimetric characteristics of the new source must be determined using experimental and Monte Carlo simulations, before its use in clinical applications thus The goal of this report is the experimental and theoretical determination of the dosimetric characteristics of this source following the recommendations in the AAPM TG-43U1 protocol. Figure 1 shows the geometry of the IRA- 103 Pd source. The source consists of a cylindrical silver core, 0.3 cm long x 0.05 cm in diameter, onto which 0.5 nm layer of 103 Pd has been uniformly adsorbed. The effective active length of source is 0.3 cm and the silver core encapsulated inside a hollow titanium tube with 0.45 cm long, 0.07 cm and 0.08 inner and outer diameters and two caps. The Monte Carlo N-Particle (MCNP) code, version 4C, was used to determine the relevant dosimetric parameters of the source. The geometry of the Monte Carlo simulation performed in this study consisted of a sphere with 30 cm diameter. Dose distributions around this source were measured in two Perspex phantom using enough TLD chips. For these measurements, slabs of Perspex material were machined to accommodate the source and TLD chips. A value of 0.67± 1% cGy.h -1 .U -1 for, Λ, was calculated as the ratio of d(r 0 ,θ 0 ) and s K , that may be compared with Λ values obtained for 103 Pd sources. Result of calculations and measurements values of dosimetric parameters of the source including radial dose function, g(r), and anisotropy function, F(r,θ), has been shown in separate figures. The radial dose function, g(r), for the IRA- 103 Pd source and other 103 Pd sources is included in Fig. 2. Comparison between measured and Monte Carlo simulated dose function, g(r), and anisotropy function, F(r,θ), of this source demonstrated that they are in good agreement with each other and The value of Λ is

Flash X-Ray (FXR) Accelerator Optimization Electronic Time-Resolved Measurement of X-Ray Source Size

International Nuclear Information System (INIS)

Jacob, J; Ong, M; Wargo, P

2005-01-01

Lawrence Livermore National Laboratory (LLNL) is currently investigating various approaches to minimize the x-ray source size on the Flash X-Ray (FXR) linear induction accelerator in order to improve x-ray flux and increase resolution for hydrodynamic radiography experiments. In order to effectively gauge improvements to final x-ray source size, a fast, robust, and accurate system for measuring the spot size is required. Timely feedback on x-ray source size allows new and improved accelerator tunes to be deployed and optimized within the limited run-time constraints of a production facility with a busy experimental schedule; in addition, time-resolved measurement capability allows the investigation of not only the time-averaged source size, but also the evolution of the source size, centroid position, and x-ray dose throughout the 70 ns beam pulse. Combined with time-resolved measurements of electron beam parameters such as emittance, energy, and current, key limiting factors can be identified, modeled, and optimized for the best possible spot size. Roll-bar techniques are a widely used method for x-ray source size measurement, and have been the method of choice at FXR for many years. A thick bar of tungsten or other dense metal with a sharp edge is inserted into the path of the x-ray beam so as to heavily attenuate the lower half of the beam, resulting in a half-light, half-dark image as seen downstream of the roll-bar; by measuring the width of the transition from light to dark across the edge of the roll-bar, the source size can be deduced. For many years, film has been the imaging medium of choice for roll-bar measurements thanks to its high resolution, linear response, and excellent contrast ratio. Film measurements, however, are fairly cumbersome and require considerable setup and analysis time; moreover, with the continuing trend towards all-electronic measurement systems, film is becoming increasingly difficult and expensive to procure. Here, we shall

Infrared measurements in defence application

CSIR Research Space (South Africa)

Mudau, AE

2011-03-01

Full Text Available the measurements and tests are done both in laboratory and field environments, it is important to understand and account for the influence of the environment on the measurement outcome. In addition, consistently disciplined measurement practices are required... stream_source_info Mudau_2011.pdf.txt stream_content_type text/plain stream_size 11031 Content-Encoding ISO-8859-1 stream_name Mudau_2011.pdf.txt Content-Type text/plain; charset=ISO-8859-1 Measurement...

Can we decide which outcomes should be measured in every clinical trial? A scoping review of the existing conceptual frameworks and processes to develop core outcome sets.

Science.gov (United States)

Idzerda, Leanne; Rader, Tamara; Tugwell, Peter; Boers, Maarten

2014-05-01

The usefulness of randomized control trials to advance clinical care depends upon the outcomes reported, but disagreement on the choice of outcome measures has resulted in inconsistency and the potential for reporting bias. One solution to this problem is the development of a core outcome set: a minimum set of outcome measures deemed critical for clinical decision making. Within rheumatology the Outcome Measures in Rheumatology (OMERACT) initiative has pioneered the development of core outcome sets since 1992. As the number of diseases addressed by OMERACT has increased and its experience in formulating core sets has grown, clarification and update of the conceptual framework and formulation of a more explicit process of area/domain core set development has become necessary. As part of the update process of the OMERACT Filter criteria to version 2, a literature review was undertaken to compare and contrast the OMERACT conceptual framework with others within and outside rheumatology. A scoping search was undertaken to examine the extent, range, and nature of conceptual frameworks for core set outcome selection in health. We searched the following resources: Cochrane Library Methods Group Register; Medline; Embase; PsycInfo; Environmental Studies and Policy Collection; and ABI/INFORM Global. We also conducted a targeted Google search. Five conceptual frameworks were identified: the WHO tripartite definition of health; the 5 Ds (discomfort, disability, drug toxicity, dollar cost, and death); the International Classification of Functioning (ICF); PROMIS (Patient-Reported Outcomes Measurement System); and the Outcomes Hierarchy. Of these, only the 5 Ds and ICF frameworks have been systematically applied in core set development. Outside the area of rheumatology, several core sets were identified; these had been developed through a limited range of consensus-based methods with varying degrees of methodological rigor. None applied a framework to ensure content validity of

Outcome measures and scar aesthetics in minimally invasive video-assisted parathyroidectomy.

LENUS (Irish Health Repository)

Casserly, Paula

2012-02-01

OBJECTIVES: To compare the scar outcome of video-assisted parathyroidectomy (VAP) with traditional bilateral cervical exploration (BCE) using previously validated scar assessment scales, and to examine the feasibility of introducing VAP into a general otolaryngology-head and neck practice. DESIGN: A retrospective review of medical records from a prospectively obtained database of patients and long-term follow-up of scar analysis. PATIENTS: The records of 60 patients undergoing parathyroidectomy were reviewed: 29 patients underwent VAP and 31 patients underwent an open procedure with BCE. The groups were matched for age and sex. A total of 46 patients were followed up to assess scar outcome. MAIN OUTCOME MEASURES: The primary outcome was a comparison of patient and observer scar satisfaction between VAP and traditional BCE using validated scar assessment tools: the Patient Scar Assessment Scale and the Manchester Scar Scale. The secondary outcomes were to retrospectively evaluate our results with VAP and to assess the suitability of introducing this technique into a general otolaryngology-head and neck practice. RESULTS: The average scar length in the VAP group was 1.7 cm, and the average scar length in the BCE group was 4.3 cm. The patients in the BCE group scored higher than the patients in the VAP group on the Manchester Scar Scale (P < .01) and on the Patient and Observer Scar Scales (P = .02), indicating a worse scar outcome. The mean operative time in the VAP group was 41 minutes compared with 115 minutes in the open procedure BCE group. There was no difference between the 2 groups in terms of postoperative complications. CONCLUSIONS: Video-assisted parathyroidectomy is a safe and feasible procedure in the setting of a general otolaryngology-head and neck practice, with outcomes and complication rates that are comparable to those of traditional bilateral neck exploration. Both patient and observer analysis demonstrated that VAP was associated with a more

Localisation of a neutron source using measurements and calculation of the neutron flux and its gradient

CERN Document Server

Linden, P; Dahl, B; Pázsit, I; Por, G

1999-01-01

We have performed laboratory measurements of the neutron flux and its gradient in a static model experiment, similar to a model problem proposed in Pazsit (Ann. Nucl. Energy 24 (1997) 1257). The experimental system consists of a radioactive neutron source located in a water tank. The measurements are performed using a recently developed very small optical fibre detector. The measured values of the flux and its gradient are then used to test the possibility of localising the source. The results show that it is possible to measure the flux on the circumference of a circle and from this calculate the flux gradient vector. Then, by comparison of the measured quantities with corresponding MCNP calculations, both the direction and the distance to the source are found and thus the position of the source can be determined.

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

Directory of Open Access Journals (Sweden)

Prem S. Fry

2014-01-01

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

Validation of the Focus on the Outcomes of Communication under Six outcome measure

Science.gov (United States)

Thomas-Stonell, Nancy; Oddson, Bruce; Robertson, Bernadette; Rosenbaum, Peter

2013-01-01

Aim The aim of this study was to establish the construct validity of the Focus on the Outcomes of Communication Under Six (FOCUS©),a tool designed to measure changes in communication skills in preschool children. Method Participating families' children (n=97; 68 males, 29 females; mean age 2y 8mo; SD 1.04y, range 10mo–4y 11mo) were recruited through eight Canadian organizations. The children were on a waiting list for speech and language intervention. Parents completed the Ages and Stages Questionnaire – Social/Emotional (ASQ-SE) and the FOCUS three times: at assessment and at the start and end of treatment. A second sample (n=28; 16 males 12 females) was recruited from another organization to correlate the FOCUS scores with speech, intelligibility and language measures. Second sample participants ranged in age from 3 years 1 month to 4 years 9 months (mean 3y 11mo; SD 0.41y). At the start and end of treatment, children were videotaped to obtain speech and language samples. Parents and speech–language pathologists (SLPs) independently completed the FOCUS tool. SLPs who were blind to the pre/post order of the videotapes analysed the samples. Results The FOCUS measured significantly more change (p<0.01) during treatment than during the waiting list period. It demonstrated both convergent and discriminant validity against the ASQ-SE. The FOCUS change corresponded to change measured by a combination of clinical speech and language measures (κ=0.31, p<0.05). Conclusion The FOCUS shows strong construct validity as a change-detecting instrument. PMID:23461266

Characterization of γ-ray background at IMAT beamline of ISIS Spallation Neutron Source

Science.gov (United States)

Festa, G.; Andreani, C.; Arcidiacono, L.; Burca, G.; Kockelmann, W.; Minniti, T.; Senesi, R.

2017-08-01

The environmental γ -ray background on the IMAT beamline at ISIS Spallation Neutron Source, Target Station 2, is characterized via γ spectroscopy. The measurements include gamma exposure at the imaging detector position, along with the gamma background inside the beamline. Present results are discussed and compared with previous measurements recorded at INES and VESUVIO beamlines operating at Target Station 1. They provide new outcome for expanding and optimizing the PGAA experimental capability at the ISIS neutron source for the investigation of materials, engineering components and cultural heritage objects at the ISIS neutron source.

Characterization of γ-ray background at IMAT beamline of ISIS Spallation Neutron Source

International Nuclear Information System (INIS)

Festa, G.; Andreani, C.; Arcidiacono, L.; Senesi, R.; Burca, G.; Kockelmann, W.; Minniti, T.

2017-01-01

The environmental γ -ray background on the IMAT beamline at ISIS Spallation Neutron Source, Target Station 2, is characterized via γ  spectroscopy. The measurements include gamma exposure at the imaging detector position, along with the gamma background inside the beamline. Present results are discussed and compared with previous measurements recorded at INES and VESUVIO beamlines operating at Target Station 1. They provide new outcome for expanding and optimizing the PGAA experimental capability at the ISIS neutron source for the investigation of materials, engineering components and cultural heritage objects at the ISIS neutron source.

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

Science.gov (United States)

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

2017-06-01

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

Measuring Learning Outcomes. A Learner Perspective in Auditing Education

DEFF Research Database (Denmark)

Holm, Claus; Steenholdt, Niels

The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education which reflects that some students taking accounting classes also are provided with on-the-job training in accounting...... is part of every day life within most accounting firms. Developing a sound on-the-job training environment is pivotal in the recruitment and design of supervision, and in the end for the expected "successrate" in retaining (valuable) employees. Prior research suggests that scripts or schemas provide...

Payer source influence on effectiveness of lifestyle medicine programs.

Science.gov (United States)

Vogelgesang, Joseph; Drozek, David; Nakazawa, Masato; Shubrook, Jay H

2015-09-01

Many chronic diseases are responsive to interventions focused on diet and physical activity. The Complete Health Improvement Program (CHIP) is an intensive, community-based lifestyle intervention that effectively treats many chronic diseases and their risk factors. This is a pilot study examining the effect of payer source for CHIP tuition on participants' outcomes. Seventy-nine self-selected participants (73.4% female) attended 1 of 3 CHIP classes (classes 7-9) offered January through May 2013 in Athens, Ohio. Participants were categorized into 3 groups based on the source(s) of their tuition payment: self-pay, employer-pay, or scholarship. Chronic disease risk factors for each individual were assessed at the beginning and conclusion of the program. Outcome variables included percent reduction between pre- and post CHIP measures in body mass index, systolic and diastolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and fasting blood glucose. Results were compared between type of payer source (out of pocket vs employer and/or scholarship) and between each individual CHIP class attended. There was no statistical difference in outcomes based on payer source. Those who received funding through their employer or a scholarship experienced similar effects from a lifestyle intervention program as those who paid out of pocket. This study demonstrates that the benefit of CHIP for reducing chronic disease risk factors exists independent of payment source, and thus suggests its benefit may cross socioeconomic lines.

Gasdynamic measurements for the LASL intense neutron source

International Nuclear Information System (INIS)

Johnston, S.C.

1978-02-01

Measurements made on a two-dimensional simulation of the Los Alamos Scientific Laboratory (LASL) Intense Neutron Source (INS) experiment are discussed. The purpose of this work was to characterize the supersonic INS channel flow under conditions of large amounts of energy deposition. Nozzle channel wall pressure measurements, cold flow leakage rates, vacuum channel pressure and Mach number, leakage flow rates with mass addition to and momentum extraction from the main flow, and flow visualization photographs are given. Energy addition up to thirty percent of the theoretical maximum was achieved via mass addition to and momentum extraction from the main channel flow. In this range, both a weak and strong regime for leakage flow were identified. These regimes differed by about twenty percent in leakage flow rates

Unaccounted source of systematic errors in measurements of the Newtonian gravitational constant G

International Nuclear Information System (INIS)

DeSalvo, Riccardo

2015-01-01

Many precision measurements of G have produced a spread of results incompatible with measurement errors. Clearly an unknown source of systematic errors is at work. It is proposed here that most of the discrepancies derive from subtle deviations from Hooke's law, caused by avalanches of entangled dislocations. The idea is supported by deviations from linearity reported by experimenters measuring G, similarly to what is observed, on a larger scale, in low-frequency spring oscillators. Some mitigating experimental apparatus modifications are suggested. - Highlights: • Source of discrepancies on universal gravitational constant G measurements. • Collective motion of dislocations results in breakdown of Hook's law. • Self-organized criticality produce non-predictive shifts of equilibrium point. • New dissipation mechanism different from loss angle and viscous models is necessary. • Mitigation measures proposed may bring coherence to the measurements of G

High order statistical signatures from source-driven measurements of subcritical fissile systems

International Nuclear Information System (INIS)

Mattingly, J.K.

1998-01-01

This research focuses on the development and application of high order statistical analyses applied to measurements performed with subcritical fissile systems driven by an introduced neutron source. The signatures presented are derived from counting statistics of the introduced source and radiation detectors that observe the response of the fissile system. It is demonstrated that successively higher order counting statistics possess progressively higher sensitivity to reactivity. Consequently, these signatures are more sensitive to changes in the composition, fissile mass, and configuration of the fissile assembly. Furthermore, it is shown that these techniques are capable of distinguishing the response of the fissile system to the introduced source from its response to any internal or inherent sources. This ability combined with the enhanced sensitivity of higher order signatures indicates that these techniques will be of significant utility in a variety of applications. Potential applications include enhanced radiation signature identification of weapons components for nuclear disarmament and safeguards applications and augmented nondestructive analysis of spent nuclear fuel. In general, these techniques expand present capabilities in the analysis of subcritical measurements

Characterization of the γ background in epithermal neutron scattering measurements at pulsed neutron sources

International Nuclear Information System (INIS)

Pietropaolo, A.; Tardocchi, M.; Schooneveld, E.M.; Senesi, R.

2006-01-01

This paper reports the characterization of the different components of the γ background in epithermal neutron scattering experiments at pulsed neutron sources. The measurements were performed on the VESUVIO spectrometer at ISIS spallation neutron source. These measurements, carried out with a high purity germanium detector, aim to provide detailed information for the investigation of the effect of the γ energy discrimination on the signal-to-background ratio. It is shown that the γ background is produced by different sources that can be identified with their relative time structure and relative weight

Some problems of neutron source multiplication method for site measurement technology in nuclear critical safety

International Nuclear Information System (INIS)

Shi Yongqian; Zhu Qingfu; Hu Dingsheng; He Tao; Yao Shigui; Lin Shenghuo

2004-01-01

The paper gives experiment theory and experiment method of neutron source multiplication method for site measurement technology in the nuclear critical safety. The measured parameter by source multiplication method actually is a sub-critical with source neutron effective multiplication factor k s , but not the neutron effective multiplication factor k eff . The experiment research has been done on the uranium solution nuclear critical safety experiment assembly. The k s of different sub-criticality is measured by neutron source multiplication experiment method, and k eff of different sub-criticality, the reactivity coefficient of unit solution level, is first measured by period method, and then multiplied by difference of critical solution level and sub-critical solution level and obtained the reactivity of sub-critical solution level. The k eff finally can be extracted from reactivity formula. The effect on the nuclear critical safety and different between k eff and k s are discussed

Correlating nerve conduction studies and clinical outcome measures on carpal tunnel syndrome: lessons from a randomized controlled trial

NARCIS (Netherlands)

Schrijver, H.M.; Gerritsen, A.A.M.; Strijers, R.L.; Uitdehaag, B.M.J.; Scholten, R.J.P.M.; Vet, de H.C.W.; Bouter, L.M.

2005-01-01

0.4) were found between the neurophysiologic and clinical outcome measures after 12 months, and between the changes in these different categories of outcome measures. This study confirms that the parameters of NCS improve significantly after treatment for CTS, but the modest correlations between

Creating a Novel Video Vignette Stroke Preparedness Outcome Measure Using a Community-Based Participatory Approach.

Science.gov (United States)

Skolarus, Lesli E; Murphy, Jillian B; Dome, Mackenzie; Zimmerman, Marc A; Bailey, Sarah; Fowlkes, Sophronia; Morgenstern, Lewis B

2015-07-01

Evaluating the efficacy of behavioral interventions for rare outcomes is a challenge. One such topic is stroke preparedness, defined as inteventions to increase stroke symptom recognition and behavioral intent to call 911. Current stroke preparedness intermediate outcome measures are centered on written vignettes or open-ended questions and have been shown to poorly reflect actual behavior. Given that stroke identification and action requires aural and visual processing, video vignettes may improve on current measures. This article discusses an approach for creating a novel stroke preparedness video vignette intermediate outcome measure within a community-based participatory research partnership. A total of 20 video vignettes were filmed of which 13 were unambiguous (stroke or not stroke) as determined by stroke experts and had test discrimination among community participants. Acceptable reliability, high satisfaction, and cultural relevance were found among the 14 community respondents. A community-based participatory approach was effective in creating a video vignette intermediate outcome. Future projects should consider obtaining expert and community feedback prior to filming all the video vignettes to improve the proportion of vignettes that are usable. While content validity and preliminary reliability were established, future studies are needed to confirm the reliability and establish construct validity. © 2014 Society for Public Health Education.

Association between changes on the Negative Symptom Assessment scale (NSA-16) and measures of functional outcome in schizophrenia.

Science.gov (United States)

Velligan, Dawn I; Alphs, Larry; Lancaster, Scott; Morlock, Robert; Mintz, Jim

2009-09-30

We examined whether changes in negative symptoms, as measured by scores on the 16-item Negative Symptom Assessment scale (NSA-16), were associated with changes in functional outcome. A group of 125 stable outpatients with schizophrenia were assessed at baseline and at 6 months using the NSA-16, the Brief Psychiatric Rating Scale, and multiple measures of functional outcome. Baseline adjusted regression coefficients indicated moderate correlations between negative symptoms and functional outcomes when baseline values of both variables were controlled. Results were nearly identical when we controlled for positive symptoms. Cross-lag panel correlations and Structural Equation Modeling were used to examine whether changes in negative symptoms drove changes in functional outcomes over time. Results indicated that negative symptoms drove the changes in the Social and Occupational Functioning Scale (SOFAS) rather than the reverse. Measures of Quality of Life and measures of negative symptoms may be assessing overlapping constructs or changes in both may be driven by a third variable. Negative symptoms were unrelated over time to scores on a performance-based measure of functional capacity. This study indicates that the relationship between negative symptom change and the change in functional outcomes is complex, and points to potential issues in selection of assessments.

E-line: A new crystal collimator beam line for source size measurements at CHESS

International Nuclear Information System (INIS)

White, Jeffrey A.; Revesz, Peter; Finkelstein, Ken

2007-01-01

A new X-ray beam line has been constructed at cornell high energy synchrotron source (CHESS) to measure the vertical and horizontal source size of the positron particle beam. The cornell laboratory of elementary particle physics (LEPP) operates the storage ring (CESR) for X-ray generation for the CHESS user community by circulating electrons and their antimatter counterpart positrons in counter-rotating beams. As the laboratory reduces the emittances of particle beams to increase X-ray brilliance, there has been an increasing need for diagnostic tools to measure and monitor source size. A beam line front end that accesses the positron synchrotron light has been fitted with an experimental chamber and apparatus of compact design capable of horizontal and vertical source size measurement using the 'crystal collimator' technique, and an additional setup for vertical beam position monitoring using a luminescence-based X-ray video beam position monitoring system. The crystal collimators each consist of two Si(2 2 0) crystals in a dispersive (+,+) arrangement that diffract X-rays to a fluorescent material coated on a view port observed with a CCD camera. Measurements of the positron vertical beam size using the crystal collimation method at E-line are compared with measurements of visible synchrotron light at a remotely located dedicated port on the storage ring

Greenhouse Gas Source Attribution: Measurements Modeling and Uncertainty Quantification

Energy Technology Data Exchange (ETDEWEB)

Liu, Zhen [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Safta, Cosmin [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Sargsyan, Khachik [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Najm, Habib N. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); van Bloemen Waanders, Bart Gustaaf [Sandia National Lab. (SNL-CA), Livermore, CA (United States); LaFranchi, Brian W. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Ivey, Mark D. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Schrader, Paul E. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Michelsen, Hope A. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Bambha, Ray P. [Sandia National Lab. (SNL-CA), Livermore, CA (United States)

2014-09-01

In this project we have developed atmospheric measurement capabilities and a suite of atmospheric modeling and analysis tools that are well suited for verifying emissions of green- house gases (GHGs) on an urban-through-regional scale. We have for the first time applied the Community Multiscale Air Quality (CMAQ) model to simulate atmospheric CO₂ . This will allow for the examination of regional-scale transport and distribution of CO₂ along with air pollutants traditionally studied using CMAQ at relatively high spatial and temporal resolution with the goal of leveraging emissions verification efforts for both air quality and climate. We have developed a bias-enhanced Bayesian inference approach that can remedy the well-known problem of transport model errors in atmospheric CO₂ inversions. We have tested the approach using data and model outputs from the TransCom3 global CO₂ inversion comparison project. We have also performed two prototyping studies on inversion approaches in the generalized convection-diffusion context. One of these studies employed Polynomial Chaos Expansion to accelerate the evaluation of a regional transport model and enable efficient Markov Chain Monte Carlo sampling of the posterior for Bayesian inference. The other approach uses de- terministic inversion of a convection-diffusion-reaction system in the presence of uncertainty. These approaches should, in principle, be applicable to realistic atmospheric problems with moderate adaptation. We outline a regional greenhouse gas source inference system that integrates (1) two ap- proaches of atmospheric dispersion simulation and (2) a class of Bayesian inference and un- certainty quantification algorithms. We use two different and complementary approaches to simulate atmospheric dispersion. Specifically, we use a Eulerian chemical transport model CMAQ and a Lagrangian Particle Dispersion Model - FLEXPART-WRF. These two models share the same WRF

Analysis of insertion device magnet measurements for the Advanced Light Source

International Nuclear Information System (INIS)

Marks, S.; Humphries, D.; Kincaid, B.M.; Schlueter, R.; Wang, C.

1993-07-01

The Advanced Light Source (ALS), which is currently being commissioned at Lawrence Berkeley Laboratory, is a third generation light source designed to produce XUV radiation of unprecedented brightness. To meet the high brightness goal the storage ring has been designed for very small electron beam emittance and the undulators installed in the ALS are built to a high degree of precision. The allowable magnetic field errors are driven by electron beam and radiation requirements. Detailed magnetic measurements and adjustments are performed on each undulator to qualify it for installation in the ALS. The first two ALS undulators, IDA and IDB, have been installed. This paper describes the program of measurements, data analysis, and adjustments carried out for these two devices. Calculations of the radiation spectrum, based upon magnetic measurements, are included. Final field integral distributions are also shown. Good field integral uniformity has been achieved using a novel correction scheme, which is also described

Measurement properties of patient reported outcome measures for spondyloarthritis: A systematic review.

Science.gov (United States)

Png, Kelly; Kwan, Yu Heng; Leung, Ying Ying; Phang, Jie Kie; Lau, Jia Qi; Lim, Ka Keat; Chew, Eng Hui; Low, Lian Leng; Tan, Chuen Seng; Thumboo, Julian; Fong, Warren; Østbye, Truls

2018-03-21

This systematic review aimed to identify studies investigating measurement properties of patient reported outcome measures (PROMs) for spondyloarthritis (SpA), and to evaluate their methodological quality and level of evidence relating to the measurement properties of PROMs. This systematic review was guided by the preferred reporting items for systematic review and meta-analysis (PRISMA). Articles published before 30 June 2017 were retrieved from PubMed ® , Embase ® , and PsychINFO ® (Ovid). Methodological quality and level of evidence were evaluated according to recommendations from the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). We identified 60 unique PROMs from 125 studies in 39 countries. Twenty-one PROMs were validated for two or more SpA subtypes. The literature examined hypothesis testing (82.4%) most frequently followed by reliability (60.0%). A percentage of 77.7% and 42.7% of studies that assessed PROMs for hypothesis testing and reliability, respectively had "fair" or better methodological quality. Among the PROMs identified, 41.7% were studied in ankylosing spondylitis (AS) only and 23.3% were studied in psoriatic arthritis (PsA) only. The more extensively assessed PROMs included the ankylosing spondylitis quality of life (ASQoL) and bath ankylosing spondylitis functional index (BASFI) for ankylosing spondylitis, and the psoriatic arthritis quality of life questionnaire (VITACORA-19) for psoriatic arthritis. This study identified 60 unique PROMs through a systematic review and synthesized evidence of the measurement properties of the PROMs. There is a lack of validation of PROMs for use across SpA subtypes. Future studies may consider validating PROMs for use across different SpA subtypes. Copyright © 2018 Elsevier Inc. All rights reserved.

Theoretical framework and methodological development of common subjective health outcome measures in osteoarthritis: a critical review

Directory of Open Access Journals (Sweden)

Johnston Marie

2007-03-01

Full Text Available Abstract Subjective measures involving clinician ratings or patient self-assessments have become recognised as an important tool for the assessment of health outcome. The value of a health outcome measure is usually assessed by a psychometric evaluation of its reliability, validity and responsiveness. However, psychometric testing involves an accumulation of evidence and has recognised limitations. It has been suggested that an evaluation of how well a measure has been developed would be a useful additional criteria in assessing the value of a measure. This paper explored the theoretical background and methodological development of subjective health status measures commonly used in osteoarthritis research. Fourteen subjective health outcome measures commonly used in osteoarthritis research were examined. Each measure was explored on the basis of their i theoretical framework (was there a definition of what was being assessed and was it part of a theoretical model? and ii methodological development (what was the scaling strategy, how were the items generated and reduced, what was the response format and what was the scoring method?. Only the AIMS, SF-36 and WHOQOL defined what they were assessing (i.e. the construct of interest and no measure assessed was part of a theoretical model. None of the clinician report measures appeared to have implemented a scaling procedure or described the rationale for the items selected or scoring system. Of the patient self-report measures, the AIMS, MPQ, OXFORD, SF-36, WHOQOL and WOMAC appeared to follow a standard psychometric scaling method. The DRP and EuroQol used alternative scaling methods. The review highlighted the general lack of theoretical framework for both clinician report and patient self-report measures. This review also drew attention to the wide variation in the methodological development of commonly used measures in OA. While, in general the patient self-report measures had good methodological

Family-centred service coordination in childhood health and disability services: the search for meaningful service outcome measures.

Science.gov (United States)

Trute, B; Hiebert-Murphy, D; Wright, A

2008-05-01

Potential service outcome measures were tested for their utility in the assessment of the quality of 'family centred' service coordination in the provincial network of children's disability services in Manitoba, Canada. This study is based on in-home survey data provided by 103 mothers at 6 and 18 months following assignment of a 'dedicated' service coordinator. Service outcome indicators included measures of parent self-esteem, parenting stress, family functioning and the need for family support resources. Hierarchical regression analyses showed no relationship between level of quality of family-centred service coordination and standardized psychosocial measures of parent and family functioning. However, family centredness of service coordination was found to predict significant reduction in level of family need for psychosocial support resources after 18 months of contact with a service coordinator. Outcome measures that are focused on specific and tangible results of service coordination appear to be of higher utility in service quality assessment than are more global, standardized measures of parent and family functioning.

Patient value: its nature, measurement, and role in real world evidence studies and outcomes-based reimbursement.

Science.gov (United States)

McKenna, Stephen P; Wilburn, Jeanette

2018-05-01

The assessment of "patient value" is fundamental to clinical trials, real world evidence studies, and outcomes-based reimbursement schemes. Measures of health-related quality-of-life (HRQoL) are widely used in health research. Such measures are effective in determining the presence or absence of symptoms and functional ability. However, HRQoL measures were not intended, nor designed, to determine the value to patients of alternative health states. Functions have no intrinsic value-they are a means to fulfil human needs. However, needs can be met in a variety of ways, for example by adopting different functions or by the provision of social services. It is possible to analyze all functions in terms of the needs they satisfy. A needs model has been applied in health research since the 1990s. It is concerned with the extent to which human needs are fulfilled in the presence of disease and its treatment. It is argued that this is the major concern of the patient. Needs-based measures are patient-centric and produce a valid unidimensional index of outcome. Consequently, they provide a direct means of measuring patient value. This approach provides the possibility of evaluating health services in terms of the value they provide to consumers and payers. It also has a role to play in real-world evidence studies and outcomes-based reimbursement. It is recommended that greater attention is given in future to the development of patient-reported outcome measures that provide direct assessments of patient value.

Outcomes important to burns patients during scar management and how they compare to the concepts captured in burn-specific patient reported outcome measures.

Science.gov (United States)

Jones, Laura L; Calvert, Melanie; Moiemen, Naiem; Deeks, Jonathan J; Bishop, Jonathan; Kinghorn, Philip; Mathers, Jonathan

2017-12-01

Pressure garment therapy (PGT) is an established treatment for the prevention and treatment of hypertrophic scarring; however, there is limited evidence for its effectiveness. Burn survivors often experience multiple issues many of which are not adequately captured in current PGT trial measures. To assess the effectiveness of PGT it is important to understand what outcomes matter to patients and to consider whether patient-reported outcome measures (PROMs) can be used to ascertain the effect of treatments on patients' health-related quality of life. This study aimed to (a) understand the priorities and perspectives of adult burns patients and the parents of burns patients who have experienced PGT via in-depth qualitative data, and (b) compare these with the concepts captured within burn-specific PROMs. We undertook 40 semi-structured interviews with adults and parents of paediatric and adolescent burns patients who had experienced PGT to explore their priorities and perspectives on scar management. Interviews were audio-recorded, transcribed and thematically analysed. The outcomes interpreted within the interview data were then mapped against the concepts captured within burn-specific PROMs currently in the literature. Eight core outcome domains were identified as important to adult patients and parents: (1) scar characteristics and appearance, (2) movement and function, (3) scar sensation, (4) psychological distress, adjustments and a sense of normality, (5) body image and confidence, (6) engagement in activities, (7) impact on relationships, and (8) treatment burden. The outcome domains presented reflect a complex holistic patient experience of scar management and treatments such as PGT. Some currently available PROMs do capture the concepts described here, although none assess psychological adjustments and attainment of a sense of normality following burn injury. The routine use of PROMs that represent patient experience and their relative contribution to trial

Use of outcome measures in pulmonary hypertension clinical trials.

Science.gov (United States)

Parikh, Kishan S; Rajagopal, Sudarshan; Arges, Kristine; Ahmad, Tariq; Sivak, Joseph; Kaul, Prashant; Shah, Svati H; Tapson, Victor; Velazquez, Eric J; Douglas, Pamela S; Samad, Zainab

2015-09-01

To evaluate the use of surrogate measures in pulmonary hypertension (PH) clinical trials and how it relates to clinical practice. Studies of pulmonary arterial hypertension (PAH) employ a variety of surrogate measures in addition to clinical events because of a small patient population, participant burden, and costs. The use of these measures in PH drug trials is poorly defined. We searched PubMed/MEDLINE/Embase for randomized or prospective cohort PAH clinical treatment trials from 1985 to 2013. Extracted data included intervention, trial duration, study design, patient characteristics, and primary and secondary outcome measures. To compare with clinical practice, we assessed the use of surrogate measures in a clinical sample of patients on PH medications at Duke University Medical Center between 2003 and 2014. Between 1985 and 2013, 126 PAH trials were identified and analyzed. Surrogate measures served as primary endpoints in 119 trials (94.0%). Inclusion of invasive hemodynamics decreased over time (78.6%, 75.0%, 52.2%; P for trend = .02), while functional testing (7.1%, 60.0%, 81.5%; P for trend clinical assessments regularly incorporated serial echocardiography and 6-minute walk distance tests (92% and 95% of patients, respectively) and repeat measurement of invasive hemodynamics (46% of patients). The majority of PAH trials have utilized surrogate measures as primary endpoints. The use of these surrogate endpoints has evolved significantly over time with increasing use of patient-centered endpoints and decreasing or stable use of imaging and invasive measures. In contrast, imaging and invasive measures are commonly used in contemporary clinical practice. Further research is needed to validate and standardize currently used measures. Copyright © 2015 Elsevier Inc. All rights reserved.

Radiation measurement practice for understanding statistical fluctuation of radiation count using natural radiation sources

International Nuclear Information System (INIS)

Kawano, Takao

2014-01-01

It is known that radiation is detected at random and the radiation counts fluctuate statistically. In the present study, a radiation measurement experiment was performed to understand the randomness and statistical fluctuation of radiation counts. In the measurement, three natural radiation sources were used. The sources were fabricated from potassium chloride chemicals, chemical fertilizers and kelps. These materials contain naturally occurring potassium-40 that is a radionuclide. From high schools, junior high schools and elementary schools, nine teachers participated to the radiation measurement experiment. Each participant measured the 1-min integration counts of radiation five times using GM survey meters, and 45 sets of data were obtained for the respective natural radiation sources. It was found that the frequency of occurrence of radiation counts was distributed according to a Gaussian distribution curve, although the obtained 45 data sets of radiation counts superficially looked to be fluctuating meaninglessly. (author)

Kinematic measures for upper limb robot-assisted therapy following stroke and correlations with clinical outcome measures: A review.

Science.gov (United States)

Tran, Vi Do; Dario, Paolo; Mazzoleni, Stefano

2018-03-01

This review classifies the kinematic measures used to evaluate post-stroke motor impairment following upper limb robot-assisted rehabilitation and investigates their correlations with clinical outcome measures. An online literature search was carried out in PubMed, MEDLINE, Scopus and IEEE-Xplore databases. Kinematic parameters mentioned in the studies included were categorized into the International Classification of Functioning, Disability and Health (ICF) domains. The correlations between these parameters and the clinical scales were summarized. Forty-nine kinematic parameters were identified from 67 articles involving 1750 patients. The most frequently used parameters were: movement speed, movement accuracy, peak speed, number of speed peaks, and movement distance and duration. According to the ICF domains, 44 kinematic parameters were categorized into Body Functions and Structure, 5 into Activities and no parameters were categorized into Participation and Personal and Environmental Factors. Thirteen articles investigated the correlations between kinematic parameters and clinical outcome measures. Some kinematic measures showed a significant correlation coefficient with clinical scores, but most were weak or moderate. The proposed classification of kinematic measures into ICF domains and their correlations with clinical scales could contribute to identifying the most relevant ones for an integrated assessment of upper limb robot-assisted rehabilitation treatments following stroke. Increasing the assessment frequency by means of kinematic parameters could optimize clinical assessment procedures and enhance the effectiveness of rehabilitation treatments. Copyright © 2018 IPEM. Published by Elsevier Ltd. All rights reserved.

Systematic review of mental health and well-being outcomes following community-based obesity prevention interventions among adolescents

Science.gov (United States)

Hoare, Erin; Fuller-Tyszkiewicz, Matthew; Skouteris, Helen; Millar, Lynne; Nichols, Melanie; Allender, Steven

2015-01-01

Objectives This paper aimed to systematically evaluate the mental health and well-being outcomes observed in previous community-based obesity prevention interventions in adolescent populations. Setting Systematic review of literature from database inception to October 2014. Articles were sourced from CINAHL, Global Health, Health Source: Nursing and Academic Edition, MEDLINE, PsycARTICLES and PsycINFO, all of which were accessed through EBSCOhost. The Cochrane Database was also searched to identify all eligible articles. PRISMA guidelines were followed and search terms and search strategy ensured all possible studies were identified for review. Participants Intervention studies were eligible for inclusion if they were: focused on overweight or obesity prevention, community-based, targeted adolescents (aged 10–19 years), reported a mental health or well-being measure, and included a comparison or control group. Studies that focused on specific adolescent groups or were treatment interventions were excluded from review. Quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines. Primary and secondary outcome measures Primary outcomes were measures of mental health and well-being, including diagnostic and symptomatic measures. Secondary outcomes included adiposity or weight-related measures. Results Seven studies met the inclusion criteria; one reported anxiety/depressive outcomes, two reported on self-perception well-being measures such as self-esteem and self-efficacy, and four studies reported outcomes of quality of life. Positive mental health outcomes demonstrated that following obesity prevention, interventions included a decrease in anxiety and improved health-related quality of life. Quality of evidence was graded as very low. Conclusions Although positive outcomes for mental health and well-being do exist, controlled evaluations of community-based obesity prevention interventions have

Anastomotic leakage as an outcome measure for quality of colorectal cancer surgery

NARCIS (Netherlands)

Snijders, H. S.; Henneman, D.; van Leersum, N. L.; ten Berge, M.; Fiocco, M.; Karsten, T. M.; Havenga, K.; Wiggers, T.; Dekker, J. W.; Tollenaar, R. A. E. M.; Wouters, M. W. J. M.

Introduction When comparing mortality rates between hospitals to explore hospital performance, there is an important role for adjustment for differences in case-mix. Identifying outcome measures that are less influenced by differences in case-mix may be valuable. The main goal of this study was to

A Comparison of Several Outcome Measures Used to Evaluate a Psychiatric Clerkship.

Science.gov (United States)

Cuerdon, Timothy; And Others

The teaching of interviewing skills is increasingly incorporated into clinical medicine courses in American medical schools, yet the attempts to evaluate the effectiveness of these efforts have been woefully inadequate. Typical outcome measures have included paper and pencil tests of knowledge, preceptor evaluations of clinical performance, and…

Aircrew radiation exposure: sources-risks-measurement

International Nuclear Information System (INIS)

Duftschmid, K.E.

1994-05-01

A short review is given on the actual aircrew exposure and its sources. The resulting risks for harmful effects to the health and discuss methods for in-flight measurements of exposure is evaluated. An idea for a fairly simple and economic approach to a practical, airborne active dosimeter for the assessment of individual crew exposure is presented. The exposure of civil aircrew to cosmic radiation, should not be considered a tremendous risk to the health, there is no reason for panic. However, being significantly higher than the average exposure to radiation workers, it can certainly not be neglected. As recommended by ICRP, aircrew exposure has to be considered occupational radiation exposure and aircrews are certainly entitled to the same degree of protection, as other ground-based radiation workers have obtained by law, since long time. (author)

Assessing participation in the ACL injured population: Selecting a patient reported outcome measure on the basis of measurement properties.

Science.gov (United States)

Letchford, Robert; Sparkes, Valerie; van Deursen, Robert W M

2015-06-01

A return to pre injury activity participation remains a common but often elusive goal following ACL injury. Investigations to improve our understanding of participation restrictions are limited by inconsistent use of insufficiently investigated measurement tools. The aim of this study was to follow the consensus based standards for the selection of health measurement instruments (COSMIN) guideline to provide a comparative evaluation of four patient reported outcomes (PROMs) on the basis of measurement properties. This will inform recommendations for measuring participation of ACL injured subjects, particularly in the United Kingdom (UK) National Health Service (NHS). Thirteen criteria were compiled from the COSMIN guideline. These included reliability, measurement error, content validity, construct validity, responsiveness and interpretability. Data from 51 subjects collected as part of a longitudinal observational study of recovery over the first year following ACLR was used in the analysis. Of the thirteen criteria, the required standard was met in 11 for Tegner, 11 for International Knee Documentation Committee (IKDC), 6 for Cincinnati Sports Activity Scale (CSAS) and 6 for Marx. The two weaknesses identified for the Tegner are more easily compensated for during interpretation than those in the IKDC; for this reason the Tegner is the recommended PROM. The Tegner activity rating scale performed consistently well in respect of all measurement properties in this sample, with clear benefits over the other PROMs. The measurement properties presented should be used to inform implementation and interpretation of this outcome measure in clinical practice and research. Level II prospective study. Copyright © 2015 Elsevier B.V. All rights reserved.

Implementing patient-reported outcome measures in palliative care clinical practice: a systematic review of facilitators and barriers.

Science.gov (United States)

Antunes, Bárbara; Harding, Richard; Higginson, Irene J

2014-02-01

Many patient-reported outcome measures have been developed in the past two decades, playing an increasingly important role in palliative care. However, their routine use in practice has been slow and difficult to implement. To systematically identify facilitators and barriers to the implementation of patient-reported outcome measures in different palliative care settings for routine practice, and to generate evidence-based recommendations, to inform the implementation process in clinical practice. Systematic literature review and narrative synthesis. Medline, PsycInfo, Cumulative Index to Nursing and Allied Health Literature, Embase and British Nursing Index were systematically searched from 1985. Hand searching of reference lists for all included articles and relevant review articles was performed. A total of 3863 articles were screened. Of these, 31 articles met the inclusion criteria. First, data were integrated in the main themes: facilitators, barriers and lessons learned. Second, each main theme was grouped into either five or six categories. Finally, recommendations for implementation on outcome measures at management, health-care professional and patient levels were generated for three different points in time: preparation, implementation and assessment/improvement. Successful implementation of patient-reported outcome measures should be tailored by identifying and addressing potential barriers according to setting. Having a coordinator throughout the implementation process seems to be key. Ongoing cognitive and emotional processes of each individual should be taken into consideration during changes. The educational component prior to the implementation is crucial. This could promote ownership and correct use of the measure by clinicians, potentially improving practice and the quality of care provided through patient-reported outcome measure data use in clinical decision-making.

The Premature Ejaculation Profile: validation of self-reported outcome measures for research and practice.

Science.gov (United States)

Patrick, Donald L; Giuliano, François; Ho, Kai Fai; Gagnon, Dennis D; McNulty, Pauline; Rothman, Margaret

2009-02-01

To evaluate the reliability and validity of the Premature Ejaculation Profile (PEP), a self-reported outcome instrument for evaluating domains of PE and its treatment, comprised of four single-item measures, a profile, and an index score. Data were from men participating in observational studies in the USA (PE, 207 men; non-PE, 1380) and Europe (PE, 201; non-PE, 914) and from men with PE (1238) participating in a phase III randomized, placebo-controlled clinical trial of dapoxetine. The PEP contains four measures: perceived control over ejaculation, personal distress related to ejaculation, satisfaction with sexual intercourse, and interpersonal difficulty related to ejaculation, each assessed on five-point response scales. Test-retest reliability, known-groups validity, and ability to detect a patient-reported global impression of change (PGI) in condition were evaluated for the individual PEP measures and a PEP index score (the mean of all four measures). Profile analysis was conducted using multivariate analysis of variance. All PEP measures showed acceptable reliability (intraclass correlation coefficients ranged from 0.66 to 0.83) and mean scores for all measures differed significantly between PE and non-PE groups (P measures. The PEP profiles of men with and without PE differed significantly (P measure for use in monitoring outcomes of men with PE.

Orphan Sources and Fresh Fallout: Virtual Exercise in Mobile Measurement (ORPEX)

DEFF Research Database (Denmark)

Dowdall, M.; Smethurst, M.A.; Andersson, Kasper Grann

In recent years carborne gamma spectrometry has expanded from its role as a geological survey platform to serving as a useful asset in the field of emergency response to radiological and nuclear situations. Its two main applications are searching for orphan sources and for surveying in the afterm......In recent years carborne gamma spectrometry has expanded from its role as a geological survey platform to serving as a useful asset in the field of emergency response to radiological and nuclear situations. Its two main applications are searching for orphan sources and for surveying...... spectral data were generated for imaginary point sources and inserted into genu-ine carborne measurements from in the Trondheim area of Norway. Participants were presented with a typical software tool and data in a range of typical formats and asked to report the source locations and isotopes within a time...

DEFINING THE RELEVANT OUTCOME MEASURES IN MEDICAL DEVICE ASSESSMENTS: AN ANALYSIS OF THE DEFINITION PROCESS IN HEALTH TECHNOLOGY ASSESSMENT.

Science.gov (United States)

Jacobs, Esther; Antoine, Sunya-Lee; Prediger, Barbara; Neugebauer, Edmund; Eikermann, Michaela

2017-01-01

Defining relevant outcome measures for clinical trials on medical devices (MD) is complex, as there is a large variety of potentially relevant outcomes. The chosen outcomes vary widely across clinical trials making the assessment in evidence syntheses very challenging. The objective is to provide an overview on the current common procedures of health technology assessment (HTA) institutions in defining outcome measures in MD trials. In 2012-14, the Web pages of 126 institutions involved in HTA were searched for methodological manuals written in English or German that describe methods for the predefinition process of outcome measures. Additionally, the institutions were contacted by email. Relevant information was extracted. All process steps were performed independently by two reviewers. Twenty-four manuals and ten responses from the email request were included in the analysis. Overall, 88.5 percent of the institutions describe the type of outcomes that should be considered in detail and 84.6 percent agree that the main focus should be on patient relevant outcomes. Specifically related to MD, information could be obtained in 26 percent of the included manuals and email responses. Eleven percent of the institutions report a particular consideration of MD related outcomes. This detailed analysis on common procedures of HTA institutions in the context of defining relevant outcome measures for the assessment of MD shows that standardized procedures for MD from the perspective of HTA institutions are not widespread. This leads to the question if a homogenous approach should be implemented in the field of HTA on MD.