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Sample records for strong inter-rater agreement

  1. Unfolding the phenomenon of inter-rater agreement

    DEFF Research Database (Denmark)

    Slaug, Bjørn; Schilling, Oliver; Helle, Tina

    2011-01-01

    indices, relative shares of agreement variation were calculated. Multilevel regression analysis was carried out, using rater and item characteristics as predictors of agreement variation. Results: The raters accounted for 6-11 % of the agreement variation, the items for 33-39 % and the contexts for 53......Objective: The overall objective was to unfold the phenomenon of inter-rater agreement: to identify potential sources of variation in agreement data and to explore how they can be statistically accounted for. The ultimate aim was to propose recommendations for in-depth examination of agreement......-60 %. Multilevel regression analysis showed barrier prevalence and raters’ familiarity with using standardized instruments to have the strongest impact on agreement, though for study design reasons contextual characteristics were not included. Conclusion: Supported by a conceptual analysis, we propose an approach...

  2. Inter-rater agreement among orthodontists in a blocked experiment.

    Science.gov (United States)

    Korn, E L; Baumrind, S

    1985-01-01

    Five orthodontists were asked to predict for 64 patients a particular dichotomous outcome of treatment based on pre-treatment X-ray films. The orthodontists rated the cases in blocks of size 4-6 with the knowledge of the number of positive outcomes in each block. We discuss the reasons why this blocked design is appropriate whenever clinicians are asked to rate cases which have not been randomly selected from a clinical practice similar to their own. We give a simple description of the inter-rater agreement for this type of blocked experiment as well as a procedure to test that the agreement is no better than that expected by random independent assignment.

  3. Impact of educational intervention on the inter-rater agreement of nasal endoscopy interpretation

    Science.gov (United States)

    Colley, Patrick; Mace, Jess C.; Schaberg, Madeleine R.; Smith, Timothy L.; Tabaee, Abtin

    2015-01-01

    OBJECTIVE Nasal endoscopy is integral to the evaluation of sinonasal disorders. However, prior studies have shown significant variability in the inter-rater agreement of nasal endoscopy interpretation amongst practicing rhinologists. The objective of the current study is to evaluate the inter-rater agreement of nasal endoscopy amongst otolaryngology residents from a single training program at baseline and following an educational intervention. METHODS 11 otolaryngology residents completed nasal endoscopy grading forms for 8 digitally recorded nasal endoscopic examinations. An instructional lecture reviewing nasal endoscopy interpretation was subsequently provided. The residents then completed grading forms for 8 different nasal endoscopic examinations. Inter-rate agreement amongst residents for the pre- and post-lecture videos was calculated using the unweighted Fleiss’ kappa statistic (Kf) and intra-class correlation agreement (ICC). RESULTS Inter-rater agreement improved from a baseline level of fair (Kf range 0.268–0.383) to a post-educational level of moderate (Kf range 0.401–0.547) for nasal endoscopy findings of middle meatus mucosa, middle turbinate mucosa, middle meatus discharge, sphenoethmoid recess mucosa, sphenoethmoid recess discharge and atypical lesions (ICC, pendoscopy interpretation amongst otolaryngology residents. The inter-rater agreement for the majority of the characteristics that were evaluated improved after educational intervention. Further study is needed to improve nasal endoscopy interpretation. PMID:25781864

  4. The eye of the beholder : Inter-rater agreement among experts on psychogenic jerky movement disorders

    NARCIS (Netherlands)

    van der Salm, Sandra M A; de Haan, Rob J; Cath, Daniëlle C; van Rootselaar, Anne-Fleur; Tijssen, Marina A J

    Objective The current criteria for conversion disorder in the Diagnostic and Statistical Manual of Mental Disorders rely on the assumption that neurological disorders can be distinguished from conversion disorders through clinical assessment. This study aims to assess inter-rater agreement among

  5. Inter-rater agreement in visual assessment of footpad dermatitis in Danish broiler chickens

    DEFF Research Database (Denmark)

    Oliveira, A.R.S.; Lund, Vibe Pedersen; Christensen, Jens Peter

    2017-01-01

    1. The performance of the scoring in the Danish footpad dermatitis (FPD) surveillance system was evaluated by determining inter-rater agreement in visual inspection of FPD in broilers between two independent raters (R1 and R2) and the official scoring at a Danish slaughterhouse. 2. FPD scores were...

  6. Inter-rater Agreement of End-of-shift Evaluations Based on a Single Encounter

    Directory of Open Access Journals (Sweden)

    Steven Warrington

    2017-04-01

    Full Text Available Introduction: End-of-shift evaluation (ESE forms, also known as daily encounter cards, represent a subset of encounter-based assessment forms. Encounter cards have become prevalent for formative evaluation, with some suggesting a potential for summative evaluation. Our objective was to evaluate the inter-rater agreement of ESE forms using a single scripted encounter at a conference of emergency medicine (EM educators. Methods: Following institutional review board exemption, we created a scripted video simulating an encounter between an intern and a patient with an ankle injury. That video was shown during a lecture at the Council of EM Residency Director’s Academic Assembly with attendees asked to evaluate the “resident” using one of eight possible ESE forms randomly distributed. Descriptive statistics were used to analyze the results with Fleiss’ kappa to evaluate inter-rater agreement. Results: Most of the 324 respondents were leadership in residency programs (66%, with a range of 29-47 responses per evaluation form. Few individuals (5% felt they were experts in assessing residents based on EM milestones. Fleiss’ kappa ranged from 0.157 - 0.308 and did not perform much better in two post-hoc subgroup analyses. Conclusion: The kappa ranges found show only slight to fair inter-rater agreement and raise concerns about the use of ESE forms in assessment of EM residents. Despite limitations present in this study, these results and a lack of other studies on inter-rater agreement of encounter cards should prompt further studies of such methods of assessment. Additionally, EM educators should focus research on methods to improve inter-rater agreement of ESE forms or other evaluating other methods of assessment of EM residents. [West J Emerg Med. 2017;18(3518-524.

  7. Inter-rater agreement of the triage system RETTS-HEV

    DEFF Research Database (Denmark)

    Larsen, Louise Pape; Kirkegaard, Hans; Nissen, Louise

    2014-01-01

    Objective The purpose of this study was to evaluate the inter-rater agreement among nurses using the triage system RETTS-HEV (rapid emergency triage and treatment system – hospital unit west) in a Danish emergency department (ED). Background The use of triage systems in Denmark has been implemented...... recently together with structural changes in hospital organization. Testing and evaluation is therefore needed. The RETTS-HEV is a five-scale triage system being used in the ED of Herning, Denmark, since May 2010. The ED is semilarge, with 29 000 annual visits. Materials and methods Consecutive patients...... presenting to the ED were assessed by both a duty and a study nurse using RETTS-HEV. Nurses did not receive training before the study. In all, 146 patients were enroled and a blinded, paired and simultaneous triage was conducted independently to evaluate inter-rater agreement using Fleiss j. Results A total...

  8. Inter-rater agreement of comorbid DSM-IV personality disorders in substance abusers

    Directory of Open Access Journals (Sweden)

    Thylstrup Birgitte

    2008-05-01

    Full Text Available Abstract Background Little is known about the inter-rater agreement of personality disorders in clinical settings. Methods Clinicians rated 75 patients with substance use disorders on the DSM-IV criteria of personality disorders in random order, and on rating scales representing the severity of each. Results Convergent validity agreement was moderate (range for r = 0.55, 0.67 for cluster B disorders rated with DSM-IV criteria, and discriminant validity was moderate for eight of the ten personality disorders. Convergent validity of the rating scales was only moderate for antisocial and narcissistic personality disorder. Discussion Dimensional ratings may be used in research studies and clinical practice with some caution, and may be collected as one of several sources of information to describe the personality of a patient.

  9. Inter-rater agreement in evaluation of disability: systematic review of reproducibility studies.

    Science.gov (United States)

    Barth, Jürgen; de Boer, Wout E L; Busse, Jason W; Hoving, Jan L; Kedzia, Sarah; Couban, Rachel; Fischer, Katrin; von Allmen, David Y; Spanjer, Jerry; Kunz, Regina

    2017-01-25

     To explore agreement among healthcare professionals assessing eligibility for work disability benefits.  Systematic review and narrative synthesis of reproducibility studies.  Medline, Embase, and PsycINFO searched up to 16 March 2016, without language restrictions, and review of bibliographies of included studies.  Observational studies investigating reproducibility among healthcare professionals performing disability evaluations using a global rating of working capacity and reporting inter-rater reliability by a statistical measure or descriptively. Studies could be conducted in insurance settings, where decisions on ability to work include normative judgments based on legal considerations, or in research settings, where decisions on ability to work disregard normative considerations. : Teams of paired reviewers identified eligible studies, appraised their methodological quality and generalisability, and abstracted results with pretested forms. As heterogeneity of research designs and findings impeded a quantitative analysis, a descriptive synthesis stratified by setting (insurance or research) was performed.  From 4562 references, 101 full text articles were reviewed. Of these, 16 studies conducted in an insurance setting and seven in a research setting, performed in 12 countries, met the inclusion criteria. Studies in the insurance setting were conducted with medical experts assessing claimants who were actual disability claimants or played by actors, hypothetical cases, or short written scenarios. Conditions were mental (n=6, 38%), musculoskeletal (n=4, 25%), or mixed (n=6, 38%). Applicability of findings from studies conducted in an insurance setting to real life evaluations ranged from generalisable (n=7, 44%) and probably generalisable (n=3, 19%) to probably not generalisable (n=6, 37%). Median inter-rater reliability among experts was 0.45 (range intraclass correlation coefficient 0.86 to κ-0.10). Inter-rater reliability was poor in six studies (37

  10. Ocular Motor Score (OMS): a clinical tool to evaluating ocular motor functions in children. Intrarater and inter-rater agreement.

    Science.gov (United States)

    Olsson, Monica; Teär Fahnehjelm, Kristina; Rydberg, Agneta; Ygge, Jan

    2015-08-01

    Ocular motor score (OMS) is a new clinical test protocol for evaluating ocular motor functions in children and young adults. OMS is a set of 15 important and relevant non-invasive ocular motor function parameters derived from clinical practice. The aim of the study was to evaluate OMS according to intrarater and inter-rater agreement. Forty children aged 4-10 years, 23 girls median age 6.5 (range 4.3-9.3) and 17 boys median age 5.8 (range 4.1-9.8) were included. The ocular motor functions were assessed and scored according to the OMS protocol. The examinations were videotaped. To obtain the intrarater agreement, the first author examined and scored the children twice, first in the clinic and 2 weeks later by watching the videotape. To obtain the inter-rater agreement, three other raters independently scored the ocular motor function of the children by watching the videotapes. The overall observed intrarater agreement was 88%, and the observed inter-rater agreement between the three raters was 80%. For none of the subtests was there an observed intrarater agreement lower than 65%. Three of the subtests had an observed inter-rater agreement of 65% or below. Overall there was high observed intra- and inter-rater agreement for the OMS test protocol. Subtests such as saccades and smooth pursuit were more difficult for raters to score similarly according the clinical OMS test protocol. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  11. Inter-rater and intra-rater agreement of confocal microscopy imaging in diagnosing and subtyping basal cell carcinoma

    NARCIS (Netherlands)

    Kadouch, D. J.; van Haersma de With, A.; Elshot, Y. S.; Peppelman, M.; Bekkenk, M. W.; Wolkerstorfer, A.; Eekhout, I.; Prinsen, C. A. C.; de Rie, M. A.

    2017-01-01

    Reflectance confocal microscopy (RCM) imaging can be used to diagnose and subtype basal cell carcinoma (BCC) but relies on individual morphologic pattern recognition that might vary among users. We assessed the inter-rater and intra-rater agreement of RCM in correctly diagnosing and subtyping BCC.

  12. IBZM SPECT and FDG PET in the differential diagnosis of Parkinsonian syndromes. Comparison with respect to inter-rater agreement

    DEFF Research Database (Denmark)

    Derlin, T; Afzal, W; Wilke, F

    2010-01-01

    to inter-rater agreement in 30 patients with neurodegenerative parkinsonian syndromes (PS) confirmed by FP-CIT SPECT. Methods: IBZM SPECT and FDG PET were categorized as PD or APS by visual inspection of standardized report pages and statistical parametric maps (SPMs). Categorization was performed...

  13. Improving the inter-rater agreement of hypsarrhythmia using a simplified EEG grading scale for children with infantile spasms.

    Science.gov (United States)

    Mytinger, John R; Hussain, Shaun A; Islam, Monica P; Millichap, John J; Patel, Anup D; Ryan, Nicole R; Twanow, Jaime-Dawn E; Heyer, Geoffrey L

    2015-10-01

    There is poor inter-rater agreement in determining the presence or absence of hypsarrhythmia among patients with infantile spasms. Yet, remission of hypsarrhythmia has been used as a clinical and research outcome measure. Two important features of hypsarrhythmia are the burden of epileptiform discharges and the amplitudes of background slow waves. We hypothesized that an electroencephalogram (EEG) grading scale emphasizing epileptiform discharge burden and the amplitudes of background slow waves would improve inter-rater agreement in interpreting hypsarrhythmia. Our aim was to assess inter-rater agreement of hypsarrhythmia using a novel and simplified EEG grading scale called the 'BASED' (Burden of Amplitudes and Epileptiform Discharges) score and compare this to the traditional method of EEG analysis. Twenty patients with infantile spasms were prospectively evaluated and electroclinical outcomes were determined. Forty EEG clips (20 pre-treatment and 20 post-treatment), representing the most severely abnormal five minute sleep epoch of each study, were assessed by three reviewers blinded to treatment and clinical outcome. Fleiss' kappa (К) was used to assess the inter-rater agreement in the interpretation of hypsarrhythmia when using the BASED score compared to the traditional method of EEG analysis. Reviewers had favorable inter-rater agreement using the BASED score in interpreting hypsarrhythmia (К: 0.87) compared to when using the traditional method of EEG analysis to interpret hypsarrhythmia (К: 0.09). The three reviewers all agreed on the presence or absence of hypsarrhythmia in 37/40 (93%) epochs using the BASED score but in only 15/40 (38%) epochs using the traditional method of EEG analysis, p=infantile spasms clinical trials must better define criteria for hypsarrhythmia. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  14. OC10 - Inter-rater agreement of the Paediatric Early Warning Score tools used in the central Denmark region

    DEFF Research Database (Denmark)

    Jensen, Claus Sixtus; Aagaard, Hanne; Vebert Olesen, Hanne

    2016-01-01

    through simultaneous blinded PEWS assessment on the same patients by two nurses. Fleiss' kappa was utilized to determine the level of agreement among the raters. CONCLUSION: With a paucity of published reliability testing studies, this research attempts to address identified research gaps and will thus...... instruments are only as reliable and accurate as the caregiver who obtains and documents the parameters. AIM: The purpose was to evaluate the inter-rater agreement among nurses using the PEWS systems. DESIGN: The study was conducted in five paediatrics departments. Inter-observer reliability was investigated...... inform nursing practice....

  15. Inter-Rater Reliability and Agreement of the 6-Minute Walk Test in Women With Hip Fracture

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Overgaard, Jan; Tange Kristensen, Morten

    Introduction: The 6-minute walk test (6MWT)(1) is widely used as a clinical outcome measure. However, the reliability and agreement of the 6MWT is unknown in individuals with hip fractures. Objective: The aim of the study was to evaluate the relative inter-rater reliability and agreement of the 6......MWT in individuals with hip fractures. Methods: Two senior physiotherapy students independently examined (randomized order) a convenient sample of 20 participants; their assessments were separated by two days, and testing followed instructions from the American Thoracic Society(1). Hip pain...... = -0.196, P = 0.41). On the contrary, participants walked a mean of 21.7 ± 22.6 meters longer, at the second trial (P = 0.002). Participants with moderate hip fracture- related pain walked a shorter distance than those with no or light pain during the first test (P = 0.04), while this was not the case...

  16. Inter-rater reliability and agreement of the 6-minute walk test in females with hip fractures

    DEFF Research Database (Denmark)

    Overgaard, Jan; Larsen, Camilla Marie; Tange Kristensen, Morten

    The 6-minute walk test (6MWT) is widely used as a clinical outcome measure. However, the reliability and agreement of the 6MWT is unknown in individuals with hip fractures. To evaluate the relative inter-rater reliability and agreement of the 6MWT in individuals with hip fractures. Two senior...... physiotherapy students independently examined (randomized order) a convenient sample of 20 participants; their assessments were separated by two days, and testing followed instructions from the American Thoracic Society. Hip pain was assessed with the Verbal Ranking Scale. Participants (all women) with a mean...... (SRD) were calculated as 21.4 meters and 59.4 meters, respectively. Bland-Altman plots revealed no significant difference (mean of 3.2 ± 31.5 meters, P = 0.83) between the two raters, and no heteroscedasticity was seen (r = -0.196, P = 0.41). On the contrary, participants walked a mean of 21.7 ± 22...

  17. Inter-rater agreement and reliability of the COSMIN (Consensus-based Standards for the selection of health status Measurement Instruments) Checklist

    NARCIS (Netherlands)

    Mokkink, L.B.; Terwee, C.B.; Gibbons, E.; Stratford, P.W.; Alonso, J.; Patrick, D.L.; Knol, D.L.; Bouter, L.M.; de Vet, H.C.W.

    2010-01-01

    Background. The COSMIN checklist is a tool for evaluating the methodological quality of studies on measurement properties of health-related patient-reported outcomes. The aim of this study is to determine the inter-rater agreement and reliability of each item score of the COSMIN checklist (n = 114).

  18. Inter-rater agreement in evaluation of disability : Systematic review of reproducibility studies

    NARCIS (Netherlands)

    Barth, Jurgen; de Boer, Wout E. L.; Busse, Jason W; Hoving, Jan L.; Kedzia, Sarah; Couban, Rachel; Fischer, Katrin; von Allmen, David Y.; Spanjer, Jerry; Kunz, Regina

    2017-01-01

    OBJECTIVES To explore agreement among healthcare professionals assessing eligibility for work disability benefits. DESIGN Systematic review and narrative synthesis of reproducibility studies. DATA SOURCES Medline, Embase, and PsycINFO searched up to 16 March 2016, without language restrictions, and

  19. Inter-rater agreement in evaluation of disability: systematic review of reproducibility studies

    NARCIS (Netherlands)

    Barth, Jürgen; de Boer, Wout E. L.; Busse, Jason W.; Hoving, Jan L.; Kedzia, Sarah; Couban, Rachel; Fischer, Katrin; von Allmen, David Y.; Spanjer, Jerry; Kunz, Regina

    2017-01-01

    To explore agreement among healthcare professionals assessing eligibility for work disability benefits. Systematic review and narrative synthesis of reproducibility studies. Medline, Embase, and PsycINFO searched up to 16 March 2016, without language restrictions, and review of bibliographies of

  20. Structured interview for mild traumatic brain injury after military blast: inter-rater agreement and development of diagnostic algorithm.

    Science.gov (United States)

    Walker, William C; Cifu, David X; Hudak, Anne M; Goldberg, Gary; Kunz, Richard D; Sima, Adam P

    2015-04-01

    The existing gold standard for diagnosing a suspected previous mild traumatic brain injury (mTBI) is clinical interview. But it is prone to bias, especially for parsing the physical versus psychological effects of traumatic combat events, and its inter-rater reliability is unknown. Several standardized TBI interview instruments have been developed for research use but have similar limitations. Therefore, we developed the Virginia Commonwealth University (VCU) retrospective concussion diagnostic interview, blast version (VCU rCDI-B), and undertook this cross-sectional study aiming to 1) measure agreement among clinicians' mTBI diagnosis ratings, 2) using clinician consensus develop a fully structured diagnostic algorithm, and 3) assess accuracy of this algorithm in a separate sample. Two samples (n = 66; n = 37) of individuals within 2 years of experiencing blast effects during military deployment underwent semistructured interview regarding their worst blast experience. Five highly trained TBI physicians independently reviewed and interpreted the interview content and gave blinded ratings of whether or not the experience was probably an mTBI. Paired inter-rater reliability was extremely variable, with kappa ranging from 0.194 to 0.825. In sample 1, the physician consensus prevalence of probable mTBI was 84%. Using these diagnosis ratings, an algorithm was developed and refined from the fully structured portion of the VCU rCDI-B. The final algorithm considered certain symptom patterns more specific for mTBI than others. For example, an isolated symptom of "saw stars" was deemed sufficient to indicate mTBI, whereas an isolated symptom of "dazed" was not. The accuracy of this algorithm, when applied against the actual physician consensus in sample 2, was almost perfect (correctly classified = 97%; Cohen's kappa = 0.91). In conclusion, we found that highly trained clinicians often disagree on historical blast-related mTBI determinations. A fully structured interview

  1. Inter-rater agreement in evaluation of disability: systematic review of reproducibility studies

    OpenAIRE

    Barth, Jürgen; de Boer, Wout E L; Busse, Jason W; Hoving, Jan L; Kedzia, Sarah; Couban, Rachel; Fischer, Katrin; von Allmen, David Y; Spanjer, Jerry; Kunz, Regina

    2017-01-01

    OBJECTIVES To explore agreement among healthcare professionals assessing eligibility for work disability benefits. DESIGN Systematic review and narrative synthesis of reproducibility studies. DATA SOURCES Medline, Embase, and PsycINFO searched up to 16 March 2016, without language restrictions, and review of bibliographies of included studies. ELIGIBILITY CRITERIA Observational studies investigating reproducibility among healthcare professionals performing disability evaluations using a globa...

  2. Inter-rater agreement and reliability of the COSMIN (COnsensus-based Standards for the selection of health status Measurement Instruments Checklist

    Directory of Open Access Journals (Sweden)

    Knol Dirk L

    2010-09-01

    Full Text Available Abstract Background The COSMIN checklist is a tool for evaluating the methodological quality of studies on measurement properties of health-related patient-reported outcomes. The aim of this study is to determine the inter-rater agreement and reliability of each item score of the COSMIN checklist (n = 114. Methods 75 articles evaluating measurement properties were randomly selected from the bibliographic database compiled by the Patient-Reported Outcome Measurement Group, Oxford, UK. Raters were asked to assess the methodological quality of three articles, using the COSMIN checklist. In a one-way design, percentage agreement and intraclass kappa coefficients or quadratic-weighted kappa coefficients were calculated for each item. Results 88 raters participated. Of the 75 selected articles, 26 articles were rated by four to six participants, and 49 by two or three participants. Overall, percentage agreement was appropriate (68% was above 80% agreement, and the kappa coefficients for the COSMIN items were low (61% was below 0.40, 6% was above 0.75. Reasons for low inter-rater agreement were need for subjective judgement, and accustom to different standards, terminology and definitions. Conclusions Results indicated that raters often choose the same response option, but that it is difficult on item level to distinguish between articles. When using the COSMIN checklist in a systematic review, we recommend getting some training and experience, completing it by two independent raters, and reaching consensus on one final rating. Instructions for using the checklist are improved.

  3. Inter-rater and intra-rater reliability of the fluid goniometer for measuring active knee flexion in painful knees; correlations do not mean agreement.

    Science.gov (United States)

    Remigio, Wilton; Tsai, Nancy; Layos, Leonivic; Chavez, Michelle

    2017-06-01

    [Purpose] The fluid goniometer is an instrument for measuring range of motion. Reliability of the fluid goniometer has not been established for subjects with painful knee joints. The purpose of this study was to determine the inter-rater and intra-rater reliability of the fluid goniometer in measuring active knee flexion of painful knees and to test its agreement with the gold standard ruler goniometer. [Subjects and Methods] Twenty-five individuals with either unilateral or bilateral painful knees participated in the study. Two raters each took three measurements with the same Baseline ® fluid goniometer on 35 knees. [Results] Intraclass correlation coefficients (ICC) were 0.97 for both intra-rater and inter-rater measurements, denoting high relative reliability. The large standard error of measurement (SEM) value of 6.6 degrees, and the 95% limits of agreement, which revealed a potential difference of 18.4 degrees between raters of similar subjects, however, revealed poor absolute reliability. The smallest detectable difference (SDD) of 18 degrees was also large. [Conclusion] The results revealed excellent relative reliability, but a large amount of variability between the raters' measurements. The sensitivity of the fluid level of the goniometer to end range tremors of the lower leg flexed against gravity in the obligatory prone position may contribute significantly to the large variability in knee ROM values.

  4. Inter-rater agreement of the Arabic Gross Motor Classification System Expanded & Revised in children with cerebral palsy in Jordan.

    Science.gov (United States)

    Almasri, Nihad; Saleh, Maysoun

    2015-01-01

    To examine the agreement among parents-report, research physiotherapists-report, and clinical physiotherapists-report using the Arabic-Gross Motor Classification System Expanded & Revised (GMFCS E&R) in classifying Jordanian children with cerebral palsy (CP). One-hundred and sixteen child with CP [mean age 4 years 7 months (SD = 4 years 5 months)] participated in the study. Parents were asked to classify their children using the Arabic-GMFCS family report questionnaires. Clinical and research physiotherapists were asked to classify children using the Arabic-GMFCS E&R. Agreement between respondents was determined using Cohen's linear weighted kappa statistic. An excellent level of agreement was reported between research physiotherapists and clinical physiotherapists, substantial level of agreement between parents and research physiotherapists and moderate agreement between parents and clinical physiotherapists. The Arabic-GMFCS E&R is a reliable classification system that can be administrated by health care providers and parents of children with CP in Jordan to help plan services for children. Implications for Rehabilitation The Arabic GMFCS E&R is a reliable and user friendly system that can be administrated by health care providers and parents of children with CP in Jordan to guide services planning. Classifying the children with CP should be performed by the team members (including the family and the children when they are transitioning from childhood to adulthood) independently first, then discussed among and consensus can be reached. The Arabic GMFCS E& R is a reliable classification system that can be used in Jordanian health care system despite the fact that therapists who practice in these settings were not familiar with this classification.

  5. High inter-rater reliability, agreement, and convergent validity of Constant score in patients with clavicle fractures

    DEFF Research Database (Denmark)

    Ban, Ilija; Troelsen, Anders; Kristensen, Morten Tange

    2016-01-01

    . The secondary aim was to estimate the correlation between the CS and the Disabilities of the Arm, Shoulder and Hand score and the internal consistency of the 2 scores. METHODS: On the basis of sample sizing, 36 patients (31 male and 5 female patients; mean age, 41.3 years) with clavicle fractures underwent.......9, whereas the minimal detectable change (smallest change needed to indicate a real change for an individual) was 13.6 CS points. The internal consistency of the 10 CS items was good, with a Cronbach α of .85, and we found a strong correlation (r = -0.92) between the CS and Disabilities of the Arm, Shoulder...

  6. The Bath metrology index as assessed by a trained and an untrained rater in patients with spondylarthropathy: a study of intra- and inter-rater agreements

    DEFF Research Database (Denmark)

    Madsen, O R; Hansen, L B; Rytter, A

    2008-01-01

    (median interval 7 days, range 4-11) by a trained physiotherapist (PT) and by an untrained nurse who had undergone a single 1-h training session with the PT. The median BASMI score obtained by the PT on the two test days was 3.5 (range 1-8) and 3.0 (range 1-8), respectively (NS). Test-retest BASMI scores......-rater and inter-rater reproducibility of BASMI scoring in 30 Danish patients with SpA (median age 40 years, range 22-56 years) fulfilling the European Spondylarthropathy Study Group criteria, 25 of them satisfying the modified New York Criteria for AS. Measurements were performed twice on two different days...... from the PT were significantly correlated (r(s) = 0.95, p intervals of 1. Similar...

  7. How to assess and compare inter-rater reliability, agreement and correlation of ratings: an exemplary analysis of mother-father and parent-teacher expressive vocabulary rating pairs

    Science.gov (United States)

    Stolarova, Margarita; Wolf, Corinna; Rinker, Tanja; Brielmann, Aenne

    2014-01-01

    This report has two main purposes. First, we combine well-known analytical approaches to conduct a comprehensive assessment of agreement and correlation of rating-pairs and to dis-entangle these often confused concepts, providing a best-practice example on concrete data and a tutorial for future reference. Second, we explore whether a screening questionnaire developed for use with parents can be reliably employed with daycare teachers when assessing early expressive vocabulary. A total of 53 vocabulary rating pairs (34 parent–teacher and 19 mother–father pairs) collected for two-year-old children (12 bilingual) are evaluated. First, inter-rater reliability both within and across subgroups is assessed using the intra-class correlation coefficient (ICC). Next, based on this analysis of reliability and on the test-retest reliability of the employed tool, inter-rater agreement is analyzed, magnitude and direction of rating differences are considered. Finally, Pearson correlation coefficients of standardized vocabulary scores are calculated and compared across subgroups. The results underline the necessity to distinguish between reliability measures, agreement and correlation. They also demonstrate the impact of the employed reliability on agreement evaluations. This study provides evidence that parent–teacher ratings of children's early vocabulary can achieve agreement and correlation comparable to those of mother–father ratings on the assessed vocabulary scale. Bilingualism of the evaluated child decreased the likelihood of raters' agreement. We conclude that future reports of agreement, correlation and reliability of ratings will benefit from better definition of terms and stricter methodological approaches. The methodological tutorial provided here holds the potential to increase comparability across empirical reports and can help improve research practices and knowledge transfer to educational and therapeutic settings. PMID:24994985

  8. How to assess and compare inter-rater reliability, agreement and correlation of ratings: an exemplary analysis of mother-father and parent-teacher expressive vocabulary rating pairs

    Directory of Open Access Journals (Sweden)

    Margarita eStolarova

    2014-06-01

    Full Text Available This report has two main purposes. First, we combine well-known analytical approaches to conduct a comprehensive assessment of agreement and correlation of rating-pairs and to dis-entangle these often confused concepts, providing a best-practice example on concrete data and a tutorial for future reference. Second, we explore whether a screening questionnaire deve-loped for use with parents can be reliably employed with daycare teachers when assessing early expressive vocabulary. A total of 53 vocabulary rating pairs (34 parent-teacher and 19 mother-father pairs collected for two-year-old children (12 bilingual are evaluated. First, inter-rater reliability both within and across subgroups is assessed using the intra-class correlation coefficient (ICC. Next, based on this analysis of reliability and on the test-retest reliability of the employed tool, inter-rater agreement is analyzed, magnitude and direction of rating differences are considered. Finally, Pearson correlation coefficients of standardized vocabulary scores are calculated and compared across subgroups. The results underline the necessity to distinguish between reliability measures, agreement and correlation. They also demonstrate the impact of the employed reliability on agreement evaluations. This study provides evidence that parent-teacher ratings of children’s early vocabulary can achieve agreement and correlation comparable to those of mother-father ratings on the assessed vocabulary scale. Bilingualism of the evaluated child decreased the likelihood of raters’ agreement. We conclude that future reports of agree-ment, correlation and reliability of ratings will benefit from better definition of terms and stricter methodological approaches. The methodological tutorial provided here holds the potential to increase comparability across empirical reports and can help improve research practices and knowledge transfer to educational and therapeutic settings.

  9. How to assess and compare inter-rater reliability, agreement and correlation of ratings: an exemplary analysis of mother-father and parent-teacher expressive vocabulary rating pairs.

    Science.gov (United States)

    Stolarova, Margarita; Wolf, Corinna; Rinker, Tanja; Brielmann, Aenne

    2014-01-01

    This report has two main purposes. First, we combine well-known analytical approaches to conduct a comprehensive assessment of agreement and correlation of rating-pairs and to dis-entangle these often confused concepts, providing a best-practice example on concrete data and a tutorial for future reference. Second, we explore whether a screening questionnaire developed for use with parents can be reliably employed with daycare teachers when assessing early expressive vocabulary. A total of 53 vocabulary rating pairs (34 parent-teacher and 19 mother-father pairs) collected for two-year-old children (12 bilingual) are evaluated. First, inter-rater reliability both within and across subgroups is assessed using the intra-class correlation coefficient (ICC). Next, based on this analysis of reliability and on the test-retest reliability of the employed tool, inter-rater agreement is analyzed, magnitude and direction of rating differences are considered. Finally, Pearson correlation coefficients of standardized vocabulary scores are calculated and compared across subgroups. The results underline the necessity to distinguish between reliability measures, agreement and correlation. They also demonstrate the impact of the employed reliability on agreement evaluations. This study provides evidence that parent-teacher ratings of children's early vocabulary can achieve agreement and correlation comparable to those of mother-father ratings on the assessed vocabulary scale. Bilingualism of the evaluated child decreased the likelihood of raters' agreement. We conclude that future reports of agreement, correlation and reliability of ratings will benefit from better definition of terms and stricter methodological approaches. The methodological tutorial provided here holds the potential to increase comparability across empirical reports and can help improve research practices and knowledge transfer to educational and therapeutic settings.

  10. Reproducibility of tender point examination in chronic low back pain patients as measured by intrarater and inter-rater reliability and agreement

    DEFF Research Database (Denmark)

    Jensen, Ole Kudsk; Callesen, Jacob; Nielsen, Merete Graakjaer

    2013-01-01

    back examination and return-to-work intervention, 43 and 39 patients, respectively (18 women, 46%) entered and completed the study. MAIN OUTCOME MEASURES: The reliability was estimated by the intraclass correlation coefficient (ICC), and agreement was calculated for up to ±3 TPs. Furthermore...

  11. [Inter-rater agreement on self-reported exposure to ergonomic risk factors for the upper extremities among mechanic assemblers in an automotive industry].

    Science.gov (United States)

    d'Errico, Angelo; Fontana, Dario; Merogno, Angela

    2016-01-01

    to assess reproducibility of self-reported exposure to ergonomic hazards for the upper limbs, measured through a questionnaire based on a diffused checklist for the assessment of ergonomic risk (OCRA) in a sample of mechanical assemblers of an automotive industry. cross-sectional study; reproducibility was assessed as interrater agreement of a composite index of ergonomic risk, estimated through the intraclass correlation coefficient (ICC). 58 mechanical assemblers, working in 29 twin areas, characterised by same work stations and tasks. composite index of ergonomic risk for the upper limbs. reproducibility of the ergonomic index was high in the overall sample (ICC: 0.81) and it was higher for the twin areas employing same-gender workers (ICC: 0.96), compared to those with workers of the opposite gender (ICC: 0.66). these results indicate that a questionnaire measuring with a great detail the exposure to the main ergonomic risk factors for the upper limbs, as the one based on the OCRA checklist used for this study, would allow to obtain a highly reproducible ergonomic index. If its validity against the corresponding observational checklist will be found elevated by future studies, this questionnaire may represent a useful tool for a preliminary assessment of workers' exposure to ergonomic hazards for the upper limbs.

  12. Concordância inter-observador em testes de avaliação proprioceptiva do joelho por goniometria Inter-rater agreement at knee proprioception tests by goniometry

    Directory of Open Access Journals (Sweden)

    Alberito Rodrigo de Carvalho

    2010-03-01

    Full Text Available O propósito deste foi determinar o grau de concordância inter-avaliador de dois testes que mensuram a propriocepção do joelho por meio da goniometria, em uma amostra de universitárias (n=13; 23,8±6,4 anos. Mensurou-se a acurácia proprioceptiva pelos testes de percepção do limiar de movimento passivo lento (T1, movendo-se passivamente a perna até o ângulo alvo; e pelo teste de senso de posição articular (T2, solicitando-se movimento ativo até o ângulo alvo, previamente atingido passivamente. Os ângulos alvos foram sorteados e as medições feitas simultaneamente, de forma cega, por dois avaliadores, por meio de dois goniômetros idênticos posicionados nas faces medial e lateral do joelho. As participantes sinalizavam ao atingir o ângulo alvo, registrando-se, por ambos os avaliadores, os valores angulares efetivamente alcançados. A diferença (em números absolutos entre o ângulo alvo e aquele alcançado foi considerada o "valor de erro", que reflete a acuidade proprioceptiva. Determinou-se a concordância inter-avaliador pelo teste de concordância de Kappa; os valores encontrados (T1, Kappa=0,55; T2, Kappa=0,58 mostram concordância moderada. Como a concordância inter-avaliador nos dois testes foi moderada, conclui-se que a goniometria é limitada, na avaliação proprioceptiva de movimento do joelho.The purpose here was to determine inter-rater agreement in two tests that assess knee proprioception by goniometry, in a sample of 13 female university students (aged 23.8±6.4 years. Proprioceptive accuracy was measured by means of the passive movement threshold detection test (T1, where leg is passively moved to target angle, and the sense of joint position test (T2, in which active movement to (previously passively reached target angle is required. Target angles were randomly selected; measurements were taken simultaneously by two (blinded examiners at two identical goniometers placed at knee medial and lateral sides. When

  13. Inter-rater reliability of measures to characterize the tobacco retail environment in Mexico

    Directory of Open Access Journals (Sweden)

    Marissa G Hall

    2015-11-01

    Full Text Available Objective. To evaluate the inter-rater reliability of a data collection instrument to assess the tobacco retail environ- ment in Mexico, after major marketing regulations were implemented. Materials and methods. In 2013, two data collectors independently evaluated 21 stores in two census tracts, through a data collection instrument that assessed the presence of price promotions, whether single cigarettes were sold, the number of visible advertisements, the pre- sence of signage prohibiting the sale of cigarettes to minors, and characteristics of cigarette pack displays. We evaluated the inter-rater reliability of the collected data, through the calculation of metrics such as intraclass correlation coefficient, percent agreement, Cohen’s kappa and Krippendorff’s alpha. Results. Most measures demonstrated substantial or perfect inter-rater reliability. Conclusions. Our results indicate the potential utility of the data collection instrument for future point-of-sale research.

  14. Inter-rater reliability of the Modified Modified Ashworth Scale in assessing lower limb muscle spasticity.

    Science.gov (United States)

    Ghotbi, Nastaran; Ansari, Noureddin Nakhostin; Naghdi, Soofia; Hasson, Scott; Jamshidpour, Boushra; Amiri, Somayeh

    2009-09-01

    To assess the inter-rater reliability of the Modified Modified Ashworth Scale (MMAS) in lower limb muscle spasticity. Cross-sectional observational study. Not applicable. Twenty-two adults with neurological conditions (17 women, five men, age range 21-82 years; mean +/- SD, 44 +/- 18 years) participated. Hip adductor, knee extensor and ankle plantarflexor were assessed in a random order. Inter-rater agreement for two raters was very good for the hip adductor and the knee extensor (weighted kappa = 0.82, p Ashworth Scale produced reliable measurements between raters in the assessment of lower limb muscle spasticity.

  15. Inter-rater and intra-rater reliability of a movement control test in shoulder.

    Science.gov (United States)

    Rajasekar, S; Bangera, Rakshith K; Sekaran, Padmanaban

    2017-07-01

    Movement faults are commonly observed in patients with musculoskeletal pain. The Kinetic Medial Rotation Test (KMRT) is a movement control test used to identify movement faults of the scapula and gleno-humeral joints during arm movement. Objective tests such as the KMRT need to be reliable and valid for the results to be applied across different clinical settings and patient populations. The primary objective of the present study was to determine the intra-rater and inter-rater reliability of KMRT in subjects with and without shoulder pain. Sixty subjects were included in this study based on specific inclusion and exclusion criteria. Two musculoskeletal physiotherapists with different levels of clinical experience performed the tests. The intra-rater reliability was tested in twenty asymptomatic subjects by a single assessor at two week intervals. An equal number of subjects with and without shoulder pain were tested by both the assessors to determine the inter-rater reliability. Both components of the KMRT, the Gleno- Humeral Anterior Translation (GHAT) and the Scapular Forward Tilt (SCFT) were tested. The Kappa values for inter-rater reliability of the GHAT and SCFT were K = 0.68 & K = 0.65 respectively in subjects with shoulder pain. In asymptomatic subjects, the inter-rater reliability of GHAT was K = 0.61 and SCFT was K = 0.85. Intra-rater reliability ranged from K = 0.66 for GHAT to K = 0.87 for SCFT. Our study found substantial agreement in inter-rater reliability of KMRT in subjects with shoulder pain, whereas substantial to near perfect agreement was found in intra-rater and inter-rater reliability of KMRT in subjects without shoulder pain. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Ultrasound assessment for grading structural tendon changes in supraspinatus tendinopathy: an inter-rater reliability study

    DEFF Research Database (Denmark)

    Ingwersen, Kim Gordon; Hjarbæk, John; Eshøj, Henrik

    2016-01-01

    (24 patients) were included for assessing inter-rater reliability of measurements of fibrillar disruption, neovascularity, as well as the number and total length of calcifications and tendon thickness. Linear weighted κ, intraclass correlation (ICC), SEM, limits of agreement (LOA) and minimal...

  17. Inter-rater and intra-rater reliability of nursing process records for patients with schizophrenia.

    Science.gov (United States)

    Chung, Min-Huey; Chiang, I-Jen; Chou, Kuei-Ru; Chu, Hsin; Chang, Hsiu-Ju

    2010-11-01

    This study explored the inter-rater and intra-rater reliability to evaluate the consistency of nursing process records for patients with schizophrenia. By writing accurate and complete nursing process records, nurses can quickly communicate the care that has been delivered. However, little is known about the accuracy of nursing records to reflect the patients' problems, especially in psychiatry. A prospective observational study. Two nurses with similar work experience in psychiatric wards assessed patient records produced by 14 psychiatric nurses to compute inter-rater reliability of nursing diagnoses and their defining characteristics. Collecting the records and the time spans between the first and the second data collection took one month to compute the intra-reliability of the nursing diagnoses by the same nurse. The greatest intra-rater consistency was in identifying 'disturbed thought processes' (kappa = 0.77, 95% CI: 0.56-0.98). A moderate level of inter-rater agreement among nurses was observed for the nursing diagnoses of 'disturbed thought process' and 'disturbed sleep pattern' from 0.41-0.53. Furthermore, the inter-rater agreement of among nurses with less work experience (less than four years) showed greater higher consistency on 'disturbed thought process' (kappa = 0.56, 95% CI: 0.23-0.89) and 'disturbed sleep pattern' (kappa = 0.41, 95% CI: 0.07-0.73) than that observed among nurses with more work experience (more than four years). Overall, intra-rater reliability was greater than inter-rater reliability for psychiatric nursing process records. Furthermore, more inter-rater and intra-rater agreement were observed among records from less experienced nurses than among records produced by more experienced ones. To evaluate the consistency of nursing process records, both the intra-rater reliability and the inter-rater reliability show the importance of using standardised terms and more detailed nursing records. Our results clearly indicate that using

  18. Inter-rater reliability study of the modified Oxford Grading Scale and the Peritron manometer.

    Science.gov (United States)

    Ferreira, Cristine Homsi Jorge; Barbosa, Patrícia Brentegani; de Oliveira Souza, Flaviane; Antônio, Flávia Ignácio; Franco, Maíra Menezes; Bø, Kari

    2011-06-01

    To evaluate the inter-rater reliability of the modified Oxford Grading Scale and the Peritron manometer. All participants were evaluated twice, first by one examiner and 30 days later by a second examiner. Measurements of vaginal squeeze pressure were compared with the results from the palpation test. Nineteen women with a mean age of 23.7 years (range 21 to 28 years). Inter-rater reliability for vaginal palpation was fair (κ=0.33, 95% confidence interval 0.09 to 0.57). Using the Peritron manometer, the difference between examiners was less than 10cmH(2)O in 11 of the 19 (58%) cases. The palpation test did not differentiate between weak, moderate, good and strong muscle contractions. This study found fair inter-rater reliability for the modified Oxford Grading Scale and moderate inter-rater reliability for the Peritron manometer. The inter-rater reliability of vaginal squeeze pressure measurement using the Peritron manometer is acceptable and can be used in re-evaluations performed by different examiners in clinical practice. However, for research purposes, the ideal situation would be for a single examiner to assess and re-assess the subject. Vaginal palpation is important in the clinical assessment of correctness of a pelvic floor muscle contraction, but this study does not support the use of the modified Oxford Grading Scale as a reliable and valid method to measure and differentiate pelvic floor muscle strength. Copyright © 2010 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  19. The Inter-Rater Reliability in Scoring Composition

    Science.gov (United States)

    Wang, Ping

    2009-01-01

    This paper makes a study of the rater reliability in scoring composition in the test of English as a foreign language (EFL) and focuses on the inter-rater reliability as well as several interactions between raters and the other facets involved (that is examinees, rating criteria and rating methods). Results showed that raters were fairly…

  20. Inter-rater reliability of diagnostic criteria for sacroiliac joint-, disc- and facet joint pain.

    Science.gov (United States)

    van Tilburg, Cornelis W J; Groeneweg, Johannes G; Stronks, Dirk L; Huygen, Frank J P M

    2017-01-01

    Several diagnostic criteria sets are described in the literature to identify low back pain subtypes, but very little is known about the inter-rater reliability of these criteria. We conducted a study to determine the reliability of diagnostic tests that point towards SI joint-, disc- or facet joint pain. Inter-rater reliability study alongside three randomized clinical trials. Multidisciplinary pain center of general hospital. Patients aged 18 or more with medical history and physical examination suggestive of sacroiliac joint-, disc- and facet joint pain on lumbar level. Making use of nowadays most common used diagnostic criteria, a physical examination is taken independently by three physicians (two pain physicians and one orthopedic surgeon). Inter-rater reliability (Kappa (κ) measure of agreement) and significance (p) between raters are presented. Strengths of agreement, indicated with κ values above 0,20, are presented in order of agreement. One hundred patients were included. None of the parameters from the physical investigation had κ values of more than 0.21 (fair) in all pairs of raters. Between two raters (C and D), there was an almost perfect agreement on three parameters, more specifically ``Abnormal sensory and motor examination, hyperactive or diminished reflexes'', ``Sitting exam shows no reflex, motor or sensory signs in the legs'' and ``Straight leg raising (Laségue) negative between 30 and 70 degrees of flexion''. The ``Drop test positive'' parameters had moderate strength of agreement between raters A and D and fair strength between raters A and B. The ``Digital interspinous pressure test positive'' had moderate strength of agreement between raters C and D and fair strength of agreement between raters A and B as well as raters B and C. Three other parameters had a fair strength of agreement between two raters, all other parameters had a slight or poor strength of agreement. Inter-rater reliability, confidence intervals and significance of

  1. Inter-rater reliability of three standardized functional tests in patients with low back pain

    Science.gov (United States)

    Tidstrand, Johan; Horneij, Eva

    2009-01-01

    Background Of all patients with low back pain, 85% are diagnosed as "non-specific lumbar pain". Lumbar instability has been described as one specific diagnosis which several authors have described as delayed muscular responses, impaired postural control as well as impaired muscular coordination among these patients. This has mostly been measured and evaluated in a laboratory setting. There are few standardized and evaluated functional tests, examining functional muscular coordination which are also applicable in the non-laboratory setting. In ordinary clinical work, tests of functional muscular coordination should be easy to apply. The aim of this present study was to therefore standardize and examine the inter-rater reliability of three functional tests of muscular functional coordination of the lumbar spine in patients with low back pain. Methods Nineteen consecutive individuals, ten men and nine women were included. (Mean age 42 years, SD ± 12 yrs). Two independent examiners assessed three tests: "single limb stance", "sitting on a Bobath ball with one leg lifted" and "unilateral pelvic lift" on the same occasion. The standardization procedure took altered positions of the spine or pelvis and compensatory movements of the free extremities into account. The inter-rater reliability was analyzed by Cohen's kappa coefficient (κ) and by percentage agreement. Results The inter-rater reliability for the right and the left leg respectively was: for the single limb stance very good (κ: 0.88–1.0), for sitting on a Bobath ball good (κ: 0.79) and very good (κ: 0.88) and for the unilateral pelvic lift: good (κ: 0.61) and moderate (κ: 0.47). Conclusion The present study showed good to very good inter-rater reliability for two standardized tests, that is, the single-limb stance and sitting on a Bobath-ball with one leg lifted. Inter-rater reliability for the unilateral pelvic lift test was moderate to good. Validation of the tests in their ability to evaluate lumbar

  2. Inter-rater reliability of three standardized functional tests in patients with low back pain

    Directory of Open Access Journals (Sweden)

    Tidstrand Johan

    2009-06-01

    Full Text Available Abstract Background Of all patients with low back pain, 85% are diagnosed as "non-specific lumbar pain". Lumbar instability has been described as one specific diagnosis which several authors have described as delayed muscular responses, impaired postural control as well as impaired muscular coordination among these patients. This has mostly been measured and evaluated in a laboratory setting. There are few standardized and evaluated functional tests, examining functional muscular coordination which are also applicable in the non-laboratory setting. In ordinary clinical work, tests of functional muscular coordination should be easy to apply. The aim of this present study was to therefore standardize and examine the inter-rater reliability of three functional tests of muscular functional coordination of the lumbar spine in patients with low back pain. Methods Nineteen consecutive individuals, ten men and nine women were included. (Mean age 42 years, SD ± 12 yrs. Two independent examiners assessed three tests: "single limb stance", "sitting on a Bobath ball with one leg lifted" and "unilateral pelvic lift" on the same occasion. The standardization procedure took altered positions of the spine or pelvis and compensatory movements of the free extremities into account. The inter-rater reliability was analyzed by Cohen's kappa coefficient (κ and by percentage agreement. Results The inter-rater reliability for the right and the left leg respectively was: for the single limb stance very good (κ: 0.88–1.0, for sitting on a Bobath ball good (κ: 0.79 and very good (κ: 0.88 and for the unilateral pelvic lift: good (κ: 0.61 and moderate (κ: 0.47. Conclusion The present study showed good to very good inter-rater reliability for two standardized tests, that is, the single-limb stance and sitting on a Bobath-ball with one leg lifted. Inter-rater reliability for the unilateral pelvic lift test was moderate to good. Validation of the tests in their

  3. THE COMMUNICATION DEALL DEVELOPMENTAL CHECKLIST - INTER RATER RELIABILITY

    OpenAIRE

    Pratibha Karanth

    2011-01-01

    A checklist is ideal when assessing young children who are ‘difficult to test’. The Communication DEALL Developmental Checklist (CDDC) was developed by Karanth (1), to assess developmental skills of children up to the age of 6 years, along eight developmental domains, with norms based on an Indian population. Since all checklists depend on rater reliability, the aim of the current study was to establish inter rater reliability of the CDDC. Two senior Speech Language Pathologists used a 4-poin...

  4. Inter-rater reliability of the food environment audit for diverse neighborhoods (FEAD-N).

    Science.gov (United States)

    Izumi, Betty T; Zenk, Shannon N; Schulz, Amy J; Mentz, Graciela B; Sand, Sharon L; de Majo, Ricardo F; Wilson, Christine; Odoms-Young, Angela

    2012-06-01

    Studies have shown that neighborhood food environments are important influences on dietary intake and may contribute to health disparities. While instruments with high reliability have been developed to assess food availability, price, and quality, few measures to assess items associated with the physical and social features of food stores have been developed. Yet, recent qualitative studies have documented aspects associated with such features of urban food stores that are barriers to food acquisition. We assessed the reliability of measures to assess multiple components of the food environment-including physical and social store features--in three geographically distinct and diverse communities in Detroit, Michigan, using the Food Environment Audit for Diverse Neighborhoods (FEAD-N). Using the FEAD-N, four trained observers conducted observations of 167 food stores over a 10-week period between October and December 2008. To assess inter-rater reliability, two trained observers independently visited, on the same day, a random subset of 44 food stores. Kappa statistics and percent agreement were used to evaluate inter-rater reliability. Overall, the instrument had mostly high inter-rater reliability with more than 75% of items with kappa scores between 0.80 and 1.00, indicating almost perfect reliability. More than half of the physical store features and 47% of the social store features had almost perfect reliability and about 37% and 47%, respectively, had substantial reliability. Measuring factors associated with the physical and social environment of food stores with mostly high reliability is feasible. Systematic documentation of the physical and social features of food stores using objective measures may promote a more comprehensive understanding of how neighborhood food environments influence health.

  5. The Nordic Housing Enabler: inter-rater reliability in cross-Nordic occupational therapy practice.

    Science.gov (United States)

    Helle, Tina; Nygren, Carita; Slaug, Björn; Brandt, Aase; Pikkarainen, Aila; Hansen, Anne-Grethe; Pétursdórttir, Emma; Iwarsson, Susanne

    2010-12-01

    This study addresses development of a content-valid cross-Nordic version of the Housing Enabler and investigation of its inter-rater reliability when used in occupational therapy rating situations, involving occupational therapists, clients, and their home environments. The instrument was translated from the original Swedish version of the Housing Enabler, and adapted according to accessibility norms and guidelines for housing design in Sweden, Denmark, Finland, and Iceland. This iterative process involved occupational therapists, architects, building engineers, and professional translators, resulting in the Nordic Housing Enabler. For reliability testing, the sampling strategy and data collection procedures used were the same in all countries. Twenty voluntary occupational therapists, pair-wise but independently of each other, collected data from 106 cases by means of the Nordic Housing Enabler. Inter-rater reliability was calculated by means of percentage agreement and kappa statistics. Overall good percentage agreement for the personal and environmental components of the instrument was shown, indicating that the instrument was sufficiently reliable for application in practice and research in the Nordic context. The varying kappa results highlight the need for further study in order to understand the influence of prevalence more profoundly, which should be kept in mind when interpreting the results.

  6. Inter-Rater Reliability of Provider Interpretations of Irritable Bowel Syndrome Food and Symptom Journals.

    Science.gov (United States)

    Zia, Jasmine; Chung, Chia-Fang; Xu, Kaiyuan; Dong, Yi; Schenk, Jeanette M; Cain, Kevin; Munson, Sean; Heitkemper, Margaret M

    2017-11-04

    There are currently no standardized methods for identifying trigger food(s) from irritable bowel syndrome (IBS) food and symptom journals. The primary aim of this study was to assess the inter-rater reliability of providers' interpretations of IBS journals. A second aim was to describe whether these interpretations varied for each patient. Eight providers reviewed 17 IBS journals and rated how likely key food groups (fermentable oligo-di-monosaccharides and polyols, high-calorie, gluten, caffeine, high-fiber) were to trigger IBS symptoms for each patient. Agreement of trigger food ratings was calculated using Krippendorff's α-reliability estimate. Providers were also asked to write down recommendations they would give to each patient. Estimates of agreement of trigger food likelihood ratings were poor (average α = 0.07). Most providers gave similar trigger food likelihood ratings for over half the food groups. Four providers gave the exact same written recommendation(s) (range 3-7) to over half the patients. Inter-rater reliability of provider interpretations of IBS food and symptom journals was poor. Providers favored certain trigger food likelihood ratings and written recommendations. This supports the need for a more standardized method for interpreting these journals and/or more rigorous techniques to accurately identify personalized IBS food triggers.

  7. Inter-Rater Reliability of Provider Interpretations of Irritable Bowel Syndrome Food and Symptom Journals

    Directory of Open Access Journals (Sweden)

    Jasmine Zia

    2017-11-01

    Full Text Available There are currently no standardized methods for identifying trigger food(s from irritable bowel syndrome (IBS food and symptom journals. The primary aim of this study was to assess the inter-rater reliability of providers’ interpretations of IBS journals. A second aim was to describe whether these interpretations varied for each patient. Eight providers reviewed 17 IBS journals and rated how likely key food groups (fermentable oligo-di-monosaccharides and polyols, high-calorie, gluten, caffeine, high-fiber were to trigger IBS symptoms for each patient. Agreement of trigger food ratings was calculated using Krippendorff’s α-reliability estimate. Providers were also asked to write down recommendations they would give to each patient. Estimates of agreement of trigger food likelihood ratings were poor (average α = 0.07. Most providers gave similar trigger food likelihood ratings for over half the food groups. Four providers gave the exact same written recommendation(s (range 3–7 to over half the patients. Inter-rater reliability of provider interpretations of IBS food and symptom journals was poor. Providers favored certain trigger food likelihood ratings and written recommendations. This supports the need for a more standardized method for interpreting these journals and/or more rigorous techniques to accurately identify personalized IBS food triggers.

  8. Inter-rater reliability of AMSTAR is dependent on the pair of reviewers.

    Science.gov (United States)

    Pieper, Dawid; Jacobs, Anja; Weikert, Beate; Fishta, Alba; Wegewitz, Uta

    2017-07-11

    Inter-rater reliability (IRR) is mainly assessed based on only two reviewers of unknown expertise. The aim of this paper is to examine differences in the IRR of the Assessment of Multiple Systematic Reviews (AMSTAR) and R(evised)-AMSTAR depending on the pair of reviewers. Five reviewers independently applied AMSTAR and R-AMSTAR to 16 systematic reviews (eight Cochrane reviews and eight non-Cochrane reviews) from the field of occupational health. Responses were dichotomized and reliability measures were calculated by applying Holsti's method (r) and Cohen's kappa (κ) to all potential pairs of reviewers. Given that five reviewers participated in the study, there were ten possible pairs of reviewers. Inter-rater reliability varied for AMSTAR between r = 0.82 and r = 0.98 (median r = 0.88) using Holsti's method and κ = 0.41 and κ = 0.69 (median κ = 0.52) using Cohen's kappa and for R-AMSTAR between r = 0.77 and r = 0.89 (median r = 0.82) and κ = 0.32 and κ = 0.67 (median κ = 0.45) depending on the pair of reviewers. The same pair of reviewers yielded the highest IRR for both instruments. Pairwise Cohen's kappa reliability measures showed a moderate correlation between AMSTAR and R-AMSTAR (Spearman's ρ =0.50). The mean inter-rater reliability for AMSTAR was highest for item 1 (κ = 1.00) and item 5 (κ = 0.78), while lowest values were found for items 3, 8, 9 and 11, which showed only fair agreement. Inter-rater reliability varies widely depending on the pair of reviewers. There may be some shortcomings associated with conducting reliability studies with only two reviewers. Further studies should include additional reviewers and should probably also take account of their level of expertise.

  9. Simulated patient training: Using inter-rater reliability to evaluate simulated patient consistency in nursing education.

    Science.gov (United States)

    MacLean, Sharon; Geddes, Fiona; Kelly, Michelle; Della, Phillip

    2018-03-01

    Simulated patients (SPs) are frequently used for training nursing students in communication skills. An acknowledged benefit of using SPs is the opportunity to provide a standardized approach by which participants can demonstrate and develop communication skills. However, relatively little evidence is available on how to best facilitate and evaluate the reliability and accuracy of SPs' performances. The aim of this study is to investigate the effectiveness of an evidenced based SP training framework to ensure standardization of SPs. The training framework was employed to improve inter-rater reliability of SPs. A quasi-experimental study was employed to assess SP post-training understanding of simulation scenario parameters using inter-rater reliability agreement indices. Two phases of data collection took place. Initially a trial phase including audio-visual (AV) recordings of two undergraduate nursing students completing a simulation scenario is rated by eight SPs using the Interpersonal Communication Assessments Scale (ICAS) and Quality of Discharge Teaching Scale (QDTS). In phase 2, eight SP raters and four nursing faculty raters independently evaluated students' (N=42) communication practices using the QDTS. Intraclass correlation coefficients (ICC) were >0.80 for both stages of the study in clinical communication skills. The results support the premise that if trained appropriately, SPs have a high degree of reliability and validity to both facilitate and evaluate student performance in nurse education. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  10. Examining Design and Inter-Rater Reliability of a Rubric Measuring Research Quality across Multiple Disciplines

    Directory of Open Access Journals (Sweden)

    Marilee J. Bresciani

    2009-05-01

    Full Text Available The paper presents a rubric to help evaluate the quality of research projects. The rubric was applied in a competition across a variety of disciplines during a two-day research symposium at one institution in the southwest region of the United States of America. It was collaboratively designed by a faculty committee at the institution and was administered to 204 undergraduate, master, and doctoral oral presentations by approximately 167 different evaluators. No training or norming of the rubric was given to 147 of the evaluators prior to the competition. The findings of the inter-rater reliability analysis reveal substantial agreement among the judges, which contradicts literature describing the fact that formal norming must occur prior to seeing substantial levels of inter-rater reliability. By presenting the rubric along with the methodology used in its design and evaluation, it is hoped that others will find this to be a useful tool for evaluating documents and for teaching research methods.

  11. Chest computed tomography-based scoring of thoracic sarcoidosis: Inter-rater reliability of CT abnormalities

    International Nuclear Information System (INIS)

    Heuvel, D.A.V. den; Es, H.W. van; Heesewijk, J.P. van; Spee, M.; Jong, P.A. de; Zanen, P.; Grutters, J.C.

    2015-01-01

    To determine inter-rater reliability of sarcoidosis-related computed tomography (CT) findings that can be used for scoring of thoracic sarcoidosis. CT images of 51 patients with sarcoidosis were scored by five chest radiologists for various abnormal CT findings (22 in total) encountered in thoracic sarcoidosis. Using intra-class correlation coefficient (ICC) analysis, inter-rater reliability was analysed and reported according to the Guidelines for Reporting Reliability and Agreement Studies (GRRAS) criteria. A pre-specified sub-analysis was performed to investigate the effect of training. Scoring was trained in a distinct set of 15 scans in which all abnormal CT findings were represented. Median age of the 51 patients (36 men, 70 %) was 43 years (range 26 - 64 years). All radiographic stages were present in this group. ICC ranged from 0.91 for honeycombing to 0.11 for nodular margin (sharp versus ill-defined). The ICC was above 0.60 in 13 of the 22 abnormal findings. Sub-analysis for the best-trained observers demonstrated an ICC improvement for all abnormal findings and values above 0.60 for 16 of the 22 abnormalities. In our cohort, reliability between raters was acceptable for 16 thoracic sarcoidosis-related abnormal CT findings. (orig.)

  12. Intra-rater and inter-rater reliability of the standardized ultrasound protocol for assessing subacromial structures

    DEFF Research Database (Denmark)

    Hougs Kjær, Birgitte; Ellegaard, Karen; Wieland, Ina

    2017-01-01

    BACKGROUND: US-examinations related to shoulder impingement (SI) often vary due to methodological differences, examiner positions, transducers, and recording parameters. Reliable US protocols for examination of different structures related to shoulder impingement are therefore needed. OBJECTIVES...... of the supraspinatus tendon (SUPRA) and subacromial subdeltoid (SASD) bursa in two imaging positions, and the acromial humeral distance (AHD) in one position. Additionally, agreement on dynamic impingement (DI) examination was performed. The intra- and inter-rater reliability was carried out on the same day...

  13. Inter-rater reliability of the evaluation of muscular chains associated with posture alterations in scoliosis

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    Fortin Carole

    2012-05-01

    Full Text Available Abstract Background In the Global postural re-education (GPR evaluation, posture alterations are associated with anterior or posterior muscular chain impairments. Our goal was to assess the reliability of the GPR muscular chain evaluation. Methods Design: Inter-rater reliability study. Fifty physical therapists (PTs and two experts trained in GPR assessed the standing posture from photographs of five youths with idiopathic scoliosis using a posture analysis grid with 23 posture indices (PI. The PTs and experts indicated the muscular chain associated with posture alterations. The PTs were also divided into three groups according to their experience in GPR. Experts’ results (after consensus were used to verify agreement between PTs and experts for muscular chain and posture assessments. We used Kappa coefficients (K and the percentage of agreement (%A to assess inter-rater reliability and intra-class coefficients (ICC for determining agreement between PTs and experts. Results For the muscular chain evaluation, reliability was moderate to substantial for 12 PI for the PTs (%A: 56 to 82; K: 0.42 to 0.76 and perfect for 19 PI for the experts. For posture assessment, reliability was moderate to substantial for 12 PI for the PTs (%A > 60%; K: 0.42 to 0.75 and moderate to perfect for 18 PI for the experts (%A: 80 to 100; K: 0.55 to 1.00. The agreement between PTs and experts was good for most muscular chain evaluations (18 PI; ICC: 0.82 to 0.99 and PI (19 PI; ICC: 0.78 to 1.00. Conclusions The GPR muscular chain evaluation has good reliability for most posture indices. GPR evaluation should help guide physical therapists in targeting affected muscles for treatment of abnormal posture patterns.

  14. Inter-rater reliability of the evaluation of muscular chains associated with posture alterations in scoliosis

    Science.gov (United States)

    2012-01-01

    Background In the Global postural re-education (GPR) evaluation, posture alterations are associated with anterior or posterior muscular chain impairments. Our goal was to assess the reliability of the GPR muscular chain evaluation. Methods Design: Inter-rater reliability study. Fifty physical therapists (PTs) and two experts trained in GPR assessed the standing posture from photographs of five youths with idiopathic scoliosis using a posture analysis grid with 23 posture indices (PI). The PTs and experts indicated the muscular chain associated with posture alterations. The PTs were also divided into three groups according to their experience in GPR. Experts’ results (after consensus) were used to verify agreement between PTs and experts for muscular chain and posture assessments. We used Kappa coefficients (K) and the percentage of agreement (%A) to assess inter-rater reliability and intra-class coefficients (ICC) for determining agreement between PTs and experts. Results For the muscular chain evaluation, reliability was moderate to substantial for 12 PI for the PTs (%A: 56 to 82; K: 0.42 to 0.76) and perfect for 19 PI for the experts. For posture assessment, reliability was moderate to substantial for 12 PI for the PTs (%A > 60%; K: 0.42 to 0.75) and moderate to perfect for 18 PI for the experts (%A: 80 to 100; K: 0.55 to 1.00). The agreement between PTs and experts was good for most muscular chain evaluations (18 PI; ICC: 0.82 to 0.99) and PI (19 PI; ICC: 0.78 to 1.00). Conclusions The GPR muscular chain evaluation has good reliability for most posture indices. GPR evaluation should help guide physical therapists in targeting affected muscles for treatment of abnormal posture patterns. PMID:22639838

  15. The inter-rater reliability and prognostic value of coma scales in Nepali children with acute encephalitis syndrome.

    Science.gov (United States)

    Ray, Stephen; Rayamajhi, Ajit; Bonnett, Laura J; Solomon, Tom; Kneen, Rachel; Griffiths, Michael J

    2018-02-01

    Background Acute encephalitis syndrome (AES) is a common cause of coma in Nepali children. The Glasgow coma scale (GCS) is used to assess the level of coma in these patients and predict outcome. Alternative coma scales may have better inter-rater reliability and prognostic value in encephalitis in Nepali children, but this has not been studied. The Adelaide coma scale (ACS), Blantyre coma scale (BCS) and the Alert, Verbal, Pain, Unresponsive scale (AVPU) are alternatives to the GCS which can be used. Methods Children aged 1-14 years who presented to Kanti Children's Hospital, Kathmandu with AES between September 2010 and November 2011 were recruited. All four coma scales (GCS, ACS, BCS and AVPU) were applied on admission, 48 h later and on discharge. Inter-rater reliability (unweighted kappa) was measured for each. Correlation and agreement between total coma score and outcome (Liverpool outcome score) was measured by Spearman's rank and Bland-Altman plot. The prognostic value of coma scales alone and in combination with physiological variables was investigated in a subgroup (n = 22). A multivariable logistic regression model was fitted by backward stepwise. Results Fifty children were recruited. Inter-rater reliability using the variables scales was fair to moderate. However, the scales poorly predicted clinical outcome. Combining the scales with physiological parameters such as systolic blood pressure improved outcome prediction. Conclusion This is the first study to compare four coma scales in Nepali children with AES. The scales exhibited fair to moderate inter-rater reliability. However, the study is inadequately powered to answer the question on the relationship between coma scales and outcome. Further larger studies are required.

  16. Exploring Differences in Measurement and Reporting of Classroom Observation Inter-Rater Reliability

    Science.gov (United States)

    Wilhelm, Anne Garrison; Gillespie Rouse, Amy; Jones, Francesca

    2018-01-01

    Although inter-rater reliability is an important aspect of using observational instruments, it has received little theoretical attention. In this article, we offer some guidance for practitioners and consumers of classroom observations so that they can make decisions about inter-rater reliability, both for study design and in the reporting of data…

  17. Evaluation of inter-rater reliability of subjective and objective criteria for diagnosis of lymphedema in upper and lower limbs

    Directory of Open Access Journals (Sweden)

    Larissa Louise Campanholi

    2015-03-01

    Full Text Available BACKGROUND: The diagnosis of lymphedema can be obtained objectively by measurement methods, and also by subjective methods, based on the patient's complaint. OBJECTIVE: To evaluate inter-rater reliability of objective and subjective criteria used for diagnosis of lymphedema and to propose a lymphedema cut-off for differences in volume between affected and control limbs. METHODS: We studied 84 patients who had undergone lymphadenectomy for treatment of cutaneous melanoma. Physical measures were obtained by manual perimetry (MP. The subjective criteria analyzed were clinical diagnosis of lymphedema in patients' medical records and self-report of feelings of heaviness and/or increase in volume in the affected limb. RESULTS: For upper limbs, the subjective criteria clinical observation (k 0.754, P<0.001 and heaviness and swelling (k 0.689, P<0.001 both exhibited strong agreement with MP results and there was moderate agreement between MP results and swelling (k 0.483 P<0.001, heaviness (k 0.576, P<0.001 and heaviness or swelling (k 0.412, P=0.001. For lower limbs there was moderate agreement between MP results and clinical observation (k 0.423, P=0.003 and regular agreement between MP and self-report of swelling (k 0.383, P=0.003. Cut-off values for diagnosing lymphedema were defined as a 9.7% difference between an affected upper limb and control upper limb and a 5.7% difference between lower limbs. CONCLUSION: Manual perimetry, medical criteria, and self-report of heaviness and/or swelling exhibited better agreement for upper limbs than for lower limbs for diagnosis of lymphedema.

  18. THE COMMUNICATION DEALL DEVELOPMENTAL CHECKLIST - INTER RATER RELIABILITY

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    Pratibha Karanth

    2011-05-01

    Full Text Available A checklist is ideal when assessing young children who are ‘difficult to test’. The Communication DEALL Developmental Checklist (CDDC was developed by Karanth (1, to assess developmental skills of children up to the age of 6 years, along eight developmental domains, with norms based on an Indian population. Since all checklists depend on rater reliability, the aim of the current study was to establish inter rater reliability of the CDDC. Two senior Speech Language Pathologists used a 4-point rating scale, to assess 40 children with developmental disabilities (across the ages of 0-6 years on the CDDC checklist. Each rater independently made two ratings during the assessment; the first as reported by the parent (PR1 and PR2, and the second based on the clinician’s own observation (CR1 and CR2. The correlation between CR1 and CR2, as well as PR1 and PR2 for each rater separately, was found to be high, suggesting that the CDDC provides a reliable baseline for the developmental skills of children up to 6 years.DOI 10.5463/DCID.v22i1.9

  19. Inter-rater reliability in the radiological classification of renal injuries.

    Science.gov (United States)

    Pretorius, Elias J; Zarrabi, Amir D; Griffith-Richards, Stephanie; Harvey, Justin; Ackermann, Hilgard M; Meintjes, Catharina M; Cilliers, Willem G; Zunza, Moleen; Szpytko, Alexander J; Pitcher, Richard D

    2018-03-01

    Although many radiologists invoke the surgical classification of renal injury proposed by the American Association for Surgery in Trauma (AAST), there has been only limited work on the role of the AAST system as an imaging stratification. The aim was to determine the inter-rater reliability (IRR) amongst radiologists and urologists using the AAST system. A 1-year retrospective study of consecutive patients with computed tomography (CT) evidence of renal trauma managed at a Level 1 trauma center. Three radiologists and three urologists independently stratified the presentation CT findings according to the AAST renal trauma classification. Agreement between independent raters and mutually exclusive groups was determined utilizing weighted kappa coefficients. One hundred and one patients were included. Individual inter-observer agreements ranged from 54/101 (53.4%) to 62/101 (61.4%), with corresponding weighted kappa values from 0.61 to 0.69, constituting substantial agreement. Urologists achieved intra-disciplinary agreement in 49 cases (48.5%) and radiologists in 36 cases (35.6%). Six-reader agreement was achieved in 24 cases (23.7%). The AAST grade I injuries had the highest level of agreement, overall. The finding of substantial IRR amongst radiologists and urologists utilizing the AAST system supports continued use of the broad parameters of the AAST system, with some modification in specific categories with lower agreement.

  20. Approaches to describing inter-rater reliability of the overall clinical appearance of febrile infants and toddlers in the emergency department.

    Science.gov (United States)

    Walsh, Paul; Thornton, Justin; Asato, Julie; Walker, Nicholas; McCoy, Gary; Baal, Joe; Baal, Jed; Mendoza, Nanse; Banimahd, Faried

    2014-01-01

    Objectives. To measure inter-rater agreement of overall clinical appearance of febrile children aged less than 24 months and to compare methods for doing so. Study Design and Setting. We performed an observational study of inter-rater reliability of the assessment of febrile children in a county hospital emergency department serving a mixed urban and rural population. Two emergency medicine healthcare providers independently evaluated the overall clinical appearance of children less than 24 months of age who had presented for fever. They recorded the initial 'gestalt' assessment of whether or not the child was ill appearing or if they were unsure. They then repeated this assessment after examining the child. Each rater was blinded to the other's assessment. Our primary analysis was graphical. We also calculated Cohen's κ, Gwet's agreement coefficient and other measures of agreement and weighted variants of these. We examined the effect of time between exams and patient and provider characteristics on inter-rater agreement. Results. We analyzed 159 of the 173 patients enrolled. Median age was 9.5 months (lower and upper quartiles 4.9-14.6), 99/159 (62%) were boys and 22/159 (14%) were admitted. Overall 118/159 (74%) and 119/159 (75%) were classified as well appearing on initial 'gestalt' impression by both examiners. Summary statistics varied from 0.223 for weighted κ to 0.635 for Gwet's AC2. Inter rater agreement was affected by the time interval between the evaluations and the age of the child but not by the experience levels of the rater pairs. Classifications of 'not ill appearing' were more reliable than others. Conclusion. The inter-rater reliability of emergency providers' assessment of overall clinical appearance was adequate when described graphically and by Gwet's AC. Different summary statistics yield different results for the same dataset.

  1. Approaches to describing inter-rater reliability of the overall clinical appearance of febrile infants and toddlers in the emergency department

    Directory of Open Access Journals (Sweden)

    Paul Walsh

    2014-11-01

    Full Text Available Objectives. To measure inter-rater agreement of overall clinical appearance of febrile children aged less than 24 months and to compare methods for doing so.Study Design and Setting. We performed an observational study of inter-rater reliability of the assessment of febrile children in a county hospital emergency department serving a mixed urban and rural population. Two emergency medicine healthcare providers independently evaluated the overall clinical appearance of children less than 24 months of age who had presented for fever. They recorded the initial ‘gestalt’ assessment of whether or not the child was ill appearing or if they were unsure. They then repeated this assessment after examining the child. Each rater was blinded to the other’s assessment. Our primary analysis was graphical. We also calculated Cohen’s κ, Gwet’s agreement coefficient and other measures of agreement and weighted variants of these. We examined the effect of time between exams and patient and provider characteristics on inter-rater agreement.Results. We analyzed 159 of the 173 patients enrolled. Median age was 9.5 months (lower and upper quartiles 4.9–14.6, 99/159 (62% were boys and 22/159 (14% were admitted. Overall 118/159 (74% and 119/159 (75% were classified as well appearing on initial ‘gestalt’ impression by both examiners. Summary statistics varied from 0.223 for weighted κ to 0.635 for Gwet’s AC2. Inter rater agreement was affected by the time interval between the evaluations and the age of the child but not by the experience levels of the rater pairs. Classifications of ‘not ill appearing’ were more reliable than others.Conclusion. The inter-rater reliability of emergency providers’ assessment of overall clinical appearance was adequate when described graphically and by Gwet’s AC. Different summary statistics yield different results for the same dataset.

  2. Test-Retest and Inter-Rater Reliability Study of the Schedule for Oral-Motor Assessment in Persian Children

    Directory of Open Access Journals (Sweden)

    Manijeh Zarei Mahmood Abadi

    2018-03-01

    Discussion: Schedule for oral-motor assessment meets moderate levels of test-retest and inter-rater reliability criteria. Nonetheless, the percentage of decision consistency for inter-rater and test-retest examination turned out to be excellent.

  3. The impact of revised DSM-5 criteria on the relative distribution and inter-rater reliability of eating disorder diagnoses in a residential treatment setting.

    Science.gov (United States)

    Thomas, Jennifer J; Eddy, Kamryn T; Murray, Helen B; Tromp, Marilou D P; Hartmann, Andrea S; Stone, Melissa T; Levendusky, Philip G; Becker, Anne E

    2015-09-30

    This study evaluated the relative distribution and inter-rater reliability of revised DSM-5 criteria for eating disorders in a residential treatment program. Consecutive adolescent and young adult females (N=150) admitted to a residential eating disorder treatment facility were assigned both DSM-IV and DSM-5 diagnoses by a clinician (n=14) via routine clinical interview and a research assessor (n=4) via structured interview. We compared the frequency of diagnostic assignments under each taxonomy and by type of assessor. We evaluated concordance between clinician and researcher assignment through inter-rater reliability kappa and percent agreement. Significantly fewer patients received either clinician or researcher diagnoses of a residual eating disorder under DSM-5 (clinician-12.0%; researcher-31.3%) versus DSM-IV (clinician-28.7%; researcher-59.3%), with the majority of reassigned DSM-IV residual cases reclassified as DSM-5 anorexia nervosa. Researcher and clinician diagnoses showed moderate inter-rater reliability under DSM-IV (κ=.48) and DSM-5 (κ=.57), though agreement for specific DSM-5 other specified feeding or eating disorder (OSFED) presentations was poor (κ=.05). DSM-5 revisions were associated with significantly less frequent residual eating disorder diagnoses, but not with reduced inter-rater reliability. Findings support specific dimensions of clinical utility for revised DSM-5 criteria for eating disorders. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. Quality of nursing intensity data: inter-rater reliability of the patient classification after two decades in clinical use.

    Science.gov (United States)

    Liljamo, Pia; Kinnunen, Ulla-Mari; Ohtonen, Pasi; Saranto, Kaija

    2017-09-01

    The aim of this study was to measure the inter-rater reliability of the Oulu Patient Classification and to discuss existing methods of reliability testing. The Oulu Patient Classification, part of the RAFAELA ® System, has been developed to assist nursing managers with the proper allocation of nursing resources. Due to the increased intensity of inpatient care during recent years, there is a need for the reliability testing of the classification, which has been in clinical use for 20 years. Retrospective statistical study. To test inter-rater reliability, a pair of nurses classified the same patients, without knowledge of each other's ratings, as a part of annually conducted standardization. Data on the parallel classifications (n = 19,997) was obtained from inpatient units (n = 32) with different specialties at a university hospital in Finland during 2010-2015. Parallel classification practices were also analysed. The reliability of the overall classification and its subareas were calculated using suitable statistical coefficients. Inter-rater reliability coefficients were a reliable or almost perfect means of considering the nursing intensity category and various practices, but there were detectable differences between subareas. The lowest agreement levels occurred in the subareas 'Planning and Coordination of Nursing Care' and 'Guiding of Care/Continued Care and Emotional Support'. There is a need to develop the descriptions of subareas and to clarify the related concepts. Precise nursing documentation can promote a high level of agreement and reliable results. The traditional overall proportion of agreement does not provide an adequate picture of reliability - weighted kappa coefficients should be used instead. © 2017 John Wiley & Sons Ltd.

  5. Test-retest reliability and inter-rater reliability of the Modified Tardieu Scale and the Modified Ashworth Scale in hemiplegic patients with stroke.

    Science.gov (United States)

    Li, F; Wu, Y; Li, X

    2014-02-01

    The most commonly used tools for the assessment of spasticity are the Modified Ashworth Scale and Modified Tardieu Scale, but the results on the reliability of both scales keep equivocal. To evaluate the test-retest reliability and inter-rater reliability of the Modified Tardieu Scale (MTS) and Modified Ashworth Scale (MAS) in hemiplegic patients with stroke. Cross-sectional study. Inpatients referred to a rehabilitation hospital. Fifty-one inpatients with hemiplegic stroke. MTS and MAS were collected from the affected elbow flexors and ankle plantar flexors by: 1) two raters who were blinded to the results of the other assessment. 2) one rater one day apart. In the MAS measurement, the inter-rater and intra-rater Kappa values were 0.66 and 0.69 for the elbow flexors, 0.48 and 0.48 for the plantar flexors, respectively. In the angle measurement of the MTS, the inter-rater and intra-rater ICCs were between 0.58-0.89 for the R1 and R2, and between 0.62-0.70 for the R1-R2. The MAS provided moderate to substantial test-retest reliability and inter-rater reliability in the spasticity/tone measurement. The agreement of MAS elbow flexors scores was higher than that of plantar flexors scores. The reliability of angle measurement in the MTS was insufficient. Further work should avoid observing error when taking advantage of angle difference on measuring spasticity.

  6. Intra- and inter-rater reliability of endonasal activity estimation in granulomatosis with polyangiitis (Wegener´s).

    Science.gov (United States)

    Garske, Ulrike; Haack, Andrea; Beltrán, Olga; Flores-Suárez, Louis F; Bremer, Jan P; Lamprecht, Peter; Hedderich, Jürgen; Quetz, Joachim; Gross, Wolfgang L; Ambrosch, Petra; Laudien, Martin

    2012-01-01

    Granulomatosis with polyangiitis (GPA) frequently starts with an affection of the nasal and paranasal mucosa. Localised GPA of the nasal mucosa or persistent disease activity ('grumbling disease') is often encountered even under immunosuppressive therapy. Necessity for reconstructive surgery is common and careful scheduling to prevent failure and minimise revision rates is crucial. Therefore, reliable estimation of GPA activity in the upper airways using a score is mandatory for diagnosis, follow-up and scheduling reconstructive surgery. Fifty endoscopic, endonasal images of 45 patients with GPA were used. Twelve (4 German, 8 Mexican) experienced (n=7) and inexperienced (n=5) physicians assessed GPA-activity at two times (T1/T2) in dichotomy and in a grading approach (none, mild, moderate and high activity) using the novel ENT Activity Score (ENTAS). All documents were written in English. Estimation of activity in dichotomy (none vs. mild/moderate/high): Cohen's Kappa (κ) for intra-rater reliability T1/T2 in inexperienced and experienced physicians was κ=0.58 (agreement 85%) and κ=0.72 (agreement 91%). The inter-rater reliability (Fleiss's κ) T1/T2 for inexperienced and experienced physicians was κ=0.62/κ=0.59 and κ=0.50/κ=0.58 respectively. Estimation of activity in grading approach (none, mild, moderate, high): for inexperienced physicians the intra-rater reliability T1/T2 was κ=0.67 (agreement 56%) and the inter-rater reliability at T1/T2 was κ=0.29 (intraclass correlation coefficient, ICC=0.69) and κ=0.27 (ICC=0.59). For experienced physicians the intra-rater reliability T1/T2 was κ=0.80 (agreement 67%) and the inter-rater reliability at T1 and T2 was κ=0.41 (ICC=0.77) and κ=0.39 (ICC=0.75) respectively. Intra-rater reliability is high in decision in dichotomy and even in grading activity. There is no difference for experienced or inexperienced physicians. Inter-rater reliability is high in dichotomy, but low for activity grading. Thus, the ENTAS

  7. Inter-rater reliability of h-index scores calculated by Web of Science and Scopus for clinical epidemiology scientists.

    Science.gov (United States)

    Walker, Benjamin; Alavifard, Sepand; Roberts, Surain; Lanes, Andrea; Ramsay, Tim; Boet, Sylvain

    2016-06-01

    We investigated the inter-rater reliability of Web of Science (WoS) and Scopus when calculating the h-index of 25 senior scientists in the Clinical Epidemiology Program of the Ottawa Hospital Research Institute. Bibliometric information and the h-indices for the subjects were computed by four raters using the automatic calculators in WoS and Scopus. Correlation and agreement between ratings was assessed using Spearman's correlation coefficient and a Bland-Altman plot, respectively. Data could not be gathered from Google Scholar due to feasibility constraints. The Spearman's rank correlation between the h-index of scientists calculated with WoS was 0.81 (95% CI 0.72-0.92) and with Scopus was 0.95 (95% CI 0.92-0.99). The Bland-Altman plot showed no significant rater bias in WoS and Scopus; however, the agreement between ratings is higher in Scopus compared to WoS. Our results showed a stronger relationship and increased agreement between raters when calculating the h-index of a scientist using Scopus compared to WoS. The higher inter-rater reliability and simple user interface used in Scopus may render it the more effective database when calculating the h-index of senior scientists in epidemiology. © 2016 Health Libraries Group.

  8. Vibration sensibility of the median nerve in a population with chronic whiplash associated disorder: Intra- and inter-rater reliability study.

    Science.gov (United States)

    Tyros, I; Soundy, A; Heneghan, N R

    2016-09-01

    Whiplash Associated Disorders (WAD) grade II are the most prevalent group of whiplash patients seen on a regular basis by musculoskeletal physiotherapists. Impairment of vibration sensibility may be an early indicator of nerve pathology and it has previously been demonstrated in individuals with chronic WAD symptoms utilising vibrameters. A less expensive option, such the tuning fork (TF) may assist with these measures, but research regarding its measurement properties is lacking. To investigate the intra- and inter-rater reliability of vibration sensibility of the median nerve in chronic WAD II (CWAD II). A double blinded, within day intra- and inter-rater reliability study was undertaken. A convenience sample of 26 individuals (8 males, 18 females, age mean 29.9 ± 10.0 years) with CWADII was recruited. WAD I, III & indications of neuropathic pain. Vibration attenuation times were recorded from skin innervated by the median nerve (thenar eminence). Descriptive statistics (mean scores) and reliability statistics [intraclass correlation coefficient (ICC2,1) and Bland and Altman limits of agreement] were undertaken with p = 0.05. Almost perfect intra-rater reliability (Intraclass Correlation Coefficiency (ICC): 0.972-0.955) and inter-rater reliability (ICC: 0.983) were identified. Confidence Intervals (CI) for inter-rater reliability were 95% CI: -1.461 to -0.056. Almost perfect reliability scores across intra- and inter-rater reliability were found. This provides evidence that, with a standardised testing protocol the TF can be a highly reliable means of vibration sensibility testing. Future studies assessing the validity of the TF in different WAD populations may provide further information about the usefulness of this protocol. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Validation and inter-rater reliability of a three item falls risk screening tool

    Directory of Open Access Journals (Sweden)

    Catherine Maree Said

    2017-11-01

    Full Text Available Abstract Background Falls screening tools are routinely used in hospital settings and the psychometric properties of tools should be examined in the setting in which they are used. The aim of this study was to explore the concurrent and predictive validity of the Austin Health Falls Risk Screening Tool (AHFRST, compared with The Northern Hospital Modified St Thomas’s Risk Assessment Tool (TNH-STRATIFY, and the inter-rater reliability of the AHFRST. Methods A research physiotherapist used the AHFRST and TNH-STRATIFY to classify 130 participants admitted to Austin Health (five acute wards, n = 115 two subacute wards n = 15; median length of stay 6 days IQR 3–12 as ‘High’ or ‘Low’ falls risk. The AHFRST was also completed by nursing staff on patient admission. Falls data was collected from the hospital incident reporting system. Results Six falls occurred during the study period (fall rate of 4.6 falls per 1000 bed days. There was substantial agreement between the AHFRST and the TNH-STRATIFY (Kappa = 0.68, 95% CI 0.52–0.78. Both tools had poor predictive validity, with low specificity (AHFRST 46.0%, 95% CI 37.0–55.1; TNH-STRATIFY 34.7%, 95% CI 26.4–43.7 and positive predictive values (AHFRST 5.6%, 95% CI 1.6–13.8; TNH-STRATIFY 6.9%, 95% CI 2.6–14.4. The AHFRST showed moderate inter-rater reliability (Kappa = 0.54, 95% CI = 0.36–0.67, p < 0.001 although 18 patients did not have the AHFRST completed by nursing staff. Conclusions There was an acceptable level of agreement between the 3 item AHFRST classification of falls risk and the longer, 9 item TNH-STRATIFY classification. However, both tools demonstrated limited predictive validity in the Austin Health population. The results highlight the importance of evaluating the validity of falls screening tools, and the clinical utility of these tools should be reconsidered.

  10. Neonatal Eating Outcome Assessment: tool development and inter-rater reliability.

    Science.gov (United States)

    Pineda, Roberta; Harris, Rachel; Foci, Felicia; Roussin, Jessica; Wallendorf, Michael

    2018-03-01

    To define the process of tool development and revision for the Neonatal Eating Outcome (NEO) Assessment and to report preliminary inter-rater reliability. Tool development consisted of a review of the literature and observations of feeding performance among 178 preterm infants born ≤32 weeks gestation. 11 neonatal therapy feeding experts provided structured feedback to establish content validity and define the scoring matrix. The tool was then used to evaluate feeding in 50 preterm infants born ≤32 weeks of gestation and 50 full-term infants. Multiple revisions occurred at each stage of development. Finally, six neonatal occupational therapists participated in reliability testing by independently scoring five videos of oral feeding of preterm infants using version 4 of the tool. The intraclass correlation for the 'prefeeding' score was 0.71 (0.37-0.96), and the intraclass correlation for the 'total' score was 0.83 (0.56-0.98). The 'total' score had good to excellent reliability. Fleiss' Kappa scores for all 18 scorable items ranged from slight agreement to moderate agreement. Items with the lowest Kappa scores were revised, and additional feedback from therapists engaged in reliability testing was incorporated, resulting in final version 5. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  11. Inter-rater reliability of healthcare professional skills' portfolio assessments: The Andalusian Agency for Healthcare Quality model

    Directory of Open Access Journals (Sweden)

    Antonio Almuedo-Paz

    2014-07-01

    Full Text Available This study aims to determine the reliability of assessment criteria used for a portfolio at the Andalusian Agency for Healthcare Quality (ACSA. Data: all competences certification processes, regardless of their discipline. Period: 2010-2011. Three types of tests are used: 368 certificates, 17,895 reports and 22,642 clinical practice reports (N = 3,010 candidates. The tests were evaluated in pairs by the ACSA team of raters using two categories: valid and invalid. Results: The percentage agreement in assessments of certificates was 89,9%, while for the reports of clinical practice was 85,1 % and for clinical practice reports was 81,7%. The inter-rater agreement coefficients (kappa ranged from 0,468 to 0,711. Discussion: The results of this study show that the inter-rater reliability of assessments varies from fair to good. Compared with other similar studies, the results put the reliability of the model in a comfortable position. Among the improvements incorporated, progressive automation of evaluations must be highlighted.

  12. Inter-rater reliability of surgical reviews for AREN03B2: a COG renal tumor committee study.

    Science.gov (United States)

    Hamilton, Thomas E; Barnhart, Douglas; Gow, Kenneth; Ferrer, Fernando; Kandel, Jessica; Glick, Richard; Dasgupta, Roshni; Naranjo, Arlene; He, Ying; Gratias, Eric; Geller, James; Mullen, Elizabeth; Ehrlich, Peter

    2014-01-01

    The Children's Oncology Group (COG) renal tumor study (AREN03B2) requires real-time central review of radiology, pathology, and the surgical procedure to determine appropriate risk-based therapy. The purpose of this study was to determine the inter-rater reliability of the surgical reviews. Of the first 3200 enrolled AREN03B2 patients, a sample of 100 enriched for blood vessel involvement, spill, rupture, and lymph node involvement was selected for analysis. The surgical assessment was then performed independently by two blinded surgical reviewers and compared to the original assessment, which had been completed by another of the committee surgeons. Variables assessed included surgeon-determined local tumor stage, overall disease stage, type of renal procedure performed, presence of tumor rupture, occurrence of intraoperative tumor spill, blood vessel involvement, presence of peritoneal implants, and interpretation of residual disease. Inter-rater reliability was measured using the Fleiss' Kappa statistic two-sided hypothesis tests (Kappa, p-value). Local tumor stage correlated in all 3 reviews except in one case (Kappa=0.9775, p<0.001). Similarly, overall disease stage had excellent correlation (0.9422, p<0.001). There was strong correlation for type of renal procedure (0.8357, p<0.001), presence of tumor rupture (0.6858, p<0.001), intraoperative tumor spill (0.6493, p<0.001), and blood vessel involvement (0.6470, p<0.001). Variables that had lower correlation were determination of the presence of peritoneal implants (0.2753, p<0.001) and interpretation of residual disease status (0.5310, p<0.001). The inter-rater reliability of the surgical review is high based on the great consistency in the 3 independent review results. This analysis provides validation and establishes precedent for real-time central surgical review to determine treatment assignment in a risk-based stratagem for multimodal cancer therapy. © 2014.

  13. Accuracy, intra- and inter-rater reliability of three scoring systems for the glottic view at videolaryngoscopy.

    Science.gov (United States)

    O'Loughlin, E J; Swann, A D; English, J D; Ramadas, R

    2017-07-01

    An accurate and reproducible recording of laryngoscopic view at tracheal intubation is an important aspect of anaesthetic practice. Unlike direct laryngoscopy, in which the view achieved by the line of sight directly relates to the ease of intubating the trachea, videolaryngoscopy can create a situation in which the view is good, but intubation difficult or impossible. Communicating this to a subsequent anaesthetist is important. We compared three scoring systems: Cormack and Lehane; POGO (percentage of glottic opening); and the Fremantle score, as used by 74 critical care doctors rating 30 anonymised videos of videolaryngoscopic intubations. Accuracy (degree of agreement of score with an expert panel assessment) was higher for POGO (75.5%) and the Fremantle score (73.9%) than for Cormack and Lehane (65.4%; p scores and mean Cronbach's Alpha for continuous score) was higher for Fremantle score (0.796) and Cormack and Lehane (0.773) than POGO (0.693). Inter-rater reliability for Fremantle score (0.618) and POGO (0.614) were similar and higher than the inter-rater reliability of Cormack and Lehane 0.464 (p score suggest they are preferable to Cormack and Lehane for use when documenting videolaryngoscopy. The additional information about ease of intubation conveyed by the Fremantle score may support its routine use in recording videolaryngoscopic intubation. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

  14. The intra- and inter-rater reliability of five clinical muscle performance tests in patients with and without neck pain

    Science.gov (United States)

    2013-01-01

    Background This study investigates the reliability of muscle performance tests using cost- and time-effective methods similar to those used in clinical practice. When conducting reliability studies, great effort goes into standardising test procedures to facilitate a stable outcome. Therefore, several test trials are often performed. However, when muscle performance tests are applied in the clinical setting, clinicians often only conduct a muscle performance test once as repeated testing may produce fatigue and pain, thus variation in test results. We aimed to investigate whether cervical muscle performance tests, which have shown promising psychometric properties, would remain reliable when examined under conditions similar to those of daily clinical practice. Methods The intra-rater (between-day) and inter-rater (within-day) reliability was assessed for five cervical muscle performance tests in patients with (n = 33) and without neck pain (n = 30). The five tests were joint position error, the cranio-cervical flexion test, the neck flexor muscle endurance test performed in supine and in a 45°-upright position and a new neck extensor test. Results Intra-rater reliability ranged from moderate to almost perfect agreement for joint position error (ICC ≥ 0.48-0.82), the cranio-cervical flexion test (ICC ≥ 0.69), the neck flexor muscle endurance test performed in supine (ICC ≥ 0.68) and in a 45°-upright position (ICC ≥ 0.41) with the exception of a new test (neck extensor test), which ranged from slight to moderate agreement (ICC = 0.14-0.41). Likewise, inter-rater reliability ranged from moderate to almost perfect agreement for joint position error (ICC ≥ 0.51-0.75), the cranio-cervical flexion test (ICC ≥ 0.85), the neck flexor muscle endurance test performed in supine (ICC ≥ 0.70) and in a 45°-upright position (ICC ≥ 0.56). However, only slight to fair agreement was found for the neck extensor test (ICC

  15. The development, content validity and inter-rater reliability of the SMART-Goal Evaluation Method: A standardised method for evaluating clinical goals.

    Science.gov (United States)

    Bowman, Julia; Mogensen, Lise; Marsland, Elisabeth; Lannin, Natasha

    2015-12-01

    Goal setting is a complex skill. The use of formal goal writing procedures (including the use of the SMART goal model) has been advocated. However, a standardised method of writing and evaluating SMART goals is currently lacking. This study comprised of two phases. The aims of phase one was to (i) develop the SMART Goal Evaluation Method (SMART-GEM) based on a SMART goal model; and (ii) investigate the content validity of the SMART-GEM. The aim of phase two of the study was to test the inter-rater reliability of the SMART-GEM. Development of the SMART- GEM involved defining and constructing evaluation criteria suitable for auditing goal statements. A content validity assessment was conducted using an expert panel of Occupational Therapists (n = 10). Inter-rater reliability of the SMART-GEM was examined using a purposive sample of multiple raters (n = 24). The SMART- GEM was rated as having good content validity (individual items CVI ranged from 0.90 to 1.00; total SMART- GEM CVI = 0.99, ρ = 0.05). Agreement between raters on individual items ranged from poor (κ = 0.254) to excellent (κ = 0.965) and agreement of overall grades was fair to good (κ = 0.582). Inter-rater agreement on total scores was found to be very good (ICC = 0.895, 95% CI = 0.743 to 0.986, ρ = 0.001) with excellent internal consistency (α = 0.995). The SMART-GEM demonstrated good construct validity and very good inter-rater reliability on total score and shows promise as a standardised method to writing and evaluating clinical goals. © 2015 Occupational Therapy Australia.

  16. Inter-rater reliability and double reading analysis of an automated three-dimensional breast ultrasound system: comparison of two independent examiners.

    Science.gov (United States)

    Maier, Anna; Heil, Joerg; Lauer, Anna; Harcos, Aba; Schaefgen, Benedikt; von Au, Alexandra; Spratte, Julia; Riedel, Fabian; Rauch, Geraldine; Hennigs, André; Domschke, Christoph; Schott, Sarah; Rom, Joachim; Schuetz, Florian; Sohn, Christof; Golatta, Michael

    2017-07-26

    Breast ultrasound could be a valuable tool complementary to mammography in breast cancer screening. Automated 3D breast ultrasound (ABUS) addresses challenges of hand-held ultrasound and could allow double reading analysis of ultrasound images. This trial assesses the inter-rater reliability and double reading analysis of an ABUS system. To assess the reproducibility and diagnostic validity of the ABUS system, SomoV™, a blinded double reading analysis, was performed in 1019 patients (2038 breasts) by two examiners (examiner A/B) and compared to single reading results, as well as to the reference standard regarding its diagnostic validity. Cohen's kappa coefficients were calculated to measure the inter-rater reliability and agreement of the different diagnostic modalities. Patient comfort and time consumption for image acquisition and reading were analyzed descriptively as secondary objectives. Analysis of inter-rater reliability yielded agreement in 81.6% (κ = 0.37; p reading analysis of SomoV™ exams (examiner A/examiner B) compared to reference standard showed good specificity (examiner A: 88.3%/examiner B: 84.5%), fair inter-rater agreement (examiner A: κ = 0.31/examiner B: κ = 0.31), and adequate sensitivity (examiner A: 53.1%/examiner B: 64.2%). Double reading analysis yielded good sensitivity and specificity (73.7 and 77.7%). Mammography (n = 1911) alone detected 160 of 176 carcinomas (sensitivity 90.1%). Adding SomoV™ to mammography would have detected 12 additional carcinomas, resulting in a higher sensitivity of 97.7%. SomoV™ is a promising technique with good sensitivity, high patient comfort, and fair inter-examiner reliability. It allows double reading analysis that, in combination with mammography, could increase detection rates in breast cancer screening.

  17. Inter-rater reliability of two paediatric early warning score tools

    DEFF Research Database (Denmark)

    Jensen, Claus Sixtus; Aagaard, Hanne; Olesen, Hanne Vebert

    2017-01-01

    BACKGROUND: Paediatric early warning score (PEWS) assessment tools can assist healthcare providers in the timely detection and recognition of subtle patient condition changes signalling clinical deterioration. However, PEWS tools instrument data are only as reliable and accurate as the caregivers...... who obtain and document the parameters. OBJECTIVE: The aim of this study is to evaluate inter-rater reliability among nurses using PEWS systems. DESIGN: The study was carried out in five paediatrics departments in the Central Denmark Region. Inter-rater reliability was investigated through parallel...

  18. Introducing a new definition of a near fall: intra-rater and inter-rater reliability.

    Science.gov (United States)

    Maidan, I; Freedman, T; Tzemah, R; Giladi, N; Mirelman, A; Hausdorff, J M

    2014-01-01

    Near falls (NFs) are more frequent than falls, and may occur before falls, potentially predicting fall risk. As such, identification of a NF is important. We aimed to assess intra and inter-rater reliability of the traditional definition of a NF and to demonstrate the potential utility of a new definition. To this end, 10 older adults, 10 idiopathic elderly fallers, and 10 patients with Parkinson's disease (PD) walked in an obstacle course while wearing a safety harness. All walks were videotaped. Forty-nine video segments were extracted to create 2 clips each of 8.48 min. Four raters scored each event using the traditional definition and, two weeks later, using the new definition. A fifth rater used only the new definition. Intra-rater reliability was determined using Kappa (K) statistics and inter-rater reliability was determined using ICC. Using the traditional definition, three raters had poor intra-rater reliability (K0.137) and one rater had moderate intra-rater reliability (K=0.624, pdefinition, inter-rater reliability between the four raters was moderate (ICC=0.667, pdefinition showed high intra-rater (K>0.601, pdefinition of NF is required. The results of the present study suggest that the proposed new definition increases intra and inter-rater reliability, a critical step for using NFs to quantify fall risk. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. And the Winner Is … : Inter-Rater Reliability among Scholarship Assessors

    Science.gov (United States)

    Johnston, Lucy; Schluter, Philip J.

    2017-01-01

    With increasing competition for postgraduate research scholarships, awarding processes demand attention and scrutiny. We examine inter-rater reliability for two prestigious New Zealand scholarships, the Shirtcliffe Fellowship and the Gordon Watson Scholarship. For each scholarship, five assessors (three academic; two non-academic) independently…

  20. Inter-rater reliability for measurement of passive physiological movements in lower extremity joints is generally low: a systematic review.

    NARCIS (Netherlands)

    Trijffel, E. van; Pol, R.J. van de; Oostendorp, R.A.B.; Lucas, C.

    2010-01-01

    QUESTION: What is the inter-rater reliability for measurements of passive physiological or accessory movements in lower extremity joints? DESIGN: Systematic review of studies of inter-rater reliability. PARTICIPANTS: Individuals with and without lower extremity disorders. OUTCOME MEASURES: Range of

  1. Inter-rater reliability of shoulder measurements in middle-aged women.

    Science.gov (United States)

    De Groef, A; Van Kampen, M; Vervloesem, N; Clabau, E; Christiaens, M-R; Neven, P; Geraerts, I; Struyf, F; Devoogdt, N

    2017-06-01

    To investigate inter-rater reliability of a set of shoulder measurements including inclinometry [shoulder range of motion (ROM)], acromion-table distance and pectoralis minor muscle length (static scapular positioning), upward rotation with two inclinometers (scapular kinematics) and pain pressure thresholds (muscle tenderness) in middle-aged women. Observational study. Thirty symptom-free middle-aged women (first cohort) were measured by two raters. All measurements with an intraclass correlation coefficient (ICC) below 0.75 were retested after an additional training period in a second cohort of 30 symptom-free middle-aged women. Inter-rater reliability of all variables was measured with the ICC (95% confidence interval) and standard error of measurement (SEM). Acromion-table distance (ICC=0.91, SEM 0.22 to 0.28% of body length), pectoralis minor muscle length (ICC=0.91, SEM 0.16% of body length), pain pressure thresholds (ICC=0.78 to 0.85, SEM 0.39 to 0.70kg) and abduction ROM (ICC=0.77, SEM 5°) showed good to excellent inter-rater reliability in the first cohort. After an additional training period, forward flexion ROM showed good inter-rater reliability (ICC=0.83, SEM 5°), scapular upward rotation in resting position showed moderate reliability (ICC=0.52, SEM 2°), and other scaption angles showed weak reliability (ICC=0.26 to 0.43, SEM 3 to 8°). In a battery of clinical tools to evaluate factors contributing to shoulder pain, static scapular positioning and pressure pain thresholds were found to have good to excellent inter-rater reliability in middle-aged women. Additional training is recommended for measurements with a gravity inclinometer. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  2. Intra-rater and inter-rater reliabilities of real-time acceleration gait analysis system.

    Science.gov (United States)

    Osaka, Hiroshi; Shinkoda, Koichi; Watanabe, Susumu; Fujita, Daisuke; Kobara, Kenichi; Yoshimura, Yosuke; Ito, Tomotaka

    2016-01-01

    The purposes of this study were to construct a real-time acceleration gait analysis system equipped with software to analyse real-time trunk acceleration during walking and to examine the intra-rater and inter-rater reliabilities of the this system. This system has been comprised of an accelerometer, an acceleration amplifier, a transmitter, two foot switches, a receiver and a personal computer installed with the real-time acceleration analysis software. The acceleration signals received were analysed using the real-time acceleration analysis software, and gait parameters were calculated. The subjects were 20 healthy individuals and two raters. The intra-rater and inter-rater reliabilities of the measurement results obtained from this system were examined by performing intraclass correlation coefficients (ICC) and Bland-Altman analysis. The intra-rater and inter-rater ICCs ranged from 0.61 to 0.92 in any gait parameters. In the Bland-Altman analysis, neither fixed nor proportional bias was found in any of the gait parameters. From the ICC and Bland-Altman analysis results, the gait measurement using this system clearly demonstrates that the intra-rater and inter-rater measurements had good reproducibility. Owing to this system, we can improve the clinical efficiency of gait analysis and gait training for physiotherapy. Implication for Rehabilitation This study focused on the advantage of a gait analysis method using an accelerometer and constructed a gait analysis system that calculates real-time gait parameters from trunk acceleration measurements during walking. The gait analysis using this system has good intra-rater and inter-rater reliabilities, and using this system can improve the clinical efficiency of gait analysis and gait training.

  3. The Surgical Safety Checklist and Teamwork Coaching Tools: a study of inter-rater reliability.

    Science.gov (United States)

    Huang, Lyen C; Conley, Dante; Lipsitz, Stu; Wright, Christopher C; Diller, Thomas W; Edmondson, Lizabeth; Berry, William R; Singer, Sara J

    2014-08-01

    To assess the inter-rater reliability (IRR) of two novel observation tools for measuring surgical safety checklist performance and teamwork. Data surgical safety checklists can promote adherence to standards of care and improve teamwork in the operating room. Their use has been associated with reductions in mortality and other postoperative complications. However, checklist effectiveness depends on how well they are performed. Authors from the Safe Surgery 2015 initiative developed a pair of novel observation tools through literature review, expert consultation and end-user testing. In one South Carolina hospital participating in the initiative, two observers jointly attended 50 surgical cases and independently rated surgical teams using both tools. We used descriptive statistics to measure checklist performance and teamwork at the hospital. We assessed IRR by measuring percent agreement, Cohen's κ, and weighted κ scores. The overall percent agreement and κ between the two observers was 93% and 0.74 (95% CI 0.66 to 0.79), respectively, for the Checklist Coaching Tool and 86% and 0.84 (95% CI 0.77 to 0.90) for the Surgical Teamwork Tool. Percent agreement for individual sections of both tools was 79% or higher. Additionally, κ scores for six of eight sections on the Checklist Coaching Tool and for two of five domains on the Surgical Teamwork Tool achieved the desired 0.7 threshold. However, teamwork scores were high and variation was limited. There were no significant changes in the percent agreement or κ scores between the first 10 and last 10 cases observed. Both tools demonstrated substantial IRR and required limited training to use. These instruments may be used to observe checklist performance and teamwork in the operating room. However, further refinement and calibration of observer expectations, particularly in rating teamwork, could improve the utility of the tools. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  4. Inter-rater reliability of surgical reviews for AREN03B2: A COG renal tumor committee study✩

    Science.gov (United States)

    Hamilton, Thomas E.; Barnhart, Douglas; Gow, Kenneth; Ferrer, Fernando; Kandel, Jessica; Glick, Richard; Dasgupta, Roshni; Naranjo, Arlene; He, Ying; Gratias, Eric; Geller, James; Mullen, Elizabeth; Ehrlich, Peter

    2014-01-01

    Purpose The Children's Oncology Group (COG) renal tumor study (AREN03B2) requires real-time central review of radiology, pathology, and the surgical procedure to determine appropriate risk-based therapy. The purpose of this study was to determine the inter-rater reliability of the surgical reviews. Methods Of the first 3200 enrolled AREN03B2 patients, a sample of 100 enriched for blood vessel involvement, spill, rupture, and lymph node involvement was selected for analysis. The surgical assessment was then performed independently by two blinded surgical reviewers and compared to the original assessment, which had been completed by another of the committee surgeons. Variables assessed included surgeon-determined local tumor stage, overall disease stage, type of renal procedure performed, presence of tumor rupture, occurrence of intraoperative tumor spill, blood vessel involvement, presence of peritoneal implants, and interpretation of residual disease. Inter-rater reliability was measured using the Fleiss' Kappa statistic two-sided hypothesis tests (Kappa, p-value). Results Local tumor stage correlated in all 3 reviews except in one case (Kappa = 0.9775, p < 0.001). Similarly, overall disease stage had excellent correlation (0.9422, p < 0.001). There was strong correlation for type of renal procedure (0.8357, p < 0.001), presence of tumor rupture (0.6858, p < 0.001), intraoperative tumor spill (0.6493, p < 0.001), and blood vessel involvement (0.6470, p < 0.001). Variables that had lower correlation were determination of the presence of peritoneal implants (0.2753, p < 0.001) and interpretation of residual disease status (0.5310, p < 0.001). Conclusion The inter-rater reliability of the surgical review is high based on the great consistency in the 3 independent review results. This analysis provides validation and establishes precedent for real-time central surgical review to determine treatment assignment in a risk-based stratagem for multimodal cancer therapy

  5. Inter-rater reliability of data elements from a prototype of the Paul Coverdell National Acute Stroke Registry

    Directory of Open Access Journals (Sweden)

    Wehner Susan

    2008-06-01

    Full Text Available Abstract Background The Paul Coverdell National Acute Stroke Registry (PCNASR is a U.S. based national registry designed to monitor and improve the quality of acute stroke care delivered by hospitals. The registry monitors care through specific performance measures, the accuracy of which depends in part on the reliability of the individual data elements used to construct them. This study describes the inter-rater reliability of data elements collected in Michigan's state-based prototype of the PCNASR. Methods Over a 6-month period, 15 hospitals participating in the Michigan PCNASR prototype submitted data on 2566 acute stroke admissions. Trained hospital staff prospectively identified acute stroke admissions, abstracted chart information, and submitted data to the registry. At each hospital 8 randomly selected cases were re-abstracted by an experienced research nurse. Inter-rater reliability was estimated by the kappa statistic for nominal variables, and intraclass correlation coefficient (ICC for ordinal and continuous variables. Factors that can negatively impact the kappa statistic (i.e., trait prevalence and rater bias were also evaluated. Results A total of 104 charts were available for re-abstraction. Excellent reliability (kappa or ICC > 0.75 was observed for many registry variables including age, gender, black race, hemorrhagic stroke, discharge medications, and modified Rankin Score. Agreement was at least moderate (i.e., 0.75 > kappa ≥; 0.40 for ischemic stroke, TIA, white race, non-ambulance arrival, hospital transfer and direct admit. However, several variables had poor reliability (kappa Conclusion The excellent reliability of many of the data elements supports the use of the PCNASR to monitor and improve care. However, the poor reliability for several variables, particularly time-related events in the emergency department, indicates the need for concerted efforts to improve the quality of data collection. Specific recommendations

  6. Feasibility and Inter-Rater Reliability of Physical Performance Measures in Acutely Admitted Older Medical Patients

    DEFF Research Database (Denmark)

    Bodilsen, Ann Christine; Juul-Larsen, Helle Gybel; Petersen, Janne

    2015-01-01

    OBJECTIVE: Physical performance measures can be used to predict functional decline and increased dependency in older persons. However, few studies have assessed the feasibility or reliability of such measures in hospitalized older patients. Here we assessed the feasibility and inter......-rater reliability of four simple measures of physical performance in acutely admitted older medical patients. DESIGN: During the first 24 hours of hospitalization, the following were assessed twice by different raters in 52 (≥ 65 years) patients admitted for acute medical illness: isometric hand grip strength, 4......, and 30-s chair stand were 8%, 7%, and 18%, and the SRD95% values were 22%, 17%, and 49%. CONCLUSION: In acutely admitted older medical patients, grip strength, gait speed, and the Cumulated Ambulation Score measurements were feasible and showed high inter-rater reliability when administered by different...

  7. Intra- and Inter-Rater Reliability of Bioimpedance in the Evaluation of Lymphedema Secondary to Treatment of Breast Cancer.

    Science.gov (United States)

    Ferro, Ana Paula; Ferreira, Vânia Tie Koga; Rezende, Monique Silva; de Souza, Thamires Rodrigues; Almeida, Ana Maria de; Guirro, Rinaldo Roberto de Jesus; Guirro, Elaine Caldeira de Oliveira

    2017-12-18

    The objective of the study was to evaluate the intra- and inter-rater reliability of bioimpedance in determining upper limb volume in women with lymphedema resulting from breast cancer treatment, as well as its correlation with the upper limb volume calculated by circumferential measurement. A blind cross-sectional study was performed in which 27 women (62.59 ± 10.50 years) were evaluated with upper limb lymphedema secondary to breast cancer treatment. Two examiners performed assessments in the same volunteers independently and twice, with an interval of 1 week between assessments. The collections were performed by the direct tetrapolar multifrequency segmental bioimpedance and by the circumference of the upper limb homolateral to the breast cancer. The results of the circumference showed that the homolateral limb had lymphedema. The intra- and inter-rater analysis showed excellent reliability with intraclass correlation coefficient (ICC) values ranging from 0.954 to 0.999 for the amount of liquid and excellent reliability with ICC values ranging from 0.852 to 0.999 for the electrical impedance of the upper limb with lymphedema. The correlation was strong and negative (p < 0.05) between intracellular, extracellular, and total water when associated with electrical impedance and moderate and positive (p < 0.05) when associated with upper limb volume for all frequencies. The correlations between upper limb volume and water quantities were moderate and positive (p < 0.05). The results indicate that bioimpedance is a reliable method for the evaluation of lymphedema, and the volume of the homolateral upper limb is associated with the amount of water in women with lymphedema secondary to the treatment of breast cancer.

  8. Inter-rater reliability of the evaluation of muscular chains associated with posture alterations in scoliosis

    OpenAIRE

    Fortin, Carole; Feldman, Debbie Ehrmann; Tanaka, Clarice; Houde, Michelle; Labelle, Hubert

    2012-01-01

    Abstract Background In the Global postural re-education (GPR) evaluation, posture alterations are associated with anterior or posterior muscular chain impairments. Our goal was to assess the reliability of the GPR muscular chain evaluation. Methods Design: Inter-rater reliability study. Fifty physical therapists (PTs) and two experts trained in GPR assessed the standing posture from photographs of five youths with idiopathic scoliosis using a posture analysis grid with 23 posture indices (PI)...

  9. Cultural adaptation, content validity and inter-rater reliability of the "STAR Skin Tear Classification System"

    Directory of Open Access Journals (Sweden)

    Kelly Cristina Strazzieri-Pulido

    2015-02-01

    Full Text Available AIMS: to perform the cultural adaptation of the STAR Skin Tear Classification System into the Portuguese language and to test the content validity and inter-rater reliability of the adapted version.METHODS: methodological study with a quantitative approach. The cultural adaptation was developed in three phases: translation, evaluation by a committee of judges and back-translation. The instrument was tested regarding content validity and inter-rater reliability.RESULTS: the adapted version obtained a regular level of concordance when it was applied by nurses using photographs of friction injuries. Regarding its application in clinical practice, the adapted version obtained a moderate and statistically significant level of concordance.CONCLUSION: the study tested the content validity and inter-rater reliability of the version adapted into the Portuguese language. Its inclusion in clinical practice will enable the correct identification of this type of injury, as well as the implementation of protocols for the prevention and treatment of friction injuries.

  10. Inter-rater reliability of case-note audit: a systematic review.

    Science.gov (United States)

    Lilford, Richard; Edwards, Alex; Girling, Alan; Hofer, Timothy; Di Tanna, Gian Luca; Petty, Jane; Nicholl, Jon

    2007-07-01

    The quality of clinical care is often assessed by retrospective examination of case-notes (charts, medical records). Our objective was to determine the inter-rater reliability of case-note audit. We conducted a systematic review of the inter-rater reliability of case-note audit. Analysis was restricted to 26 papers reporting comparisons of two or three raters making independent judgements about the quality of care. Sixty-six separate comparisons were possible, since some papers reported more than one measurement of reliability. Mean kappa values ranged from 0.32 to 0.70. These may be inflated due to publication bias. Measured reliabilities were found to be higher for case-note reviews based on explicit, as opposed to implicit, criteria and for reviews that focused on outcome (including adverse effects) rather than process errors. We found an association between kappa and the prevalence of errors (poor quality care), suggesting alternatives such as tetrachoric and polychoric correlation coefficients be considered to assess inter-rater reliability. Comparative studies should take into account the relationship between kappa and the prevalence of the events being measured.

  11. Inter-rater and intrarater reliability of the South African Triage Scale in low-resource settings of Haiti and Afghanistan.

    Science.gov (United States)

    Dalwai, Mohammed; Tayler-Smith, Katie; Twomey, Michèle; Nasim, Masood; Popal, Abdul Qayum; Haqdost, Waliul Haq; Gayraud, Olivia; Cheréstal, Sophia; Wallis, Lee; Valles, Pola

    2018-03-16

    The South African Triage Scale (SATS) has demonstrated good validity in the EDs of Médecins Sans Frontières (MSF)-supported sites in Afghanistan and Haiti; however, corresponding reliability in these settings has not yet been reported on. This study set out to assess the inter-rater and intrarater reliability of the SATS in four MSF-supported EDs in Afghanistan and Haiti (two trauma-only EDs and two mixed (including both medical and trauma cases) EDs). Under classroom conditions between December 2013 and February 2014, ED nurses at each site assigned triage ratings to a set of context-specific vignettes (written case reports of ED patients). Inter-rater reliability was assessed by comparing triage ratings among nurses; intrarater reliability was assessed by asking the nurses to retriage 10 random vignettes from the original set and comparing these duplicate ratings. Inter-rater reliability was calculated using the unweighted kappa, linearly weighted kappa and quadratically weighted kappa (QWK) statistics, and the intraclass correlation coefficient (ICC). Intrarater reliability was calculated according to the percentage of exact agreement and the percentage of agreement allowing for one level of discrepancy in triage ratings. The correlation between years of nursing experience and reliability of the SATS was assessed based on comparison of ICCs and the respective 95% CIs. A total of 67 nurses agreed to participate in the study: In Afghanistan there were 19 nurses from Kunduz Trauma Centre and nine from Ahmed Shah Baba; in Haiti, there were 20 nurses from Martissant Emergency Centre and 19 from Tabarre Surgical and Trauma Centre. Inter-rater agreement was moderate across all sites (ICC range: 0.50-0.60; QWK range: 0.50-0.59) apart from the trauma ED in Haiti where it was moderate to substantial (ICC: 0.58; QWK: 0.61). Intrarater agreement was similar across the four sites (68%-74% exact agreement); when allowing for a one-level discrepancy in triage ratings

  12. Intra and inter-rater reliability study of pelvic floor muscle dynamometric measurements

    Directory of Open Access Journals (Sweden)

    Natalia M. Martinho

    2015-04-01

    Full Text Available OBJECTIVE: The aim of this study was to evaluate the intra and inter-rater reliability of pelvic floor muscle (PFM dynamometric measurements for maximum and average strengths, as well as endurance. METHOD: A convenience sample of 18 nulliparous women, without any urogynecological complaints, aged between 19 and 31 (mean age of 25.4±3.9 participated in this study. They were evaluated using a pelvic floor dynamometer based on load cell technology. The dynamometric evaluations were repeated in three successive sessions: two on the same day with a rest period of 30 minutes between them, and the third on the following day. All participants were evaluated twice in each session; first by examiner 1 followed by examiner 2. The vaginal dynamometry data were analyzed using three parameters: maximum strength, average strength, and endurance. The Intraclass Correlation Coefficient (ICC was applied to estimate the PFM dynamometric measurement reliability, considering a good level as being above 0.75. RESULTS: The intra and inter-raters' analyses showed good reliability for maximum strength (ICCintra-rater1=0.96, ICCintra-rater2=0.95, and ICCinter-rater=0.96, average strength (ICCintra-rater1=0.96, ICCintra-rater2=0.94, and ICCinter-rater=0.97, and endurance (ICCintra-rater1=0.88, ICCintra-rater2=0.86, and ICCinter-rater=0.92 dynamometric measurements. CONCLUSIONS: The PFM dynamometric measurements showed good intra- and inter-rater reliability for maximum strength, average strength and endurance, which demonstrates that this is a reliable device that can be used in clinical practice.

  13. Medical record review to recover missing data in a Portuguese birth cohort: agreement with self-reported data collected by questionnaire and inter-rater variability Revisión de registros médicos para recuperar datos incompletos en una cohorte de nacimiento portuguesa: concordancia con datos recogidos por cuestionario y variabilidad interobservador

    Directory of Open Access Journals (Sweden)

    Elisabete Alves

    2011-06-01

    Full Text Available Objectives: To assess the yield of medical record review to recover missing data originally collected by questionnaire, to analyze the agreement between these two data sources and to determine interobserver variability in clinical record review. Methods: We analyzed data from a birth cohort of 8,127 women who were consecutively recruited after giving birth from 2005-2006. Recruitment was conducted at all public maternity units of Porto, Portugal. We reviewed the medical records of 3,657 women with missing data in the baseline questionnaire and assessed agreement between these two sources by using information from participants with data from both sources. Interobserver variability was assessed by using 400 randomly selected clinical records. Results: Data on pregnancy complications and maternal anthropometric parameters were successfully recovered. Agreement between the questionnaire and records in family history data was fair, particularly for cardiovascular disease [k=0.27; 95% confidence interval (95%CI: 0.23-0.32]. The highest agreement was observed for personal history of diabetes (k=0.82; 95%CI 0.70-0.93, while agreement for hypertension was moderate (k=0.60; 95%CI 0.50-0.69. Discrepancies in prepregnancy body mass index classes were observed in 10.3% women. Data were highly consistent between the two reviewers, with the highest agreement found for gestational diabetes (k=1.00 and birth weight (99.5% concordance. Conclusion: Data from the medical records and questionnaire were concordant with regard to pregnancy and well-known risk factors. The low interobserver variability did not threaten the precision of our data.Objetivo: Evaluar el rendimiento de la revisión de registros médicos para completar datos originalmente recogidos por cuestionario, y analizar la concordancia entre ambas fuentes de datos y la variabilidad interobservador en la revisión de registros médicos. Métodos: Cohorte de nacimiento con 8.127 mujeres reclutadas de

  14. Inter-rater reliability of modified modified Ashworth scale in the assessment of plantar flexor muscle spasticity in patients with spinal cord injury.

    Science.gov (United States)

    Mishra, Chittaranjan; Ganesh, G Shankar

    2014-12-01

    Spasticity occurs in disorders of the central nervous system such as stroke, spinal cord injury (SCI), multiple sclerosis and traumatic brain injury. The recently developed clinical measurement for the measurement of spasticity is the Modified Modified Ashworth Scale (MMAS) PURPOSE OF STUDY: The purpose of this study is to determine the inter-rater reliability of the MMAS in the assessment of plantar flexor spasticity in patients with SCI. Thirty-eight subjects (32 males and six females, mean age 31.9 ± 12.6 years) were recruited for the study. Excluded from the study were patients with contracture in the lower limb and where passive movements were contraindicated. Each patient was assessed by two raters in a single session. After the performance of the procedure by the first assessor and rating of the patient's muscle tone with the MMAS, the same procedure was repeated by the second assessor after 1 hour. The evaluation was carried out in side-lying position. The extent of agreement was analysed by non-weighted Cohen kappa. The agreement between the raters was good (soleus - ĸ: 0.75, SE = 0 .084, p < 0.0001, gastrocnemius - ĸ:0.70, SE = 0.105, p < 0.0001). The MMAS has good inter-rater reliability in the assessment of plantar flexor muscle spasticity in patients with SCI. Copyright © 2014 John Wiley & Sons, Ltd.

  15. Inter-rater reliability of the Modified Modified Ashworth Scale as a clinical tool in measurements of post-stroke elbow flexor spasticity.

    Science.gov (United States)

    Ansari, Noureddin Nakhostin; Naghdi, Soofia; Hasson, Scott; Mousakhani, Atefeh; Nouriyan, Azam; Omidvar, Zeinab

    2009-01-01

    Patients with neurological conditions may be affected by spasticity. The Modified Modified Ashworth Scale (MMAS) is a clinical tool used to measure spasticity. The purpose of the present study was to investigate the inter-rater reliability of the MMAS during the assessment of elbow flexor spasticity in adult patients with post-stroke hemiplegia. Twenty-one adult patients with stroke (5 women, 16 men) with a median age of 60 years (interquartile range, 47-68) were tested. Elbow flexors on the affected side were examined. Inter-rater reliability for two inexperienced raters was very good. The weighted Kappa value was 0.81 (Standard Error = 0.097, 95% CI: 0.62-1.00, p = 0.0002). The weighted percentage agreement was 97.4%. The agreement between raters occurred mostly on score 1 (38.1%) followed by score 0 (23.8%). The MMAS yielded reliable measurements between raters when used on patients post-stroke with elbow flexor spasticity.

  16. The Nordic Housing Enabler: Inter-rater reliability in cross-Nordic occupational therapy practice. Previously published in Scandinavian Journal of Occupational Therapy 2010; 17: 258-266.

    Science.gov (United States)

    Helle, Tina; Nygren, Carita; Slaug, Björn; Brandt, Aase; Pikkarainen, Aila; Hansen, Anne-Grethe; Pétursdórttir, Emma; Iwarsson, Susanne

    2014-01-01

    This study addresses development of a content-valid cross-Nordic version of the Housing Enabler and investigation of its inter-rater reliability when used in occupational therapy rating situations, involving occupational therapists, clients, and their home environments. The instrument was translated from the original Swedish version of the Housing Enabler, and adapted according to accessibility norms and guidelines for housing design in Sweden, Denmark, Finland, and Iceland. This iterative process involved occupational therapists, architects, building engineers, and professional translators, resulting in the Nordic Housing Enabler. For reliability testing, the sampling strategy and data collection procedures used were the same in all countries. Twenty voluntary occupational therapists, pair-wise but independently of each other, collected data from 106 cases by means of the Nordic Housing Enabler. Inter-rater reliability was calculated by means of percentage agreement and kappa statistics. Overall good percentage agreement for the personal and environmental components of the instrument was shown, indicating that the instrument was sufficiently reliable for application in practice and research in the Nordic context. The varying kappa results highlight the need for further study in order to understand the influence of prevalence more profoundly, which should be kept in mind when interpreting the results.

  17. Inter-rater reliability of an observation-based ergonomics assessment checklist for office workers.

    Science.gov (United States)

    Pereira, Michelle Jessica; Straker, Leon Melville; Comans, Tracy Anne; Johnston, Venerina

    2016-12-01

    To establish the inter-rater reliability of an observation-based ergonomics assessment checklist for computer workers. A 37-item (38-item if a laptop was part of the workstation) comprehensive observational ergonomics assessment checklist comparable to government guidelines and up to date with empirical evidence was developed. Two trained practitioners assessed full-time office workers performing their usual computer-based work and evaluated the suitability of workstations used. Practitioners assessed each participant consecutively. The order of assessors was randomised, and the second assessor was blinded to the findings of the first. Unadjusted kappa coefficients between the raters were obtained for the overall checklist and subsections that were formed from question-items relevant to specific workstation equipment. Twenty-seven office workers were recruited. The inter-rater reliability between two trained practitioners achieved moderate to good reliability for all except one checklist component. This checklist has mostly moderate to good reliability between two trained practitioners. Practitioner Summary: This reliable ergonomics assessment checklist for computer workers was designed using accessible government guidelines and supplemented with up-to-date evidence. Employers in Queensland (Australia) can fulfil legislative requirements by using this reliable checklist to identify and subsequently address potential risk factors for work-related injury to provide a safe working environment.

  18. [Inter-rater concordance of the "Nursing Activities Score" in intensive care].

    Science.gov (United States)

    Valls-Matarín, Josefa; Salamero-Amorós, Maria; Roldán-Gil, Carmen; Quintana-Riera, Salvador

    2015-01-01

    To evaluate inter-rater concordance in the valuation of the "Nursing Activities Score". Cross-sectional descriptive study conducted from December 2012 until June 2013 in a general intensive care unit with twelve beds. Three evaluator nurses, simultaneously and independently, through the patient daily charts, scored the nursing workload using Nursing Activities Score scale in all patients admitted over 18 years old. Three hundreds and thirty-nine records were collected. The intra-class correlation coefficient (ICC) between evaluators was 0.92 (0.89-0.94). A perfect concordance was obtained in 39.1% of the items, with 52.2% having a high, and 8.7% having lower concordance, corresponding to two of the items with multiple scoring options. Significant differences between two of the evaluators (P=.049) were found. Although the inter-rater concordance was high, more accurate records are needed to reduce the variability of the items with multiple options and to allow more accuracy in the interpretation and measurement of the data regarding nursing workload. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  19. Inter-rater reliability of the Pediatric Transplant Rating Instrument (P-TRI): challenges to reliably identifying adherence risk factors during pediatric pre-transplant evaluations.

    Science.gov (United States)

    Fisher, M; Storfer-Isser, A; Shaw, R J; Bernard, R S; Drury, S; Ularntinon, S; Horwitz, S M

    2011-03-01

    The purpose of this study was to assess the inter-rater reliability of the P-TRI, a 17-item instrument developed to identify risk factors associated with poor treatment adherence in pediatric solid organ transplant candidates. Because factors influencing treatment adherence may vary with age, the 89 subject samples were divided into pre-adolescent (0-11 yr) and adolescent (12-19 yr) groups. Each subject received two independent P-TRI ratings based on pretransplant psychosocial assessments separately conducted by a PSYC and a SWTC. Inter-rater reliability was assessed using the delta statistic. Overall, agreement was higher in the pre-adolescent group, with delta>0.70 for five items and delta0.70 and seven items had a deltaPSYC P-TRI ratings indicated fewer areas of concern on items assessing family dynamics compared with SWTC P-TRI ratings, whereas the reverse was true for items related to psychiatric history. Results highlight the challenges of conducting a reliable pretransplant assessment of adherence-related risk factors and suggest the need for revisions to the P-TRI prior to its use in clinical practice. © 2011 John Wiley & Sons A/S.

  20. Assessment of apraxia: inter-rater reliability of a new apraxia test, association between apraxia and other cognitive deficits and prevalence of apraxia in a rehabilitation setting.

    Science.gov (United States)

    Zwinkels, Angeliek; Geusgens, Chantal; van de Sande, Peter; Van Heugten, Caroline

    2004-11-01

    To investigate the inter-rater reliability of a new apraxia test. Furthermore to examine the association of apraxia with other neuropsychological impairments and the prevalence of apraxia in a rehabilitation setting on the basis of the new test. Cross-sectional cohort study, involving 100 patients with a first stroke admitted to a rehabilitation centre in the Netherlands. General patient characteristics and stroke-related aspects. Cognitive screening involving apraxia, visuospatial scanning, abstract thinking and reasoning, memory, attention, planning and aphasia. The indices for inter-rater agreement range from excellent to poor. Significant correlations are found between apraxia and visuospatial scanning, memory, attention, planning and aphasia. The patients with apraxia perform significantly worse than the patients without apraxia on memory, the time needed to complete the tests for scanning and attention, and aphasia. The prevalence of apraxia is 25.3% in the total group, 51.3% in the left hemisphere stroke patients and 6.0% in the right hemisphere stroke patients. Patients with and without apraxia do not differ significantly concerning age, gender and type of stroke. The apraxia test has been shown to be a reliable instrument. Apraxia is often associated with aphasia, memory problems and mental slowness. This study shows that on the basis of the apraxia test, the prevalence of apraxia among patients in the rehabilitation centre is high, especially among patients with left hemisphere lesions.

  1. The Outdoor MEDIA DOT: The development and inter-rater reliability of a tool designed to measure food and beverage outlets and outdoor advertising.

    Science.gov (United States)

    Poulos, Natalie S; Pasch, Keryn E

    2015-07-01

    Few studies of the food environment have collected primary data, and even fewer have reported reliability of the tool used. This study focused on the development of an innovative electronic data collection tool used to document outdoor food and beverage (FB) advertising and establishments near 43 middle and high schools in the Outdoor MEDIA Study. Tool development used GIS based mapping, an electronic data collection form on handheld devices, and an easily adaptable interface to efficiently collect primary data within the food environment. For the reliability study, two teams of data collectors documented all FB advertising and establishments within one half-mile of six middle schools. Inter-rater reliability was calculated overall and by advertisement or establishment category using percent agreement. A total of 824 advertisements (n=233), establishment advertisements (n=499), and establishments (n=92) were documented (range=8-229 per school). Overall inter-rater reliability of the developed tool ranged from 69-89% for advertisements and establishments. Results suggest that the developed tool is highly reliable and effective for documenting the outdoor FB environment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Content validity and inter-rater reliability of an instrument to characterize unintentional medication discrepancies.

    Science.gov (United States)

    Claeys, Coraline; Nève, Jean; Tulkens, Paul M; Spinewine, Anne

    2012-07-01

    Medication discrepancies are medication-related problems (MRPs) that frequently occur when patients are transferred between settings of care. Older patients are at high risk for several reasons, including high consumption of medicines, and physical and cognitive deficiencies that can impair the communication process. Most previous studies that have evaluated medication discrepancies used instruments designed for clinical practice, but a well-validated and reliable instrument for clinical research is still lacking. The aims of this study were to (i) develop an instrument to characterize medication discrepancies that fulfils quality requirements for classification of MRPs related to continuity of care and (ii) assess its content validity and inter-rater reliability. The instrument was developed based on three main inputs: (i) a literature review to collect information about the quality requirements of instruments to characterize MRPs; (ii) another literature review to identify existing instruments to characterize MRPs and, more specifically, medication discrepancies; and (iii) previous experience from a pilot study on Belgian patients discharged from surgical and medical wards. Content validity was assessed using a modified Delphi technique with 11 healthcare professionals. Content validity indexes were calculated. For inter-rater reliability, three pharmacists (one experienced and two naive) were asked to identify and categorize (type and cause of) unintentional medication discrepancies for 21 patients discharged from hospital into the community. The intra-class correlation coefficient was calculated to compare the number of discrepancies identified, and a paradox-resistant index (AC1) was used to determine the inter-rater reliability for the type and cause of the discrepancy. The instrument had 54 items classified in three sections (type of discrepancy, cause and intervention), with detailed specifications on how to use it. All evaluations relative to content

  3. The inter-rater reliability of the modified finger goniometer for measuring forearm rotation.

    Science.gov (United States)

    Szekeres, Mike; MacDermid, Joy C; Birmingham, Trevor; Grewal, Ruby

    2016-01-01

    Prospective cohort study. To compare the inter-rater reliability of using a modified finger goniometer (MFG) for the measurement of isolated forearm rotation for patients with distal radius fractures to the currently accepted technique for isolated forearm measurement. The currently accepted method of forearm measurement requires the assessor to visually estimate vertical for the stationary arm and placement of the moveable arm while placing a straight edge along a curved surface. Inter-rater reliability may be limited as assessors may estimate the placement of the goniometer arms differently depending on their experience, posture, and even their positioning relative to the patient. Rather than continue to place a straight edge on a round surface, we evaluate a new technique using an MFG for measuring isolated forearm rotation. Patients with clinically healed distal radius fractures were enrolled in the study. Measurement of active forearm pronation and supination was recorded using 2 separate measurement techniques. These measurements were taken by 2 separate hand therapists with more than 10 years of clinical experience in a tertiary care setting at the beginning and end of hand therapy sessions for 3 consecutive weekly visits. Intraclass correlation coefficients (ICCs), standard error of measurement, and minimal detectable change were calculated for each technique. The point estimates for the MFG method demonstrated a slightly higher ICC than the standard method for pronation (0.86 vs 0.82). For supination, both measurement techniques displayed equally high pooled ICCs (0.95). The standard error of measurements for the MFG were 2.1 for pronation and 1.2 for supination compared with 2.9 (pronation) and 1.2 (supination) for the standard technique. These translate into 90% minimal detectable changes of 5° and 3° for the MFG pronation/supination compared with 7° (pronation) and 3° (supination) for the standard technique, respectively. Although the point

  4. Inter-rater and intra-rater reliability of a clinical protocol for measuring turnout in collegiate dancers.

    Science.gov (United States)

    Greene, Amanda; Lasner, Andrea; Deu, Rajwinder; Oliphant, Seth; Johnson, Kenneth

    2018-02-02

    Reliable methods of measuring turnout in dancers and comparing active turnout (used in class) with functional (uncompensated) turnout are needed. Authors have suggested measurement techniques but there is no clinically useful, easily reproducible technique with established inter-rater and intra-rater reliability. We adapted a technique based on previous research, which is easily reproducible. We hypothesized excellent inter-rater and intra-rater reliability between experienced physical therapists (PTs) and a briefly trained faculty member from a university's department of dance. Thirty-two participants were recruited from the same dance department. Dancers' active and functional turnout was measured by each rater. We found that our technique for measuring active and functional turnout has excellent inter-rater and intra-rater reliability when performed by two experienced PTs and by one briefly trained university-level dance faculty member. For active turnout, inter-rater reliability was 0.78 among all raters and 0.82 among only the PT raters; intra-rater reliability was 0.82 among all raters and 0.85 among only the PT raters. For functional turnout, inter-rater reliability was 0.86 among all raters and 0.88 among only the PT raters; intra-rater reliability was 0.87 among all raters and 0.88 among only the PT raters. The measurement technique described provides a standardized protocol with excellent inter-rater and intra-rater reliability when performed by experienced PTs or by a briefly trained university-level dance faculty member.

  5. Inter-rater and intra-rater reliability of the Balance Computerized Adaptive Test in patients with stroke.

    Science.gov (United States)

    Chiang, Hsin-Yu; Lu, Wen-Shian; Yu, Wan-Hui; Hsueh, I-Ping; Hsieh, Ching-Lin

    2018-04-10

    To examine the inter-rater and intra-rater reliability of the Balance Computerized Adaptive Test (Balance CAT) in patients with chronic stroke having a wide range of balance functions. A repeated-assessments design (1 week apart) was used to examine the inter-rater and intra-rater reliability of the Balance CAT. The Balance CAT was administered by 3 raters in the inter-rater reliability study and by 2 raters in the intra-rater reliability study. Seven teaching hospitals PARTICIPANTS: Two independent groups of outpatients (n=50 for the inter-rater reliability study; n=52 for the intra-rater reliability study) with chronic stroke were recruited. Not applicable. Balance CAT. For the inter-rater reliability study, the values of ICC, minimal detectable change (MDC), and MDC% for the Balance CAT were 0.84, 1.90, and 31.0%, respectively. For the intra-rater reliability study, the values of ICC, MDC, and MDC% ranged from 0.89 to 0.91, 1.14 to 1.26, and 17.1% to 18.6%, respectively. The Balance CAT showed sufficient intra-rater reliability in patients with chronic stroke having balance functions ranging from sitting with support to independent walking. While the Balance CAT may have good inter-rater reliability, we found substantial random measurement error between different raters. Accordingly, if the Balance CAT is used as an outcome measure in clinical or research settings, same raters are suggested over different time points to ensure reliable assessments. Copyright © 2018. Published by Elsevier Inc.

  6. Inter-Rater Agreement Measures and the Refinement of Metrics in the PLATO MT Evaluation Paradigm

    National Research Council Canada - National Science Library

    Miller, Keith J; Vanni, Michelle

    2005-01-01

    ...), namely, clarity, coherence, morphology, syntax, general and domain-specific lexical robustness, and named-entity translation, as well as a DARPA-inspired measure of adequacy are at the core of the program...

  7. Computing Inter-Rater Reliability for Observational Data: An Overview and Tutorial

    Directory of Open Access Journals (Sweden)

    Kevin A. Hallgren

    2012-02-01

    Full Text Available Many research designs require the assessment of inter-rater reliability (IRR to demonstrate consistency among observational ratings provided by multiple coders. However, many studies use incorrect statistical procedures, fail to fully report the information necessary to interpret their results, or do not address how IRR affects the power of their subsequent analyses for hypothesis testing. This paper provides an overview of methodological issues related to the assessment of IRR with a focus on study design, selection of appropriate statistics, and the computation, interpretation, and reporting of some commonly-used IRR statistics. Computational examples include SPSS and R syntax for computing Cohen’s kappa and intra-class correlations to assess IRR.

  8. Inter-rater reliability of kinesthetic measurements with the KINARM robotic exoskeleton.

    Science.gov (United States)

    Semrau, Jennifer A; Herter, Troy M; Scott, Stephen H; Dukelow, Sean P

    2017-05-22

    Kinesthesia (sense of limb movement) has been extremely difficult to measure objectively, especially in individuals who have survived a stroke. The development of valid and reliable measurements for proprioception is important to developing a better understanding of proprioceptive impairments after stroke and their impact on the ability to perform daily activities. We recently developed a robotic task to evaluate kinesthetic deficits after stroke and found that the majority (~60%) of stroke survivors exhibit significant deficits in kinesthesia within the first 10 days post-stroke. Here we aim to determine the inter-rater reliability of this robotic kinesthetic matching task. Twenty-five neurologically intact control subjects and 15 individuals with first-time stroke were evaluated on a robotic kinesthetic matching task (KIN). Subjects sat in a robotic exoskeleton with their arms supported against gravity. In the KIN task, the robot moved the subjects' stroke-affected arm at a preset speed, direction and distance. As soon as subjects felt the robot begin to move their affected arm, they matched the robot movement with the unaffected arm. Subjects were tested in two sessions on the KIN task: initial session and then a second session (within an average of 18.2 ± 13.8 h of the initial session for stroke subjects), which were supervised by different technicians. The task was performed both with and without the use of vision in both sessions. We evaluated intra-class correlations of spatial and temporal parameters derived from the KIN task to determine the reliability of the robotic task. We evaluated 8 spatial and temporal parameters that quantify kinesthetic behavior. We found that the parameters exhibited moderate to high intra-class correlations between the initial and retest conditions (Range, r-value = [0.53-0.97]). The robotic KIN task exhibited good inter-rater reliability. This validates the KIN task as a reliable, objective method for quantifying

  9. Inter-rater reliability of the German version of the Nurses' Global Assessment of Suicide Risk scale.

    Science.gov (United States)

    Kozel, Bernd; Grieser, Manuela; Abderhalden, Christoph; Cutcliffe, John R

    2016-10-01

    In comparison to the general population, the suicide rates of psychiatric inpatient populations in Germany and Switzerland are very high. An important preventive contribution to the lowering of the suicide rates in mental health care is to ensure that the risk of suicide of psychiatric inpatients is assessed as accurately as possible. While risk-assessment instruments can serve an important function in determining such risk, very few have been translated to German. Therefore, in the present study, we reported on the German version of Nurses' Global Assessment of Suicide Risk (NGASR) scale. After translating the original instrument into German and pretesting the German version, we tested the inter-rater reliability of the instrument. Twelve video case studies were evaluated by 13 raters with the NGASR scale in a 'laboratory' trial. In each case, the observer's agreement was calculated for the single items, the overall scale, the risk levels, and the sum scores. The statistical data analysis was conducted with kappa and AC1 statistics for dichotomous (items, scale) scales. A high-to-very high observers' agreement (AC1: 0.62-1.00, kappa: 0.00-1.00) was determined for 16 items of the German version of the NGASR scale. We conclude that the German version of the NGASR scale is a reliable instrument for evaluating risk factors for suicide. A reliable application in the clinical practise appears to be enhanced by training in the use of the instrument and the right implementation instructions. © 2016 Australian College of Mental Health Nurses Inc.

  10. Inter-rater reliability of a video-analysis method measuring low-back load in a field situation

    NARCIS (Netherlands)

    Coenen, P.; Kingma, I.; Boot, C.R.L.; Bongers, P.M.; Dieën, J.H. van

    2013-01-01

    Valid and reliable low-back load assessment tools that can be used in field situations are needed for epidemiologic studies and for ergonomic practice. The aim of this study was to assess the inter-rater reliability of a low-back load video-analysis method in a field setting.Five raters analyzed 50

  11. Inter-Rater Reliability of the Modified Ashworth Scale and Modified Modified Ashworth Scale in Assessing Poststroke Elbow Flexor Spasticity

    Science.gov (United States)

    Kaya, Taciser; Goksel Karatepe, Altinay; Gunaydin, Rezzan; Koc, Aysegul; Altundal Ercan, Ulku

    2011-01-01

    The Modified Ashworth Scale (MAS) is commonly used in clinical practice for grading spasticity. However, it was modified recently by omitting grade "1+" of the MAS and redefining grade "2". The aim of this study was to investigate the inter-rater reliability of MAS and modified MAS (MMAS) for the assessment of poststroke elbow flexor spasticity.…

  12. Impaired self-awareness after traumatic brain injury: Inter-rater reliability and factor structure of the Dysexecutive Questionnaire (DEX in patients, significant others and clinicians.

    Directory of Open Access Journals (Sweden)

    Brian eMcGuire

    2014-10-01

    Full Text Available Aims: This study sought to address two questions: 1 what is the inter-rater reliability of the Dysexecutive Questionnaire (DEX when completed by patients, their significant others, and clinicians; and 2 does the factor structure of the DEX vary for these three groups?Methods: We obtained DEX ratings for 113 patients with an acquired brain injury from two brain injury services in the UK and two services in Ireland. We gathered data from two groups of raters – significant others (DEX-SO such as partners and close family members and clinicians (DEX-C, who were psychologists or rehabilitation physicians working closely with the patient and who were able to provide an opinion about the patient’s level of everyday executive functioning. Intra-class correlation coefficients and their 95% confidence intervals were calculated between each of the three groups (self, significant other, clinician. Principal component factor analyses were also conducted for each of the three groups.Results: The factor analysis revealed a consistent one-factor model for each of the three groups of raters. However, the inter-rater reliability analyses showed a low level of agreement between the self-ratings and the ratings of the two groups of independent raters. We also found low agreement between the significant others and the clinicians.Conclusion: Although there was a consistent finding of a single factor solution for each of the three groups, the low level of agreement between significant others and clinicians raises a question about the reliability of the DEX.

  13. INTER-RATER RELIABILITY OF THE SELECTIVE FUNCTIONAL MOVEMENT ASSESSMENT (SFMA) BY SFMA CERTIFIED PHYSICAL THERAPISTS WITH SIMILAR CLINICAL AND RATING EXPERIENCE.

    Science.gov (United States)

    Dolbeer, Jeffery; Mason, John; Morris, Jamie; Crowell, Michael; Goss, Donald

    2017-10-01

    The Selective Functional Movement Assessment (SFMA) assesses posture, muscle balance, and movement patterns in order to identify relevant musculoskeletal dysfunction in a clinical population. The purposes of this study were to: (1) determine if raters with similar clinical experience and rating experience exhibit adequate agreement of the scoring for the SFMA during clinical use; (2) determine the reliability of the categorical scoring of the SFMA in a clinical population; (3) determine the reliability of the criterion checklist scoring of the SFMA in a clinical population; (4) compare the reliability of real-time assessment to recorded assessment. Inter-rater reliability study. 49 clinical subjects (20.7 years ± 1.6) were simultaneously assessed in real-time by two physical therapists and were recorded with digital video cameras in the sagittal and frontal view while they performed the fifteen component movement patterns that comprise the top-tier SFMA. The third physical therapist assessed the patterns from the video. Subjects were assessed using the SFMA categorical scoring and criterion checklist scoring tools. The two live clinical raters demonstrated the greatest Cohen's Kappa scores (10 of 15) with moderate or better inter-rater agreement (Kappa > 0.40) using the categorical scoring tool. The overall ICC [2,1] score indicated fair to moderate agreement between all raters for the criterion checklist scoring (ICC, SEM, p-value) (0.61, 8.23, p scoring tool (0.72, 1.95, p=0.43). Using the categorical and criterion checklist tools in a clinical population to score the fifteen component fundamental movements of the SFMA demonstrated moderate or better reliability when performed clinically by certified SFMA raters. Reliability, Level 2.

  14. Inter-rater reliability and stability of diagnoses of autism spectrum disorder in children identified through screening at a very young age

    NARCIS (Netherlands)

    van Daalen, Emma; Kemner, Chantal; Dietz, Claudine; Swinkels, Sophie H. N.; Buitelaar, Jan K.; van Engeland, Herman

    2009-01-01

    To examine the inter-rater reliability and stability of autism spectrum disorder (ASD) diagnoses made at a very early age in children identified through a screening procedure around 14 months of age. In a prospective design, preschoolers were recruited from a screening study for ASD. The inter-rater

  15. Inter-rater reliability for measurement of passive physiological range of motion of upper extremity joints is better if instruments are used: a systematic review

    NARCIS (Netherlands)

    van de Pol, Rachel J.; van Trijffel, Emiel; Lucas, Cees

    2010-01-01

    Question: What is the inter-rater reliability for measurements of passive physiological or accessory movements in upper extremity joints? Design: Systematic review of studies of inter-rater reliability. Participants: Individuals with and without upper extremity disorders. Outcome measures: Range of

  16. Test-retest and inter-rater reliability of a method to measure wrist and finger spasticity.

    Science.gov (United States)

    Gäverth, Johan; Sandgren, Maria; Lindberg, Påvel G; Forssberg, Hans; Eliasson, Ann-Christin

    2013-07-01

    To describe the reliability of an instrument (Neuro- Flexor) designed to be used in the clinic for quantification of the relative contribution of spasticity, elasticity and viscosity to resistance during passive wrist movements. A test-retest and inter-rater reliability study. A convenience sample of 34 adults with chronic stroke with spasticity in the hand, and a reference group of 10 healthy persons. Two raters assessed the participants with the NeuroFlexor. Elastic, viscous and neural components of passive movement resistance were quantified at the wrist. Test-retest and inter-rater intraclass correlation coefficient (ICC2.1) were calculated for each component for both raters and two sessions. Degree of measurement error was evaluated using the coefficient of variation and the repeatability coefficient. Reliability was high for the neural component (test-retest: 0.90-0.96; inter-rater: 0.90-0.94), fair to good for the elastic component (test-retest: 0.79-0.88; inter-rater: 0.76-0.76), and fair to high for the viscous component (test-retest: 0.88-0.90; inter-rater: 0.75-0.80). Based on test-retest data, the coefficients of variation for the neural, elastic and viscous components were 25%, 26% and 16%, respectively, and the repeatability coefficients were 1.798, 1.897 and 1.404, respectively. The NeuroFlexor instrument is a reliable measure of spasticity and of muscle elasticity and viscosity in individuals with wrist and finger muscle resistance to passive stretch after stroke.

  17. The health preoccupation diagnostic interview: inter-rater reliability of a structured interview for diagnostic assessment of DSM-5 somatic symptom disorder and illness anxiety disorder.

    Science.gov (United States)

    Axelsson, Erland; Andersson, Erik; Ljótsson, Brjánn; Wallhed Finn, Daniel; Hedman, Erik

    2016-06-01

    Somatic symptom disorder (SSD) and illness anxiety disorder (IAD) are two new diagnoses introduced in the DSM-5. There is a need for reliable instruments to facilitate the assessment of these disorders. We therefore developed a structured diagnostic interview, the Health Preoccupation Diagnostic Interview (HPDI), which we hypothesized would reliably differentiate between SSD, IAD, and no diagnosis. Persons with clinically significant health anxiety (n = 52) and healthy controls (n = 52) were interviewed using the HPDI. Diagnoses were then compared with those made by an independent assessor, who listened to audio recordings of the interviews. Ratings generally indicated moderate to almost perfect inter-rater agreement, as illustrated by an overall Cohen's κ of .85. Disagreements primarily concerned (a) the severity of somatic symptoms, (b) the differential diagnosis of panic disorder, and (c) SSD specifiers. We conclude that the HPDI can be used to reliably diagnose DSM-5 SSD and IAD.

  18. Inter-rater reliability of the QuIS as an assessment of the quality of staff-inpatient interactions

    Directory of Open Access Journals (Sweden)

    Ines Mesa-Eguiagaray

    2016-12-01

    Full Text Available Abstract Background Recent studies of the quality of in-hospital care have used the Quality of Interaction Schedule (QuIS to rate interactions observed between staff and inpatients in a variety of ward conditions. The QuIS was developed and evaluated in nursing and residential care. We set out to develop methodology for summarising information from inter-rater reliability studies of the QuIS in the acute hospital setting. Methods Staff-inpatient interactions were rated by trained staff observing care delivered during two-hour observation periods. Anticipating the possibility of the quality of care varying depending on ward conditions, we selected wards and times of day to reflect the variety of daytime care delivered to patients. We estimated inter-rater reliability using weighted kappa, κ w , combined over observation periods to produce an overall, summary estimate, κ ^ w $$ {\\widehat{\\upkappa}}_w $$ . Weighting schemes putting different emphasis on the severity of misclassification between QuIS categories were compared, as were different methods of combining observation period specific estimates. Results Estimated κ ^ w $$ {\\widehat{\\upkappa}}_w $$ did not vary greatly depending on the weighting scheme employed, but we found simple averaging of estimates across observation periods to produce a higher value of inter-rater reliability due to over-weighting observation periods with fewest interactions. Conclusions We recommend that researchers evaluating the inter-rater reliability of the QuIS by observing staff-inpatient interactions during observation periods representing the variety of ward conditions in which care takes place, should summarise inter-rater reliability by κ w , weighted according to our scheme A4. Observation period specific estimates should be combined into an overall, single summary statistic κ ^ w random $$ {\\widehat{\\upkappa}}_{w\\ random} $$ , using a random effects approach, with κ ^ w random $$ {\\widehat

  19. Content validity and inter-rater reliability of the Halliwick-concept-based instrument 'Swimming with Independent Measure'.

    Science.gov (United States)

    Sršen, Katja Groleger; Vidmar, Gaj; Pikl, Maša; Vrečar, Irena; Burja, Cirila; Krušec, Klavdija

    2012-06-01

    The Halliwick concept is widely used in different settings to promote joyful movement in water and swimming. To assess the swimming skills and progression of an individual swimmer, a valid and reliable measure should be used. The Halliwick-concept-based Swimming with Independent Measure (SWIM) was introduced for this purpose. We aimed to determine its content validity and inter-rater reliability. Fifty-four healthy children, 3.5-11 years old, from a mainstream swimming program participated in a content validity study. They were evaluated with SWIM and the national evaluation system of swimming abilities (classifying children into seven categories). To study the inter-rater reliability of SWIM, we included 37 children and youth from a Halliwick swimming program, aged 7-22 years, who were evaluated by two Halliwick instructors independently. The average SWIM score differed between national evaluation system categories and followed the expected order (P<0.001), whereby a ceiling effect was observed in the higher categories. High inter-rater reliability was found for all 11 SWIM items. The lowest reliability was observed for item G (sagittal rotation), although the estimates were still above 0.9. As expected, the highest reliability was observed for the total score (intraclass correlation 0.996). The validity of SWIM with respect to the national evaluation system of swimming abilities is high until the point where a swimmer is well adapted to water and already able to learn some swimming techniques. The inter-rater reliability of SWIM is very high; thus, we believe that SWIM can be used in further research and practice to follow the progress of swimmers.

  20. High intra- and inter-rater chance variation of the movement assessment battery for children 2, ageband 2.

    Science.gov (United States)

    Holm, Inger; Tveter, Anne Therese; Aulie, Vibeke Smith; Stuge, Britt

    2013-02-01

    The aim of the present study was to evaluate the intra- and inter-tester reliability of the movement assessment battery for children-second edition (MABC-2), ageband 2. We wanted to analyze the collected data, with adequate statistical methods, to provide relevant recommendations for physical therapists who are interpreting changes in the context of daily clinical practice. Forty-five healthy children, 23 girls and 22 boys with a mean age of 8.7±0.7 years, participated in the study, the inter-tester procedures were performed the same day and the intra-tester procedures within a one to two week interval. The statistical methods used were intra-class correlation coefficient (ICC), standard error of measurement (SEM), and smallest detectable change (SDC). The children had no failed items during the tests. The ICC values ranged from 0.23 to 0.76. The items "treading lace" and "one-board balance" showed the highest measurement errors both for the intra- and inter-rater reliability. The SDC(90%) values were 9.7 and 18.5 for the intra- and inter-rater reliability, respectively. The present study showed high intra- and inter-rater chance variation MABC-2, ageband 2. A change of more than ±9.7 and ±18.5 on the total test score (TTS) should be required to state (with a 90% confidence) that a real change in a single individual has occurred, for intra- and inter-rater testing, respectively. These findings may indicate that the MABC-2 might be more suitable for diagnostic or clinical decision making purposes, than for evaluation of change over time. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Inter-Rater Reliability of Historical Data Collected by Non-Medical Research Assistants and Physicians in Patients with Acute Abdominal Pain

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    Mills, Angela M

    2009-02-01

    Full Text Available OBJECTIVES: In many academic emergency departments (ED, physicians are asked to record clinical data for research that may be time consuming and distracting from patient care. We hypothesized that non-medical research assistants (RAs could obtain historical information from patients with acute abdominal pain as accurately as physicians.METHODS: Prospective comparative study conducted in an academic ED of 29 RAs to 32 resident physicians (RPs to assess inter-rater reliability in obtaining historical information in abdominal pain patients. Historical features were independently recorded on standardized data forms by a RA and RP blinded to each others' answers. Discrepancies were resolved by a third person (RA who asked the patient to state the correct answer on a third questionnaire, constituting the "criterion standard." Inter-rater reliability was assessed using kappa statistics (kappa and percent crude agreement (CrA.RESULTS: Sixty-five patients were enrolled (mean age 43. Of 43 historical variables assessed, the median agreement was moderate (kappa 0.59 [Interquartile range 0.37-0.69]; CrA 85.9% and varied across data categories: initial pain location (kappa 0.61 [0.59-0.73]; CrA 87.7%, current pain location (kappa 0.60 [0.47-0.67]; CrA 82.8%, past medical history (kappa 0.60 [0.48-0.74]; CrA 93.8%, associated symptoms (kappa 0.38 [0.37-0.74]; CrA 87.7%, and aggravating/alleviating factors (kappa 0.09 [-0.01-0.21]; CrA 61.5%. When there was disagreement between the RP and the RA, the RA more often agreed with the criterion standard (64% [55-71%] than the RP (36% [29-45%].CONCLUSION: Non-medical research assistants who focus on clinical research are often more accurate than physicians, who may be distracted by patient care responsibilities, at obtaining historical information from ED patients with abdominal pain.

  2. Inter-rater reliability in the classification of supraspinatus tendon tears using 3D ultrasound – a question of experience?

    Directory of Open Access Journals (Sweden)

    Giorgio Tamborrini

    2016-09-01

    Full Text Available Background: Three-dimensional (3D ultrasound of the shoulder is characterized by a comparable accuracy to two-dimensional (2D ultrasound. No studies investigating 2D versus 3D inter-rater reliability in the detection of supraspinatus tendon tears taking into account the level of experience of the raters have been carried out so far. Objectives: The aim of this study was to determine the inter-rater reliability in the analysis of 3D ultrasound image sets of the supraspinatus tendon between sonographer with different levels of experience. Patients and methods: Non-interventional, prospective, observational pilot study of 2309 images of 127 adult patients suffering from unilateral shoulder pain. 3D ultrasound image sets were scored by three raters independently. The intra-and interrater reliabilities were calculated. Results: There was an excellent intra-rater reliability of rater A in the overall classification of supraspinatus tendon tears (2D vs 3D κ = 0.892, pairwise reliability 93.81%, 3D scoring round 1 vs 3D scoring round 2 κ = 0.875, pairwise reliability 92.857%. The inter-rater reliability was only moderate compared to rater B on 3D (κ = 0.497, pairwise reliability 70.95% and fair compared to rater C (κ = 0.238, pairwise reliability 42.38%. Conclusions: The reliability of 3D ultrasound of the supraspinatus tendon depends on the level of experience of the sonographer. Experience in 2D ultrasound does not seem to be sufficient for the analysis of 3D ultrasound imaging sets. Therefore, for a 3D ultrasound analysis new diagnostic criteria have to be established and taught even to experienced 2D sonographers to improve reproducibility.

  3. Translation, adaptation and inter-rater reliability of the administration manual for the Fugl-Meyer assessment.

    Science.gov (United States)

    Michaelsen, Stella M; Rocha, André S; Knabben, Rodrigo J; Rodrigues, Luciano P; Fernandes, Claudia G C

    2011-01-01

    Recently, the reliability of the Brazilian version of the Fugl-Meyer Assessment (FMA) was assessed through the scoring given according to observations made by a single evaluator who applied the test. When different raters apply the scale, the reliability may depend on the interpretation given to the assessment sheet. In such cases, a clear administration manual is essential for ensuring homogeneity of application. To translate and adapt the French Canadian version of the FMA administration manual into Brazilian Portuguese and to evaluate the inter-rater reliability when different evaluators apply the FMA on the basis of the information contained in the manual. Eighteen adults (59±10 years) with chronic hemiparesis (38±35 months after a stroke) took part in this study. Eight patients participated in the first part of the study and 10 in the second part. Based on analyzing the results from part 1, an adapted version was developed, in which information and photos were added to illustrate the positions of the patient and evaluator. The inter-rater reliability was assessed using the intraclass correlation coefficient (ICC). The reliability of the FMA based on the adapted version of the manual was excellent for the total motor scores for the upper limbs (ICC=0.98) and lower limbs (ICC=0.90), as well as for movement sense (ICC=0.98) and upper and lower-limb passive range of motion (ICC=0.84 and 0.90, respectively). The reliability was moderate for tactile sensitivity (0.75). The joint pain assessment presented low reliability. The results showed that, except for pain assessment, application of the FMA based on the adapted version of the application manual for Brazilian Portuguese presented adequate inter-rater reliability.

  4. Validity and inter-rater reliability of medio-lateral knee motion observed during a single-limb mini squat

    DEFF Research Database (Denmark)

    Ageberg, Eva; Bennell, Kim L; Hunt, Michael A

    2010-01-01

    , such as the medio-lateral knee motion may also be important. The aim was to validate an observational clinical test of assessing the medio-lateral knee motion, using a three-dimensional (3-D) motion analysis system. In addition, the inter-rater reliability was evaluated.......Muscle function may influence the risk of knee injury and outcomes following injury. Clinical tests, such as a single-limb mini squat, resemble conditions of daily life and are easy to administer. Fewer squats per 30 seconds indicate poorer function. However, the quality of movement...

  5. Effects of Rating Training on Inter-Rater Consistency for Developing a Dental Hygiene Clinical Rater Qualification System

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    Jeong Ran Park

    2007-12-01

    Full Text Available We tried to develop itemized evaluation criteria and a clinical rater qualification system through rating training of inter-rater consistency for experienced clinical dental hygienists and dental hygiene clinical educators. A total of 15 clinical dental hygienists with 1-year careers participated as clinical examination candidates, while 5 dental hygienists with 3-year educations and clinical careers or longer participated as clinical raters. They all took the clinical examination as examinees. The results were compared, and the consistency of competence was measured. The comparison of clinical competence between candidates and clinical raters showed that the candidate group?占퐏 mean clinical competence ranged from 2.96 to 3.55 on a 5-point system in a total of 3 instruments (Probe, Explorer, Curet, while the clinical rater group?占퐏 mean clinical competence ranged from 4.05 to 4.29. There was a higher inter-rater consistency after education of raters in the following 4 items: Probe, Explorer, Curet, and insertion on distal surface. The mean score distribution of clinical raters ranged from 75% to 100%, which was more uniform in the competence to detect an artificial calculus than that of candidates (25% to 100%. According to the above results, there was a necessity in the operating clinical rater qualification system for comprehensive dental hygiene clinicians. Furthermore, in order to execute the clinical rater qualification system, it will be necessary to keep conducting a series of studies on educational content, time, frequency, and educator level.

  6. Inter-Rater Reliability of Preprocessing EEG Data: Impact of Subjective Artifact Removal on Associative Memory Task ERP Results

    Directory of Open Access Journals (Sweden)

    Steven D. Shirk

    2017-06-01

    Full Text Available The processing of EEG data routinely involves subjective removal of artifacts during a preprocessing stage. Preprocessing inter-rater reliability (IRR and how differences in preprocessing may affect outcomes of primary event-related potential (ERP analyses has not been previously assessed. Three raters independently preprocessed EEG data of 16 cognitively healthy adult participants (ages 18–39 years who performed a memory task. Using intraclass correlations (ICCs, IRR was assessed for Early-frontal, Late-frontal, and Parietal Old/new memory effects contrasts across eight regions of interest (ROIs. IRR was good to excellent for all ROIs; 22 of 26 ICCs were above 0.80. Raters were highly consistent in preprocessing across ROIs, although the frontal pole ROI (ICC range 0.60–0.90 showed less consistency. Old/new parietal effects had highest ICCs with the lowest variability. Rater preprocessing differences did not alter primary ERP results. IRR for EEG preprocessing was good to excellent, and subjective rater-removal of EEG artifacts did not alter primary memory-task ERP results. Findings provide preliminary support for robustness of cognitive/memory task-related ERP results against significant inter-rater preprocessing variability and suggest reliability of EEG to assess cognitive-neurophysiological processes multiple preprocessors are involved.

  7. Inter-rater and intra-rater reliability outcomes of a rapid bacteria counting system with pressure ulcer samples.

    Science.gov (United States)

    Nakagami, G; Mori, M; Yoshida, M; Kitamura, A; Hayashi, A; Miyagaki, T; Sasaki, S; Sugama, J; Sanada, H

    2017-02-01

    Evaluating bacterial load in pressure ulcers (PUs) is key to combat infection; therefore, using technologies to measure bacterial count can be particularly useful. A rapid bacteria counting system was recently developed and introduced to the wound care field. However, its reliability was not established. This cross-sectional study aimed to evaluate the inter-rater and intra-rater reliability of bacterial count using this rapid counting system. We took bacterial swabs from patients with category I or greater PUs to assess inter- and intra-rater reliability. An assessor swabbed the longest axis of the PU once and bacterial counts were measured using a rapid bacteria counting system. To confirm the inter-rater and intra-rater reliability, intraclass correlation coefficients (ICCs) were calculated. We took 63 and 57 pairs of bacterial counts from 13 patients with 16 category I or greater PUs to assess inter- and intra-rater reliability, respectively. Overall ICCs [95% confidence intervals (CI)] for the bacterial counts were 0.83 [0.73-0.90, pcounting bacterial numbers in PU sites was confirmed. The results should encourage clinicians and researchers to use this type of device for the real-time assessment of wound bacterial bioburden at the patient's bedside.

  8. An Icelandic version of the Kiddie-SADS-PL: translation, cross-cultural adaptation and inter-rater reliability.

    Science.gov (United States)

    Lauth, Bertrand; Magnusson, Pall; Ferrari, Pierre; Pétursson, Hannes

    2008-01-01

    The development of structured diagnostic instruments has been an important step for research in child and adolescent psychiatry, but the adequacy of a diagnostic instrument in a given culture does not guarantee its reliability or validity in another population. The objective of the study was to describe the process of cross-cultural adaptation into Icelandic of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (Kiddie-SADS-PL) and to test the inter-rater reliability of the adapted version. To attain cross-cultural equivalency, five important dimensions were addressed: semantic, technical, content, criterion and conceptual. The adapted Icelandic version was introduced into an inpatient clinical setting, and inter-rater reliability was estimated both at the symptom and diagnoses level, for the most frequent diagnostic categories in both international diagnostic classification systems (DSM-IV and ICD-10). The cross-cultural adaptation has provided an Icelandic version allowing similar understanding among different raters and has achieved acceptable cross-cultural equivalence. This initial study confirmed the quality of the translation and adaptation of Kiddie-SADS-PL and constitutes the first step of a larger validation study of the Icelandic version of the instrument.

  9. Inter-rater Reliability of the Dysphagia Outcome and Severity Scale (DOSS): Effects of Clinical Experience, Audio-Recording and Training.

    Science.gov (United States)

    Zarkada, Angeliki; Regan, Julie

    2017-10-19

    The Dysphagia Outcome and Severity Scale (DOSS) is widely used to measure dysphagia severity based on videofluoroscopy (VFSS). This study investigated inter-rater reliability (IRR) of the DOSS. It also determined the effect of clinical experience, VFSS audio-recording and training on DOSS IRR. A quantitative prospective research design was used. Seventeen speech and language pathologists (SLPs) were recruited from an acute teaching hospital, Dublin (> 3 years' VFSS experience, n = 10) and from a postgraduate dysphagia programme in a university setting (audio-recording). Each VFSS clip was independently rated using the DOSS scale. Four weeks later, the less experienced group attended a 1-h training session on DOSS rating after which DOSS IRR was re-tested. Cohen's kappa co-efficient was used to establish IRR. IRR of the DOSS presented only fair agreement (κ = 0.36, p audio-recording (κ = 0.287) compared to VFSS clips without audio-recording (κ = - 0.0395) (p < 0.05). IRR of the DOSS pre-training (κ = 0.328) was significantly better comparing to post-training (κ = 0.218) (p < 0.05). Findings raise concerns as the DOSS is frequently used in clinical practice to capture dysphagia severity and to monitor changes.

  10. Intra- and inter-rater reliability of maximum inspiratory pressure measured using a portable capsule-sensing pressure gauge device in healthy adults.

    Science.gov (United States)

    Jalan, Nikita S; Daftari, Sonam S; Retharekar, Seemi S; Rairikar, Savita A; Shyam, Ashok M; Sancheti, Parag K

    2015-01-01

    Measurement of maximum inspiratory pressure is the most prevalent method used in clinical practice to assess the strength of the inspiratory muscles. Although there are many devices available for the assessment of inspiratory muscle strength, there is a dearth of literature describing the reliability of devices that can be used in clinical patient assessment. The capsule-sensing pressure gauge (CSPG-V) is a new tool that measures the strength of inspiratory muscles; it is easy to use, noninvasive, inexpensive and lightweight. To test the intra- and inter-rater reliability of a CSPG-V device in healthy adults. A cross-sectional study involving 80 adult subjects with a mean (± SD) age of 22±3 years was performed. Using simple randomization, 40 individuals (20 male, 20 female) were used for intrarater and 40 (20 male, 20 female) were used for inter-rater reliability testing of the CSPG-V device. The subjects performed three inspiratory efforts, which were sustained for at least 3 s; the best of the three readings was used for intra- and inter-rater comparison. The intra- and inter-rater reliability were calculated using intraclass correlation coefficients (ICCs). The intrarater reliability ICC was 0.962 and the inter-rater reliability ICC was 0.922. Results of the present study suggest that maximum inspiratory pressure measured using a CSPG-V device has excellent intraand inter-rater reliability, and can be used as a diagnostic and prognostic tool in patients with respiratory muscle impairment.

  11. A COMPARATIVE STUDY ON THE INTER-RATER RELIABILITY OF THE ASHWORTH SCALES IN ASSESSMENT OF SPASTICITY

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    N. Nakhostin-Ansari

    2006-08-01

    Full Text Available Ashworth and modified Ashworth scales are the most widely used tests to assess the severity of muscle spasticity. These clinical scales offer qualitative and subjective information and consequently there are issues concerning reliability when two or more clinicians are involved in assessment of spasticity. This article presents the result of a study assessing inter-rater reliability of the original and of the modified Ashworth scales for the assessment of elbow flexor muscle spasticity in patients with hemiplegia. Thirteen patients with hemiplegia (8 men and 5 women participated in this study. Two physiotherapists rated the muscle tone of elbow flexors according to the original and to the modified Ashworth scales. Each patient was assessed during a single session in a supine position on a bed with the arms at the sides of the body. Movements were performed three times by each assessor. No discussion of the results between the assessors occurred during the course of the study to ensure they were blind to each others’ results. Kappa values for the original Ashworth and the modified Ashworth scales were 0.22 (SE 0.27, P = 0.43 and 0.24 (SE 0.23, P = 0.24, respectively. The modified Ashworth scale was slightly more reliable than was the original scale but this difference was not significant (P > 0.05. Inter-rater reliability of the original and of the modified Ashworth scales in the assessment of elbow flexor spasticity was poor and therefore these spasticity scales may not be valid.

  12. Improving Teacher Selection: The Effect of Inter-Rater Reliability in the Screening Process. CEDR Working Paper. WP #2015-7

    Science.gov (United States)

    Martinkova, Patricia; Goldhaber, Dan

    2015-01-01

    Inter-rater reliability, commonly assessed by intra-class correlation coefficient ICC, is an important index for describing the extent to which there is consistency amongst two or more raters in assigned measures. In organizational research, the data structure is often hierarchical and designs deviate substantially from the ideal of a balanced…

  13. Excellent test-retest and inter-rater reliability for Tardieu Scale measurements with inertial sensors in elbow flexors of stroke patients.

    Science.gov (United States)

    Paulis, Winifred D; Horemans, Herwin L D; Brouwer, Betty S; Stam, Henk J

    2011-02-01

    Spasticity is often clinically assessed with the Tardieu Scale, using goniometry to measure the range of motion and angle of catch. However, the test-retest and inter-rater reliability of these measurements have been questioned. Inertial sensors (IS) have been developed to measure orientation in space and are suggested to be a more appropriate tool than goniometry to measure angles in Tardieu Scale measurements. To compare the test-retest and inter-rater reliability of Tardieu Scale scores measured with IS and goniometry. Two physiotherapists performed Tardieu Scale measurements in two sessions, using both goniometry and IS, to quantify spasticity in elbow flexors of 13 stroke patients. For goniometry, test-retest and inter-rater reliability proved to be excellent (ICC 0.86) and fair to good (ICC 0.66), respectively. For IS, both test-retest (ICC 0.76) and inter-rater reliability (ICC 0.84) were excellent. Inertial sensors are reliable and accurate to use in Tardieu Scale measurements to quantify spasticity in the elbow flexors of hemiplegic stroke patients. Copyright © 2010 Elsevier B.V. All rights reserved.

  14. Intra- and Inter-Rater Reliability of the Rate of Force Development of Hip Abductor Muscles Measured by Hand-Held Dynamometer

    Science.gov (United States)

    Takeda, Kazuya; Tanabe, Shigeo; Koyama, Soichiro; Nagai, Tomoko; Sakurai, Hiroaki; Kanada, Yoshikiyo; Shomoto, Koji

    2018-01-01

    The aim of this study was to clarify the intra- and inter-rater reliability of the rate of force development in hip abductor muscle force measurements using a hand-held dynamometer. Thirty healthy adults were separately assessed by two independent raters on two separate days. Rate of force development was calculated from the slope of the…

  15. Inter-Rater Reliability and Concurrent Validity of the Goodenough-Harris and McCarthy Draw-A-Child Scoring Systems.

    Science.gov (United States)

    Naglieri, Jack A.; Maxwell, Susanna

    1981-01-01

    Inter-rater reliability of the Goodenough-Harris and McCarthy Draw-A-Child scoring systems was examined for a sample of 60 children, including 20 school-labeled learning disabled, 20 mentally retarded, and 20 normal children between the ages of six and eight-and-one-half years. (Author)

  16. Inter-Rater Reliability and Agreement of the 6-Minute Walk Test in Women With Hip Fracture

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Overgaard, Jan; Tange Kristensen, Morten

    MWT in individuals with hip fractures. Methods: Two senior physiotherapy students independently examined (randomized order) a convenient sample of 20 participants; their assessments were separated by two days, and testing followed instructions from the American Thoracic Society(1). Hip pain...

  17. Inter-rater reliability and agreement of the 6-minute walk test in females with hip fractures

    DEFF Research Database (Denmark)

    Overgaard, Jan; Larsen, Camilla Marie; Tange Kristensen, Morten

    physiotherapy students independently examined (randomized order) a convenient sample of 20 participants; their assessments were separated by two days, and testing followed instructions from the American Thoracic Society. Hip pain was assessed with the Verbal Ranking Scale. Participants (all women) with a mean...

  18. IBZM SPECT and FDG PET in the differential diagnosis of Parkinsonian syndromes. Comparison with respect to inter-rater agreement

    DEFF Research Database (Denmark)

    Derlin, T; Afzal, W; Wilke, F

    2010-01-01

    Aim: Both IBZM SPECT and FDG PET may be used for differentiation between Parkinson's disease (PD) and atypical neurodegenerative parkinsonian syndromes (APS). However, there are only very limited data of both modalities in the same subjects. The present study compared both modalities with respect...

  19. Assessing and quantifying inter-rater variation for dichotomous ratings using a Rasch model

    DEFF Research Database (Denmark)

    Petersen, Jørgen Holm; Larsen, Klaus; Kreiner, Svend

    2010-01-01

    We present a new model-based approach to the analysis of agreement between raters in a situation where all raters have supplied dichotomous ratings of the same cases in a sample. The model is a logistic regression model with random effects - a Rasch model. In the rater setting, the Rasch model...... includes parameters that allow raters to have different propensities to score a given set of individuals positively or negatively - the rater bias. An exact score test of the hypothesis of no rater bias is proposed and is shown to be an exact generalised McNemar's test. Based on the model, we suggest...

  20. The inter-rater reliability of a standardised classification system for pregnancy-related lumbopelvic pain.

    Science.gov (United States)

    Gutke, Annelie; Kjellby-Wendt, Gunilla; Oberg, Birgitta

    2010-02-01

    Pregnancy-related lumbopelvic pain has varying clinical presentations and effects among subgroups. Different lumbopelvic pain subgroups require different specific management approaches which require the differentiation between lumbar and pelvic girdle pain (PGP). Thirty-one consecutive pregnant women with non-specific lumbopelvic pain were evaluated by two examiners and classified into lumbar pain, PGP, or combined pelvic girdle and lumbar pain. A standard history about different positions/activities of daily life such as bending, sitting, standing, walking, and lying, was followed by a standardised mechanical assessment of the lumbar spine (Mechanical Diagnosis and Therapy), including tests of repeated end-range movements to standing and lying, pelvic pain provocation tests (distraction test, posterior pelvic pain provocation test, Gaenslen's test, compression test, and sacral thrust) a hip-rotation range-of-motion test, the active straight-leg-raising test, and a neurological examination. Agreement for the three syndromes (lumbar pain, PGP, or combined pelvic girdle and lumbar pain) was 87% (27/31), with a kappa coefficient of 0.79 (95% CI 0.60-0.98). It was possible to perform the classification procedure throughout pregnancy. There was substantial agreement between the two examiners for the classification of non-specific lumbopelvic pain into lumbar pain and PGP in pregnant women.

  1. Analyses of inter-rater reliability between professionals, medical students and trained school children as assessors of basic life support skills.

    Science.gov (United States)

    Beck, Stefanie; Ruhnke, Bjarne; Issleib, Malte; Daubmann, Anne; Harendza, Sigrid; Zöllner, Christian

    2016-10-07

    Training of lay-rescuers is essential to improve survival-rates after cardiac arrest. Multiple campaigns emphasise the importance of basic life support (BLS) training for school children. Trainings require a valid assessment to give feedback to school children and to compare the outcomes of different training formats. Considering these requirements, we developed an assessment of BLS skills using MiniAnne and tested the inter-rater reliability between professionals, medical students and trained school children as assessors. Fifteen professional assessors, 10 medical students and 111-trained school children (peers) assessed 1087 school children at the end of a CPR-training event using the new assessment format. Analyses of inter-rater reliability (intraclass correlation coefficient; ICC) were performed. Overall inter-rater reliability of the summative assessment was high (ICC = 0.84, 95 %-CI: 0.84 to 0.86, n = 889). The number of comparisons between peer-peer assessors (n = 303), peer-professional assessors (n = 339), and peer-student assessors (n = 191) was adequate to demonstrate high inter-rater reliability between peer- and professional-assessors (ICC: 0.76), peer- and student-assessors (ICC: 0.88) and peer- and other peer-assessors (ICC: 0.91). Systematic variation in rating of specific items was observed for three items between professional- and peer-assessors. Using this assessment and integrating peers and medical students as assessors gives the opportunity to assess hands-on skills of school children with high reliability.

  2. Test-re-test reliability and inter-rater reliability of a digital pelvic inclinometer in young, healthy males and females.

    Science.gov (United States)

    Beardsley, Chris; Egerton, Tim; Skinner, Brendon

    2016-01-01

    Objective. The purpose of this study was to investigate the reliability of a digital pelvic inclinometer (DPI) for measuring sagittal plane pelvic tilt in 18 young, healthy males and females. Method. The inter-rater reliability and test-re-test reliabilities of the DPI for measuring pelvic tilt in standing on both the right and left sides of the pelvis were measured by two raters carrying out two rating sessions of the same subjects, three weeks apart. Results. For measuring pelvic tilt, inter-rater reliability was designated as good on both sides (ICC = 0.81-0.88), test-re-test reliability within a single rating session was designated as good on both sides (ICC = 0.88-0.95), and test-re-test reliability between two rating sessions was designated as moderate on the left side (ICC = 0.65) and good on the right side (ICC = 0.85). Conclusion. Inter-rater reliability and test-re-test reliability within a single rating session of the DPI in measuring pelvic tilt were both good, while test-re-test reliability between rating sessions was moderate-to-good. Caution is required regarding the interpretation of the test-re-test reliability within a single rating session, as the raters were not blinded. Further research is required to establish validity.

  3. Validity and inter-rater reliability of medio-lateral knee motion observed during a single-limb mini squat

    Directory of Open Access Journals (Sweden)

    Simic Milena

    2010-11-01

    Full Text Available Abstract Background Muscle function may influence the risk of knee injury and outcomes following injury. Clinical tests, such as a single-limb mini squat, resemble conditions of daily life and are easy to administer. Fewer squats per 30 seconds indicate poorer function. However, the quality of movement, such as the medio-lateral knee motion may also be important. The aim was to validate an observational clinical test of assessing the medio-lateral knee motion, using a three-dimensional (3-D motion analysis system. In addition, the inter-rater reliability was evaluated. Methods Twenty-five (17 women non-injured participants (mean age 25.6 years, range 18-37 were included. Visual analysis of the medio-lateral knee motion, scored as knee-over-foot or knee-medial-to-foot by two raters, and 3-D kinematic data were collected simultaneously during a single-limb mini squat. Frontal plane 2-D peak tibial, thigh, and knee varus-valgus angles, and 3-D peak hip internal-external rotation, and knee varus-valgus angles were calculated. Results Ten subjects were scored as having a knee-medial-to-foot position and 15 subjects a knee-over-foot position assessed by visual inspection. In 2-D, the peak tibial angle (mean 89.0 (SE 0.7 vs mean 86.3 (SE 0.4 degrees, p = 0.001 and peak thigh angle (mean 77.4 (SE 1.0 vs mean 81.2 (SE 0.5 degrees, p = 0.001 with respect to the horizontal, indicated that the knee was more medially placed than the ankle and thigh, respectively. Thus, the knee was in more valgus (mean 11.6 (SE 1.5 vs 5.0 (SE 0.8 degrees, p 0.90 and 96 between raters. Conclusions Medio-lateral motion of the knee can reliably be assessed during a single-leg mini-squat. The test is valid in 2-D, while the actual movement, in 3-D, is mainly exhibited as increased internal hip rotation. The single-limb mini squat is feasible and easy to administer in the clinical setting and in research to address lower extremity movement quality.

  4. Inter-rater variability of visual interpretation and comparison with quantitative evaluation of 11C-PiB PET amyloid images of the Japanese Alzheimer's Disease Neuroimaging Initiative (J-ADNI) multicenter study

    International Nuclear Information System (INIS)

    Yamane, Tomohiko; Ishii, Kenji; Sakata, Muneyuki; Ikari, Yasuhiko; Nishio, Tomoyuki; Ishii, Kazunari; Kato, Takashi; Ito, Kengo; Senda, Michio

    2017-01-01

    The aim of this study was to assess the inter-rater variability of the visual interpretation of 11 C-PiB PET images regarding the positivity/negativity of amyloid deposition that were obtained in a multicenter clinical research project, Japanese Alzheimer's Disease Neuroimaging Initiative (J-ADNI). The results of visual interpretation were also compared with a semi-automatic quantitative analysis using mean cortical standardized uptake value ratio to the cerebellar cortex (mcSUVR). A total of 162 11 C-PiB PET scans, including 45 mild Alzheimer's disease, 60 mild cognitive impairment, and 57 normal cognitive control cases that had been acquired as J-ADNI baseline scans were analyzed. Based on visual interpretation by three independent raters followed by consensus read, each case was classified into positive, equivocal, and negative deposition (ternary criteria) and further dichotomized by merging the former two (binary criteria). Complete agreement of visual interpretation by the three raters was observed for 91.3% of the cases (Cohen κ = 0.88 on average) in ternary criteria and for 92.3% (κ = 0.89) in binary criteria. Cases that were interpreted as visually positive in the consensus read showed significantly higher mcSUVR than those visually negative (2.21 ± 0.37 vs. 1.27 ± 0.09, p < 0.001), and positive or negative decision by visual interpretation was dichotomized by a cut-off value of mcSUVR = 1.5. Significant positive/negative associations were observed between mcSUVR and the number of raters who evaluated as positive (ρ = 0.87, p < 0.0001) and negative (ρ = -0.85, p < 0.0001) interpretation. Cases of disagreement among raters showed generally low mcSUVR. Inter-rater agreement was almost perfect in 11 C-PiB PET scans. Positive or negative decision by visual interpretation was dichotomized by a cut-off value of mcSUVR = 1.5. As some cases of disagreement among raters tended to show low mcSUVR, referring to quantitative method may facilitate

  5. Development, inter-rater reliability and feasibility of a checklist to assess implementation (Ch-IMP) in systematic reviews: the case of provider-based prevention and treatment programs targeting children and youth.

    Science.gov (United States)

    Cargo, Margaret; Stankov, Ivana; Thomas, James; Saini, Michael; Rogers, Patricia; Mayo-Wilson, Evan; Hannes, Karin

    2015-09-07

    Several papers report deficiencies in the reporting of information about the implementation of interventions in clinical trials. Information about implementation is also required in systematic reviews of complex interventions to facilitate the translation and uptake of evidence of provider-based prevention and treatment programs. To capture whether and how implementation is assessed within systematic effectiveness reviews, we developed a checklist for implementation (Ch-IMP) and piloted it in a cohort of reviews on provider-based prevention and treatment interventions for children and young people. This paper reports on the inter-rater reliability, feasibility and reasons for discrepant ratings. Checklist domains were informed by a framework for program theory; items within domains were generated from a literature review. The checklist was pilot-tested on a cohort of 27 effectiveness reviews targeting children and youth. Two raters independently extracted information on 47 items. Inter-rater reliability was evaluated using percentage agreement and unweighted kappa coefficients. Reasons for discrepant ratings were content analysed. Kappa coefficients ranged from 0.37 to 1.00 and were not influenced by one-sided bias. Most kappa values were classified as excellent (n = 20) or good (n = 17) with a few items categorised as fair (n = 7) or poor (n = 1). Prevalence-adjusted kappa coefficients indicate good or excellent agreement for all but one item. Four areas contributed to scoring discrepancies: 1) clarity or sufficiency of information provided in the review; 2) information missed in the review; 3) issues encountered with the tool; and 4) issues encountered at the review level. Use of the tool demands time investment and it requires adjustment to improve its feasibility for wider use. The case of provider-based prevention and treatment interventions showed relevancy in developing and piloting the Ch-IMP as a useful tool for assessing the extent to

  6. Inter-rater variability of visual interpretation and comparison with quantitative evaluation of {sup 11}C-PiB PET amyloid images of the Japanese Alzheimer's Disease Neuroimaging Initiative (J-ADNI) multicenter study

    Energy Technology Data Exchange (ETDEWEB)

    Yamane, Tomohiko [Saitama Medical University Saitama International Center, Department of Nuclear Medicine, Hidaka (Japan); Institute of Biomedical Research and Innovation, Division of Molecular Imaging, Kobe (Japan); Tokyo Metropolitan Institute of Gerontology, Team for Neuroimaging Research, Tokyo (Japan); Ishii, Kenji; Sakata, Muneyuki [Tokyo Metropolitan Institute of Gerontology, Team for Neuroimaging Research, Tokyo (Japan); Ikari, Yasuhiko; Nishio, Tomoyuki [Institute of Biomedical Research and Innovation, Division of Molecular Imaging, Kobe (Japan); Research Association for Biotechnology, Tokyo (Japan); Ishii, Kazunari [Kinki University Hospital, Department of Radiology, Osaka, Sayama (Japan); Kato, Takashi; Ito, Kengo [National Center for Geriatrics and Gerontology, Department of Brain Science and Molecular Imaging, Obu (Japan); Senda, Michio [Institute of Biomedical Research and Innovation, Division of Molecular Imaging, Kobe (Japan); Collaboration: J-ADNI Study Group

    2017-05-15

    The aim of this study was to assess the inter-rater variability of the visual interpretation of {sup 11}C-PiB PET images regarding the positivity/negativity of amyloid deposition that were obtained in a multicenter clinical research project, Japanese Alzheimer's Disease Neuroimaging Initiative (J-ADNI). The results of visual interpretation were also compared with a semi-automatic quantitative analysis using mean cortical standardized uptake value ratio to the cerebellar cortex (mcSUVR). A total of 162 {sup 11}C-PiB PET scans, including 45 mild Alzheimer's disease, 60 mild cognitive impairment, and 57 normal cognitive control cases that had been acquired as J-ADNI baseline scans were analyzed. Based on visual interpretation by three independent raters followed by consensus read, each case was classified into positive, equivocal, and negative deposition (ternary criteria) and further dichotomized by merging the former two (binary criteria). Complete agreement of visual interpretation by the three raters was observed for 91.3% of the cases (Cohen κ = 0.88 on average) in ternary criteria and for 92.3% (κ = 0.89) in binary criteria. Cases that were interpreted as visually positive in the consensus read showed significantly higher mcSUVR than those visually negative (2.21 ± 0.37 vs. 1.27 ± 0.09, p < 0.001), and positive or negative decision by visual interpretation was dichotomized by a cut-off value of mcSUVR = 1.5. Significant positive/negative associations were observed between mcSUVR and the number of raters who evaluated as positive (ρ = 0.87, p < 0.0001) and negative (ρ = -0.85, p < 0.0001) interpretation. Cases of disagreement among raters showed generally low mcSUVR. Inter-rater agreement was almost perfect in {sup 11}C-PiB PET scans. Positive or negative decision by visual interpretation was dichotomized by a cut-off value of mcSUVR = 1.5. As some cases of disagreement among raters tended to show low mcSUVR, referring to quantitative method may

  7. The Statin-Associated Muscle Symptom Clinical Index (SAMS-CI): Revision for Clinical Use, Content Validation, and Inter-rater Reliability.

    Science.gov (United States)

    Rosenson, Robert S; Miller, Kate; Bayliss, Martha; Sanchez, Robert J; Baccara-Dinet, Marie T; Chibedi-De-Roche, Daniela; Taylor, Beth; Khan, Irfan; Manvelian, Garen; White, Michelle; Jacobson, Terry A

    2017-04-01

    The Statin-Associated Muscle Symptom Clinical Index (SAMS-CI) is a method for assessing the likelihood that a patient's muscle symptoms (e.g., myalgia or myopathy) were caused or worsened by statin use. The objectives of this study were to prepare the SAMS-CI for clinical use, estimate its inter-rater reliability, and collect feedback from physicians on its practical application. For content validity, we conducted structured in-depth interviews with its original authors as well as with a panel of independent physicians. Estimation of inter-rater reliability involved an analysis of 30 written clinical cases which were scored by a sample of physicians. A separate group of physicians provided feedback on the clinical use of the SAMS-CI and its potential utility in practice. Qualitative interviews with providers supported the content validity of the SAMS-CI. Feedback on the clinical use of the SAMS-CI included several perceived benefits (such as brevity, clear wording, and simple scoring process) and some possible concerns (workflow issues and applicability in primary care). The inter-rater reliability of the SAMS-CI was estimated to be 0.77 (confidence interval 0.66-0.85), indicating high concordance between raters. With additional provider feedback, a revised SAMS-CI instrument was created suitable for further testing, both in the clinical setting and in prospective validation studies. With standardized questions, vetted language, easily interpreted scores, and demonstrated reliability, the SAMS aims to estimate the likelihood that a patient's muscle symptoms were attributable to statins. The SAMS-CI may support better detection of statin-associated muscle symptoms in clinical practice, optimize treatment for patients experiencing muscle symptoms, and provide a useful tool for further clinical research.

  8. The Correlation between Modified Ashworth Scale and Biceps T-reflex and Inter-rater and Intra-rater Reliability of Biceps T-reflex.

    Science.gov (United States)

    Min, Ji Hong; Shin, Yong-Il; Joa, Kyung Lim; Ko, Sung Hwa; Shin, Myung Jun; Chang, Jae Hyeok; Ko, Hyun-Yoon

    2012-08-01

    To establish a correlation between the modified Ashworth scale (MAS) and amplitude and latency of T-reflex and to demonstrate inter-rater and intra-rater reliability of the T-reflex of the biceps muscle for assessing spasticity after stroke. A total of 21 patients with hemiplegia and spasticity after ischemic stroke were enrolled for this study. The spasticity of biceps muscle was evaluated by an occupational therapist using the MAS. The mean value of manual muscle test of biceps muscles was 2.3±0.79. Latency and amplitude of T-reflex were recorded from biceps muscles by two physicians. The onset latency and peak to peak amplitude of the mean of 5 big T-reflex were measured. The examinations were carried out by two physicians at the same time to evaluate the inter-rater reliability. Further, one of the physicians performed the examination again after one week to evaluate the intra-rater reliability. The correlations between MAS and T-reflex, and the intra- and inter-rater reliability of biceps T-reflex were established by calculating the Spearman correlation coefficients and the intra-class correlation coefficients (ICCs). Amplitude of the biceps T-reflex increased with increasing level of MAS (r(s)=0.464 and 0.573, respectively, p<0.01). ICCs of latency and amplitude of biceps T-reflex were 0.914 and 0.822. The Spearman correlation coefficients of latency and amplitude of biceps T-reflex were 0.937 and 0.635, respectively (p<0.01). Biceps T-reflex demonstrates a good quantitative measurement and correlation tool with MAS for spasticity, and also shows acceptable inter- and intra-rater reliability, which can be used for patients with spasticity after stroke.

  9. Inter-rater Reliability on the Individual Music-Centered Assessment Profile forNeurodevelopmental Disorders: (IMCAP-ND) for Autism Spectrum Disorder

    DEFF Research Database (Denmark)

    Carpente, John; Manne, Stela; Gattino, Gustavo

    2018-01-01

    scores; and c) to examine the inter-rater reliabilities of the weighted overall MCPS and MRS scores Methods: Two raters scored thirty randomly chosen music therapy session video recorded sessions (n = 30)featuring individuals diagnosed with autism spectrum disorder using the MEARS, MCPS, and MRS. Inter......Background: The Individual Music-Centered Assessment Profile for Neurodevelopmental Disorders (IMCAP-ND) is an evaluation instrument made up of three criterion-referenced rating scales designed to examine how clients perceive, interpret, and make music with the therapist while participating...

  10. Intra-Rater, Inter-Rater and Test-Retest Reliability of an Instrumented Timed Up and Go (iTUG Test in Patients with Parkinson's Disease.

    Directory of Open Access Journals (Sweden)

    Rob C van Lummel

    Full Text Available The "Timed Up and Go" (TUG is a widely used measure of physical functioning in older people and in neurological populations, including Parkinson's Disease. When using an inertial sensor measurement system (instrumented TUG [iTUG], the individual components of the iTUG and the trunk kinematics can be measured separately, which may provide relevant additional information.The aim of this study was to determine intra-rater, inter-rater and test-retest reliability of the iTUG in patients with Parkinson's Disease.Twenty eight PD patients, aged 50 years or older, were included. For the iTUG the DynaPort Hybrid (McRoberts, The Hague, The Netherlands was worn at the lower back. The device measured acceleration and angular velocity in three directions at a rate of 100 samples/s. Patients performed the iTUG five times on two consecutive days. Repeated measurements by the same rater on the same day were used to calculate intra-rater reliability. Repeated measurements by different raters on the same day were used to calculate intra-rater and inter-rater reliability. Repeated measurements by the same rater on different days were used to calculate test-retest reliability.Nineteen ICC values (15% were ≥ 0.9 which is considered as excellent reliability. Sixty four ICC values (49% were ≥ 0.70 and < 0.90 which is considered as good reliability. Thirty one ICC values (24% were ≥ 0.50 and < 0.70, indicating moderate reliability. Sixteen ICC values (12% were ≥ 0.30 and < 0.50 indicating poor reliability. Two ICT values (2% were < 0.30 indicating very poor reliability.In conclusion, in patients with Parkinson's disease the intra-rater, inter-rater, and test-retest reliability of the individual components of the instrumented TUG (iTUG was excellent to good for total duration and for turning durations, and good to low for the sub durations and for the kinematics of the SiSt and StSi. The results of this fully automated analysis of instrumented TUG movements

  11. Intra- and inter-rater reliabilities of measurement of ultrasound imaging for muscle thickness and pennation angle of tibialis anterior muscle in stroke patients.

    Science.gov (United States)

    Cho, Ki Hun; Lee, Hwang Jae; Lee, Wan Hee

    2017-07-01

    Dysfunction of skeletal muscle has been commonly reported in stroke patients. The purpose of this study was to investigate the intra- and inter-rater reliabilities of measurement of ultrasound imaging (USI) for pennation angle (PA) and muscle thickness (MT) of tibialis anterior muscle in stroke patients. Thirty-four stroke patients (19 men) participated in this study. USI was used for measurement of PA and MT of the tibialis anterior muscles at rest and during maximum voluntary contraction (MVC). Two examiners acquired images from all participants during two separate testing sessions, seven days apart. Intra-class correlation coefficients (ICCs), confidence interval (CI), standard error of measurement, minimal detectable change, and Bland-Altman plots were used for estimation of reliability. In the intra-rater reliability between measures, for all variables (PA and MT of the paretic and non-paretic sides of tibialis anterior muscles at rest and during MVC), the ICCs ranged between 0.639 and 0.998 and the CI was within an acceptable range of 0.388-0.999. In inter-rater reliability between examiners for the two tests, for all variables, the ICCs ranged between 0.690 and 0.995 and the CI was within an acceptable range of 0.463-0.997. In addition, significant difference was observed between the paretic and non-paretic sides of the tibialis anterior muscle architecture (p stroke patients. In addition, objective and quantitative measurements of tibialis anterior muscle using USI may provide appropriate management for the walking recovery of stroke patients.

  12. Thoracic magnetic resonance venography using Gadofosveset in patients with venous pathology-A comparative study of image quality and inter-rater variability.

    Science.gov (United States)

    Åkesson, Michael; Lehti, Leena; Höglund, Peter; Åkeson, Per; Wassélius, Johan

    2017-08-01

    Background High-quality non-invasive imaging of the deep venous system in the thorax is challenging, but nevertheless required for diagnosis of vascular pathology as well as for patient selection and preoperative planning for endovascular procedures. Purpose To compare the diagnostic quality of Gadofosveset-enhanced thoracic magnetic resonance venography, seven consecutive patients with suspected or known disease affecting the central thoracic veins were compared to seven consecutive magnetic resonance venography using conventional gadolinium-based contrast agents. Materials and methods Diagnostic capability, defined as the ability to assess vessel patency and pathologic conditions, for the major thoracic deep venous segments was assessed by two-independent readers. Both reviewers rated the overall subjective image quality on a four-graded scale, and inter-rater variability was analyzed using unweighted and weighted Cohen's kappa values. Results Diagnostic capability was generally considerably higher in the Gadofosveset group for all examined vessel segments. The overall images quality rating was significantly higher for the Gadofosveset group with a mean rating of 2.9 and 2.7 for the two-independent readers, compared to 1.2 and 1.0 for the control croup. Inter-rater variability showed less variability for the Gadofosveset group with a quadratic-weighted Cohen's Kappa value of 0.58 compared to 0.36 for the control group. Conclusion Our results show that Gadofosveset-enhanced magnetic resonance venography of the central thoracic veins is a reliable technique in clinical routine practice that results in diagnostic images, superior to conventional gadolinium-based contrast medium.

  13. The occurrence and inter-rater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: A prospective study in non-specific low back pain patients and controls in general practice

    NARCIS (Netherlands)

    K.H. Njoo (Khing Hua); E. van der Does (Emiel)

    1994-01-01

    textabstractThe presence of a trigger point is essential to the myofascial pain syndrome. This study centres on identifying clearer criteria for the presence of trigger points in the quadratus lumborum and gluteus medius muscle by investigating the occurrence and inter-rater reliability of trigger

  14. Inter-rater variability of visual interpretation and comparison with quantitative evaluation of11C-PiB PET amyloid images of the Japanese Alzheimer's Disease Neuroimaging Initiative (J-ADNI) multicenter study.

    Science.gov (United States)

    Yamane, Tomohiko; Ishii, Kenji; Sakata, Muneyuki; Ikari, Yasuhiko; Nishio, Tomoyuki; Ishii, Kazunari; Kato, Takashi; Ito, Kengo; Senda, Michio

    2017-05-01

    The aim of this study was to assess the inter-rater variability of the visual interpretation of 11 C-PiB PET images regarding the positivity/negativity of amyloid deposition that were obtained in a multicenter clinical research project, Japanese Alzheimer's Disease Neuroimaging Initiative (J-ADNI). The results of visual interpretation were also compared with a semi-automatic quantitative analysis using mean cortical standardized uptake value ratio to the cerebellar cortex (mcSUVR). A total of 162 11 C-PiB PET scans, including 45 mild Alzheimer's disease, 60 mild cognitive impairment, and 57 normal cognitive control cases that had been acquired as J-ADNI baseline scans were analyzed. Based on visual interpretation by three independent raters followed by consensus read, each case was classified into positive, equivocal, and negative deposition (ternary criteria) and further dichotomized by merging the former two (binary criteria). Complete agreement of visual interpretation by the three raters was observed for 91.3% of the cases (Cohen κ = 0.88 on average) in ternary criteria and for 92.3% (κ = 0.89) in binary criteria. Cases that were interpreted as visually positive in the consensus read showed significantly higher mcSUVR than those visually negative (2.21 ± 0.37 vs. 1.27 ± 0.09, p PiB PET scans. Positive or negative decision by visual interpretation was dichotomized by a cut-off value of mcSUVR = 1.5. As some cases of disagreement among raters tended to show low mcSUVR, referring to quantitative method may facilitate correct diagnosis when evaluating images of low amyloid deposition.

  15. Inter-rater reliability of the Greek version of CAARMS among two groups of mental health professionals.

    Science.gov (United States)

    Kollias, C; Kontaxakis, V; Havaki-Kontaxaki, B; Simmons, M B; Stefanis, N; Papageorgiou, C

    2015-01-01

    There is increasing interest within the Greek psychiatric community in the early detection and prevention of psychotic disorders. To support this, there is a need for a valid and reliable tool to identify young people that may be at risk of developing a psychotic disorder. Our team has previously translated the Comprehensive Assessment of At-Risk Mental States (CAARMS). The validity of the CAARMS was ensured by the procedure of translation and the aim of the current study was to estimate the interrater reliability of the CAARMS Greek translation among residents in psychiatry and specialized mental health professionals. 43 mental health workers (27 residents in psychiatry and 16 specialized mental health professionals (i.e. 11 psychiatrists and 5 psychologist) participated in two seminars that covered theoretical information about the ultra high risk concept and training in the CAARMS. During the seminars, 10 vignettes with psychiatric history cases were presented, including healthy, ultra high risk and first episode psychosis. The mean correlated percentage of agreement with the correct answers regarding diagnosis of the presented history cases among all our subjects was 81.42, among specialized mental health professionals 77.88, and among residents 84.46. Intraclass correlation co-efficients were 0.994 for specialized mental health professionals and 0.997 for residents. The translated Greek version of CAARMS presents a satisfying interrater reliability when used by both residents and specialized mental health professionals. Residents declare even higher intraclass correlation co-efficients and mean correlated percentage of agreement than specialized mental health professionals, which indicate that residents are capable of using the CAARMS in early intervention units.

  16. Inter-rater variability in motor function assessment in Parkinson's disease between experts in movement disorders and nurses specialising in PD management.

    Science.gov (United States)

    de Deus Fonticoba, T; Santos García, D; Macías Arribí, M

    2017-05-23

    In clinical practice, assessing patients with Parkinson's disease (PD) is a complex, time-consuming task. Our purpose is to provide a rigorous and objective evaluation of how motor function in PD patients is assessed by neurologists specialising in movement disorders, on the one hand, and by nurses specialising in PD management, on the other. We conducted an observational, cross-sectional, single-centre study of 50 patients with PD (52% men; mean age: 64.7 ± 8.7 years) who were assessed between 5 January 2016 and 20 July 2016. A neurologist and a nurse evaluated motor function in the early morning hours using the Unified Parkinson's Disease Rating Scale (UPDRS) parts III and IV and Hoehn & Yahr (H&Y) scale. Tests were administered in the same PD periods (in 48 patients during the 'off' time and in 2 patients during the 'on' time). Inter-rater variability was estimated with the intraclass correlation coefficient (ICC). Forty-nine patients (98%) were classified in the same H&Y stage by both raters. Assessment times were similar for both raters. ICC for UPDRS-IV and UPDRS-III total scores were 0.955 (Pde Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. SU-E-T-511: Inter-Rater Variability in Classification of Incidents in a New Incident Reporting System

    International Nuclear Information System (INIS)

    Pappas, D; Reis, S; Ali, A; Kapur, A

    2015-01-01

    Purpose To determine how consistent the results of different raters are when reviewing the same cases within the Radiation Oncology Incident Learning System (ROILS). Methods Three second-year medical physics graduate students filled out incident reports in spreadsheets set up to mimic ROILS. All students studied the same 33 cases and independently entered their assessments, for a total of 99 reviewed cases. The narratives for these cases were obtained from a published International Commission on Radiological Protection (ICRP) report which included shorter narratives selected from the Radiation Oncology Safety Information System (ROSIS) database. Each category of questions was reviewed to see how consistent the results were by utilizing free-marginal multirater kappa analysis. The percentage of cases where all raters shared full agreement or full disagreement was recorded to show which questions were answered consistently by multiple raters for a given case. The consistency among the raters was analyzed between ICRP and ROSIS cases to see if either group led to more reliable results. Results The categories where all raters agreed 100 percent in their choices were the event type (93.94 percent of cases 0.946 kappa) and the likelihood of the event being harmful to the patient (42.42 percent of cases 0.409 kappa). The categories where all raters disagreed 100 percent in their choices were the dosimetric severity scale (39.39 percent of cases 0.139 kappa) and the potential future toxicity (48.48 percent of cases 0.205 kappa). ROSIS had more cases where all raters disagreed than ICRP (23.06 percent of cases compared to 15.58 percent, respectively). Conclusion Despite reviewing the same cases, the results among the three raters was widespread. ROSIS narratives were shorter than ICRP, which suggests that longer narratives lead to more consistent results. This study shows that the incident reporting system can be optimized to yield more consistent results

  18. SU-E-T-511: Inter-Rater Variability in Classification of Incidents in a New Incident Reporting System

    Energy Technology Data Exchange (ETDEWEB)

    Pappas, D; Reis, S; Ali, A [Hofstra University, Hempstead, NY (United States); Kapur, A [Long Island Jewish Medical Center, New Hyde Park, NY (United States)

    2015-06-15

    Purpose To determine how consistent the results of different raters are when reviewing the same cases within the Radiation Oncology Incident Learning System (ROILS). Methods Three second-year medical physics graduate students filled out incident reports in spreadsheets set up to mimic ROILS. All students studied the same 33 cases and independently entered their assessments, for a total of 99 reviewed cases. The narratives for these cases were obtained from a published International Commission on Radiological Protection (ICRP) report which included shorter narratives selected from the Radiation Oncology Safety Information System (ROSIS) database. Each category of questions was reviewed to see how consistent the results were by utilizing free-marginal multirater kappa analysis. The percentage of cases where all raters shared full agreement or full disagreement was recorded to show which questions were answered consistently by multiple raters for a given case. The consistency among the raters was analyzed between ICRP and ROSIS cases to see if either group led to more reliable results. Results The categories where all raters agreed 100 percent in their choices were the event type (93.94 percent of cases 0.946 kappa) and the likelihood of the event being harmful to the patient (42.42 percent of cases 0.409 kappa). The categories where all raters disagreed 100 percent in their choices were the dosimetric severity scale (39.39 percent of cases 0.139 kappa) and the potential future toxicity (48.48 percent of cases 0.205 kappa). ROSIS had more cases where all raters disagreed than ICRP (23.06 percent of cases compared to 15.58 percent, respectively). Conclusion Despite reviewing the same cases, the results among the three raters was widespread. ROSIS narratives were shorter than ICRP, which suggests that longer narratives lead to more consistent results. This study shows that the incident reporting system can be optimized to yield more consistent results.

  19. Establishing Intra- and Inter-Rater Agreement of the Face, Legs, Activity, Cry, Consolability Scale for Evaluating Pain in Toddlers During Immunization

    Directory of Open Access Journals (Sweden)

    Rebecca J Gomez

    2013-01-01

    Full Text Available BACKGROUND: The Face, Legs, Activity, Cry, Consolability (FLACC scale is a five-item tool that was developed to assess postoperative pain in young children. The tool is frequently used as an outcome measure in studies investigating acute procedural pain in young children; however, there are limited published psychometric data in this context.

  20. Poor Agreement Among Expert Witnesses in Bile Duct Injury Malpractice Litigation An Expert Panel Survey

    NARCIS (Netherlands)

    de Reuver, Philip R.; Dijkgraaf, Marcel G. W.; Gevers, Sjef K. M.; Gouma, Dirk J.

    2008-01-01

    Objective: To determine the inter-rater agreement of expert witness testimonies in bile duct injury malpractice litigation. Background Data: Malpractice litigation is an increasing concern in modem surgical practice. As most of the lawyers are not educated in medicine, expert witnesses are asked to

  1. Poor agreement among expert witnesses in bile duct injury malpractice litigation: an expert panel survey.

    NARCIS (Netherlands)

    Reuver, P.R. de; Dijkgraaf, M.G.; Gevers, S.K.; Gouma, D.J.; Bleichrodt, R.P.; Cuesta, M.A.; Erp, W.F. van; Gerritsen, J.; Hesselink, E.J.; Laarhoven, C.J.H.M. van; Lange, J. de; Obertop, H.; Stassen, L.P.; Terpstra, O.T.; Tilanus, H.W.; Vroonhoven, T.J.; Wit, L. de

    2008-01-01

    OBJECTIVE: To determine the inter-rater agreement of expert witness testimonies in bile duct injury malpractice litigation. BACKGROUND DATA: Malpractice litigation is an increasing concern in modern surgical practice. As most of the lawyers are not educated in medicine, expert witnesses are asked to

  2. Agreements

    International Nuclear Information System (INIS)

    2001-01-01

    These columns summarize the different bilateral and multilateral agreements concluded recently between the different OECD countries and concerning the nuclear energy domain: Argentina - Australia: Agreement concerning Co-operation in the Peaceful Uses of Nuclear Energy (2001). Argentina - Brazil: Joint Declaration regarding the Creation of the Argentinean-Brazilian Agency for Nuclear Energy Applications (2001). Australia - Czech Republic / Australia - Hungary: Agreements on Co-operation in Peaceful Uses of Nuclear Energy and the Transfer of Nuclear Material (2001). Australia - Indonesia: Arrangement Concerning Co-operation on Nuclear Safeguards and Related Matters (2001). Austria - Switzerland: Agreement on the Early Exchange of Information in the Field of Nuclear Safety and Radiation. Brazil - United States: Extension of the Agreement concerning Research and Development in Nuclear Material Control, Accountancy, Verification, Physical Protection, and Advanced Containment and Surveillance Technologies for International Safeguards Applications (2001). Czech Republic - Republic of Korea: Agreement for Co-operation in the Peaceful Uses of Nuclear Energy (2001). European Union- Russian Federation: Agreements on Nuclear Safety and Controlled Nuclear Fusion (2001). France - United States: Agreement for Co-operation in Advanced Nuclear Reactor Science and Technology (2001). Japan - United Kingdom: Co-operation Agreement on Advanced Nuclear Fuel Cycle, Fast Breeder Reactor and Other Related Technologies (2001). Republic OF Korea - United States: Annex IV Joint Project on Cintichem Technology (2000). Morocco - United States: Protocol amending the Co-operation Agreement on the Peaceful Uses of Nuclear Energy (2001). Multilateral Agreements: Agreement for Information Exchange on Radiological Surveillance in Northern Europe (2001). Status of Conventions in the Field of Nuclear Energy. (author)

  3. Precisão de avaliadores na avaliação da criatividade por meio da produção de metáforas Inter rater reliability in the creativity assessment using metaphor production

    Directory of Open Access Journals (Sweden)

    Ricardo Primi

    2007-12-01

    for a creativity test based on metaphors creation, making use of items like "The camel is the ______ of the desert". The participants were 19 people and nine raters. The metaphor test is made of nine items, to which the participants gave 513 answers. Each answer was independently measured by the raters using a scale from 0 to 3, indicating the metaphor's elaboration. Reliability was calculated by a Rasch model assuming every idea as a case and each judge as an item of a hypothetical test in procedure called judge-linking network. The inter-rater reliability varied from .52 to .83 with a mean of .74 (SD=.08 resulting in a acceptable inter-rater reliability.

  4. Importância da variação do PASI realizado por diversos observadores Inter-rater concordance study of the PASI (Psoriasis Area and Severity Index

    Directory of Open Access Journals (Sweden)

    Joana Ribeiro Costa de Faria

    2010-10-01

    Full Text Available FUNDAMENTO: O índice da área e gravidade da psoríase foi método desenvolvido em 1978, para quantificar a gravidade da psoríase. Desde então, têm recebido algumas críticas, por ser longo, complexo e apresentar divergências na sua interpretação. OBJETIVO: Demonstrar o grau de concordância do índice da área e gravidade da psoríase aplicado em pacientes de psoríase por três avaliadores isoladamente. MATERIAL E MÉTODO: Estudo observacional, transversal, realizado no ambulatório de psoríase, no ano de 2007, onde foram selecionados 20 pacientes. Os pacientes foram avaliados por três pós-graduandos de dermatologia, que determinaram o índice da área e gravidade da psoríase, isoladamente. A fidedignidade interobservador foi avaliada pelo coeficiente de correlação intraclasses (ICC e os gráficos de Bland & Altman. RESULTADOS: O ICC de 0,729 (IC 95%: 0,440 - 0,882 demonstrou que existe boa concordância entre os observadores. Pela análise dos gráficos de Bland e Altman, no máximo, duas diferenças estão fora dos limites de concordância, expressando boa concordância. Observou-se também que existe comportamento sistemático nas diferenças do índice da área e gravidade da psoríase em relação a sua média, segundo o qual mostrou para valores altos do índice da área e gravidade da psoríase, ou seja, um predomínio de diferenças maiores. CONCLUSÃO: Notamos, através deste estudo, que o índice da área e gravidade da psoríase apresenta bons critérios de confiabilidade quando houve a avaliação da gravidade da psoríase, mesmo que realizado por diferentes avaliadores.BACKGROUND: Developed in 1978, the PASI (Psoriasis Area and Severity Index is a method to rate psoriasis severity. Since then, it has been criticized for being extremely long, complex and for yielding significantly divergent interpretations. OBJECTIVE: To determine the PASI inter-rater reliability among three independent evaluators examining the same

  5. Inter-rater reliability of the Reaper Oral Mucosa Pressure Injury Scale (ROMPIS): A novel scale for the assessment of the severity of pressure injuries to the mouth and oral mucosa.

    Science.gov (United States)

    Reaper, Sue; Green, Cameron; Gupta, Sachin; Tiruvoipati, Ravindranath

    2017-05-01

    Patients who are intubated in the ICU are at risk of developing pressure injuries to the mouth and lips from endotracheal tubes. Clear documentation is important for pressure wound care; however, no validated instruments currently exist for the staging of pressure injuries to the oral mucosa. Instruments designed for the assessment of pressure injuries to other bodily regions are anatomically unsuited to the lips and mouth. This study aimed to develop and then assess the reliability of a novel scale for the assessment of pressure injuries to the mouth and oral mucosa. The Reaper Oral Mucosa Pressure Injury Scale (ROMPIS) was developed in consultation with ICU nurses, clinical nurse educators, Intensivists, and experts in pressure wound management. ICU nurses and portfolio-holders in pressure wound care from Peninsula Health (Victoria, Australia) were invited to use the ROMPIS to stage 19 de-identified clinical photographs of oral pressure injuries via secure online survey. Inter-rater reliability (IRR) was calculated using Krippendorff's alpha (α). Among ICU nurses (n=52), IRR of the ROMPIS was α=0.307; improving to α=0.463 when considering only responses where injuries were deemed to be stageable using the ROMPIS (i.e. excluding responses where respondents considered an injury to be unstageable). Among a cohort of experts in pressure wound care (n=8), IRR was α=0.306; or α=0.443 excluding responses indicating that wounds were unstageable. An instrument for the assessment and monitoring of pressure injuries to the mouth and lips has practical implications for patient care. This preliminary study indicates that the ROMPIS instrument has potential to be used clinically for this purpose; however, the performance of this scale may be somewhat reliant on the confidence or experience of the ICU nurse utilising it. Further validation is required. Copyright © 2016 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  6. Intra and inter-rater reliability of infrared image analysis of masticatory and upper trapezius muscles in women with and without temporomandibular disorder Confiabilidade intra e interexaminador da análise de imagens infravermelhas dos músculos mastigatórios e trapézio superior em mulheres com e sem disfunção temporomandibular

    Directory of Open Access Journals (Sweden)

    Ana C. S Costa

    2013-02-01

    Full Text Available BACKGROUND: Infrared thermography is an aid tool that can be used to evaluate several pathologies given its efficiency in analyzing the distribution of skin surface temperature. OBJECTIVES: To propose two forms of infrared image analysis of the masticatory and upper trapezius muscles, and to determine the intra and inter-rater reliability of both forms of analysis. METHOD: Infrared images of masticatory and upper trapezius muscles of 64 female volunteers with and without temporomandibular disorder (TMD were collected. Two raters performed the infrared image analysis, which occurred in two ways: temperature measurement of the muscle length and in central portion of the muscle. The Intraclass Correlation Coefficient (ICC was used to determine the intra and inter-rater reliability. RESULTS: The ICC showed excellent intra and inter-rater values for both measurements: temperature measurement of the muscle length (TMD group, intra-rater, ICC ranged from 0.996 to 0.999, inter-rater, ICC ranged from 0.992 to 0.999; control group, intra-rater, ICC ranged from 0.993 to 0.998, inter-rater, ICC ranged from 0.990 to 0.998, and temperature measurement of the central portion of the muscle (TMD group, intra-rater, ICC ranged from 0.981 to 0.998, inter-rater, ICC ranged from 0.971 to 0.998; control group, intra-rater, ICC ranged from 0.887 to 0.996, inter-rater, ICC ranged from 0.852 to 0.996. CONCLUSION: The results indicated that temperature measurements of the masticatory and upper trapezius muscles carried out by the analysis of the muscle length and central portion yielded excellent intra and inter-rater reliability.CONTEXTUALIZAÇÃO: A termografia infravermelha vem sendo utilizada como instrumento auxiliar na avaliação de patologias diversas, dada a sua eficiência na investigação da distribuição da temperatura superficial cutânea. OBJETIVOS: Propor duas formas de análise das imagens infravermelhas dos músculos mastigatórios e trapézio superior

  7. Test-retest agreement and reliability of the Six Spot Step Test in persons with multiple sclerosis

    DEFF Research Database (Denmark)

    Callesen, Jacob; Richter, Christina; Kristensen, Cecilie

    2017-01-01

    -day, day-to-day, and inter-rater agreement and reliability of the SSST in PwMS. A secondary aim was to investigate the validity of handheld timing. METHODS: A total of 38 PwMS with an Expanded Disability Status Scale (EDSS) ... days were ±15% and ±19%, while ICC were 0.987 and 0.983, respectively. A minor learning effect was found over four tests. The handheld timing error was ±0.5 seconds when compared to video-based timing. CONCLUSION: The SSST has an acceptable within- and between-day agreement and reliability...

  8. Inter-radiologist agreement for CT scoring of pediatric splenic injuries and effect on an established clinical practice guideline

    Energy Technology Data Exchange (ETDEWEB)

    Leschied, Jessica R.; Smith, Ethan A.; Ladino-Torres, Maria F.; Dillman, Jonathan R. [University of Michigan Health System, Department of Radiology, Section of Pediatric Radiology, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Mazza, Michael B.; Chong, Suzanne T.; Hoff, Carrie N. [University of Michigan Health System, Department of Radiology, Division of Emergency Radiology, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Davenport, Matthew S. [University of Michigan Health System, Department of Radiology, Division of Abdominal Imaging, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Khalatbari, Shokoufeh [University of Michigan, Michigan Institute for Clinical and Health Research, Ann Arbor, MI (United States); Ehrlich, Peter F. [University of Michigan Health System, Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States)

    2016-02-15

    The American Pediatric Surgical Association (APSA) advocates for the use of a clinical practice guideline to direct management of hemodynamically stable pediatric spleen injuries. The clinical practice guideline is based on the CT score of the spleen injury according to the American Association for the Surgery of Trauma (AAST) CT scoring system. To determine the potential effect of radiologist agreement for CT scoring of pediatric spleen injuries on an established APSA clinical practice guideline. We retrospectively analyzed blunt splenic injuries occurring in children from January 2007 to January 2012 at a single level 1 trauma center (n = 90). Abdominal CT exams performed at clinical presentation were reviewed by four radiologists who documented the following: (1) splenic injury grade (AAST system), (2) arterial extravasation and (3) pseudoaneurysm. Inter-rater agreement for AAST injury grade was assessed using the multi-rater Fleiss kappa and Kendall coefficient of concordance. Inter-rater agreement was assessed using weighted (AAST injury grade) or prevalence-adjusted bias-adjusted (binary measures) kappa statistics; 95% confidence intervals were calculated. We evaluated the hypothetical effect of radiologist disagreement on an established APSA clinical practice guideline. Inter-rater agreement was good for absolute AAST injury grade (kappa: 0.64 [0.59-0.69]) and excellent for relative AAST injury grade (Kendall w: 0.90). All radiologists agreed on the AAST grade in 52% of cases. Based on an established clinical practice guideline, radiologist disagreement could have changed the decision for intensive care management in 11% (10/90) of children, changed the length of hospital stay in 44% (40/90), and changed the time to return to normal activity in 44% (40/90). Radiologist agreement when assigning splenic AAST injury grades is less than perfect, and disagreements have the potential to change management in a substantial number of pediatric patients. (orig.)

  9. Reliability of Pain Measurements Using Computerized Cuff Algometry: A DoloCuff Reliability and Agreement Study.

    Science.gov (United States)

    Kvistgaard Olsen, Jack; Fener, Dilay Kesgin; Waehrens, Eva Elisabet; Wulf Christensen, Anton; Jespersen, Anders; Danneskiold-Samsøe, Bente; Bartels, Else Marie

    2017-07-01

    Computerized pneumatic cuff pressure algometry (CPA) using the DoloCuff is a new method for pain assessment. Intra- and inter-rater reliabilities have not yet been established. Our aim was to examine the inter- and intrarater reliabilities of DoloCuff measures in healthy subjects. Twenty healthy subjects (ages 20 to 29 years) were assessed three times at 24-hour intervals by two trained raters. Inter-rater reliability was established based on the first and second assessments, whereas intrarater reliability was based on the second and third assessments. Subjects were randomized 1:1 to first assessment at either rater 1 or rater 2. The variables of interest were pressure pain threshold (PT), pressure pain tolerance (PTol), and temporal summation index (TSI). Reliability was estimated by a two-way mixed intraclass correlation coefficient (ICC) absolute agreement analysis. Reliability was considered excellent if ICC > 0.75, fair to good if 0.4 TSI was 0.88 (95% CI: 0.69 to 0.95), 0.86 (95% CI: 0.65 to 0.95), and 0.81 (95% CI: 0.42 to 0.94), respectively. The intrarater reliability for PT, PTol, and TSI was 0.81 (95% CI: 0.53 to 0.92), 0.89 (95% CI: 0.74 to 0.96), and 0.75 (95% CI: 0.28 to 0.91), respectively. Inter-rater reliability was excellent for PT, PTol, and TSI. Similarly, the intrarater reliability for PT and PTol was excellent, while borderline excellent/good for TSI. Therefore, the DoloCuff can be used to obtain reliable measures of pressure pain parameters in healthy subjects. © 2016 World Institute of Pain.

  10. Reliability of Patient-Led Screening with the Malnutrition Screening Tool: Agreement between Patient and Health Care Professional Scores in the Cancer Care Ambulatory Setting.

    Science.gov (United States)

    Di Bella, Alexandra; Blake, Claire; Young, Adrienne; Pelecanos, Anita; Brown, Teresa

    2018-02-01

    The prevalence of malnutrition in patients with cancer is reported as high as 60% to 80%, and malnutrition is associated with lower survival, reduced response to treatment, and poorer functional status. The Malnutrition Screening Tool (MST) is a validated tool when administered by health care professionals; however, it has not been evaluated for patient-led screening. This study aims to assess the reliability of patient-led MST screening through assessment of inter-rater reliability between patient-led and dietitian-researcher-led screening and intra-rater reliability between an initial and a repeat patient screening. This cross-sectional study included 208 adults attending ambulatory cancer care services in a metropolitan teaching hospital in Queensland, Australia, in October 2016 (n=160 inter-rater reliability; n=48 intra-rater reliability measured in a separate sample). Primary outcome measures were MST risk categories (MST 0-1: not at risk, MST ≥2: at risk) as determined by screening completed by patients and a dietitian-researcher, patient test-retest screening, and patient acceptability. Percent and chance-corrected agreement (Cohen's kappa coefficient, κ) were used to determine agreement between patient-MST and dietitian-MST (inter-rater reliability) and MST completed by patient on admission to unit (patient-MSTA) and MST completed by patient 1 to 3 hours after completion of initial MST (patient-MSTB) (intra-rater reliability). High inter-rater reliability and intra-rater reliability were observed. Agreement between patient-MST and dietitian-MST was 96%, with "almost perfect" chance-adjusted agreement (κ=0.92, 95% CI 0.84 to 0.97). Agreement between repeated patient-MSTA and patient-MSTB was 94%, with "almost perfect" chance-adjusted agreement (κ=0.88, 95% CI 0.71 to 1.00). Based on dietitian-MST, 33% (n=53) of patients were identified as being at risk for malnutrition, and 40% of these reported not seeing a dietitian. Of 156 patients who provided

  11. Inter rater reliability of Pressure Ulcer Scale for Healing (PUSH in patients with chronic leg ulcers Confiabilidad inter-observadores del Pressure Ulcer Scale for Healing (PUSH en pacientes con úlceras crónicas en la pierna Confiabilidade interobservadores do Pressure Ulcer Scale for Healing (PUSH, em pacientes com úlceras crônicas de perna

    Directory of Open Access Journals (Sweden)

    Vera Lúcia Conceição de Gouveia Santos

    2007-06-01

    Full Text Available This study aimed to evaluate the inter rater reliability of the Pressure Ulcer Scale for Healing (PUSH, in its version adapted to the Portuguese language, in patients with chronic leg ulcers. Kappa index was used for the analysis. After accomplishing ethical issues, 41 patients with ulcers were examined. A total of 49% of the ulcers were located in the right leg and 36% of them were venous ulcers. The Kappa indices (0.97 to 1.00 obtained in the comparison between the observations of the clinical nurses and the stomal therapists for all sub-scales and for total score, confirmed the tool inter rater reliability, with statistical significance (pEl objetivo del estúdio fue probar la confiabilidad inter-observadores del Pressure Ulcer Scale for Healing (PUSH, en su versión adaptada al portugués, en pacientes con úlceras crónicas en la pierna. Para el análisis de concordancia se utilizó el Indice Kappa. Posterior a la aprobación del Comité de Ética, 41 pacientes con úlcera fueron examinados, siendo que 49% de las úlceras se localizaron a la derecha y 36% eran de etiología venosa. Los indices Kappa obtenidos (0,97 a 1,00, con un nivel significativo de pTestar a confiabilidade interobservadores do Pressure Ulcer Scale for Healing (PUSH, em sua versão adaptada para o português, em pacientes com úlceras crônicas de perna foi o objetivo deste estudo. Para a análise de concordância, utilizou-se o índice Kappa. Após aprovação pelo Comitê de Ética, pacientes com úlceras (41 úlceras foram examinados, sendo que 49% das úlceras localizavam-se à direita e 36% eram de etiologia venosa. Os índices Kappa obtidos (0,97 a 1,00, com significância estatística (p<0,001, ratificaram a confiabilidade interobservadores, ao ser obtida concordância de muito boa a total entre as observações de enfermeiros clínicos e especialistas em estomaterapia (padrão-ouro, para todas as subescalas do PUSH, como para o escore total. Esses resultados

  12. Tradução, adaptação e confiabilidade interexaminadores do manual de administração da escala de Fugl-Meyer Translation, adaptation and inter-rater reliability of the administration manual for the Fugl-Meyer assessment

    Directory of Open Access Journals (Sweden)

    Stella M Michaelsen

    2011-02-01

    a single evaluator who applied the test. When different raters apply the scale, the reliability may depend on the interpretation given to the assessment sheet. In such cases, a clear administration manual is essential for ensuring homogeneity of application. OBJECTIVES: To translate and adapt the French Canadian version of the FMA administration manual into Brazilian Portuguese and to evaluate the inter-rater reliability when different evaluators apply the FMA on the basis of the information contained in the manual. METHODS: Eighteen adults (59±10 years with chronic hemiparesis (38±35 months after a stroke took part in this study. Eight patients participated in the first part of the study and 10 in the second part. Based on analyzing the results from part 1, an adapted version was developed, in which information and photos were added to illustrate the positions of the patient and evaluator. The inter-rater reliability was assessed using the intraclass correlation coefficient (ICC. RESULTS: The reliability of the FMA based on the adapted version of the manual was excellent for the total motor scores for the upper limbs (ICC=0.98 and lower limbs (ICC=0.90, as well as for movement sense (ICC=0.98 and upper and lower-limb passive range of motion (ICC=0.84 and 0.90, respectively. The reliability was moderate for tactile sensitivity (0.75. The joint pain assessment presented low reliability. CONCLUSIONS: The results showed that, except for pain assessment, application of the FMA based on the adapted version of the application manual for Brazilian Portuguese presented adequate inter-rater reliability.

  13. Scales of degree of facial paralysis: analysis of agreement

    Directory of Open Access Journals (Sweden)

    Kércia Melo de Oliveira Fonseca

    2015-06-01

    Full Text Available INTRODUCTION: It has become common to use scales to measure the degree of involvement of facial paralysis in phonoaudiological clinics. OBJECTIVE: To analyze the inter- and intra-rater agreement of the scales of degree of facial paralysis and to elicit point of view of the appraisers regarding their use. METHODS: Cross-sectional observational clinical study of the Chevalier and House & Brackmann scales performed by five speech therapists with clinical experience, who analyzed the facial expression of 30 adult subjects with impaired facial movements two times, with a one week interval between evaluations. The kappa analysis was employed. RESULTS: There was excellent inter-rater agreement for both scales (kappa > 0.80, and on the Chevalier scale a substantial intra-rater agreement in the first assessment (kappa = 0.792 and an excellent agreement in the second assessment (kappa = 0.928. The House & Brackmann scale showed excellent agreement at both assessments (kappa = 0.850 and 0.857. As for the appraisers' point of view, one appraiser thought prior training is necessary for the Chevalier scale and, four appraisers felt that training is important for the House & Brackmann scale. CONCLUSION: Both scales have good inter- and intra-rater agreement and most of the appraisers agree on the ease and relevance of the application of these scales.

  14. Scales of degree of facial paralysis: analysis of agreement.

    Science.gov (United States)

    Fonseca, Kércia Melo de Oliveira; Mourão, Aline Mansueto; Motta, Andréa Rodrigues; Vicente, Laelia Cristina Caseiro

    2015-01-01

    It has become common to use scales to measure the degree of involvement of facial paralysis in phonoaudiological clinics. To analyze the inter- and intra-rater agreement of the scales of degree of facial paralysis and to elicit point of view of the appraisers regarding their use. Cross-sectional observational clinical study of the Chevalier and House & Brackmann scales performed by five speech therapists with clinical experience, who analyzed the facial expression of 30 adult subjects with impaired facial movements two times, with a one week interval between evaluations. The kappa analysis was employed. There was excellent inter-rater agreement for both scales (kappa>0.80), and on the Chevalier scale a substantial intra-rater agreement in the first assessment (kappa=0.792) and an excellent agreement in the second assessment (kappa=0.928). The House & Brackmann scale showed excellent agreement at both assessments (kappa=0.850 and 0.857). As for the appraisers' point of view, one appraiser thought prior training is necessary for the Chevalier scale and, four appraisers felt that training is important for the House & Brackmann scale. Both scales have good inter- and intra-rater agreement and most of the appraisers agree on the ease and relevance of the application of these scales. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  15. Interobserver agreement and validity of bedside 'positive signs' for functional weakness, sensory and gait disorders in conversion disorder: a pilot study.

    Science.gov (United States)

    Daum, Corinna; Gheorghita, Fulvia; Spatola, Marianna; Stojanova, Vesna; Medlin, Friedrich; Vingerhoets, François; Berney, Alexandre; Gholam-Rezaee, Mehdi; Maccaferri, Giorgio E; Hubschmid, Monica; Aybek, Selma

    2015-04-01

    Conversion disorder (CD) is no longer a diagnosis of exclusion. The new DSM-V criteria highlight the importance of 'positive signs' on neurological examination. Only few signs have been validated, and little is known about their reliability. The aim was to examine the clinical value of bedside positive signs in the diagnosis of CD presenting with weakness, gait or sensory symptoms by assessing their specificity, sensitivity and their inter-rater reliability. Standardised video recorded neurological examinations were performed in 20 consecutive patients with CD and 20 'organic' controls. Ten previously validated sensory and motor signs were grouped in a scale. Thirteen additional motor/sensory 'positive signs', 14 gait patterns and 1 general sign were assessed in a pilot validation study. In addition, two blinded independent neurologists rated the video recordings to assess the inter-rater reliability (Cohen's κ) of each sign. A score of ≥ 4/14 on the sensory motor scale showed a 100% specificity (CI 85 to 100) and a 95% sensitivity (CI 85 to 100). Among the additional tested signs, 10 were significantly more frequent in CD than controls. The interobserver agreement was acceptable for 23/38 signs (2 excellent, 10 good, 11 moderate). Our study confirms that six bedside 'positive signs' are highly specific for CD with good-excellent inter-rater reliability; we propose to consider them as 'highly reliable signs'. In addition 13 signs could be considered as 'reliable signs' and six further signs as 'suggestive signs' while all others should be used with caution until further validation is available. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. Alberta stroke program early computed tomographic scoring performance in a series of patients undergoing computed tomography and MRI: reader agreement, modality agreement, and outcome prediction.

    Science.gov (United States)

    McTaggart, Ryan A; Jovin, Tudor G; Lansberg, Maarten G; Mlynash, Michael; Jayaraman, Mahesh V; Choudhri, Omar A; Inoue, Manabu; Marks, Michael P; Albers, Gregory W

    2015-02-01

    In this study, we compare the performance of pretreatment Alberta Stroke Program Early Computed Tomographic scoring (ASPECTS) using noncontrast CT (NCCT) and MRI in a large endovascular therapy cohort. Prospectively enrolled patients underwent baseline NCCT and MRI and started endovascular therapy within 12 hours of stroke onset. Inclusion criteria for this analysis were evaluable pretreatment NCCT, diffusion-weighted MRI (DWI), and 90-day modified Rankin Scale scores. Two expert readers graded ischemic change on NCCT and DWI using the ASPECTS. ASPECTS scores were analyzed with the full scale or were trichotomized (0-4 versus 5-7 versus 8-10) or dichotomized (0-7 versus 8-10). Good functional outcome was defined as a 90-day modified Rankin Scale score of 0 to 2. Seventy-four patients fulfilled our study criteria. The full-scale inter-rater agreement for CT-ASPECTS and DWI-ASPECTS was 0.579 and 0.867, respectively. DWI-ASPECTS correlated with functional outcome (P=0.004), whereas CT-ASPECTS did not (P=0.534). Both DWI-ASPECTS and CT-ASPECTS correlated with DWI volume. The receiver operating characteristic analysis revealed that DWI-ASPECTS outperformed both CT-ASPECTS and the time interval between symptom onset and start of the procedure for predicting good functional outcome (modified Rankin Scale score, ≤2) and DWI volume ≥70 mL. Inter-rater agreement for DWI-ASPECTS was superior to that for CT-ASPECTS. DWI-ASPECTS outperformed NCCT ASPECTS for predicting functional outcome at 90 days. © 2014 American Heart Association, Inc.

  17. Reviewer agreement trends from four years of electronic submissions of conference abstract

    Directory of Open Access Journals (Sweden)

    Blitz Sandra

    2006-03-01

    Full Text Available Abstract Background The purpose of this study was to determine the inter-rater agreement between reviewers on the quality of abstract submissions to an annual national scientific meeting (Canadian Association of Emergency Physicians; CAEP to identify factors associated with low agreement. Methods All abstracts were submitted using an on-line system and assessed by three volunteer CAEP reviewers blinded to the abstracts' source. Reviewers used an on-line form specific for each type of study design to score abstracts based on nine criteria, each contributing from two to six points toward the total (maximum 24. The final score was determined to be the mean of the three reviewers' scores using Intraclass Correlation Coefficient (ICC. Results 495 Abstracts were received electronically during the four-year period, 2001 – 2004, increasing from 94 abstracts in 2001 to 165 in 2004. The mean score for submitted abstracts over the four years was 14.4 (95% CI: 14.1–14.6. While there was no significant difference between mean total scores over the four years (p = 0.23, the ICC increased from fair (0.36; 95% CI: 0.24–0.49 to moderate (0.59; 95% CI: 0.50–0.68. Reviewers agreed less on individual criteria than on the total score in general, and less on subjective than objective criteria. Conclusion The correlation between reviewers' total scores suggests general recognition of "high quality" and "low quality" abstracts. Criteria based on the presence/absence of objective methodological parameters (i.e., blinding in a controlled clinical trial resulted in higher inter-rater agreement than the more subjective and opinion-based criteria. In future abstract competitions, defining criteria more objectively so that reviewers can base their responses on empirical evidence may lead to increased consistency of scoring and, presumably, increased fairness to submitters.

  18. Training Programs on Endoscopic Scoring Systems for Inflammatory Bowel Disease Lead to a Significant Increase in Interobserver Agreement Among Community Gastroenterologists.

    Science.gov (United States)

    Daperno, Marco; Comberlato, Michele; Bossa, Fabrizio; Armuzzi, Alessandro; Biancone, Livia; Bonanomi, Andrea G; Cosintino, Rocco; Lombardi, Giovanni; Mangiarotti, Roberto; Papa, Alfredo; Pica, Roberta; Grassano, Luca; Pagana, Guido; D'Incà, Renata; Orlando, Ambrogio; Rizzello, Fernando

    2017-05-01

    Endoscopic outcomes are increasingly used in clinical trials and in routine practice for inflammatory bowel disease [IBD] in order to reach more objective patient evaluations than possible using only clinical features. However, reproducibility of endoscopic scoring systems used to categorize endoscopic activity has been reported to be suboptimal. The aim of this study was to analyse the inter-rated agreement of non-dedicated gastroenterologists on IBD endoscopic scoring systems, and to explore the effects of a dedicated training programme on agreement. A total of 237 physicians attended training courses on IBD endoscopic scoring systems, and they independently scored a set of IBD endoscopic videos for ulcerative colitis [with Mayo endoscopic subscore], post-operative Crohn's disease [with Rutgeerts score] and luminal Crohn's disease (with the Simple Endoscopic Score for Crohn's Disease [SESCD] and Crohn's Endoscopic Index of Severity [CDEIS]). A second round of scoring was collected after discussion about determinants of discrepancy. Interobserver agreement was measured by means of the Fleiss' kappa [kappa] or intraclass correlation coefficient [ICC] as appropriate. The inter-rater agreement increased from kappa 0.51 (95% confidence interval [95% CI] 0.48-0.55) to 0.76 [95% CI 0.72-0.79] for the Mayo endoscopic subscore, and from 0.45 [95% CI 0.40-0.50] to 0.79 [0.74-0.83] for the Rutgeerts score before and after the training programme, respectively, and both differences were significant [P training programme can significantly impact on inter-rater agreement, increasing it to levels expected among expert central reviewers. Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com

  19. Impact of 3 Tesla MRI on interobserver agreement in clinically isolated syndrome: A MAGNIMS multicentre study.

    Science.gov (United States)

    Hagens, Marloes Hj; Burggraaff, Jessica; Kilsdonk, Iris D; Ruggieri, Serena; Collorone, Sara; Cortese, Rosa; Cawley, Niamh; Sbardella, Emilia; Andelova, Michaela; Amann, Michael; Lieb, Johanna M; Pantano, Patrizia; Lissenberg-Witte, Birgit I; Killestein, Joep; Oreja-Guevara, Celia; Wuerfel, Jens; Ciccarelli, Olga; Gasperini, Claudio; Lukas, Carsten; Rovira, Alex; Barkhof, Frederik; Wattjes, Mike P

    2018-01-01

    Compared to 1.5 T, 3 T magnetic resonance imaging (MRI) increases signal-to-noise ratio leading to improved image quality. However, its clinical relevance in clinically isolated syndrome suggestive of multiple sclerosis remains uncertain. The purpose of this study was to investigate how 3 T MRI affects the agreement between raters on lesion detection and diagnosis. We selected 30 patients and 10 healthy controls from our ongoing prospective multicentre cohort. All subjects received baseline 1.5 and 3 T brain and spinal cord MRI. Patients also received follow-up brain MRI at 3-6 months. Four experienced neuroradiologists and four less-experienced raters scored the number of lesions per anatomical region and determined dissemination in space and time (McDonald 2010). In controls, the mean number of lesions per rater was 0.16 at 1.5 T and 0.38 at 3 T ( p = 0.005). For patients, this was 4.18 and 4.40, respectively ( p = 0.657). Inter-rater agreement on involvement per anatomical region and dissemination in space and time was moderate to good for both field strengths. 3 T slightly improved agreement between experienced raters, but slightly decreased agreement between less-experienced raters. Overall, the interobserver agreement was moderate to good. 3 T appears to improve the reading for experienced readers, underlining the benefit of additional training.

  20. Bristol Stool Form Scale reliability and agreement decreases when determining Rome III stool form designations.

    Science.gov (United States)

    Chumpitazi, B P; Self, M M; Czyzewski, D I; Cejka, S; Swank, P R; Shulman, R J

    2016-03-01

    Rater reproducibility of the Bristol Stool Form Scale (BSFS), which categorizes stools into one of seven types, is unknown. We sought to determine reliability and agreement by individual stool type and when responses are categorized by Rome III clinical designation as normal or abnormal (constipation or diarrhea). Thirty-four gastroenterology providers from three institutions rated 35 stool photographs using the BSFS. Twenty rerated the photographs. 1190 individual stool type ratings were completed. Though only four photographs had absolute agreement (all Type 1 or Type 7), general agreement was high with 1132 (95.1%) of ratings being within one category type of the modal rating. Inter-rater and intra-rater reliability of the BSFS by individual stool type was excellent with intraclass correlations of 0.88 (95% CI: 0.86-0.90, p Bristol Stool Form Scale has excellent reliability and agreement when used to rate individual stool type by raters. However, BSFS reliability and agreement decreases when determining Rome III stool form categories. © 2015 John Wiley & Sons Ltd.

  1. Inter-operator and inter-device agreement and reliability of the SEM Scanner.

    Science.gov (United States)

    Clendenin, Marta; Jaradeh, Kindah; Shamirian, Anasheh; Rhodes, Shannon L

    2015-02-01

    The SEM Scanner is a medical device designed for use by healthcare providers as part of pressure ulcer prevention programs. The objective of this study was to evaluate the inter-rater and inter-device agreement and reliability of the SEM Scanner. Thirty-one (31) volunteers free of pressure ulcers or broken skin at the sternum, sacrum, and heels were assessed with the SEM Scanner. Each of three operators utilized each of three devices to collect readings from four anatomical sites (sternum, sacrum, left and right heels) on each subject for a total of 108 readings per subject collected over approximately 30 min. For each combination of operator-device-anatomical site, three SEM readings were collected. Inter-operator and inter-device agreement and reliability were estimated. Over the course of this study, more than 3000 SEM Scanner readings were collected. Agreement between operators was good with mean differences ranging from -0.01 to 0.11. Inter-operator and inter-device reliability exceeded 0.80 at all anatomical sites assessed. The results of this study demonstrate the high reliability and good agreement of the SEM Scanner across different operators and different devices. Given the limitations of current methods to prevent and detect pressure ulcers, the SEM Scanner shows promise as an objective, reliable tool for assessing the presence or absence of pressure-induced tissue damage such as pressure ulcers. Copyright © 2015 Bruin Biometrics, LLC. Published by Elsevier Ltd.. All rights reserved.

  2. Emergency Physicians Are Able to Detect Right Ventricular Dilation With Good Agreement Compared to Cardiology.

    Science.gov (United States)

    Rutz, Matt A; Clary, Julie M; Kline, Jeffrey A; Russell, Frances M

    2017-07-01

    Focused cardiac ultrasound (FOCUS) is a useful tool in evaluating patients presenting to the emergency department (ED) with acute dyspnea. Prior work has shown that right ventricular (RV) dilation is associated with repeat hospitalizations and shorter life expectancy. Traditionally, RV assessment has been evaluated by cardiologist-interpreted comprehensive echocardiography. The primary goal of this study was to determine the inter-rater reliability between emergency physicians (EPs) and a cardiologist for determining RV dilation on FOCUS performed on ED patients with acute dyspnea. This was a prospective, observational study at two urban academic EDs; patients were enrolled if they had acute dyspnea and a computed tomographic pulmonary angiogram without acute disease. All patients had an EP-performed FOCUS to assess for RV dilation. RV dilation was defined as an RV to left ventricular ratio greater than 1. FOCUS interpretations were compared to a blinded cardiologist FOCUS interpretation using agreement and kappa statistics. Of 84 FOCUS examinations performed on 83 patients, 17% had RV dilation. Agreement and kappa, for EP-performed FOCUS for RV dilation were 89% (95% confidence interval [CI] 80-95%) and 0.68 (95% CI 0.48-0.88), respectively. Emergency physician sonographers are able to detect RV dilation with good agreement when compared to cardiology. These results support the wider use of EP-performed FOCUS to evaluate for RV dilation in ED patients with dyspnea. © 2017 by the Society for Academic Emergency Medicine.

  3. Exact one-sided confidence limits for Cohen's kappa as a measurement of agreement.

    Science.gov (United States)

    Shan, Guogen; Wang, Weizhen

    2017-04-01

    Cohen's kappa coefficient, κ, is a statistical measure of inter-rater agreement or inter-annotator agreement for qualitative items. In this paper, we focus on interval estimation of κ in the case of two raters and binary items. So far, only asymptotic and bootstrap intervals are available for κ due to its complexity. However, there is no guarantee that such intervals will capture κ with the desired nominal level 1- α. In other words, the statistical inferences based on these intervals are not reliable. We apply the Buehler method to obtain exact confidence intervals based on four widely used asymptotic intervals, three Wald-type confidence intervals and one interval constructed from a profile variance. These exact intervals are compared with regard to coverage probability and length for small to medium sample sizes. The exact intervals based on the Garner interval and the Lee and Tu interval are generally recommended for use in practice due to good performance in both coverage probability and length.

  4. The agreement between proxy and self-completed EQ-5D for care home residents was better for index scores than individual domains.

    Science.gov (United States)

    Devine, Angela; Taylor, Stephanie J C; Spencer, Anne; Diaz-Ordaz, Karla; Eldridge, Sandra; Underwood, Martin

    2014-09-01

    Proxy measures are an alternative source of data for care home residents who are unable to complete the health utility measure, but the agreement levels between residents and care home staff for the EQ-5D have not been investigated previously. The objective of the present study was to examine the inter-rater agreement levels for the reporting of EQ-5D by care home residents and staff, adjusting for the impact of clustering. The data consist of EQ-5D scores for 565 pairs of care home residents and proxies and quality-adjusted life-years (QALYs) for 248 pairs. Cluster-adjusted agreement was compared for the domains, index scores, and QALYs from the EQ-5D. Factors influencing index score agreement are also described. The results show poor to fair agreement at the domain level (cluster-adjusted Kappa -0.03 to 0.26) and moderate agreement at the score level (cluster-adjusted intra-class correlation coefficient [ICC] 0.44-0.50) and for QALYs (cluster-adjusted ICC 0.59). A higher likelihood of depression and lower cognitive impairment were both associated with smaller discrepancy between proxy and self-completed scores. Proxies appear to be an acceptable source of data for index scores and QALYs but may be less reliable if individual domains are considered. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  5. The agreement between proxy and self-completed EQ-5D for care home residents was better for index scores than individual domains☆

    Science.gov (United States)

    Devine, Angela; Taylor, Stephanie J.C.; Spencer, Anne; Diaz-Ordaz, Karla; Eldridge, Sandra; Underwood, Martin

    2014-01-01

    Objective Proxy measures are an alternative source of data for care home residents who are unable to complete the health utility measure, but the agreement levels between residents and care home staff for the EQ-5D have not been investigated previously. The objective of the present study was to examine the inter-rater agreement levels for the reporting of EQ-5D by care home residents and staff, adjusting for the impact of clustering. Study Design and Setting The data consist of EQ-5D scores for 565 pairs of care home residents and proxies and quality-adjusted life-years (QALYs) for 248 pairs. Cluster-adjusted agreement was compared for the domains, index scores, and QALYs from the EQ-5D. Factors influencing index score agreement are also described. Results The results show poor to fair agreement at the domain level (cluster-adjusted Kappa −0.03 to 0.26) and moderate agreement at the score level (cluster-adjusted intra-class correlation coefficient [ICC] 0.44–0.50) and for QALYs (cluster-adjusted ICC 0.59). A higher likelihood of depression and lower cognitive impairment were both associated with smaller discrepancy between proxy and self-completed scores. Conclusion Proxies appear to be an acceptable source of data for index scores and QALYs but may be less reliable if individual domains are considered. PMID:24837298

  6. Bilateral agreements

    International Nuclear Information System (INIS)

    1998-01-01

    Ten bilateral agreements are presented. These are: 1) Co-operation agreement relating to the peaceful uses of nuclear energy between Argentina and EURATOM (1996); 2) Agreement on co-operation in the peaceful uses of nuclear energy between Argentina and Greece (1997); 3) Implementing arrangement for technical exchange and co-operation in the area of peaceful uses of nuclear energy between Argentina and the United States (1997); 4) Agreement concerning co-operation in nuclear science and technology between Australia and Indonesia (1997); 5) Implementation of the 1985 Agreement for co-operation concerning the peaceful uses of nuclear energy between the People's Republic of China and the United States (1998); 6) Protocol of co-operation between France and Lithuania (1997); 7) Agreement on co-operation in energy research, science and technology, and development between Germany and the United States (1998); 8) Agreement on early notification of a nuclear accident and exchange of information on nuclear facilities between Greece and Romania (1997); 9) Agreement on early notification of nuclear accidents and co-operation in the field of nuclear safety between Hungary and the Ukraine (1997); 10) Agreement in the field of radioactive waste management between Switzerland and the United States (1997). (K.A.)

  7. Vibration Response Imaging: evaluation of rater agreement in healthy subjects and subjects with pneumonia

    International Nuclear Information System (INIS)

    Bartziokas, Konstantinos; Daenas, Christos; Preau, Sebastien; Zygoulis, Paris; Triantaris, Apostolos; Kerenidi, Theodora; Makris, Demosthenes; Gourgoulianis, Konstantinos I; Daniil, Zoe

    2010-01-01

    We evaluated pulmonologists variability in the interpretation of Vibration response imaging (VRI) obtained from healthy subjects and patients hospitalized for community acquired pneumonia. The present is a prospective study conducted in a tertiary university hospital. Twenty healthy subjects and twenty three pneumonia cases were included in this study. Six pulmonologists blindly analyzed images of normal subjects and pneumonia cases and evaluated different aspects of VRI images related to the quality of data aquisition, synchronization of the progression of breath sound distribution and agreement between the maximal energy frame (MEF) of VRI (which is the maximal geographical area of lung vibrations produced at maximal inspiration) and chest radiography. For qualitative assessment of VRI images, the raters' evaluations were analyzed by degree of consistency and agreement. The average value for overall identical evaluations of twelve features of the VRI image evaluation, ranged from 87% to 95% per rater (94% to 97% in control cases and from 79% to 93% per rater in pneumonia cases). Inter-rater median (IQR) agreement was 91% (82-96). The level of agreement according to VRI feature evaluated was in most cases over 80%; intra-class correlation (ICC) obtained by using a model of subject/rater for the averaged features was overall 0.86 (0.92 in normal and 0.73 in pneumonia cases). Our findings suggest good agreement in the interpretation of VRI data between different raters. In this respect, VRI might be helpful as a radiation free diagnostic tool for the management of pneumonia

  8. Bilateral agreements

    International Nuclear Information System (INIS)

    Anon.

    2004-01-01

    The bilateral agreements concern Brazil with United States relative to the co operation in nuclear energy, Germany with Russian Federation relative to the elimination and disposal of nuclear weapons; The multilateral agreements concerns the signature of the Protocols to amend the Paris and Brussels Conventions, the multilateral nuclear environmental programme in the Russian Federation, the status of Conventions in the field of nuclear energy. (N.C.)

  9. Inter-Rater Reliability for Speech-Language Therapists' Judgement of Oesophageal Abnormality during Oesophageal Visualization

    Science.gov (United States)

    Miles, Anna

    2017-01-01

    Background: Oesophageal abnormalities are common findings in a speech-language therapy videofluoroscopy clinic. Fluoroscopic screening involving oropharynx alone fails to identify these patients. Oesophageal screening as an adjunct to videofluoroscopy is gaining popularity. Yet currently, little is known about the reliability of speech and…

  10. Evaluation of the Military Functional Assessment Program: Inter rater Reliability of Task Scores

    Science.gov (United States)

    2017-09-19

    been developed to accommodate a variety of Soldier injuries while maintaining a high enough level of difficulty to reflect active-duty requirements...the Soldier was successful with minimal assistance and the majority of all comments reflected that. 14 The MSTC-MCS vignette described a simulation...makes advances in TBI evaluation. Defense Centers of Excellence Blog . Retrieved 19 October 2014 from http://www.dcoe.mil/ blog /12-01- 06

  11. Assessment of the inter-rater reliability of the microscopic diagnosis ...

    African Journals Online (AJOL)

    malaria-operational-plans/fy14/ rwanda_mop_fy14.pdf?sfvrsn=8. Rafael, M. E., Taylor, T., Magill, A., Lim, Y.-W., Girosi, F., &. Allan, R. (2006). Reducing the burden of childhood malaria in Africa: the role of improved. Nature, 444 Suppl , 39–48.

  12. Inter-rater Reliability of the Modified Ashworth Scale for Spasticity in Hemiplegic Patients.

    Science.gov (United States)

    Sloan, R. L.; And Others

    1992-01-01

    This study tested the interrater reliability of the Modified Ashworth Scale in measuring upper and lower limb spasticity in 34 hemiplegic adult patients examined by 2 physiotherapists and 2 doctors. Findings indicated satisfactory reliability for upper limb spasticity but less satisfactory results for lower limb spasticity. (DB)

  13. Inter-Rater Reliability of the Food Environment Audit for Diverse Neighborhoods (FEAD-N)

    OpenAIRE

    Izumi, Betty T.; Zenk, Shannon N.; Schulz, Amy J.; Mentz, Graciela B.; Sand, Sharon L.; de Majo, Ricardo F.; Wilson, Christine; Odoms-Young, Angela

    2012-01-01

    Studies have shown that neighborhood food environments are important influences on dietary intake and may contribute to health disparities. While instruments with high reliability have been developed to assess food availability, price, and quality, few measures to assess items associated with the physical and social features of food stores have been developed. Yet, recent qualitative studies have documented aspects associated with such features of urban food stores that are barriers to food a...

  14. Inter-rater reliability of direct observations of the physical and psychosocial working conditions in eldercare

    DEFF Research Database (Denmark)

    Karstad, Kristina; Rugulies, Reiner; Skotte, Jørgen

    2018-01-01

    The aim of the study was to develop and evaluate the reliability of the "Danish observational study of eldercare work and musculoskeletal disorders" (DOSES) observation instrument to assess physical and psychosocial risk factors for musculoskeletal disorders (MSD) in eldercare work. During 1...... is appropriate for assessing physical and psychosocial risk factors for MSD among eldercare workers....

  15. Inter-rater reliability of the EPUAP pressure ulcer classification system using photographs.

    NARCIS (Netherlands)

    Defloor, T.; Schoonhoven, L.

    2004-01-01

    BACKGROUND: Many classification systems for grading pressure ulcers are discussed in the literature. Correct identification and classification of a pressure ulcer is important for accurate reporting of the magnitude of the problem, and for timely prevention. The reliability of pressure ulcer

  16. Emotional and Behavioral Screener: Test-Retest Reliability, Inter-Rater Reliability, and Convergent Validity

    Science.gov (United States)

    Nordness, Philip D.; Epstein, Michael H.; Cullinan, Douglas; Pierce, Corey D.

    2014-01-01

    The Emotional and Behavioral Screener (EBS) is a universal screening instrument designed to identify students whose excessive problem behaviors put them at risk of the education disability category of emotional disturbance (ED). This article reports findings from three studies that address the reliability and validity of the EBS. Studies 1 and 2…

  17. Validity and Inter-Rater Reliability of a Novel Bedside Referral Tool for Spasticity

    Science.gov (United States)

    2018-02-20

    Spasticity, Muscle; Muscular Diseases; Musculoskeletal Disease; Muscle Hypertonia; Muscle Spasticity; Neuromuscular Manifestations; Signs and Symptoms; Nervous System Diseases; Neurologic Manifestations

  18. Complementizer Agreement

    NARCIS (Netherlands)

    van Koppen, J.M.

    2017-01-01

    Complementizers agree in phi-features with the embedded subject in dialects of German and Dutch, in Tense with the embedded clause in Irish and in phi-features with the matrix subject in certain African languages. These complementizer agreement phenomena will be the main empirical focus of this

  19. Strongly Agree or Strongly Disagree?

    DEFF Research Database (Denmark)

    Carrizosa, Emilio; Nogales-Gómez, Amaya; Morales, Dolores Romero

    2016-01-01

    In linear classifiers, such as the Support Vector Machine (SVM), a score is associated with each feature and objects are assigned to classes based on the linear combination of the scores and the values of the features. Inspired by discrete psychometric scales, which measure the extent to which...... a factor is in agreement with a statement, we propose the Discrete Level Support Vector Machine (DILSVM) where the feature scores can only take on a discrete number of values, defined by the so-called feature rating levels. The DILSVM classifier benefits from interpretability and it has visual appeal...

  20. License Agreements concerning trademarks

    OpenAIRE

    Dráb, Ladislav

    2014-01-01

    The thesis deals with license agreements in relation to trademarks, specially the trademark license agreement. The thesis contains in its theoretical interpretation of the concept and sources of the license agreement. There are also analyzed various types of license agreements, including modifying the license agreement in the new Civil Code, and related types of contracts as a franchising or merchandising. Another interpretation is more concerned with trademark and trademark license agreement...

  1. Therapist adherence in the strong without anorexia nervosa (SWAN) study: A randomized controlled trial of three treatments for adults with anorexia nervosa.

    Science.gov (United States)

    Andony, Louise J; Tay, Elaine; Allen, Karina L; Wade, Tracey D; Hay, Phillipa; Touyz, Stephen; McIntosh, Virginia V W; Treasure, Janet; Schmidt, Ulrike H; Fairburn, Christopher G; Erceg-Hurn, David M; Fursland, Anthea; Crosby, Ross D; Byrne, Susan M

    2015-12-01

    To develop a psychotherapy rating scale to measure therapist adherence in the Strong Without Anorexia Nervosa (SWAN) study, a multi-center randomized controlled trial comparing three different psychological treatments for adults with anorexia nervosa. The three treatments under investigation were Enhanced Cognitive Behavioural Therapy (CBT-E), the Maudsley Anorexia Nervosa Treatment for Adults (MANTRA), and Specialist Supportive Clinical Management (SSCM). The SWAN Psychotherapy Rating Scale (SWAN-PRS) was developed, after consultation with the developers of the treatments, and refined. Using the SWAN-PRS, two independent raters initially rated 48 audiotapes of treatment sessions to yield inter-rater reliability data. One rater proceeded to rate a total of 98 audiotapes from 64 trial participants. The SWAN-PRS demonstrated sound psychometric properties, and was considered a reliable measure of therapist adherence. The three treatments were highly distinguishable by independent raters, with therapists demonstrating significantly more behaviors consistent with the actual allocated treatment compared to the other two treatment modalities. There were no significant site differences in therapist adherence observed. The findings provide support for the internal validity of the SWAN study. The SWAN-PRS was deemed suitable for use in other trials involving CBT-E, MANTRA, or SSCM. The Authors. International Journal of Eating Disorders Published by Wiley Periodicals, Inc.

  2. Agreement Workflow Tool (AWT)

    Data.gov (United States)

    Social Security Administration — The Agreement Workflow Tool (AWT) is a role-based Intranet application used for processing SSA's Reimbursable Agreements according to SSA's standards. AWT provides...

  3. Face validity and inter-rater reliability of the Danish version of the modified-Yale Preoperative Anxiety Scale

    DEFF Research Database (Denmark)

    Skovby, Pernille; Rask, Charlotte Ulrikka; Dall, Rolf

    2014-01-01

    Introduction Preoperative anxiety is common in young children and associated with adverse outcomes after sur-gery. The modified Yale Preoperative Anxiety Scale (m-YPAS) has been developed to assess pre-operative anxiety in children. The purpose of this study was to translate and adapt the m...... anxiety score was in: induction 1:0.92 and induction 2: 0.92 Conclusion Standardized and validated assessment tools are needed to evaluate interventions aiming to reduce preoperative anxiety in children. The Danish m-YPAS had a satisfactory face validity and inter-reliability, based on a minor empirical...

  4. Intra- and inter-rater reliability of the Sollerman hand function test in patients with chronic stroke

    DEFF Research Database (Denmark)

    Brogårdh, Christina; Persson, Ann L; Sjölund, Bengt H

    2007-01-01

    PURPOSE: To examine whether the Sollerman hand function test is reliable in a test-retest situation in patients with chronic stroke. METHOD: Three independent examiners observed each patient at three experimental sessions; two days in week 1 (short-term test-retest) and one day in week 4 (long...... hand function test seems to be a reliable test in patients with chronic stroke, but we recommend that the same examiner evaluates a patient's hand function pre- and post-treatment....

  5. The intra- and inter-rater reliability of five clinical muscle performance tests in patients with and without neck pain

    DEFF Research Database (Denmark)

    Juul, Tina; Langberg, Henning; Enoch, Flemming

    2013-01-01

    This study investigates the reliability of muscle performance tests using cost- and time-effective methods similar to those used in clinical practice. When conducting reliability studies, great effort goes into standardising test procedures to facilitate a stable outcome. Therefore, several test ...

  6. Analysis of unintended events in hospitals: inter-rater reliability of constructing causal trees and classifying root causes

    NARCIS (Netherlands)

    Smits, M.; Janssen, J.; Vet, de H.C.W.; Zwaan, L.; Timmermans, D.R.M.; Groenewegen, P.P.; Wagner, C.

    2009-01-01

    BACKGROUND: Root cause analysis is a method to examine causes of unintended events. PRISMA (Prevention and Recovery Information System for Monitoring and Analysis: is a root cause analysis tool. With PRISMA, events are described in causal trees and root causes are subsequently classified with the

  7. Analysis of unintended events in hospitals : inter-rater reliability of constructing causal trees and classifying root causes

    NARCIS (Netherlands)

    Smits, M.; Janssen, J.; Vet, R. de; Zwaan, L.; Groenewegen, P.P.; Timmermans, D.

    2009-01-01

    Background. Root cause analysis is a method to examine causes of unintended events. PRISMA (Prevention and Recovery Information System for Monitoring and Analysis) is a root cause analysis tool. With PRISMA, events are described in causal trees and root causes are subsequently classified with the

  8. Content Validity and Inter-Rater Reliability of the Halliwick-Concept-Based Instrument "Swimming with Independent Measure"

    Science.gov (United States)

    Srsen, Katja Groleger; Vidmar, Gaj; Pikl, Masa; Vrecar, Irena; Burja, Cirila; Krusec, Klavdija

    2012-01-01

    The Halliwick concept is widely used in different settings to promote joyful movement in water and swimming. To assess the swimming skills and progression of an individual swimmer, a valid and reliable measure should be used. The Halliwick-concept-based Swimming with Independent Measure (SWIM) was introduced for this purpose. We aimed to determine…

  9. The Barthel Index: comparing inter-rater reliability between nurses and doctors in an older adult rehabilitation unit.

    LENUS (Irish Health Repository)

    Hartigan, Irene

    2011-02-01

    To ensure accuracy in recording the Barthel Index (BI) in older people, it is essential to determine who is best placed to administer the index. The aim of this study was to compare doctors\\' and nurses\\' reliability in scoring the BI.

  10. Intra- and inter-rater reliability of movement and palpation tests in patients with neck pain: A systematic review.

    Science.gov (United States)

    Jonsson, Anders; Rasmussen-Barr, Eva

    2018-03-01

    Neck pain is common and often becomes chronic. Various clinical tests of the cervical spine are used to direct and evaluate treatment. This systematic review aimed to identify studies examining the intra- and/or interrater reliability of tests used in clinical examination of patients with neck pain. A database search up to April 2016 was conducted in PubMed, CINAHL, and AMED. The Quality Appraisal of Reliability Studies Checklist (QAREL) was used to assess risk of bias. Eleven studies were included, comprising tests of active and passive movement and pain evaluating participants with ongoing neck pain. One study was assessed with a low risk of bias, three with medium risk, while the rest were assessed with high risk of bias. The results showed differing reliabilities for the included tests ranging from poor to almost perfect. In conclusion, active movement and pain for pain or mobility overall presented acceptable to very good reliability (Kappa >0.40); while passive intervertebral tests had lower Kappa values, suggesting poor reliability. It may be a coincidence that the studies indicating very good reliability tended to be of higher quality (low to moderate risk of bias), while studies finding poor reliability tended to be of lower quality (high risk of bias). Regardless, the current recommendation from this review would suggest the clinical use of tests with acceptable reliability and avoiding the use of tests that have been shown to not be reliable. Finally, it is critical that all future reliability studies are of higher quality with low risk of bias.

  11. Analysis of unintended events in hospitals: inter-rater reliability of constructing causal trees and classifying root causes.

    NARCIS (Netherlands)

    Smits, M.; Janssen, J.; Vet, R. de; Zwaan, L.; Timmermans, D.; Groenewegen, P.; Wagner, C.

    2009-01-01

    Background: Root cause analysis is a method to examine causes of unintended events. PRISMA (Prevention and Recovery Information System for Monitoring and Analysis) is a root cause analysis tool. With PRISMA, events are described in causal trees and root causes are subsequently classified with the

  12. Nuclear cooperation agreements

    International Nuclear Information System (INIS)

    Nuclear cooperation agreements are reviewed in tabular form, especially agreements with developing countries. The reporting countries are the USA, the Federal Republic of Germany, Canada, Australia, Japan, and France. A separate EURATOM list is annexed

  13. Shareholders' agreements in Denmark

    DEFF Research Database (Denmark)

    Werlauff, Erik

    2010-01-01

    The article warns that with effect from 1 March 2010, the new Danish Companies Act (on public and private limited companies) has seriously weakened the effect of shareholders’ agreements which have been entered into on Danish companies. These agreements (in the act’s new terminology: “owners...

  14. Competition for Assistance Agreements

    Science.gov (United States)

    It is EPA policy to promote competition in the award of assistance agreements to the maximum extent practicable.When assistance agreements are awarded competitively, it is EPA policy that the competitive process be fair and open & that no applicant receive

  15. The Sicomines Agreement

    DEFF Research Database (Denmark)

    Jansson, Johanna

    of the global political economy have shifted, and that China’s position as a foreign policy actor is now consolidated. Continuity, since the 2009 amendment of the agreement, which came about partly as a result of China’s ambitions to take up an active role in the International Monetary Fund (IMF......, the investment into the DRC’s mining sector is in itself beneficial for the country, and the renegotiation of the agreement was positive in the sense that the Congolese state guarantee for the mining component was removed. However, the question of whether the Sicomines agreement is a good deal for the DRC...

  16. Trade Agreements PTI

    Data.gov (United States)

    Department of Homeland Security — The objective of the Trade Agreements PTI is to advance CBP’s mission by working with internal and external stakeholders to facilitate legitimate trade and address...

  17. Australia's nuclear safeguards agreements

    International Nuclear Information System (INIS)

    1990-01-01

    This is a compilation of the bilateral agreements concluded by Australia concerning co-operation in the peaceful uses of nuclear energy. The publication also includes the agreement with the International Atomic Energy Agency (IAEA) for the application of safeguards in connection with the Treaty on the Non-Proliferation of Nuclear Weapons (NPT) and the agreement with EURATOM on transfers of nuclear materials from Australia to the European Atomic Energy Community. The other agreements were concluded with the following countries: Canada, Egypt, Finland, France, Japan, Republic of Korea, Philippines, Singapore, Sweden, Switzerland, USSR, United Kingdom and United States. They concern transfers of nuclear materials and equipment, research and development, exchange of information, etc. All contain provisions on safeguards, physical protection and restrictions on exports to third countries [fr

  18. Watershed Management Partnership Agreement

    Science.gov (United States)

    On November 19, 2004, the U.S. Environmental Protection Agency and the U.S. Army Corps of Engineers signed the Watershed Management Partnership Agreement to promote watershed health, economic sustainability and community vitality through effective manageme

  19. International Fisheries Agreements

    DEFF Research Database (Denmark)

    Pintassilgo, Pedro; Kronbak, Lone Grønbæk; Lindroos, Marko

    2015-01-01

    This paper surveys the application of game theory to the economic analysis of international fisheries agreements. The relevance of this study comes not only from the existence of a vast literature on the topic but especially from the specific features of these agreements. The emphasis of the survey...... is on coalition games, an approach that has become prominent in the fisheries economics literature over the last decade. It is shown that coalition games were first applied to international fisheries agreements in the late 1990s addressing cooperative issues under the framework of characteristic function games....... Then, progres- sively, this cooperative approach was combined with non-cooperative elements such as the stability analysis of the agreements. Finally, partition function games, which model coalition formation endogenously, were introduced and became the standard approach to study the formation...

  20. The reproducibility and validity of the Canadian Occupational Performance Measure in parents of children with disabilities

    NARCIS (Netherlands)

    Verkerk, Gijs J. Q.; Wolf, Marie Jeanne M. A. G.; Louwers, Annoek M.; Meester-Delver, Anke; Nollet, Frans

    2006-01-01

    OBJECTIVE: To study the reproducibility (inter-rater agreement), the construct and criterion validity of the Canadian Occupational Performance Measure (COPM) in the parents of children with disabilities. DESIGN: The COPM was administered twice by two different occupational therapists. The

  1. FFTF Authorization Agreement

    Energy Technology Data Exchange (ETDEWEB)

    DAUTEL, W.A.

    2000-02-25

    The purpose of the Authorization Agreement is to serve as a mechanism whereby the U.S. Department of Energy, Richland Operations Office (RL) and Fluor Hanford (FH) jointly clarify and agree to key conditions for conducting work safely and efficiently.

  2. International environmental agreements

    NARCIS (Netherlands)

    de Zeeuw, Aart

    2015-01-01

    The regulation of environmental externalities at the global level requires international agreements between sovereign states. Game theory provides an appropriate theoretical tool for analysis. However, game theory can result in a wide range of outcomes, and therefore it is important to discuss the

  3. REAL ESTATE PURCHASE AGREEMENTS

    Directory of Open Access Journals (Sweden)

    Bujorel FLOREA

    2016-12-01

    Full Text Available The study presented herein represents a field with good present and future perspectives, especially because real estate property is not under the incidence of a single normative act regarding the sale-purchase agreement of such goods, and given the fact that there are specific legal provisions with respect to various real estate categories and the localization of such property. The article deals with the sale-purchase agreement of various real estate categories, such as fields, buildings, the correspondent lots, urban area, farm, and forests fields, focusing on some particularities. A special care is attributed to examining the applicable laws with regard to the purchase agreements of field lands, the special conditions to be taken into account, the persons that may act as buyers, including foreigners, those without citizenship, and legal persons of a nationality other than Romanian. Finally, a special concern is given to the formalities required for legally exerting the pre-emptive right and the applicable sanctions in that respect.

  4. Testing strong interaction theories

    International Nuclear Information System (INIS)

    Ellis, J.

    1979-01-01

    The author discusses possible tests of the current theories of the strong interaction, in particular, quantum chromodynamics. High energy e + e - interactions should provide an excellent means of studying the strong force. (W.D.L.)

  5. Reliability of one-repetition maximum performance in people with chronic heart failure.

    Science.gov (United States)

    Ellis, Rachel; Holland, Anne E; Dodd, Karen; Shields, Nora

    2018-02-24

    Evaluate intra-rater and inter-rater reliability of the one-repetition maximum strength test in people with chronic heart failure. Intra-rater and inter-rater reliability study. A public tertiary hospital in northern metropolitan Melbourne. Twenty-four participants (nine female, mean age 71.8 ± 13.1 years) with mild to moderate heart failure of any aetiology. Lower limb strength was assessed by determining the maximum weight that could be lifted using a leg press. Intra-rater reliability was tested by one assessor on two separate occasions . Inter-rater reliability was tested by two assessors in random order. Intra-class correlation coefficients and 95% confidence intervals were calculated. Bland and Altman analyses were also conducted, including calculation of mean differences between measures ([Formula: see text]) and limits of agreement . Ten intra-rater and 21 inter-rater assessments were completed. Excellent intra-rater (intra-class correlation coefficient 2,1 0.96) and inter-rater (intra-class correlation coefficient 2,1 0.93) reliability was found. Intra-rater assessment showed less variability (mean difference 4.5 kg, limits of agreement -8.11 to 17.11 kg) than inter-rater agreement (mean difference -3.81 kg, limits of agreement -23.39 to 15.77 kg). One-repetition maximum determined using a leg press is a reliable measure in people with heart failure. Given its smaller limits of agreement, intra-rater testing is recommended. Implications for Rehabilitation Using a leg press to determine a one-repetition maximum we were able to demonstrate excellent inter-rater and intra-rater reliability using an intra-class correlation coefficient. The Bland and Altman levels of agreement were wide for inter-rater reliability and so we recommend using one assessor if measuring change in strength within an individual over time.

  6. Integration of oncology and palliative care: a systematic review.

    Science.gov (United States)

    Hui, David; Kim, Yu Jung; Park, Ji Chan; Zhang, Yi; Strasser, Florian; Cherny, Nathan; Kaasa, Stein; Davis, Mellar P; Bruera, Eduardo

    2015-01-01

    Both the American Society of Clinical Oncology and the European Society for Medical Oncology strongly endorse integrating oncology and palliative care (PC); however, a global consensus on what constitutes integration is currently lacking. To better understand what integration entails, we conducted a systematic review to identify articles addressing the clinical, educational, research, and administrative indicators of integration. We searched Ovid MEDLINE and Ovid EMBase between 1948 and 2013. Two researchers independently reviewed each citation for inclusion and extracted the indicators related to integration. The inter-rater agreement was high (κ = 0.96, p oncology journals (59%) and in or after 2010 (64%, p oncology and PC. ©AlphaMed Press.

  7. International nuclear agreements

    International Nuclear Information System (INIS)

    Miatello, A.; Severino, R.

    1988-01-01

    This multilingual glossary, in the laborious compilation of which the authors have been greatly assisted by a group of professional translators and experts, presents for the first time a substantial number of entries in four languages (English, French, German and Italian), whose terminology and phraseology, all bearing the appropriate normative reference, has been drawn from the official text of the most relevant international agreements on nuclear policy. It is complemented by a thorough critical study on the status of nonproliferation by Lawrence Scheinman and Josef Pilat. Librarians, translators and interpreters as well as scholars and researchers in international law will find this volume a reference tool of specific interest

  8. Agreement in Persian

    Directory of Open Access Journals (Sweden)

    Lofti, Ahmad R.

    2006-01-01

    Full Text Available This article investigates agreement as a number marking mechanism in Persian. The mechanism differs from number marking on nominals in that with an inanimate plural subject, the SG verbal ending signals a collective conceptualization of the experience where the members of the group are considered together as a single unit. The PL ending, on the other hand, signals a distributive conceptualization where the entities are individuated; hence, they are considered to be dispersed over space, or distinct in sort or time. Autonomy - whether the entity is conceived of as governing the course of events or not - seems to underlie the choice between SG and PL.

  9. THE PLEA BARGAIN AGREEMENT

    Directory of Open Access Journals (Sweden)

    Mihai Daniel ONIȘOR

    2015-07-01

    Full Text Available Alongside major changes in Romanian criminal law, the plea bargain agreement gave a new approach on the mechanisms of criminal procedure in national law, thus creating a series of problems and divergent interpretations of the content and limits of this mechanism in solving criminal litigation. What motivated us in our scientific analysis was the novelty of the issues that arose both in the doctrine and interpretation of the legal provisions and in the practice of prosecution offices and national courts, the high impact that the new proceedings can have on criminal policy and the need for clear and efficient provisions that can ensure legal certainty. Our paper is divided in four major parts: the nature and object of the agreement, the conditions of plea bargain, the prosecutorial phase, court validation and appeal procedure, in each of these sections taking into account the legal provisions, analyzing working hypothesis, identifying probable issues and problems and providing our opinion on possible solutions. Our findings prove the fact that the novelty aspect of this procedure determined a number of gaps in the law, aspects that can dramatically influence the result of the criminal case and the guarantees that the parties have in criminal law. Moreover it will underline the unclear provisions that make the new law inapplicable in certain cases and leave a number of situations without any lawful solution.

  10. Predicative Adjective Agreement

    DEFF Research Database (Denmark)

    Vikner, Sten

    2001-01-01

    German is a complicated language. Any speaker of e.g. French or Danish who has ever tried to learn German would agree to this. Coming from languages with only two genders and with no case outside the pronoun system, German, with three genders and with four cases throughout the nominal system, seems...... unjustifiably complicated, as if it had been specially designed to torment poor students. However, there is one area where German agreement morphology could not possibly be simpler, and where German is much easier for non-native speakers than e.g. French or Danish: predicative adjectives. Both gender and number...... distinctions, disappear when adjectives are used predicatively. This paper will try to account for why the Germanic languages that inflect attiributive adjectives but not predicative ones are all SOV-languages (e.g. German, Dutch, Frisian and Yiddish)....

  11. VHA Data Sharing Agreement Repository

    Data.gov (United States)

    Department of Veterans Affairs — The VHA Data Sharing Agreement Repository serves as a centralized location to collect and report on agreements that share VHA data with entities outside of VA. It...

  12. Seismic contracts and agreements

    International Nuclear Information System (INIS)

    Cooper, N.M.; Krause, V.

    1999-01-01

    Some points to consider regarding management of seismic projects within the Canadian petroleum industry were reviewed. Seismic projects involve the integration of many services. This paper focused on user-provider relationships, the project planning process, competitive bid considerations, the types of agreement used for seismic and their implications, and the impact that certain points of control may have on a company: (1) initial estimate versus actual cost, (2) liability, (3) safety and operational performance, and (4) quality of deliverables. The objective is to drive home the point that in today's environment where companies are forming, merging, or collapsing on a weekly basis , chain of command and accountability are issues that can no longer be dealt with casually. Companies must form business relationships with service providers with a full knowledge of benefits and liabilities of the style of relationship they choose. Diligent and proactive management tends to optimize cost, safety and liability issues, all of which have a bearing on the points of control available to the company

  13. Strongly Correlated Topological Insulators

    Science.gov (United States)

    2016-02-03

    Strongly Correlated Topological Insulators In the past year, the grant was used for work in the field of topological phases, with emphasis on finding...surface of topological insulators. In the past 3 years, we have started a new direction, that of fractional topological insulators. These are materials...in which a topologically nontrivial quasi-flat band is fractionally filled and then subject to strong interactions. The views, opinions and/or

  14. Strong Cosmic Censorship

    Science.gov (United States)

    Isenberg, James

    2017-01-01

    The Hawking-Penrose theorems tell us that solutions of Einstein's equations are generally singular, in the sense of the incompleteness of causal geodesics (the paths of physical observers). These singularities might be marked by the blowup of curvature and therefore crushing tidal forces, or by the breakdown of physical determinism. Penrose has conjectured (in his `Strong Cosmic Censorship Conjecture`) that it is generically unbounded curvature that causes singularities, rather than causal breakdown. The verification that ``AVTD behavior'' (marked by the domination of time derivatives over space derivatives) is generically present in a family of solutions has proven to be a useful tool for studying model versions of Strong Cosmic Censorship in that family. I discuss some of the history of Strong Cosmic Censorship, and then discuss what is known about AVTD behavior and Strong Cosmic Censorship in families of solutions defined by varying degrees of isometry, and discuss recent results which we believe will extend this knowledge and provide new support for Strong Cosmic Censorship. I also comment on some of the recent work on ``Weak Null Singularities'', and how this relates to Strong Cosmic Censorship.

  15. Predicting word sense annotation agreement

    DEFF Research Database (Denmark)

    Martinez Alonso, Hector; Johannsen, Anders Trærup; Lopez de Lacalle, Oier

    2015-01-01

    High agreement is a common objective when annotating data for word senses. However, a number of factors make perfect agreement impossible, e.g. the limitations of the sense inventories, the difficulty of the examples or the interpretation preferences of the annotations. Estimating potential...... agreement is thus a relevant task to supplement the evaluation of sense annotations. In this article we propose two methods to predict agreement on word-annotation instances. We experiment with a continuous representation and a three-way discretization of observed agreement. In spite of the difficulty...

  16. Reliability of the School Food Checklist for in-school audits and photograph analysis of children's packed lunches.

    Science.gov (United States)

    Mitchell, S A; Miles, C L; Brennan, L; Matthews, J

    2010-02-01

    Assessment of children's diets is problematic, typically relying on error-prone parent or child recall or reporting, or resource intensive direct observation. The School Food Checklist (SFC) is an objective instrument comprising of 20 food and beverage categories designed to measure the foods contained in children's packed lunches. The present study aimed to assess intra-rater and inter-rater reliability of each of the food and beverage categories of the SFC for both in-school audits and photograph analysis of children's school lunches. Participants comprised 176 children aged 5-8 years from five primary schools in Northern Metropolitan Melbourne. The SFC was used to measure the foods contained in children's packed lunches in the school setting and using photographs. Photograph analysis was conducted by the auditors 2-3 months after completion of in-school audits. Both intra-rater [intra-class correlation coefficient (ICC) = 0.78-1] and inter-rater (ICC = 0.50-0.95) reliability analysis indicated strong agreement for in-school auditing. With the exception of the food category titled 'leftovers', there was strong intra-rater reliability for auditors' live audits and their analysis of photographs [ICC = 0.57-0.98 (Auditor 1); ICC = 0.72-0.90 (Auditor 2)], and strong inter-rater reliability for photograph analysis (ICC = 0.68-0.92). The SFC is a reliable method of measuring the foods and beverages contained in children's packed lunches when used in the school setting or for photograph analysis. This finding has broad implications, particularly for the use of photograph analysis, because this approach offers a convenient and cost effective method of measuring what food and beverages children bring to school in home packed lunches.

  17. Strong Arcwise Connectedness

    OpenAIRE

    Espinoza, Benjamin; Gartside, Paul; Kovan-Bakan, Merve; Mamatelashvili, Ana

    2012-01-01

    A space is `n-strong arc connected' (n-sac) if for any n points in the space there is an arc in the space visiting them in order. A space is omega-strong arc connected (omega-sac) if it is n-sac for all n. We study these properties in finite graphs, regular continua, and rational continua. There are no 4-sac graphs, but there are 3-sac graphs and graphs which are 2-sac but not 3-sac. For every n there is an n-sac regular continuum, but no regular continuum is omega-sac. There is an omega-sac ...

  18. Abortion: Strong's counterexamples fail

    DEFF Research Database (Denmark)

    Di Nucci, Ezio

    2009-01-01

    This paper shows that the counterexamples proposed by Strong in 2008 in the Journal of Medical Ethics to Marquis's argument against abortion fail. Strong's basic idea is that there are cases--for example, terminally ill patients--where killing an adult human being is prima facie seriously morally......'s scenarios have some valuable future or admitted that killing them is not seriously morally wrong. Finally, if "valuable future" is interpreted as referring to objective standards, one ends up with implausible and unpalatable moral claims....

  19. A strong comeback

    International Nuclear Information System (INIS)

    Marier, D.

    1992-01-01

    This article presents the results of a financial rankings survey which show a strong economic activity in the independent energy industry. The topics of the article include advisor turnover, overseas banks, and the increase in public offerings. The article identifies the top project finance investors for new projects and restructurings and rankings for lenders

  20. Voluntary agreements in environmental policy

    International Nuclear Information System (INIS)

    Torvanger, Asbjoern

    2001-01-01

    A typically voluntary agreement is signed between the authorities and an industrial sector in order to reduce the emission of environmentally harmful substances. There are many different types of agreements. Voluntary agreements are not strictly voluntary, since in the background there is often some kind of ''threat'' about taxation or fees if the industry is unwilling to cooperate. This type of agreements has become popular in many OECD countries during the last decades. In Norway there are only a few agreements of this type. Experience with the use of voluntary agreements as well as research show that they are less cost-effective than market-based instruments such as taxes and quota systems. If there are great restrictions on the use of taxes and quota systems because of information- or measurement problems, or because these instruments are not politically acceptable, then voluntary agreements may be an interesting alternative. Thus, voluntary agreements are best used as a supplement to other instruments in some niche areas of the environmental policy. In some cases, voluntary agreements may be used between two countries or at a regional level, for example within the EU

  1. Labor Agreement Information System (LAIRS)

    Data.gov (United States)

    Office of Personnel Management — The Labor Agreement Information Retrieval System (LAIRS) is a database containing historical information on labor-management relations in the Federal Government. It...

  2. Intra-rater, inter-rater and test-retest reliability of an instrumented Timed Up and Go (iTUG) test in patients with Parkinson's disease.

    NARCIS (Netherlands)

    Van Lummel, Rob C.; Walgaard, Stefan; Hobert, Markus A.; Maetzler, Walter; Van Dieën, Jaap H.; Galindo-Garre, Francisca; Terwee, Caroline B

    2016-01-01

    Background The "Timed Up and Go" (TUG) is a widely used measure of physical functioning in older people and in neurological populations, including Parkinson's Disease. When using an inertial sensor measurement system (instrumented TUG [iTUG]), the individual components of the iTUG and the trunk

  3. Experience and grammatical agreement: statistical learning shapes number agreement production.

    Science.gov (United States)

    Haskell, Todd R; Thornton, Robert; Macdonald, Maryellen C

    2010-02-01

    A robust result in research on the production of grammatical agreement is that speakers are more likely to produce an erroneous verb with phrases such as the key to the cabinets, with a singular noun followed by a plural one, than with phrases such as the keys to the cabinet, where a plural noun is followed by a singular. These asymmetries are thought to reflect core language production processes. Previous accounts have attributed error patterns to a syntactic number feature present on plurals but not singulars. An alternative approach is presented in which a process similar to structural priming contributes to the error asymmetry via speakers' past experiences with related agreement constructions. A corpus analysis and two agreement production studies test this account. The results suggest that agreement production is shaped by statistical learning from past language experience. Implications for accounts of agreement are discussed. Copyright 2009 Elsevier B.V. All rights reserved.

  4. Strong Electroweak Symmetry Breaking

    CERN Document Server

    Grinstein, Benjamin

    2011-01-01

    Models of spontaneous breaking of electroweak symmetry by a strong interaction do not have fine tuning/hierarchy problem. They are conceptually elegant and use the only mechanism of spontaneous breaking of a gauge symmetry that is known to occur in nature. The simplest model, minimal technicolor with extended technicolor interactions, is appealing because one can calculate by scaling up from QCD. But it is ruled out on many counts: inappropriately low quark and lepton masses (or excessive FCNC), bad electroweak data fits, light scalar and vector states, etc. However, nature may not choose the minimal model and then we are stuck: except possibly through lattice simulations, we are unable to compute and test the models. In the LHC era it therefore makes sense to abandon specific models (of strong EW breaking) and concentrate on generic features that may indicate discovery. The Technicolor Straw Man is not a model but a parametrized search strategy inspired by a remarkable generic feature of walking technicolor,...

  5. Plasmons in strong superconductors

    International Nuclear Information System (INIS)

    Baldo, M.; Ducoin, C.

    2011-01-01

    We present a study of the possible plasmon excitations that can occur in systems where strong superconductivity is present. In these systems the plasmon energy is comparable to or smaller than the pairing gap. As a prototype of these systems we consider the proton component of Neutron Star matter just below the crust when electron screening is not taken into account. For the realistic case we consider in detail the different aspects of the elementary excitations when the proton, electron components are considered within the Random-Phase Approximation generalized to the superfluid case, while the influence of the neutron component is considered only at qualitative level. Electron screening plays a major role in modifying the proton spectrum and spectral function. At the same time the electron plasmon is strongly modified and damped by the indirect coupling with the superfluid proton component, even at moderately low values of the gap. The excitation spectrum shows the interplay of the different components and their relevance for each excitation modes. The results are relevant for neutrino physics and thermodynamical processes in neutron stars. If electron screening is neglected, the spectral properties of the proton component show some resemblance with the physical situation in high-T c superconductors, and we briefly discuss similarities and differences in this connection. In a general prospect, the results of the study emphasize the role of Coulomb interaction in strong superconductors.

  6. Experimental investigation of strong field trident production

    CERN Document Server

    Esberg, J; Knudsen, H; Thomsen, H D; Uggerhøj, E; Uggerhøj, U I; Sona, P; Mangiarotti, A; Ketel, T J; Dizdar, A; Dalton, M M; Ballestrero, S; Connell, S H

    2010-01-01

    We show by experiment that an electron impinging on an electric field that is of critical magnitude in its rest frame, may produce an electron-positron pair. Our measurements address higher-order QED, using the strong electric fields obtainable along particular crystallographic directions in single crystals. For the amorphous material our data are in good agreement with theory, whereas a discrepancy with theory on the magnitude of the trident enhancement is found in the precisely aligned case where the strong electric field acts.

  7. Gluon scattering amplitudes at strong coupling

    Energy Technology Data Exchange (ETDEWEB)

    Alday, Luis F. [Institute for Theoretical Physics and Spinoza Institute, Utrecht University, 3508 TD Utrecht (Netherlands); Maldacena, Juan [School of Natural Sciences, Institute for Advanced Study, Princeton, NJ 08540 (United States)

    2007-06-15

    We describe how to compute planar gluon scattering amplitudes at strong coupling in N = 4 super Yang Mills by using the gauge/string duality. The computation boils down to finding a certain classical string configuration whose boundary conditions are determined by the gluon momenta. The results are infrared divergent. We introduce the gravity version of dimensional regularization to define finite quantities. The leading and subleading IR divergencies are characterized by two functions of the coupling that we compute at strong coupling. We compute also the full finite form for the four point amplitude and we find agreement with a recent ansatz by Bern, Dixon and Smirnov.

  8. Strong-coupling approximations

    International Nuclear Information System (INIS)

    Abbott, R.B.

    1984-03-01

    Standard path-integral techniques such as instanton calculations give good answers for weak-coupling problems, but become unreliable for strong-coupling. Here we consider a method of replacing the original potential by a suitably chosen harmonic oscillator potential. Physically this is motivated by the fact that potential barriers below the level of the ground-state energy of a quantum-mechanical system have little effect. Numerically, results are good, both for quantum-mechanical problems and for massive phi 4 field theory in 1 + 1 dimensions. 9 references, 6 figures

  9. Strong interaction and QFD

    International Nuclear Information System (INIS)

    Ebata, T.

    1981-01-01

    With an assumed weak multiplet structure for bosonic hadrons, which is consistent with the ΔI = 1/2 rule, it is shown that the strong interaction effective hamiltonian is compatible with the weak SU(2) x U(1) gauge transformation. Especially the rho-meson transforms as a triplet under SU(2)sub(w), and this is the origin of the rho-photon analogy. It is also shown that the existence of the non-vanishing Cabibbo angle is a necessary condition for the absence of the exotic hadrons. (orig.)

  10. Strong Coupling Holography

    CERN Document Server

    Dvali, Gia

    2009-01-01

    We show that whenever a 4-dimensional theory with N particle species emerges as a consistent low energy description of a 3-brane embedded in an asymptotically-flat (4+d)-dimensional space, the holographic scale of high-dimensional gravity sets the strong coupling scale of the 4D theory. This connection persists in the limit in which gravity can be consistently decoupled. We demonstrate this effect for orbifold planes, as well as for the solitonic branes and string theoretic D-branes. In all cases the emergence of a 4D strong coupling scale from bulk holography is a persistent phenomenon. The effect turns out to be insensitive even to such extreme deformations of the brane action that seemingly shield 4D theory from the bulk gravity effects. A well understood example of such deformation is given by large 4D Einstein term in the 3-brane action, which is known to suppress the strength of 5D gravity at short distances and change the 5D Newton's law into the four-dimensional one. Nevertheless, we observe that the ...

  11. Federal Facility Agreement progress report

    Energy Technology Data Exchange (ETDEWEB)

    1993-10-01

    The (SRS) Federal Facility Agreement (FFA) was made effective by the US. Environmental Protection Agency Region IV (EPA) on August 16, 1993. To meet the reporting requirements in Section XXV of the Agreement, the FFA Progress Report was developed. The FFA Progress Report is the first of a series of quarterly progress reports to be prepared by the SRS. As such this report describes the information and action taken to September 30, 1993 on the SRS units identified for investigation and remediation in the Agreement. This includes; rubble pits, runoff basins, retention basin, seepage basin, burning pits, H-Area Tank 16, and spill areas.

  12. Federal Facility Agreement progress report

    International Nuclear Information System (INIS)

    1993-10-01

    The (SRS) Federal Facility Agreement (FFA) was made effective by the US. Environmental Protection Agency Region IV (EPA) on August 16, 1993. To meet the reporting requirements in Section XXV of the Agreement, the FFA Progress Report was developed. The FFA Progress Report is the first of a series of quarterly progress reports to be prepared by the SRS. As such this report describes the information and action taken to September 30, 1993 on the SRS units identified for investigation and remediation in the Agreement. This includes; rubble pits, runoff basins, retention basin, seepage basin, burning pits, H-Area Tank 16, and spill areas

  13. LIGO: The strong belief

    CERN Multimedia

    Antonella Del Rosso

    2016-01-01

    Twenty years of designing, building and testing a number of innovative technologies, with the strong belief that the endeavour would lead to a historic breakthrough. The Bulletin publishes an abstract of the Courier’s interview with Barry Barish, one of the founding fathers of LIGO.   The plots show the signals of gravitational waves detected by the twin LIGO observatories at Livingston, Louisiana, and Hanford, Washington. (Image: Caltech/MIT/LIGO Lab) On 11 February, the Laser Interferometer Gravitational-Wave Observatory (LIGO) and Virgo collaborations published a historic paper in which they showed a gravitational signal emitted by the merger of two black holes. These results come after 20 years of hard work by a large collaboration of scientists operating the two LIGO observatories in the US. Barry Barish, Linde Professor of Physics, Emeritus at the California Institute of Technology and former Director of the Global Design Effort for the Internat...

  14. Material Transfer Agreement (MTA) | FNLCR

    Science.gov (United States)

    Material Transfer Agreements are appropriate for exchange of materials into or out of the Frederick National Laboratory for research or testing purposes, with no collaborative research by parties involving the materials.

  15. Corporate Integrity Agreement (CIA) documents

    Data.gov (United States)

    U.S. Department of Health & Human Services — OIG negotiates corporate integrity agreements (CIA) with health care providers and other entities as part of the settlement of Federal health care program...

  16. Beta-Testing Agreement | FNLCR

    Science.gov (United States)

    Beta-Testing Agreements are appropriate forlimited term evaluation and applications development of new software, technology, or equipment platforms by the Frederick National Laboratory in collaboration with an external commercial partner. It ma

  17. Pesticide Worker Safety Cooperative Agreements

    Science.gov (United States)

    The worker safety program cooperative agreements fund projects to educate pesticide applicators, handlers, and farmworkers on working safely with, and around, pesticides. Read about pesticide related grant opportunities and reports from previous grants.

  18. Application Agreement and Integration Services

    Science.gov (United States)

    Driscoll, Kevin R.; Hall, Brendan; Schweiker, Kevin

    2013-01-01

    Application agreement and integration services are required by distributed, fault-tolerant, safety critical systems to assure required performance. An analysis of distributed and hierarchical agreement strategies are developed against the backdrop of observed agreement failures in fielded systems. The documented work was performed under NASA Task Order NNL10AB32T, Validation And Verification of Safety-Critical Integrated Distributed Systems Area 2. This document is intended to satisfy the requirements for deliverable 5.2.11 under Task 4.2.2.3. This report discusses the challenges of maintaining application agreement and integration services. A literature search is presented that documents previous work in the area of replica determinism. Sources of non-deterministic behavior are identified and examples are presented where system level agreement failed to be achieved. We then explore how TTEthernet services can be extended to supply some interesting application agreement frameworks. This document assumes that the reader is familiar with the TTEthernet protocol. The reader is advised to read the TTEthernet protocol standard [1] before reading this document. This document does not re-iterate the content of the standard.

  19. John Strong (1941 - 2006)

    CERN Multimedia

    Wickens, F

    Our friend and colleague John Strong was cruelly taken from us by a brain tumour on Monday 31st July, a few days before his 65th birthday John started his career working with a group from Westfield College, under the leadership of Ted Bellamy. He obtained his PhD and spent the early part of his career on experiments at Rutherford Appleton Laboratory (RAL), but after the early 1970s his research was focussed on experiments in CERN. Over the years he made a number of notable contributions to experiments in CERN: The Omega spectrometer adopted a system John had originally developed for experiments at RAL using vidicon cameras to record the sparks in the spark chambers; He contributed to the success of NA1 and NA7, where he became heavily involved in the electronic trigger systems; He was responsible for the second level trigger system for the ALEPH detector and spent five years leading a team that designed and built the system, which ran for twelve years with only minor interventions. Following ALEPH he tur...

  20. Stirring Strongly Coupled Plasma

    CERN Document Server

    Fadafan, Kazem Bitaghsir; Rajagopal, Krishna; Wiedemann, Urs Achim

    2009-01-01

    We determine the energy it takes to move a test quark along a circle of radius L with angular frequency w through the strongly coupled plasma of N=4 supersymmetric Yang-Mills (SYM) theory. We find that for most values of L and w the energy deposited by stirring the plasma in this way is governed either by the drag force acting on a test quark moving through the plasma in a straight line with speed v=Lw or by the energy radiated by a quark in circular motion in the absence of any plasma, whichever is larger. There is a continuous crossover from the drag-dominated regime to the radiation-dominated regime. In the crossover regime we find evidence for significant destructive interference between energy loss due to drag and that due to radiation as if in vacuum. The rotating quark thus serves as a model system in which the relative strength of, and interplay between, two different mechanisms of parton energy loss is accessible via a controlled classical gravity calculation. We close by speculating on the implicati...

  1. Strong-interaction nonuniversality

    International Nuclear Information System (INIS)

    Volkas, R.R.; Foot, R.; He, X.; Joshi, G.C.

    1989-01-01

    The universal QCD color theory is extended to an SU(3) 1 direct product SU(3) 2 direct product SU(3) 3 gauge theory, where quarks of the ith generation transform as triplets under SU(3)/sub i/ and singlets under the other two factors. The usual color group is then identified with the diagonal subgroup, which remains exact after symmetry breaking. The gauge bosons associated with the 16 broken generators then form two massive octets under ordinary color. The interactions between quarks and these heavy gluonlike particles are explicitly nonuniversal and thus an exploration of their physical implications allows us to shed light on the fundamental issue of strong-interaction universality. Nonuniversality and weak flavor mixing are shown to generate heavy-gluon-induced flavor-changing neutral currents. The phenomenology of these processes is studied, as they provide the major experimental constraint on the extended theory. Three symmetry-breaking scenarios are presented. The first has color breaking occurring at the weak scale, while the second and third divorce the two scales. The third model has the interesting feature of radiatively induced off-diagonal Kobayashi-Maskawa matrix elements

  2. Dayton Agreement as Legalization of Ethnic Cleainsing

    Directory of Open Access Journals (Sweden)

    Irina Vinčić Manojlović

    2015-06-01

    Full Text Available The article analyzes neo-racism in Bosnia and Herzegovina, which is a direct result of the political structure of the country. The constitution of Bosnia and Herzegovina, drafted under the Dayton Agreement, does not define BiH as a country of its citizens, but as a country of ethnically pure groups, mainly Serbs, Croats, Bosnians, and members of minority groups. The country continually reproduces neo-racism and the marginalization of its citizens, because the primary purpose of ethno-nationalist policies is to ensure the unity of a particular ethnic group. In this society, human rights are limited to collective rights, and the individual becomes entirely irrelevant. By analyzing policies and discourses of political parties, and analyzing the educational system and media freedom, the author focuses on the tools used for ideological control, which produces neo-racism. The article also analyzes neo-racist discrimination in state symbols and state holidays. In the end, the author discusses the possibility of the abolition of the Dayton Agreement. Examples of respect and solidarity between people, in the author's opinion, are the most suitable basis for the fight against neo-racism. The article concludes that the ethno-nationalist political divide remains strong, and that it is not likely that, in the near future, Bosnia and Herzegovina will abolish the Dayton Agreement, and with it the neo-racist discrimination against its citizens.

  3. Framework agreements in public procurement

    DEFF Research Database (Denmark)

    Andrecka, Marta; Telles, Pedro

    2015-01-01

    Interview with Dr. Marta Andrecka, Postdoctoral Fellow at the Department of Law at the University of Aarhus, where she is currently working on a project called "Dealing with legal loopholes and uncertainties within EU public procurement law regarding framework agreements" sponsored by the Carlsberg...... Foundation. Before taking up her present position she carried out her doctoral research in Denmark and Australia and worked at law offices in both Poland and the UK. The topic for today’s talk is framework agreements, a relatively popular way of undertaking public procurement...

  4. Uranium ore purchase and custom milling agreements

    International Nuclear Information System (INIS)

    Dolan, B.T.

    1976-01-01

    Important considerations involved in structuring agreements for ore sale or other disposition are discussed. Payment provisions in ore purchase agreements and custom milling agreement provisions are considered. Proposed forms of Ore Purchase Agreement and Custom Milling Agreement are included as appendices

  5. 46 CFR Sec. 4 - Service agreements.

    Science.gov (United States)

    2010-10-01

    ... Service agreements. Contract MA ___ Service Agreement, Federal Port Controller This agreement, made as of... compensation after the contract comes into force will be negotiated, if appropriate. Employee service expenses... secure this agreement upon any agreement for a commission, percentage, brokerage, or contingent fee...

  6. Between voluntary agreement and legislation

    DEFF Research Database (Denmark)

    Gwozdz, Wencke; Hedegaard, Liselotte; Reisch, Lucia

    2009-01-01

    Voluntary agreements and self-imposed standards are broadly applied to restrict the influence food advertising exerts on children’s food choices – yet their effects are unknown. The current project will therefore investigate whether and, if yes, how the Danish Code for Responsible Food Marketing...

  7. Governance of material transfer agreements

    NARCIS (Netherlands)

    Rodriguez, V.F.

    2008-01-01

    The governance of material transfer agreements (MTAs) is crucial for research and the progress of science. When developing a research project, researchers face the problem of availability of research material or restrictive provisions imposed by providers. This article discusses the governance of

  8. Form 6 - gas balancing agreement

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    In 1988, a special Committee of the Rocky Mountain Mineral Law Foundation undertook a project to draft a model from gas balancing agreement. This project was initiated at the request of a number of Foundation members who felt that a model form gas balancing agreement would facilitate the negotiation of operating agreement, since gas balancing issues had become sticking points in the process. The Committee was composed of attorneys representing a wide cross-section of the oil and gas industry including both major and independent oil companies, production companies with interstate pipeline affiliates, and private practitioners. The Committee attempted to address the more controversial issues in gas balancing with optional provisions in the Form. To facilitate the negotiation process, the number of optional provisions was minimized. This form may be used as an Appendix to the new A.A.P.L. Form 610-1989 Model Form Operating Agreement. This book includes provision of this Form which are: Ownership of gas production; Balancing of production accounts; Cash balancing upon depletion; Deliverability tests; Nominations; Statements; Payment of taxes; Operating expenses; Overproducing allowable; Payment of leasehold burdens; Operator's liability; Successors and assigns; Audits; Arbitration; and Operator's fees

  9. 76 FR 20668 - Notice of Agreements Filed

    Science.gov (United States)

    2011-04-13

    ... Agreement. Agreement No.: 012105-001. Title: SCM Lines Transportes/CCNI Agreement. Parties: Compania Chilena de Navegacion Interoceanica S.A. and SCM Lines Transportes Maritimos Sociedade Unipessoal, LDA...

  10. 76 FR 16420 - Notice of Agreements Filed

    Science.gov (United States)

    2011-03-23

    .... Title: Hanjin and WHS Transpacific Vessel Sharing and Slot Allocation Agreement. Parties: Hanjin... amendment would add COSCON as a party to the Agreement and revise the name of the Agreement to Hanjin/WHS...

  11. 78 FR 35270 - Notice of Agreements Filed

    Science.gov (United States)

    2013-06-12

    ... Russia from the geographic scope of the agreement. Agreement No.: 012210. Title: Siem Car Carrier Pacific AS/Eukor Car Carriers Inc. Space Charter Agreement. Parties: Siem Car Carrier Pacific AS and Eukor...

  12. International agreements on nuclear weapons

    International Nuclear Information System (INIS)

    Dombey, N.

    1982-01-01

    The satellite detection of a nuclear explosion in the South Atlantic and Israel's destruction of a research reactor in Iraq make it essential to strengthen existing monitoring and enforcement programs to prevent proliferation. While there was no reliable evidence that either South Africa or Iraq was violating non-proliferation agreements, worst case scenarios can demonstrate to unfriendly countries that South Africa had diverted fuel to test a nuclear weapon and that Iraq is intending to produce weapons-grade plutonium 239. The situation can be improved by formulating better terms and conditions for internationalizing access to materials. Nuclear suppliers need to agree on terms that will assure their customers that contracts for civil programs will be honored. The International Atomic Energy Agency (IAEA), which includes both nuclear suppliers and customers, could achieve stronger agreements that take into account recent technological advances that will expand enrichment and reprocessing activities. 23 references, 1 figure

  13. Rater reliability and construct validity of a mobile application for posture analysis.

    Science.gov (United States)

    Szucs, Kimberly A; Brown, Elena V Donoso

    2018-01-01

    [Purpose] Measurement of posture is important for those with a clinical diagnosis as well as researchers aiming to understand the impact of faulty postures on the development of musculoskeletal disorders. A reliable, cost-effective and low tech posture measure may be beneficial for research and clinical applications. The purpose of this study was to determine rater reliability and construct validity of a posture screening mobile application in healthy young adults. [Subjects and Methods] Pictures of subjects were taken in three standing positions. Two raters independently digitized the static standing posture image twice. The app calculated posture variables, including sagittal and coronal plane translations and angulations. Intra- and inter-rater reliability were calculated using the appropriate ICC models for complete agreement. Construct validity was determined through comparison of known groups using repeated measures ANOVA. [Results] Intra-rater reliability ranged from 0.71 to 0.99. Inter-rater reliability was good to excellent for all translations. ICCs were stronger for translations versus angulations. The construct validity analysis found that the app was able to detect the change in the four variables selected. [Conclusion] The posture mobile application has demonstrated strong rater reliability and preliminary evidence of construct validity. This application may have utility in clinical and research settings.

  14. 29 CFR 1908.10 - Cooperative Agreements.

    Science.gov (United States)

    2010-07-01

    ... CONSULTATION AGREEMENTS § 1908.10 Cooperative Agreements. (a) Who may make Agreements. The Assistant Secretary... consultation services to private sector employers. (3) Renegotiation of existing Agreements funded under this part shall be initiated within 30 days of the effective date of these revisions. (c) Contents of...

  15. 77 FR 42310 - Notice of Agreements Filed

    Science.gov (United States)

    2012-07-18

    ...; Washington, DC 20006-4007. Synopsis: The agreement would provide for delivery of data to the Port of Oakland... delivery. Agreement No.: 201217. Title: Port of Long Beach Data Services Agreement. Parties: Port of Long... 1100; Washington, DC 20006-4007. Synopsis: The agreement would provide for delivery of data to the Port...

  16. 7 CFR 947.111 - Marketing agreement.

    Science.gov (United States)

    2010-01-01

    ... Definitions § 947.111 Marketing agreement. Marketing agreement means Marketing Agreement No. 114, as amended. ... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing agreement. 947.111 Section 947.111 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing...

  17. 77 FR 27227 - Notice of Agreements Filed

    Science.gov (United States)

    2012-05-09

    ... agreement. Agreement No.: 011275-032. Title: Australia and New Zealand-United States Discussion Agreement....G. Filing Party: Tara L. Leiter, Esquire; Blank Rome LLP; 600 New Hampshire Avenue NW., Washington... trade between the U.S. East Coast and China. Agreement No.: 012169. Title: Crowley/ELJSA Space Charter...

  18. Enhanced thermal photon and dilepton production in strongly coupled = 4 SYM plasma in strong magnetic field

    Science.gov (United States)

    Mamo, Kiminad A.

    2013-08-01

    We calculate the DC conductivity tensor of strongly coupled = 4 super-Yang-Mills (SYM) plasma in a presence of a strong external magnetic field B ≫ T 2 by using its gravity dual and employing both the RG flow approach and membrane paradigm which give the same results. We find that, since the magnetic field B induces anisotropy in the plasma, different components of the DC conductivity tensor have different magnitudes depending on whether its components are in the direction of the magnetic field B. In particular, we find that a component of the DC conductivity tensor in the direction of the magnetic field B increases linearly with B while the other components (which are not in the direction of the magnetic field B) are independent of it. These results are consistent with the lattice computations of the DC conductivity tensor of the QCD plasma in an external magnetic field B. Using the DC conductivity tensor, we calculate the soft or low-frequency thermal photon and dilepton production rates of the strongly coupled = 4 SYM plasma in the presence of the strong external magnetic field B ≫ T 2. We find that the strong magnetic field B enhances both the thermal photon and dilepton production rates of the strongly coupled = 4 SYM plasma in a qualitative agreement with the experimentally observed enhancements at the heavy-ion collision experiments.

  19. Analysis of international negotiations and trade agreements

    OpenAIRE

    Górriz Gonzalo, Verónica

    2014-01-01

    This study aims to analyze international trade agreements and negotiations. For that purpose, two agreements made by the United States are chosen to be analyzed. In the first place, the North America Free Trade Agreement (NAFTA) agreement, that was signed by the United States, Canada and Mexico in 1994 in order to create a free trade area. In addition, the Transatlantic Trade and Investment Partnership (TTIP) will be analyze, an agreement that is still being negotiated between the United Stat...

  20. Quantum electrodynamics of strong fields

    International Nuclear Information System (INIS)

    Greiner, W.

    1983-01-01

    Quantum Electrodynamics of Strong Fields provides a broad survey of the theoretical and experimental work accomplished, presenting papers by a group of international researchers who have made significant contributions to this developing area. Exploring the quantum theory of strong fields, the volume focuses on the phase transition to a charged vacuum in strong electric fields. The contributors also discuss such related topics as QED at short distances, precision tests of QED, nonperturbative QCD and confinement, pion condensation, and strong gravitational fields In addition, the volume features a historical paper on the roots of quantum field theory in the history of quantum physics by noted researcher Friedrich Hund

  1. 76 FR 41526 - Centennial Challenges 2011 Strong Tether Challenge

    Science.gov (United States)

    2011-07-14

    .... 2451 (314)(d). The 2011 Strong Tether Challenge is scheduled and teams that wish to compete may... prize competitors must (1) Register and comply with all requirements in the rules and team agreement; (2... the United States, and in the case of an individual, whether participating singly or in a group, shall...

  2. Strong WW Interaction at LHC

    Energy Technology Data Exchange (ETDEWEB)

    Pelaez, Jose R

    1998-12-14

    We present a brief pedagogical introduction to the Effective Electroweak Chiral Lagrangians, which provide a model independent description of the WW interactions in the strong regime. When it is complemented with some unitarization or a dispersive approach, this formalism allows the study of the general strong scenario expected at the LHC, including resonances.

  3. Strong-back safety latch

    International Nuclear Information System (INIS)

    DeSantis, G.N.

    1995-01-01

    The calculation decides the integrity of the safety latch that will hold the strong-back to the pump during lifting. The safety latch will be welded to the strong-back and will latch to a 1.5-in. dia cantilever rod welded to the pump baseplate. The static and dynamic analysis shows that the safety latch will hold the strong-back to the pump if the friction clamps fail and the pump become free from the strong-back. Thus, the safety latch will meet the requirements of the Lifting and Rigging Manual for under the hook lifting for static loading; it can withstand shock loads from the strong-back falling 0.25 inch

  4. Strong-back safety latch

    Energy Technology Data Exchange (ETDEWEB)

    DeSantis, G.N.

    1995-03-06

    The calculation decides the integrity of the safety latch that will hold the strong-back to the pump during lifting. The safety latch will be welded to the strong-back and will latch to a 1.5-in. dia cantilever rod welded to the pump baseplate. The static and dynamic analysis shows that the safety latch will hold the strong-back to the pump if the friction clamps fail and the pump become free from the strong-back. Thus, the safety latch will meet the requirements of the Lifting and Rigging Manual for under the hook lifting for static loading; it can withstand shock loads from the strong-back falling 0.25 inch.

  5. Point-of-care urine tests for smoking status and isoniazid treatment monitoring in adult patients.

    Directory of Open Access Journals (Sweden)

    Ioana Nicolau

    Full Text Available Poor adherence to isoniazid (INH preventive therapy (IPT is an impediment to effective control of latent tuberculosis (TB infection. TB patients who smoke are at higher risk of latent TB infection, active disease, and TB mortality, and may have lower adherence to their TB medications. The objective of our study was to validate IsoScreen and SmokeScreen (GFC Diagnostics, UK, two point-of-care tests for monitoring INH intake and determining smoking status. The tests could be used together in the same individual to help identify patients with a high-risk profile and provide a tailored treatment plan that includes medication management, adherence interventions, and smoking cessation programs.200 adult outpatients attending the TB and/or the smoking cessation clinic were recruited at the Montreal Chest Institute. Sensitivity and specificity were measured for each test against the corresponding composite reference standard. Test reliability was measured using kappa statistic for intra-rater and inter-rater agreement. Univariate and multivariate logistic regression models were used to explore possible covariates that might be related to false-positive and false-negative test results. IsoScreen had a sensitivity of 93.2% (95% confidence interval [CI] 80.3, 98.2 and specificity of 98.7% (94.8, 99.8. IsoScreen had intra-rater agreement (kappa of 0.75 (0.48, 0.94 and inter-rater agreement of 0.61 (0.27, 0.90. SmokeScreen had a sensitivity of 69.2% (56.4, 79.8, specificity of 81.6% (73.0, 88.0, intra-rater agreement of 0.77 (0.56, 0.94, and inter-rater agreement of 0.66 (0.42, 0.88. False-positive SmokeScreen tests were strongly associated with INH treatment.IsoScreen had high validity and reliability, whereas SmokeScreen had modest validity and reliability. SmokeScreen tests did not perform well in a population receiving INH due to the association between INH treatment and false-positive SmokeScreen test results. Development of the next generation Smoke

  6. Titanium: light, strong, and white

    Science.gov (United States)

    Woodruff, Laurel; Bedinger, George

    2013-01-01

    Titanium (Ti) is a strong silver-gray metal that is highly resistant to corrosion and is chemically inert. It is as strong as steel but 45 percent lighter, and it is twice as strong as aluminum but only 60 percent heavier. Titanium dioxide (TiO2) has a very high refractive index, which means that it has high light-scattering ability. As a result, TiO2 imparts whiteness, opacity, and brightness to many products. ...Because of the unique physical properties of titanium metal and the whiteness provided by TiO2, titanium is now used widely in modern industrial societies.

  7. Voluntary agreement for the new energy and environmental policies goals

    International Nuclear Information System (INIS)

    Pesaro, G.

    1998-01-01

    In the field of public policies innovative instruments based on market mechanisms and voluntary action by economical subjects meet a growing favour. This emerges also from the proceedings of the recent National Conference on Energy and the Environment, held in Rome in November 1998. From a planning policy, directly implemented by public bodies and often characterised by a strong rigidity, we are now passing to a new policy style, based on main trends and principles and implemented, at least in a priority way, through a mechanism of pacts and agreements among a variety of actors. This article, starting from an introduction on the nature and the functioning limits of voluntary agreements and, on these bases, presents some hypothesis on the ways and the necessary conditions to develop a concrete system of voluntary agreements in the country, in order to reach the new energy and environmental policies goals [it

  8. Delta: a new measure of agreement between two raters.

    Science.gov (United States)

    Andrés, A Martín; Marzo, P Femia

    2004-05-01

    The most common measure of agreement for categorical data is the coefficient kappa. However, kappa performs poorly when the marginal distributions are very asymmetric, it is not easy to interpret, and its definition is based on hypothesis of independence of the responses (which is more restrictive than the hypothesis that kappa has a value of zero). This paper defines a new measure of agreement, delta, 'the proportion of agreements that are not due to chance', which comes from model of multiple-choice tests and does not have the previous limitations. The paper shows that kappa and delta generally take very similar values, except when the marginal distributions are strongly unbalanced. The case of the 2 x 2 tables (which admits very simple solutions) is considered in detail.

  9. Reliability of five methods for assessing shoulder range of motion.

    Science.gov (United States)

    Hayes, K; Walton, J R; Szomor, Z R; Murrell, G A

    2001-01-01

    In symptomatic subjects, the reliability of tests for shoulder joint range of motion has yet to be determined. For this reason, inter-rater and intra-rater agreement trials were undertaken to ascertain the reliability of visual estimation, goniometry, still photography, "stand and reach" and hand behind back reach for six different shoulder movements. Intra-class correlation coefficients (Rho) were derived by using a random effects model. For flexion, abduction and external rotation fair to good reliability was demonstrated for both trials using visual estimation (Inter-rater Rho = 0.57-0.70; Intra-rater Rho = 0.59-0.67), goniometry (Inter-rater Rho = 0.64-0.69; Intra-rater Rho = 0.53-0.65) and still photography (Inter-rater Rho = 0.62-0.73; Intra-rater Rho = 0.56-0.61). The tests had standard errors of measurement of between 14 and 25 degrees (inter-rater trial) and 11 and 23 degrees (intra-rater trial).

  10. 75 FR 31438 - Notice of Agreements Filed

    Science.gov (United States)

    2010-06-03

    ... Lines Joint Service Agreement. Filing Party: Tara L. Leiter, Esq.; Blank Rome, LLP; Watergate; 600 New... Service Agreement. Filing Party: Tara L. Leiter, Esq.; Blank Rome, LLP; Watergate; 600 New Hampshire...

  11. 75 FR 42445 - Notice of Agreement Filed

    Science.gov (United States)

    2010-07-21

    ...)-523-5793 or [email protected] . Agreement No.: 012105. Title: SCM Lines Transportes/CCNI Agreement. Parties: Compania Chilena de Navegacion Interoceanica S.A. and SCM Lines Transportes Maritimos Sociedade...

  12. 75 FR 8719 - Notice of Agreements Filed

    Science.gov (United States)

    2010-02-25

    ....; Nixon Peabody LLP; 555 West Fifth Street, 46th Floor, Los Angeles, CA 20573. Synopsis: The agreement... ports of Miami, FL and George Town, Grand Cayman. Agreement No.: 012091. Title: HLAG/HSDG Slot Charter...

  13. 27 CFR 70.485 - Closing agreements.

    Science.gov (United States)

    2010-04-01

    ... Relating to Alcohol, Tobacco, Firearms, and Explosives Administrative Remedies § 70.485 Closing agreements... disadvantage through consummation of such an agreement. (b) Scope of closing agreement—(1) In general. A...

  14. 78 FR 26779 - Notice of Agreements Filed

    Science.gov (United States)

    2013-05-08

    .... (Operating as one party). Agreement No.: 012206. Title: Industria Armamento Meridionale S.P.A./K-Line Space Charter Agreement. Parties: Industria Armamento Meridionale S.P.A. (``Inarme'') and Kawasaki Kisen Kaisha...

  15. 48 CFR 1542.1203 - Processing agreements.

    Science.gov (United States)

    2010-10-01

    ... MANAGEMENT CONTRACT ADMINISTRATION Novation and Change of Name Agreements 1542.1203 Processing agreements. (a... required documentary evidence. (2) Verify the accuracy of the list of contracts through the Contract...

  16. 78 FR 64940 - Notice of Agreements Filed

    Science.gov (United States)

    2013-10-30

    ... filing of the following agreements under the Shipping Act of 1984. Interested parties may submit comments... Charter Agreement. Parties: Nippon Yusen Kaisha and Eukor Car Carrier Inc. [[Page 64941

  17. 78 FR 6325 - Notice of Agreements Filed

    Science.gov (United States)

    2013-01-30

    ... Enterprises LLC. Agreement No.: 012193-000. Title: Siem Car Carrier Pacific AS/Compania Sud Americana de Vapores S.A. Space Charter Agreement. Parties: Siem Car Carrier Pacific AS and Compania Sud Americana de...

  18. 77 FR 71001 - Notice of Agreements Filed

    Science.gov (United States)

    2012-11-28

    .... Agreement No.: 012187-000. Title: Siem Car Carrier Pacific AS/Hoegh Autoliners, Inc. Space Charter Agreement. Parties: Siem Car Carrier Pacific AS and Hoegh Autoliners, Inc. Filing Party: Ashley W. Craig Esq...

  19. 77 FR 16838 - Notice of Agreements Filed

    Science.gov (United States)

    2012-03-22

    ... the U.S. Pacific Coast and the Middle East and Asia. Agreement No.: 012161. Title: Siem Car Carrier Pacific AS/Hyundai Glovis Co., Ltd. Space Charter Agreement. Parties: Siem Car Carrier Pacific AS; Hyundai...

  20. 75 FR 19402 - Notice of Agreements Filed

    Science.gov (United States)

    2010-04-14

    ... cargo from ports on the U.S. east coast to ports in Chile, Ecuador, Peru, Panama, Colombia, and Venezuela. Agreement No.: 012042-002. Title: MOL/ELJSA Slot Exchange Agreement. Parties: Evergreen Line...

  1. Exercise Oscillatory Ventilation: Interreviewer Agreement and a Novel Determination.

    Science.gov (United States)

    Brawner, Clinton A; Ehrman, Jonathan K; Myers, Jonathan; Chase, Paul; Vainshelboim, Baruch; Farha, Shadi; Saval, Matthew A; McGuire, Rita; Pozehl, Bunny; Keteyian, Steven J

    2018-02-01

    Determination of exercise oscillatory ventilation (EOV) is subjective, and the interreviewer agreement has not been reported. The purposes of this study were, among patients with heart failure (HF), as follows: 1) to determine the interreviewer agreement for EOV and 2) to describe a novel, objective, and quantifiable measure of EOV. This was a secondary analysis of the HEART Camp: Promoting Adherence to Exercise in Patients with Heart Failure study. EOV was determined through a blinded review by six individuals on the basis of their interpretation of the EOV literature. Interreviewer agreement was assessed using Fleiss kappa (κ). Final determination of EOV was based on agreement by four of the six reviewers. A new measure (ventilation dispersion index; VDI) was calculated for each test, and its ability to predict EOV was assessed with the receiver operator characteristics curve. Among 243 patients with HF (age, 60 ± 12 yr; 45% women), the interreviewer agreement for EOV was fair (κ = 0.303) with 10-s discrete data averages and significantly better, but only moderate (κ = 0.429) with 30-s rolling data averages. Prevalence rates of positive and indeterminate EOVs were 18% and 30% with the 10-s discrete averages and 14% and 13% with the 30-s rolling averages, respectively. VDI was strongly associated with EOV, with areas under the receiver operator characteristics curve of 0.852 to 0.890. Interreviewer agreement for EOV in patients with HF is fair to moderate, which can negatively affect risk stratification. VDI has strong predictive validity with EOV; as such, it might be a useful measure of prognosis in patients with HF.

  2. TRIPs Agreement, Important Multilateral WTO Treaty

    Directory of Open Access Journals (Sweden)

    Oana-Maria Florescu

    2006-08-01

    Full Text Available This article aims at presenting the content and the frame of the TRIPs. Agreement. It starts by introducing the reader to the terms that defined the world economical climate by the time of the Agreement negociation. Also, it explains the need of having an Agreement on intellectual property rights with impact on the business world. Moreover, the article reviews the main provisions of the Agreement and the most important intellectual property rights.

  3. 7 CFR 946.101 - Marketing agreement.

    Science.gov (United States)

    2010-01-01

    ... WASHINGTON Rules and Regulations Definitions § 946.101 Marketing agreement. Marketing agreement means... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing agreement. 946.101 Section 946.101 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing...

  4. 7 CFR 966.111 - Marketing Agreement.

    Science.gov (United States)

    2010-01-01

    ... and Regulations Definitions § 966.111 Marketing Agreement. Marketing Agreement means Marketing... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing Agreement. 966.111 Section 966.111 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing...

  5. 7 CFR 917.101 - Marketing agreement.

    Science.gov (United States)

    2010-01-01

    ... CALIFORNIA Rules and Regulations Definitions § 917.101 Marketing agreement. Marketing agreement means... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing agreement. 917.101 Section 917.101 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing...

  6. 25 CFR 502.5 - Collateral agreement.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Collateral agreement. 502.5 Section 502.5 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR GENERAL PROVISIONS DEFINITIONS OF THIS CHAPTER § 502.5 Collateral agreement. Collateral agreement means any contract, whether or not in writing...

  7. 7 CFR 1499.5 - Agreements.

    Science.gov (United States)

    2010-01-01

    ... of any other applicable civil and criminal penalties. (f) The agreement will prohibit the sale or... 7 Agriculture 10 2010-01-01 2010-01-01 false Agreements. 1499.5 Section 1499.5 Agriculture... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS FOOD FOR PROGRESS PROGRAM § 1499.5 Agreements. (a) After...

  8. 7 CFR 1599.5 - Agreements.

    Science.gov (United States)

    2010-01-01

    ... any other applicable civil and criminal penalties. (f) The agreement will prohibit the sale or... 7 Agriculture 10 2010-01-01 2010-01-01 false Agreements. 1599.5 Section 1599.5 Agriculture... AGRICULTURE McGOVERN-DOLE INTERNATIONAL FOOD FOR EDUCATION AND CHILD NUTRITION PROGRAM § 1599.5 Agreements. (a...

  9. 7 CFR 900.109 - Mediation agreement.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Mediation agreement. 900.109 Section 900.109 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing... Mediation agreement. An agreement arrived at by mediation shall not become effective until approved by the...

  10. 78 FR 21364 - Notice of Agreements Filed

    Science.gov (United States)

    2013-04-10

    .... West Coast on the one hand, and China and South Korea, on the other hand. The agreement also authorizes... parties accordingly. Agreement No.: 012116-002. Title: NYK/Hanjin/Yang Ming/Evergreen Americas North South... No.: 012199. Title: NYK/Hanjin/Hyundai Americas North South Service Slot Charter Agreement. Parties...

  11. 22 CFR 120.23 - Distribution agreement.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Distribution agreement. 120.23 Section 120.23... § 120.23 Distribution agreement. An agreement (e.g., a contract) to establish a warehouse or distribution point abroad for defense articles exported from the United States for subsequent distribution to...

  12. 75 FR 14159 - Notice of Agreements Filed

    Science.gov (United States)

    2010-03-24

    ... the foregoing, and restates the agreement. Agreement No.: 012085-001. Title: 2007 Crane Purchase...; 301 K Street, NW. Suite 1100-East Tower; Washington, DC 20005. Synopsis: The agreement details and clarifies the parties' authority to discuss and agree on matters related to use of cranes by third parties...

  13. The Pros and Cons of Petroleum Agreements.

    Science.gov (United States)

    Lipton, Charles J.

    1980-01-01

    A mineral agreements expert discusses the options open to tribes, from the most standard lease form to arrangements as yet untried by Indian Nations. Discussion covers 18 basic provisions for inclusion in agreements, tax considerations, and basic forms of petroleum agreements (leases, joint ventures, production sharing, and service contracts).…

  14. Unwrapping Court-Connected Mediation Agreements

    DEFF Research Database (Denmark)

    Adrian, Lin; Mykland, Solfrid

    2018-01-01

    Court-connected mediated agreements seem to both fulfil and fail the ideal of self-determination in mediation theory. In a study of 134 agreements from court-connected mediation, we found that the majority of agreements contain creative elements and display great variation in the provisions...... and understand them. The judicial language is well known for the drafters of the agreement but not the parties. Thus, court-connected mediation seems to fail aspects of self-determination when it comes to drafting agreements. We draw on new-institutional theory when we explore and explain this apparent...... contradiction within the court-connected mediation practice....

  15. Unfolding the phenomenon of interrater agreement

    DEFF Research Database (Denmark)

    Slaug, Björn; Schilling, Oliver; Helle, Tina

    2012-01-01

    accounted for 6-11%, the items for 32-33%, and the residual for 57-60% of the variation. Multilevel regression analysis showed barrier prevalence and raters' familiarity with using standardized instruments to have the strongest impact on agreement. CONCLUSION: Supported by a conceptual analysis, we propose......OBJECTIVE: The overall objective was to unfold the phenomenon of interrater agreement: to identify potential sources of variation in agreement data and to explore how they can be statistically accounted for. The ultimate aim was to propose recommendations for in-depth examination of agreement...... shares of agreement variation were calculated. Multilevel regression analysis was carried out, using rater and item characteristics as predictors of agreement variation. RESULTS: Following a conceptual decomposition, the agreement variation was statistically disentangled into relative shares. The raters...

  16. The SNAP Strong Lens Survey

    Energy Technology Data Exchange (ETDEWEB)

    Marshall, P.

    2005-01-03

    Basic considerations of lens detection and identification indicate that a wide field survey of the types planned for weak lensing and Type Ia SNe with SNAP are close to optimal for the optical detection of strong lenses. Such a ''piggy-back'' survey might be expected even pessimistically to provide a catalogue of a few thousand new strong lenses, with the numbers dominated by systems of faint blue galaxies lensed by foreground ellipticals. After sketching out our strategy for detecting and measuring these galaxy lenses using the SNAP images, we discuss some of the scientific applications of such a large sample of gravitational lenses: in particular we comment on the partition of information between lens structure, the source population properties and cosmology. Understanding this partitioning is key to assessing strong lens cosmography's value as a cosmological probe.

  17. Strong coupling phase in QED

    International Nuclear Information System (INIS)

    Aoki, Ken-ichi

    1988-01-01

    Existence of a strong coupling phase in QED has been suggested in solutions of the Schwinger-Dyson equation and in Monte Carlo simulation of lattice QED. In this article we recapitulate the previous arguments, and formulate the problem in the modern framework of the renormalization theory, Wilsonian renormalization. This scheme of renormalization gives the best understanding of the basic structure of a field theory especially when it has a multi-phase structure. We resolve some misleading arguments in the previous literature. Then we set up a strategy to attack the strong phase, if any. We describe a trial; a coupled Schwinger-Dyson equation. Possible picture of the strong coupling phase QED is presented. (author)

  18. Reliable classification of functional profiles and movement disorders of children with cerebral palsy.

    Science.gov (United States)

    Randall, Melinda; Harvey, Adrienne; Imms, Christine; Reid, Sue; Lee, Katherine J; Reddihough, Dinah

    2013-08-01

    To examine the inter-rater reliability of the Communication Function Classification System (CFCS), Bimanual Fine Motor Function (BFMF), Surveillance of Cerebral Palsy in Europe (SCPE) classification tree, and Gross Motor Function Classification System (GMFCS) in children with cerebral palsy (CP) and periventricular white matter injury (PWMI) aged 4-11 years. Twenty children were assessed by two raters using the four tools, in addition parents undertook ratings on the Manual Ability Classification System (MACS). Kappa statistics were used to calculate the level of agreement between raters' classifications. Participants comprised 12 males and 8 females with CP and PWMI, mean age 8 years 1 month (standard deviation 2 years 3 months). Inter-rater reliability across the four tools was 0.98 (CFCS, BFMF, and GMFCS) and 0.84 (SCPE). These findings suggest that these four tools are reasonably robust to inter-rater variability supporting their routine use along with the MACS in clinical and research applications.

  19. Strong Decomposition of Random Variables

    DEFF Research Database (Denmark)

    Hoffmann-Jørgensen, Jørgen; Kagan, Abram M.; Pitt, Loren D.

    2007-01-01

    A random variable X is stongly decomposable if X=Y+Z where Y=Φ(X) and Z=X-Φ(X) are independent non-degenerated random variables (called the components). It is shown that at least one of the components is singular, and we derive a necessary and sufficient condition for strong decomposability...

  20. Strong interaction at finite temperature

    Indian Academy of Sciences (India)

    Abstract. We review two methods discussed in the literature to determine the effective parameters of strongly interacting particles as they move through a heat bath. The first one is the general method of chiral perturbation theory, which may be readily applied to this problem. The other is the method of thermal QCD sum rules ...

  1. Strong-strong beam-beam simulation on parallel computer

    Energy Technology Data Exchange (ETDEWEB)

    Qiang, Ji

    2004-08-02

    The beam-beam interaction puts a strong limit on the luminosity of the high energy storage ring colliders. At the interaction points, the electromagnetic fields generated by one beam focus or defocus the opposite beam. This can cause beam blowup and a reduction of luminosity. An accurate simulation of the beam-beam interaction is needed to help optimize the luminosity in high energy colliders.

  2. Strong-strong beam-beam simulation on parallel computer

    International Nuclear Information System (INIS)

    Qiang, Ji

    2004-01-01

    The beam-beam interaction puts a strong limit on the luminosity of the high energy storage ring colliders. At the interaction points, the electromagnetic fields generated by one beam focus or defocus the opposite beam. This can cause beam blowup and a reduction of luminosity. An accurate simulation of the beam-beam interaction is needed to help optimize the luminosity in high energy colliders

  3. The Children's Global Assessment Scale (CGAS) and Global Assessment of Psychosocial Disability (GAPD) in clinical practice--substance and reliability as judged by intraclass correlations

    DEFF Research Database (Denmark)

    Dyrborg, J; Larsen, F W; Nielsen, S

    2000-01-01

    Studies on the inter-rater reliability on the Children's Global Assessment Scale (CGAS) and the Global Assessment of Psychosocial Disability (GAPD) involving different subgroups of 145 outpatients from 4 to 16 years of age showed fair to substantial intraclass correlations of 0.59 to 0.90. Raters...... of different training levels participated. Interrater reliability was dependent on number of ratings per rater, training, available data sources and experience. A more detailed description of anchor points resulted in higher inter-rater agreement by psychiatrists training in child and adolescent psychiatry...

  4. 48 CFR 225.403 - World Trade Organization Government Procurement Agreement and Free Trade Agreements.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false World Trade Organization Government Procurement Agreement and Free Trade Agreements. 225.403 Section 225.403 Federal Acquisition... FOREIGN ACQUISITION Trade Agreements 225.403 World Trade Organization Government Procurement Agreement and...

  5. 46 CFR 298.38 - Partnership agreements and limited liability company agreements.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Partnership agreements and limited liability company... FINANCING ASSISTANCE OBLIGATION GUARANTEES Documentation § 298.38 Partnership agreements and limited liability company agreements. Partnership and limited liability company agreements must be in form and...

  6. PREFACE: Strongly correlated electron systems Strongly correlated electron systems

    Science.gov (United States)

    Saxena, Siddharth S.; Littlewood, P. B.

    2012-07-01

    This special section is dedicated to the Strongly Correlated Electron Systems Conference (SCES) 2011, which was held from 29 August-3 September 2011, in Cambridge, UK. SCES'2011 is dedicated to 100 years of superconductivity and covers a range of topics in the area of strongly correlated systems. The correlated electronic and magnetic materials featured include f-electron based heavy fermion intermetallics and d-electron based transition metal compounds. The selected papers derived from invited presentations seek to deepen our understanding of the rich physical phenomena that arise from correlation effects. The focus is on quantum phase transitions, non-Fermi liquid phenomena, quantum magnetism, unconventional superconductivity and metal-insulator transitions. Both experimental and theoretical work is presented. Based on fundamental advances in the understanding of electronic materials, much of 20th century materials physics was driven by miniaturisation and integration in the electronics industry to the current generation of nanometre scale devices. The achievements of this industry have brought unprecedented advances to society and well-being, and no doubt there is much further to go—note that this progress is founded on investments and studies in the fundamentals of condensed matter physics from more than 50 years ago. Nevertheless, the defining challenges for the 21st century will lie in the discovery in science, and deployment through engineering, of technologies that can deliver the scale needed to have an impact on the sustainability agenda. Thus the big developments in nanotechnology may lie not in the pursuit of yet smaller transistors, but in the design of new structures that can revolutionise the performance of solar cells, batteries, fuel cells, light-weight structural materials, refrigeration, water purification, etc. The science presented in the papers of this special section also highlights the underlying interest in energy-dense materials, which

  7. Analyzing rater agreement manifest variable methods

    CERN Document Server

    von Eye, Alexander

    2014-01-01

    Agreement among raters is of great importance in many domains. For example, in medicine, diagnoses are often provided by more than one doctor to make sure the proposed treatment is optimal. In criminal trials, sentencing depends, among other things, on the complete agreement among the jurors. In observational studies, researchers increase reliability by examining discrepant ratings. This book is intended to help researchers statistically examine rater agreement by reviewing four different approaches to the technique.The first approach introduces readers to calculating coefficients that allow one to summarize agreements in a single score. The second approach involves estimating log-linear models that allow one to test specific hypotheses about the structure of a cross-classification of two or more raters'' judgments. The third approach explores cross-classifications or raters'' agreement for indicators of agreement or disagreement, and for indicators of such characteristics as trends. The fourth approach compa...

  8. Strong-field short-pulse nondipole dynamics

    DEFF Research Database (Denmark)

    Dimitrovski, Darko; Førre, Morten; Madsen, Lars Bojer

    2009-01-01

    We present a quantitative investigation of strong-field short-pulse nondipole dynamics in laser-matter interactions. We find excellent agreement between ab initio numerical and analytic results obtained using the Magnus expansion. We show that in the short-pulse limit, ultrafast transfer and cont......We present a quantitative investigation of strong-field short-pulse nondipole dynamics in laser-matter interactions. We find excellent agreement between ab initio numerical and analytic results obtained using the Magnus expansion. We show that in the short-pulse limit, ultrafast transfer...... and control of population can be achieved using nondipole effects. The relative importance of nondipole to dipole effects depends on the displacement imparted to a free classical electron....

  9. Strongly correlated systems experimental techniques

    CERN Document Server

    Mancini, Ferdinando

    2015-01-01

    The continuous evolution and development of experimental techniques is at the basis of any fundamental achievement in modern physics. Strongly correlated systems (SCS), more than any other, need to be investigated through the greatest variety of experimental techniques in order to unveil and crosscheck the numerous and puzzling anomalous behaviors characterizing them. The study of SCS fostered the improvement of many old experimental techniques, but also the advent of many new ones just invented in order to analyze the complex behaviors of these systems. Many novel materials, with functional properties emerging from macroscopic quantum behaviors at the frontier of modern research in physics, chemistry and materials science, belong to this class of systems. The volume presents a representative collection of the modern experimental techniques specifically tailored for the analysis of strongly correlated systems. Any technique is presented in great detail by its own inventor or by one of the world-wide recognize...

  10. Strongly Correlated Systems Theoretical Methods

    CERN Document Server

    Avella, Adolfo

    2012-01-01

    The volume presents, for the very first time, an exhaustive collection of those modern theoretical methods specifically tailored for the analysis of Strongly Correlated Systems. Many novel materials, with functional properties emerging from macroscopic quantum behaviors at the frontier of modern research in physics, chemistry and materials science, belong to this class of systems. Any technique is presented in great detail by its own inventor or by one of the world-wide recognized main contributors. The exposition has a clear pedagogical cut and fully reports on the most relevant case study where the specific technique showed to be very successful in describing and enlightening the puzzling physics of a particular strongly correlated system. The book is intended for advanced graduate students and post-docs in the field as textbook and/or main reference, but also for other researchers in the field who appreciates consulting a single, but comprehensive, source or wishes to get acquainted, in a as painless as po...

  11. Strongly correlated systems numerical methods

    CERN Document Server

    Mancini, Ferdinando

    2013-01-01

    This volume presents, for the very first time, an exhaustive collection of those modern numerical methods specifically tailored for the analysis of Strongly Correlated Systems. Many novel materials, with functional properties emerging from macroscopic quantum behaviors at the frontier of modern research in physics, chemistry and material science, belong to this class of systems. Any technique is presented in great detail by its own inventor or by one of the world-wide recognized main contributors. The exposition has a clear pedagogical cut and fully reports on the most relevant case study where the specific technique showed to be very successful in describing and enlightening the puzzling physics of a particular strongly correlated system. The book is intended for advanced graduate students and post-docs in the field as textbook and/or main reference, but also for other researchers in the field who appreciate consulting a single, but comprehensive, source or wishes to get acquainted, in a as painless as possi...

  12. Strongly nonlinear oscillators analytical solutions

    CERN Document Server

    Cveticanin, Livija

    2014-01-01

    This book provides the presentation of the motion of pure nonlinear oscillatory systems and various solution procedures which give the approximate solutions of the strong nonlinear oscillator equations. The book presents the original author’s method for the analytical solution procedure of the pure nonlinear oscillator system. After an introduction, the physical explanation of the pure nonlinearity and of the pure nonlinear oscillator is given. The analytical solution for free and forced vibrations of the one-degree-of-freedom strong nonlinear system with constant and time variable parameter is considered. Special attention is given to the one and two mass oscillatory systems with two-degrees-of-freedom. The criteria for the deterministic chaos in ideal and non-ideal pure nonlinear oscillators are derived analytically. The method for suppressing chaos is developed. Important problems are discussed in didactic exercises. The book is self-consistent and suitable as a textbook for students and also for profess...

  13. Developing a digital photography-based method for dietary analysis in self-serve dining settings.

    Science.gov (United States)

    Christoph, Mary J; Loman, Brett R; Ellison, Brenna

    2017-07-01

    Current population-based methods for assessing dietary intake, including food frequency questionnaires, food diaries, and 24-h dietary recall, are limited in their ability to objectively measure food intake. Digital photography has been identified as a promising addition to these techniques but has rarely been assessed in self-serve settings. We utilized digital photography to examine university students' food choices and consumption in a self-serve dining hall setting. Research assistants took pre- and post-photos of students' plates during lunch and dinner to assess selection (presence), servings, and consumption of MyPlate food groups. Four coders rated the same set of approximately 180 meals for inter-rater reliability analyses; approximately 50 additional meals were coded twice by each coder to assess intra-rater agreement. Inter-rater agreement on the selection, servings, and consumption of food groups was high at 93.5%; intra-rater agreement was similarly high with an average of 95.6% agreement. Coders achieved the highest rates of agreement in assessing if a food group was present on the plate (95-99% inter-rater agreement, depending on food group) and estimating the servings of food selected (81-98% inter-rater agreement). Estimating consumption, particularly for items such as beans and cheese that were often in mixed dishes, was more challenging (77-94% inter-rater agreement). Results suggest that the digital photography method presented is feasible for large studies in real-world environments and can provide an objective measure of food selection, servings, and consumption with a high degree of agreement between coders; however, to make accurate claims about the state of dietary intake in all-you-can-eat, self-serve settings, researchers will need to account for the possibility of diners taking multiple trips through the serving line. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Flavour Democracy in Strong Unification

    CERN Document Server

    Abel, S A; Abel, Steven; King, Steven

    1998-01-01

    We show that the fermion mass spectrum may naturally be understood in terms of flavour democratic fixed points in supersymmetric theories which have a large domain of attraction in the presence of "strong unification". Our approach provides an alternative to the approximate Yukawa texture zeroes of the Froggatt-Nielsen mechanism. We discuss a particular model based on a broken gauged $SU(3)_L\\times SU(3)_R$ family symmetry which illustrates our approach.

  15. Separation of Powers in Classifying International Agreements

    National Research Council Canada - National Science Library

    Duffy, James F

    1996-01-01

    ... are the exclusive means by which the United States assumes an international commitment Through the use of executive agreements, presidents have concluded a large variety of international commitments...

  16. 75 FR 24702 - Notice of Agreements Filed

    Science.gov (United States)

    2010-05-05

    ... Bay International Terminals, Inc. Operating Agreement. Parties: Tampa Bay International Terminals, Inc. and Tampa Port Authority. Filing Parties: Greg Lovelace, Director Cargo & Cruise Marketing; Tampa Port...

  17. Agreements on emission of greenhouse gases

    International Nuclear Information System (INIS)

    Aulstad, Johan Greger

    2001-01-01

    Agreements on emission of greenhouse gases is one of the instruments used by Norwegian authorities to meet their obligations with respect to the Climate Convention and the Kyoto Protocol. This book discusses the legal issues raised by these agreements. A main topic is how the industrial emissions conform to the Pollution Act. Does the Pollution Act apply to these emissions? What is the impact of the sanction rules in this act on the emissions? The book also deals with the following general questions that arise in connection with the application of public authority: (1) Can the administration grant concessions and permits in the form of agreements? (2) What commitments can be imposed on a private party by the administration by agreement? (3) Should the procedures set down in the Pollution Act and in the Public Administration Act be followed fully when the pollution authorities make agreements? Is the opportunity of the administration to reverse more restricted when they make agreements than when they make one-sided decisions? Although this discussion primarily deals with the emission of greenhouse gases, the reasoning and conclusions are relevant in many other types of agreements in which the public administration is one of the parties. The agreement that regulates the emissions of greenhouse gases from the Norwegian aluminium industry is described in a special section. The book also gives a brief account of how agreements are used in the Danish climate policy

  18. Driven transverse shear waves in a strongly coupled dusty plasma

    International Nuclear Information System (INIS)

    Bandyopadhyay, P.; Prasad, G.; Sen, A.; Kaw, P.K.

    2008-01-01

    The linear dispersion properties of transverse shear waves in a strongly coupled dusty plasma are experimentally studied in a DC discharge device by exciting them in a controlled manner with a variable frequency external source. The dusty plasma is maintained in the strongly coupled fluid regime with (1 c ) where Γ is the Coulomb coupling parameter and Γ c is the crystallization limit. A dispersion relation for the transverse waves is experimentally obtained over a frequency range of 0.1 Hz to 2 Hz and found to show good agreement with viscoelastic theoretical results

  19. A connection between the strong and weak interactions

    International Nuclear Information System (INIS)

    Treiman, S.B.

    1989-01-01

    By studying weak scattering reactions (such as pion-nucleon scattering), the author and his colleague Marvin L Goldberger became renowned in the 1950s for work on dispersion relations. As a result of their collaboration a remarkable and unexpected connection was found between strong and weak interaction quantities. Agreement with experiment was good. Work by others found the same result, but via the partially conserved axial reactor current relation between the axial current divergence and the canonical pion field. (UK)

  20. Thoracic surgeons' perception of frail behavior in videos of standardized patients.

    Science.gov (United States)

    Ferguson, Mark K; Thompson, Katherine; Huisingh-Scheetz, Megan; Farnan, Jeanne; Hemmerich, Josh A; Slawinski, Kris; Acevedo, Julissa; Lee, Sang Mee; Rojnica, Marko; Small, Stephen

    2014-01-01

    Frailty is a predictor of poor outcomes following many types of operations. We measured thoracic surgeons' accuracy in assessing patient frailty using videos of standardized patients demonstrating signs of physical frailty. We compared their performance to that of geriatrics specialists. We developed an anchored scale for rating degree of frailty. Reference categories were assigned to 31 videos of standardized patients trained to exhibit five levels of activity ranging from "vigorous" to "frail." Following an explanation of frailty, thoracic surgeons and geriatrics specialists rated the videos. We evaluated inter-rater agreement and tested differences between ratings and reference categories. The influences of clinical specialty, clinical experience, and self-rated expertise were examined. Inter-rater rank correlation among all participants was high (Kendall's W 0.85) whereas exact agreement (Fleiss' kappa) was only moderate (0.47). Better inter-rater agreement was demonstrated for videos exhibiting extremes of behavior. Exact agreement was better for thoracic surgeons (n = 32) than geriatrics specialists (n = 9; p = 0.045), whereas rank correlation was similar for both groups. More clinical years of experience and self-reported expertise were not associated with better inter-rater agreement. Videos of standardized patients exhibiting varying degrees of frailty are rated with internal consistency by thoracic surgeons as accurately as geriatrics specialists when referenced to an anchored scale. Ratings were less consistent for moderate degrees of frailty, suggesting that physicians require training to recognize early frailty. Such videos may be useful in assessing and teaching frailty recognition.

  1. Practicalities of using a modified version of the Cochrane Collaboration risk of bias tool for randomised and non-randomised study designs applied in a health technology assessment setting.

    Science.gov (United States)

    Robertson, Clare; Ramsay, Craig; Gurung, Tara; Mowatt, Graham; Pickard, Robert; Sharma, Pawana

    2014-09-01

    We describe our experience of using a modified version of the Cochrane risk of bias (RoB) tool for randomised and non-randomised comparative studies. To assess time to complete RoB assessment. To assess inter-rater agreement. To explore the association between RoB and treatment effect size Cochrane risk of bias assessment was performed on a sample of full text primary reports included in a systematic review comparing operative techniques for radical prostatectomy. Inter-rater agreement was assessed using the kappa statistic. Twenty-four studies were judged as high overall RoB, 13 were judged as low RoB and 11 were unclear. The weighted Kappa value was 0.35 indicating fair agreement. The median (range) time taken to rate each study was 30 min (10-49). The effect estimate for all studies was 0.61 (95% credible interval (CrI) 0.46-0.83) and 0.73 (95% CrI 0.29-1.75) for low risk studies. Although the process was time consuming, using a modified version of the RoB tool proved useful for demonstrating conservative effect estimates. That we only achieved a fair agreement between reviewers demonstrates the urgent need for further validation to improve inter-rater agreement. We suggest additional RoB levels could improve inter-rater reliability. © 2013 Crown copyright.

  2. A cause for concern: male couples' sexual agreements and their use of substances with sex.

    Science.gov (United States)

    Mitchell, Jason W; Boyd, Carol; McCabe, Sean; Stephenson, Rob

    2014-07-01

    Substance use is strongly associated with HIV risk among gay men. Many gay couples establish sexual agreements. However, little is known about gay couples' use of substances with sex, and whether substance use is associated with couples' agreements. The present study assessed whether gay couples' use of substances with sex was associated with their establishment of, type of, and adherence to, a sexual agreement. Dyadic data from 275 HIV-negative US gay couples were collected online in a nation-wide, cross-sectional study, and analyzed at the couple-level. Findings revealed that couples with an established agreement, and a recently broken agreement, were more likely to have used amyl nitrates and marijuana with sex within their relationship. This same trend was also noted, but for alcohol use with sex outside of couples' relationships. Further research is urgently needed to examine the fluidity of HIV-negative gay male couples' sexual agreements and substance use with sex.

  3. Secret Key Agreement: Fundamental Limits and Practical Challenges

    KAUST Repository

    Rezki, Zouheir

    2017-02-15

    Despite the tremendous progress made toward establishing PLS as a new paradigm to guarantee security of communication systems at the physical layerthere is a common belief among researchers and industrials that there are many practical challenges that prevent PLS from flourishing at the industrial scale. Most secure message transmission constructions available to date are tied to strong assumptions on CSI, consider simple channel models and undermine eavesdropping capabilities; thus compromising their practical interest to a big extent. Perhaps arguably, the most likely reasonable way to leverage PLS potential in securing modern wireless communication systems is via secret-key agreement. In the latter setting, the legitimate parties try to agree on a key exploiting availability of a public channel with high capacity which is also accessible to the eavesdropper. Once a key is shared by the legitimate parties, they may use it in a one-time pad encryption, for instance. In this article, we investigate two performance limits of secret-key agreement communications; namely, the secret-key diversity-multiplexing trade-off and the effect of transmit correlation on the secretkey capacity. We show via examples how secretkey agreement offers more flexibility than secure message transmissions. Finally, we explore a few challenges of secret-key agreement concept and propose a few guidelines to overturn them.

  4. Strong curvature effects in Neumann wave problems

    International Nuclear Information System (INIS)

    Willatzen, M.; Pors, A.; Gravesen, J.

    2012-01-01

    Waveguide phenomena play a major role in basic sciences and engineering. The Helmholtz equation is the governing equation for the electric field in electromagnetic wave propagation and the acoustic pressure in the study of pressure dynamics. The Schrödinger equation simplifies to the Helmholtz equation for a quantum-mechanical particle confined by infinite barriers relevant in semiconductor physics. With this in mind and the interest to tailor waveguides towards a desired spectrum and modal pattern structure in classical structures and nanostructures, it becomes increasingly important to understand the influence of curvature effects in waveguides. In this work, we demonstrate analytically strong curvature effects for the eigenvalue spectrum of the Helmholtz equation with Neumann boundary conditions in cases where the waveguide cross section is a circular sector. It is found that the linear-in-curvature contribution originates from parity symmetry breaking of eigenstates in circular-sector tori and hence vanishes in a torus with a complete circular cross section. The same strong curvature effect is not present in waveguides subject to Dirichlet boundary conditions where curvature contributions contribute to second-order in the curvature only. We demonstrate this finding by considering wave propagation in a circular-sector torus corresponding to Neumann and Dirichlet boundary conditions, respectively. Results for relative eigenfrequency shifts and modes are determined and compared with three-dimensional finite element method results. Good agreement is found between the present analytical method using a combination of differential geometry with perturbation theory and finite element results for a large range of curvature ratios.

  5. Atoms in strong laser fields

    International Nuclear Information System (INIS)

    L'Huillier, A.

    2002-01-01

    When a high-power laser focuses into a gas of atoms, the electromagnetic field becomes of the same magnitude as the Coulomb field which binds a 1s electron in a hydrogen atom. 3 highly non-linear phenomena can happen: 1) ATI (above threshold ionization): electrons initially in the ground state absorb a large number of photons, many more than the minimum number required for ionization; 2) multiple ionization: many electrons can be emitted one at a time, in a sequential process, or simultaneously in a mechanism called direct or non-sequential; and 3) high order harmonic generation (HHG): efficient photon emission in the extreme ultraviolet range, in the form of high-order harmonics of the fundamental laser field can occur. The theoretical problem consists in solving the time dependent Schroedinger equation (TDSE) that describes the interaction of a many-electron atom with a laser field. A number of methods have been proposed to solve this problem in the case of a hydrogen atom or a single-active electron atom in a strong laser field. A large effort is presently being devoted to go beyond the single-active approximation. The understanding of the physics of the interaction between atoms and strong laser fields has been provided by a very simple model called ''simple man's theory''. A unified view of HHG, ATI, and non-sequential ionization, originating from the simple man's model and the strong field approximation, expressed in terms of electrons trajectories or quantum paths is slowly emerging. (A.C.)

  6. Strongly Interacting Light Dark Matter

    Directory of Open Access Journals (Sweden)

    Sebastian Bruggisser, Francesco Riva, Alfredo Urbano

    2017-09-01

    Full Text Available In the presence of approximate global symmetries that forbid relevant interactions, strongly coupled light Dark Matter (DM can appear weakly coupled at small energy and generate a sizable relic abundance. Fundamental principles like unitarity restrict these symmetries to a small class, where the leading interactions are captured by effective operators up to dimension-8. Chiral symmetry, spontaneously broken global symmetries and non-linearly realized supersymmetry are examples of this. Their DM candidates (composite fermions, pseudo Nambu-Goldstone Bosons and Goldstini are interesting targets for LHC missing-energy searches.

  7. Strongly interacting light dark matter

    International Nuclear Information System (INIS)

    Bruggisser, Sebastian; Riva, Francesco; Urbano, Alfredo

    2016-07-01

    In the presence of approximate global symmetries that forbid relevant interactions, strongly coupled light Dark Matter (DM) can appear weakly coupled at small-energy and generate a sizable relic abundance. Fundamental principles like unitarity restrict these symmetries to a small class, where the leading interactions are captured by effective operators up to dimension-8. Chiral symmetry, spontaneously broken global symmetries and non-linearly realized supersymmetry are examples of this. Their DM candidates (composite fermions, pseudo-Nambu-Goldstone Bosons and Goldstini) are interesting targets for LHC missing-energy searches.

  8. Rydberg atoms in strong fields

    International Nuclear Information System (INIS)

    Kleppner, D.; Tsimmerman, M.

    1985-01-01

    Experimental and theoretical achievements in studying Rydberg atoms in external fields are considered. Only static (or quasistatic) fields and ''one-electron'' atoms, i.e. atoms that are well described by one-electron states, are discussed. Mainly behaviour of alkali metal atoms in electric field is considered. The state of theoretical investigations for hydrogen atom in magnetic field is described, but experimental data for atoms of alkali metals are presented as an illustration. Results of the latest experimental and theoretical investigations into the structure of Rydberg atoms in strong fields are presented

  9. Scalar strong interaction hadron theory

    CERN Document Server

    Hoh, Fang Chao

    2015-01-01

    The scalar strong interaction hadron theory, SSI, is a first principles' and nonlocal theory at quantum mechanical level that provides an alternative to low energy QCD and Higgs related part of the standard model. The quark-quark interaction is scalar rather than color-vectorial. A set of equations of motion for mesons and another set for baryons have been constructed. This book provides an account of the present state of a theory supposedly still at its early stage of development. This work will facilitate researchers interested in entering into this field and serve as a basis for possible future development of this theory.

  10. Strong Plate, Weak Slab Dichotomy

    Science.gov (United States)

    Petersen, R. I.; Stegman, D. R.; Tackley, P.

    2015-12-01

    Models of mantle convection on Earth produce styles of convection that are not observed on Earth.Moreover non-Earth-like modes, such as two-sided downwellings, are the de facto mode of convection in such models.To recreate Earth style subduction, i.e. one-sided asymmetric recycling of the lithosphere, proper treatment of the plates and plate interface are required. Previous work has identified several model features that promote subduction. A free surface or pseudo-free surface and a layer of material with a relatively low strength material (weak crust) allow downgoing plates to bend and slide past overriding without creating undue stress at the plate interface. (Crameri, et al. 2012, GRL)A low viscosity mantle wedge, possibly a result of slab dehydration, decouples the plates in the system. (Gerya et al. 2007, Geo)Plates must be composed of material which, in the case of the overriding plate, are is strong enough to resist bending stresses imposed by the subducting plate and yet, as in the case of the subducting plate, be weak enough to bend and subduct when pulled by the already subducted slab. (Petersen et al. 2015, PEPI) Though strong surface plates are required for subduction such plates may present a problem when they encounter the lower mantle.As the subducting slab approaches the higher viscosity, lower mantle stresses are imposed on the tip.Strong slabs transmit this stress to the surface.There the stress field at the plate interface is modified and potentially modifies the style of convection. In addition to modifying the stress at the plate interface, the strength of the slab affects the morphology of the slab at the base of the upper mantle. (Stegman, et al 2010, Tectonophysics)Slabs that maintain a sufficient portion of their strength after being bent require high stresses to unbend or otherwise change their shape.On the other hand slabs that are weakened though the bending process are more amenable to changes in morphology. We present the results of

  11. 49 CFR 32.620 - Cooperative agreement.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Cooperative agreement. 32.620 Section 32.620 Transportation Office of the Secretary of Transportation GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE... term does not include cooperative research and development agreements as defined in 15 U.S.C. 3710a. ...

  12. 23 CFR 710.307 - Project agreement.

    Science.gov (United States)

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Project agreement. 710.307 Section 710.307 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RIGHT-OF-WAY AND ENVIRONMENT RIGHT-OF-WAY AND REAL ESTATE Project Development § 710.307 Project agreement. As a condition of Federal-aid, the STD...

  13. Distributivity and Agreement mismatches in Serbian

    NARCIS (Netherlands)

    Bosnic, Ana

    2016-01-01

    This paper presents a truth value judgment study done on two types of numerals in the Serbian numerical system and corresponding verbal agreement mismatch that is characteristic for the numerals in question. Recent work on agreement and distributivity suggests that singular verbal marking promotes

  14. Emerging practices in community development agreements | Loutit ...

    African Journals Online (AJOL)

    Emerging practices in community development agreements. ... Journal of Sustainable Development Law and Policy (The) ... Community Development Agreements (CDAs) have the potential to facilitate the delivery of tangible benefits from large-scale investment projects, such as mines or forestry concessions, to affected ...

  15. 78 FR 51757 - Negotiated Service Agreement

    Science.gov (United States)

    2013-08-21

    ... Services (GEPS) 3 negotiated service agreement (Agreement).\\1\\ The Postal Service seeks inclusion of the... statement, and supporting financial workpapers. Id., Attachment 4 at 3. The Postal Service filed redacted versions of the financial workpapers publically. In the Notice, the Postal Service asserts that the...

  16. 77 FR 32115 - Notice of Agreements Filed

    Science.gov (United States)

    2012-05-31

    .... Title: CMA CGM/SSL Puerto Rico-Leeward Islands Space Charter Agreement. Parties: CMA CGM S.A. and Sea Star Line LLC. Filing Party: Wayne R. Rohde, Esquire; Cozen O'Connor; 1627 I Street NW., Suite 1100; Washington, DC 20006-4007. Synopsis: The agreement authorizes CMA to charter space to Sea Star in the trade...

  17. 7 CFR 1424.5 - Agreement process.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Agreement process. 1424.5 Section 1424.5 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS BIOENERGY PROGRAM § 1424.5 Agreement process. (a) To...

  18. 76 FR 56194 - Proposed Settlement Agreement

    Science.gov (United States)

    2011-09-12

    ... issue in an EPA rule that, among other things, beginning in June, 2014, forbade the production of diesel... through Friday, excluding legal holidays. Comments on a disk or CD-ROM should be formatted in Word or... Commenting on the Proposed Settlement Agreement A. How can I get a copy of the settlement agreement? The...

  19. 77 FR 35680 - Notice of Agreement Filed

    Science.gov (United States)

    2012-06-14

    ... or [email protected] . Agreement No.: 201215. Title: Port of Los Angeles Data Delivery Agreement. Parties: Port of Los Angeles; PierPass Inc.; APM Terminals Pacific; California United Terminals, Inc... data to the Port of Los Angeles by the participating marine terminal operators and PierPass Inc., and...

  20. 43 CFR 24.5 - International agreements.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false International agreements. 24.5 Section 24.5 Public Lands: Interior Office of the Secretary of the Interior DEPARTMENT OF THE INTERIOR FISH AND WILDLIFE POLICY: STATE-FEDERAL RELATIONSHIPS § 24.5 International agreements. (a) International conventions...

  1. Can altruism stabilise international climate agreements?

    NARCIS (Netherlands)

    Pol, van der T.D.; Weikard, H.P.; Ierland, van E.C.

    2012-01-01

    We study the impact of altruism on the stability of international climate agreements. We consider the standard two-stage game for the analysis of international environmental agreements where countries announce their participation at the first stage and abatement levels are chosen at the second

  2. 30 CFR 208.9 - Agreements.

    Science.gov (United States)

    2010-07-01

    ...-party agreements, relating to the method and costs of delivery of royalty oil, or crude oil exchanged... royalty oil, must be processed into refined petroleum products in the purchaser's refinery. ... FEDERAL ROYALTY OIL General Provisions § 208.9 Agreements. (a) A purchaser must submit to MMS two copies...

  3. Cooperative monitoring of regional security agreements

    Energy Technology Data Exchange (ETDEWEB)

    Pregenzer, A.L.; Vannoni, M.; Biringer, K.L. [Sandia National Labs., Albuquerque, NM (United States). Nonproliferation and Arms Control Analysis Dept.

    1996-11-01

    This paper argues that cooperative monitoring plays a critical role in the implementation of regional security agreements and confidence building measures. A framework for developing cooperative monitoring options is proposed and several possibilities for relating bilateral and regional monitoring systems to international monitoring systems are discussed. Three bilateral or regional agreements are analyzed briefly to illustrate different possibilities. These examples illustrate that the relationship of regional or bilateral arms control or security agreements to international agreements depends on a number of factors: the overlap of provisions between regional and international agreements; the degree of interest in a regional agreement among the international community; efficiency in implementing the agreement; and numerous political considerations. Given the importance of regional security to the international community, regions should be encouraged to develop their own infrastructure for implementing regional arms control and other security agreements. A regional infrastructure need not preclude participation in an international regime. On the contrary, establishing regional institutions for arms control and nonproliferation could result in more proactive participation of regional parties in developing solutions for regional and international problems, thereby strengthening existing and future international regimes. Possible first steps for strengthening regional infrastructures are identified and potential technical requirements are discussed.

  4. 75 FR 150 - Notice of Agreements Filed

    Science.gov (United States)

    2010-01-04

    ... No: E9-31187] FEDERAL MARITIME COMMISSION Notice of Agreements Filed The Commission hereby gives... submit comments on the agreements to the Secretary, Federal Maritime Commission, Washington, DC 20573...; Orient Overseas Container Line Limited; Yangming Marine Transport Corp.; and Zim Integrated Shipping...

  5. 77 FR 33459 - Notice of Agreements Filed

    Science.gov (United States)

    2012-06-06

    ... . Agreement No.: 011275-033. Title: Australia and New Zealand-United States Discussion Agreement. Parties: ANL...'Connor; 1627 I Street NW., Suite 1100; Washington, DC 20006-4007. Synopsis: The amendment would add a new... authorizes Hyundai to charter space to MOL and APL in the relevant trade and to authorize the parties to...

  6. 77 FR 64991 - Notice of Agreements Filed

    Science.gov (United States)

    2012-10-24

    ... Containers, Inc., and SSA Ventures, Inc. Filing Party: David F. Smith, Esq.; Cozen O'Connor; 1627 I Street NW.... Agreement No.: 201162-009. Title: NYSA-ILA Assessment Agreement. Parties: International Longshoremen's Association and New York Shipping Association. Filing Parties: Donato Caruso, Esq.; The Lambos Firm; 303 South...

  7. Hubs and spokes in Regional Trade Agreements

    NARCIS (Netherlands)

    Vaal, A. de

    2017-01-01

    In the plethora of Regional Trade Agreements (RTAs) some countries are involved in much more RTAs than others. Furthermore, some countries take in a position as a hub: they have trade agreements with many other countries, while their partner countries are much less involved in RTA relations. Even

  8. 48 CFR 18.118 - Trade agreements.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Trade agreements. 18.118 Section 18.118 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES EMERGENCY ACQUISITIONS Available Acquisition Flexibilities 18.118 Trade agreements...

  9. 7 CFR 1720.9 - Guarantee Agreement.

    Science.gov (United States)

    2010-01-01

    ... to absorb losses relative to risk in the guaranteed lender's portfolio and requirements on the guaranteed lender to hold additional capital against the risk of default; (16) Payment by RUS; (17) RUS... Agreement. (a) The guaranteed lender will be required to sign a guarantee agreement with the Secretary...

  10. 76 FR 64944 - Notice of Agreements Filed

    Science.gov (United States)

    2011-10-19

    ..., and New Zealand. Agreement No.: 012140. Title: CSAV/Siem Turkey Space Charter Agreement. Parties: Compania Sud Americana de Vapores, S.A. and Siem Car Carriers (Pacific) AS. Filing Party: Walter H. Lion... CSAV and Siem to cross charter space for the movement of motorized vehicles in the trade from Turkey to...

  11. Strong coupling from the Hubbard model

    Science.gov (United States)

    Minahan, Joseph A.

    2006-10-01

    It was recently observed that the one-dimensional half-filled Hubbard model reproduces the known part of the perturbative spectrum of planar {\\cal N}=4 super Yang Mills in the SU(2) sector. Assuming that this identification is valid beyond perturbation theory, we investigate the behaviour of this spectrum as the 't Hooft parameter λ becomes large. We show that the full dimension Δ of the Konishi superpartner is the solution of a sixth-order polynomial while Δ for a bare dimension 5 operator is the solution of a cubic. In both cases, the equations can be solved easily as a series expansion for both small and large λ and the equations can be inverted to express λ as an explicit function of Δ. We then consider more general operators and show how Δ depends on λ in the strong coupling limit. We are also able to distinguish those states in the Hubbard model which correspond to the gauge-invariant operators for all values of λ. Finally, we compare our results with known results for strings on AdS5 × S5, where we find agreement for a range of R-charges.

  12. Nuclear arbitration: Interpreting non-proliferation agreements

    International Nuclear Information System (INIS)

    Tzeng, Peter

    2015-01-01

    At the core of the nuclear non-proliferation regime lie international agreements. These agreements include, inter alia, the Nuclear Non-proliferation Treaty, nuclear co-operation agreements and nuclear export control agreements.1 States, however, do not always comply with their obligations under these agreements. In response, commentators have proposed various enforcement mechanisms to promote compliance. The inconvenient truth, however, is that states are generally unwilling to consent to enforcement mechanisms concerning issues as critical to national security as nuclear non-proliferation.3 This article suggests an alternative solution to the non-compliance problem: interpretation mechanisms. Although an interpretation mechanism does not have the teeth of an enforcement mechanism, it can induce compliance by providing an authoritative interpretation of a legal obligation. Interpretation mechanisms would help solve the non-compliance problem because, as this article shows, in many cases of alleged non-compliance with a non-proliferation agreement, the fundamental problem has been the lack of an authoritative interpretation of the agreement, not the lack of an enforcement mechanism. Specifically, this article proposes arbitration as the proper interpretation mechanism for non-proliferation agreements. It advocates the establishment of a 'Nuclear Arbitration Centre' as an independent branch of the International Atomic Energy Agency (IAEA), and recommends the gradual introduction of arbitration clauses into the texts of non-proliferation agreements. Section I begins with a discussion of international agreements in general and the importance of interpretation and enforcement mechanisms. Section II then discusses nuclear non-proliferation agreements and their lack of interpretation and enforcement mechanisms. Section III examines seven case studies of alleged non-compliance with non-proliferation agreements in order to show that the main problem in many cases

  13. New Danish Company Act on Shareholders' Agreements

    DEFF Research Database (Denmark)

    Werlauff, Erik

    2011-01-01

    Section 82 of the Danish Company Act, in force from 1 March 2010, provides that ‘Shareholders’ agreements are neither binding on the company nor on decisions taken by the general assembly’. This has far-reaching consequences for shareholders’ agreements, also for already existing agreements....... The substantial elements in many agreements are clauses on (1) voting for board candidates, (2) voting for dividends of certain proportions, and (3) first refusal rights, respectively, call options for shares in the company. Such clauses are at the very roots of corporate law, dealing with the shareholders’ (1......) organizational rights, (2) financial rights, and (3) rights of disposal, or in plainer words, the corporate (1) power, (2) money, and (3) exit. If a shareholders’ agreement is thoroughly kept and respected by all parties, both in the way they vote at general assemblies and in the way they act when wishing...

  14. Bayesian methods for measures of agreement

    CERN Document Server

    Broemeling, Lyle D

    2009-01-01

    Using WinBUGS to implement Bayesian inferences of estimation and testing hypotheses, Bayesian Methods for Measures of Agreement presents useful methods for the design and analysis of agreement studies. It focuses on agreement among the various players in the diagnostic process.The author employs a Bayesian approach to provide statistical inferences based on various models of intra- and interrater agreement. He presents many examples that illustrate the Bayesian mode of reasoning and explains elements of a Bayesian application, including prior information, experimental information, the likelihood function, posterior distribution, and predictive distribution. The appendices provide the necessary theoretical foundation to understand Bayesian methods as well as introduce the fundamentals of programming and executing the WinBUGS software.Taking a Bayesian approach to inference, this hands-on book explores numerous measures of agreement, including the Kappa coefficient, the G coefficient, and intraclass correlation...

  15. The Development Standard Agreement Influences on National and International Business Practices

    Directory of Open Access Journals (Sweden)

    Cindawati Cindawati

    2016-12-01

    Full Text Available The rapidly growing business traffic either nationally or internationally forces the business practices to establish a standard agreement to secure the products and to protect the buyer from any risks. The standard agreement successfully meets the demand of international trade which urgently need the high speed and the accuracy. The objective of this research is to find out how does the development of agreement affect to the commerce practices and what are the requirements of standard agreement in accordance with the right and obligation. A qualitative method is applied in searching data of business practices. This study uses a normative research which guides the rule of law or determines some business standards and norms. The finding of this study show that the development of agreement strongly affects to the commerce practices, and standar agreement is urgently needed by business practices as a guideline to perform business traffic as smooth as buyer and seller expect, then both seller and buyer should know the three alternative way used as the procedures of standard agreement, namely; contract signing, notification document agreement, and notification by bulletin board. At last, a standard agreement could be accepted as legal agreement corresponding to willingness and trustworthy.

  16. EDITORIAL: Strongly correlated electron systems Strongly correlated electron systems

    Science.gov (United States)

    Ronning, Filip; Batista, Cristian

    2011-03-01

    Strongly correlated electrons is an exciting and diverse field in condensed matter physics. This special issue aims to capture some of that excitement and recent developments in the field. Given that this issue was inspired by the 2010 International Conference on Strongly Correlated Electron Systems (SCES 2010), we briefly give some history in order to place this issue in context. The 2010 International Conference on Strongly Correlated Electron Systems was held in Santa Fe, New Mexico, a reunion of sorts from the 1989 International Conference on the Physics of Highly Correlated Electron Systems that also convened in Santa Fe. SCES 2010—co-chaired by John Sarrao and Joe Thompson—followed the tradition of earlier conferences, in this century, hosted by Buzios (2008), Houston (2007), Vienna (2005), Karlsruhe (2004), Krakow (2002) and Ann Arbor (2001). Every three years since 1997, SCES has joined the International Conference on Magnetism (ICM), held in Recife (2000), Rome (2003), Kyoto (2006) and Karlsruhe (2009). Like its predecessors, SCES 2010 topics included strongly correlated f- and d-electron systems, heavy-fermion behaviors, quantum-phase transitions, non-Fermi liquid phenomena, unconventional superconductivity, and emergent states that arise from electronic correlations. Recent developments from studies of quantum magnetism and cold atoms complemented the traditional subjects and were included in SCES 2010. 2010 celebrated the 400th anniversary of Santa Fe as well as the birth of astronomy. So what's the connection to SCES? The Dutch invention of the first practical telescope and its use by Galileo in 1610 and subsequent years overturned dogma that the sun revolved about the earth. This revolutionary, and at the time heretical, conclusion required innovative combinations of new instrumentation, observation and mathematics. These same combinations are just as important 400 years later and are the foundation of scientific discoveries that were discussed

  17. Cooperative monitoring of regional security agreements

    Energy Technology Data Exchange (ETDEWEB)

    Pregenzer, A.L.; Vannoni, M.; Biringer, K.L.

    1995-08-01

    This paper argues that cooperative monitoring plays a critical role in the implementation of regional security agreements and confidence building measures. A framework for developing cooperative monitoring options is proposed and several possibilities for relating bilateral and regional monitoring systems to international monitoring systems are discussed. Three bilateral or regional agreements are analyzed briefly to illustrate different possibilities: (1) the demilitarization of the Sinai region between Israel and Egypt in the 1970s; (2) the 1991 quadripartite agreement for monitoring nuclear facilities among Brazil, Argentina, The Argentine-Brazilian Agency for Accounting and Control of Nuclear Materials and the International Atomic Energy Agency; and (3) a bilateral Open Skies agreement between Hungary and Romania in 1991. These examples illustrate that the relationship of regional or bilateral arms control or security agreements to international agreements depends on a number of factors: the overlap of provisions between regional and international agreements; the degree of interest in a regional agreement among the international community; efficiency in implementing the agreement; and numerous political considerations.Given the importance of regional security to the international community, regions should be encouraged to develop their own infrastructure for implementing regional arms control and other security agreements. A regional infrastructure need not preclude participation in an international regime. On the contrary, establishing regional institutions for arms control and nonproliferation could result in more proactive participation of regional parties in developing solutions for regional and international problems, thereby strengthening existing and future international regimes. Possible first steps for strengthening regional infrastructures are identified and potential technical requirements are discussed.

  18. Fiber tracking: A qualitative and quantitative comparison between four different software tools on the reconstruction of major white matter tracts

    Directory of Open Access Journals (Sweden)

    Foteini Christidi

    2016-01-01

    Conclusions: Qualitative comparison of four different DTI software in addition to substantial inter-rater but poor between-software agreement highlight the differences on existing fiber tracking methodologies and several particularities of each WM tract, further supporting the need for further study in both clinical and research settings.

  19. Parent and Teacher Perspectives about Problem Behavior in Children with Williams Syndrome

    Science.gov (United States)

    Klein-Tasman, Bonita P.; Lira, Ernesto N.; Li-Barber, Kirsten T.; Gallo, Frank J.; Brei, Natalie G.

    2015-01-01

    Problem behavior of 52 children with Williams syndrome ages 6 to 17 years old was examined based on both parent and teacher report. Generally good inter-rater agreement was found. Common areas of problem behavior based both on parent and teacher report included attention problems, anxiety difficulties, repetitive behaviors (e.g., obsessions,…

  20. The reproducibility of the Canadian Occupational Performance Measure

    NARCIS (Netherlands)

    Eyssen, Isaline C J M; Beelen, A.; Dedding, C; Cardol, M.; Dekker, J

    2005-01-01

    OBJECTIVE: To assess the reproducibility (reliability and inter-rater agreement) of the client-centred Canadian Occupational Performance Measure (COPM). DESIGN: The COPM was administered twice, with a mean interval of seven days (SD 1.6, range 4-14), by two different occupational therapists. Data

  1. The reproducibility of the Canadian occupational performance measure.

    NARCIS (Netherlands)

    Eyssen, I.C.J.M.; Beelen, A.; Dedding, C.; Cardol, M.; Dekker, J.

    2005-01-01

    OBJECTIVE: To assess the reproducibility (reliability and inter-rater agreement) of the client-centred Canadian Occupational Performance Measure (COPM). Design: The COPM was administered twice, with a mean interval of seven days (SD 1.6, range 4-14), by two different occupational therapists. Data

  2. The reproducibility of the Canadian Occupational Performance Measure

    NARCIS (Netherlands)

    Eyssen, I.C.; Beelen, A.; Dedding, C.; Cardol, M.; Dekker, J.

    2005-01-01

    Objective: To assess the reproducibility (reliability and inter-rater agreement> of the client-centred Canadian Occupational Performance Measure (COPM). Design: The COPM was administered twice, with a mean interval of seven days (SD 1.6, range 4-14), by two different occupational therapists. Data

  3. The reproducibility of the Canadian Occupational Performance Measure

    NARCIS (Netherlands)

    Eyssen, I. C. J. M.; Beelen, A.; Dedding, C.; Cardol, M.; Dekker, J.

    2005-01-01

    To assess the reproducibility (reliability and inter-rater agreement) of the client-centred Canadian Occupational Performance Measure (COPM). The COPM was administered twice, with a mean interval of seven days (SD 1.6, range 4-14), by two different occupational therapists. Data analysis was based on

  4. The reproducibility of the Canadian Occupational Performance Measure

    NARCIS (Netherlands)

    Eyssen, I.C.; Beelen, A.; Dedding, C.; Cardol, M.; Dekker, J.

    2005-01-01

    OBJECTIVE: To assess the reproducibility (reliability and inter-rater agreement) of the client-centred Canadian Occupational Performance Measure (COPM). Design: The COPM was administered twice, with a mean interval of seven days (SD 1.6, range 4-14), by two different occupational therapists. Data

  5. Evaluation of the Cochrane tool for assessing risk of bias in randomized clinical trials

    DEFF Research Database (Denmark)

    Jørgensen, L; Paludan-Müller, A. S.; Laursen, David

    2016-01-01

    considered to be its choice of core bias domains (e.g. not involving funding/conflicts of interest) and issues to do with implementation (i.e. modest inter-rater agreement) and terminology. Our observational study found that the tool was used in all Cochrane reviews (100/100) and was the preferred tool...

  6. Evaluation of the McMahon Competence Assessment Instrument for Use with Midwifery Students During a Simulated Shoulder Dystocia.

    Science.gov (United States)

    McMahon, Erin; Jevitt, Cecilia; Aronson, Barbara

    2018-03-01

    Intrapartum emergencies occur infrequently but require a prompt and competent response from the midwife to prevent morbidity and mortality of the woman, fetus, and newborn. Simulation provides the opportunity for student midwives to develop competence in a safe environment. The purpose of this study was to determine the inter-rater reliability of the McMahon Competence Assessment Instrument (MCAI) for use with student midwives during a simulated shoulder dystocia scenario. A pilot study using a nonprobability convenience sample was used to evaluate the MCAI. Content validity indices were calculated for the individual items and the overall instrument using data from a panel of expert reviewers. Fourteen student midwives consented to be video recorded while participating in a simulated shoulder dystocia scenario. Three faculty raters used the MCAI to evaluate the student performance. These quantitative data were used to determine the inter-rater reliability of the MCAI. The intraclass correlation coefficient (ICC) was used to assess the inter-rater reliability of MCAI scores between 2 or more raters. The ICC was 0.86 (95% confidence interval, 0.60-0.96). Fleiss's kappa was calculated to determine the inter-rater reliability for individual items. Twenty-three of the 42 items corresponded to excellent strength of agreement. This study demonstrates a method to determine the inter-rater reliability of a competence assessment instrument to be used with student midwives. Data produced by this study were used to revise and improve the instrument. Additional research will further document the inter-rater reliability and can be used to determine changes in student competence. Valid and reliable methods of assessment will encourage the use of simulation to efficiently develop the competence of student midwives. © 2018 by the American College of Nurse-Midwives.

  7. Safeguards agreements - their legal and conceptual basis

    International Nuclear Information System (INIS)

    Sanders, B.; Rainer, R.

    1977-01-01

    The application of Agency safeguards requires treaty arrangements (''Safeguards Agreements'') between the State or States concerned and the Agency. The authority for the Agency to conclude such agreements and to implement them is provided for in the Agency's Statute (Articles II, III A.5 and XII). On the basis of the statutory provisions safeguards principles and procedures have been elaborated. These have been laid down in: (a) The Agency's Safeguards System 1965, extended in 1966 and 1968 (INFCIRC/66/Rev.2); and (b) The basis for negotiating safeguards agreements with NNWS pursuant to NPT (INFCIRC/153). The verification of the undertaking by the State concerned not to use items subject to safeguards for purposes contrary to the terms of the agreement is verified through the application of various safeguards measures (design review, records, reports and inspection). Containment and surveillance measures are expected to play an increasingly important role. NPT Safeguards Agreements foresee as one of their specific features the establishment of national systems of accounting and control of nuclear material. The majority of the agreements concluded under document INFCIRC/66/Rev.2 - i.e. the non-NPT safeguards agreements - implement obligations undertaken under co-operation agreements between States for peaceful uses of nuclear energy. These agreements naturally reflect approaches adopted by the parties, in particular as to the circumstances under which safeguards should be applied. Thus, the concepts used in the non-NPT safeguards agreements and the safeguards system of document INFCIRC/66/Rev.2 which is incorporated in these agreements by reference are in continuous evolution. Document INFCIRC/66/Rev.2 continues to be supplemented in practical application and through explicit decision by the Board. The non-NPT safeguards agreements contain, besides technical safeguards provisions from document INFCIRC/66/Rev.2, and further provision for notification, inventories

  8. Physics of Strongly Coupled Plasma

    Energy Technology Data Exchange (ETDEWEB)

    Kraeft, Wolf-Dietrich [Universitat Rostock (Germany)

    2007-07-15

    Strongly coupled plasmas (or non-ideal plasmas) are multi-component charged many-particle systems, in which the mean value of the potential energy of the system is of the same order as or even higher than the mean value of the kinetic energy. The constituents are electrons, ions, atoms and molecules. Dusty (or complex) plasmas contain still mesoscopic (multiply charged) particles. In such systems, the effects of strong coupling (non-ideality) lead to considerable deviations of physical properties from the corresponding properties of ideal plasmas, i.e., of plasmas in which the mean kinetic energy is essentially larger than the mean potential energy. For instance, bound state energies become density dependent and vanish at higher densities (Mott effect) due to the interaction of the pair with the surrounding particles. Non-ideal plasmas are of interest both for general scientific reasons (including, for example, astrophysical questions), and for technical applications such as inertially confined fusion. In spite of great efforts both experimentally and theoretically, satisfactory information on the physical properties of strongly coupled plasmas is not at hand for any temperature and density. For example, the theoretical description of non-ideal plasmas is possible only at low densities/high temperatures and at extremely high densities (high degeneracy). For intermediate degeneracy, however, numerical experiments have to fill the gap. Experiments are difficult in the region of 'warm dense matter'. The monograph tries to present the state of the art concerning both theoretical and experimental attempts. It mainly includes results of the work performed in famous Russian laboratories in recent decades. After outlining basic concepts (chapter 1), the generation of plasmas is considered (chapter 2, chapter 3). Questions of partial (chapter 4) and full ionization (chapter 5) are discussed including Mott transition and Wigner crystallization. Electrical and

  9. Strongly coupled dust coulomb clusters

    International Nuclear Information System (INIS)

    Juan Wentau; Lai Yingju; Chen Mingheng; I Lin

    1999-01-01

    The structures and motions of quasi-2-dimensional strongly coupled dust Coulomb clusters with particle number N from few to hundreds in a cylindrical rf plasma trap are studied and compared with the results from the molecular dynamic simulation using more ideal models. Shell structures with periodic packing in different shells and intershell rotational motion dominated excitations are observed at small N. As N increases, the boundary has less effect, the system recovers to the triangular lattice with isotropic vortex type cooperative excitations similar to an infinite N system except the outer shell region. The above generic behaviors are mainly determined by the system symmetry and agree with the simulation results. The detailed interaction form causes minor effect such as the fine structure of packing

  10. Probability densities in strong turbulence

    Science.gov (United States)

    Yakhot, Victor

    2006-03-01

    In this work we, using Mellin’s transform combined with the Gaussian large-scale boundary condition, calculate probability densities (PDFs) of velocity increments P(δu,r), velocity derivatives P(u,r) and the PDF of the fluctuating dissipation scales Q(η,Re), where Re is the large-scale Reynolds number. The resulting expressions strongly deviate from the Log-normal PDF P(δu,r) often quoted in the literature. It is shown that the probability density of the small-scale velocity fluctuations includes information about the large (integral) scale dynamics which is responsible for the deviation of P(δu,r) from P(δu,r). An expression for the function D(h) of the multifractal theory, free from spurious logarithms recently discussed in [U. Frisch, M. Martins Afonso, A. Mazzino, V. Yakhot, J. Fluid Mech. 542 (2005) 97] is also obtained.

  11. 48 CFR 25.403 - World Trade Organization Government Procurement Agreement and Free Trade Agreements.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false World Trade Organization Government Procurement Agreement and Free Trade Agreements. 25.403 Section 25.403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Trade Agreements...

  12. 14 CFR 372.24 - Surety bond, depository agreement, escrow agreement.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Surety bond, depository agreement, escrow... § 372.24 Surety bond, depository agreement, escrow agreement. (a) Before selling or offering to sell...)(2)(i) of this section; an escrow with the designated bank of Federal, State, or municipal bonds or...

  13. Building Climate Coalitions on Preferential Free Trade Agreements

    OpenAIRE

    Kuhn, Thomas; Pestow, Radomir; Zenker, Anja

    2017-01-01

    In this paper, we discuss the endogenous formation of climate coalitions in the tradition of the issue-linkage literature. In particular, we propose a preferential free trade agreement on which a climate coalition should be built. The basic idea is that the benefits of free trade provide strong incentives for free riders to join the coalition. As a framework, a multi-stage strategic trade model is used in which a country may discourage greenhouse gas emissions by setting an emissions cap effe...

  14. The cross-border cooperation agreement

    Directory of Open Access Journals (Sweden)

    Cătălin-Silviu SĂRARU

    2011-06-01

    Full Text Available This study aims to achieve a short analysis of cross-border cooperation agreements between territorial-administrative units in the border areas of Romania and similar structures in neighboring states. The article investigates the form they takes these agreements – contract or treaty –, the role of multinational enterprises and the law applicable to transnational contracts, the cross-border cooperation agreement governed by Law no. 215/2001 on local public administration and its legal nature. The end of the article is discussed cross-border cooperation in international documents signed by Romania with its neighbors.

  15. Client/consultant model services agreement

    CERN Document Server

    International Federation of Consulting Engineers

    2006-01-01

    The terms of the Client Consultant Model Services agreement (The White Book) have been prepared by the Fédération Internationale des Ingénieurs-Conseils (FIDIC) and are recommended for general use for the purposes of pre-investment and feasibility studies, designs and administration of construction and project management, where proposals for such services are invited on an international basis. They are equally adaptable for domestic agreements. - See more at: http://fidic.org/books/clientconsultant-model-services-agreement-4th-ed-2006-white-book#sthash.3Uxy5qT3.dpuf

  16. Arbitration Agreements and Your Malpractice Coverage

    Science.gov (United States)

    Butler, James R.

    1976-01-01

    With new legislation and favorable case law developments, many providers of health care services are turning to binding arbitration agreements as a partial solution to the medical malpractice crisis. Existing data indicate tremendous advantages can be gained from the use of such agreements, if they are carefully drawn to comply with new law, tailored to the particular situation in which they will be used and coupled with appropriate procedures to secure the intended benefits. Arbitration is not a substitute for insurance, but if a provider has taken the calculated risk of forgoing insurance he should not be without a carefully drawn binding arbitration agreement. PMID:969512

  17. Strong Ideal Convergence in Probabilistic Metric Spaces

    Indian Academy of Sciences (India)

    In the present paper we introduce the concepts of strongly ideal convergent sequence and strong ideal Cauchy sequence in a probabilistic metric (PM) space endowed with the strong topology, and establish some basic facts. Next, we define the strong ideal limit points and the strong ideal cluster points of a sequence in this ...

  18. Strong ideal convergence in probabilistic metric spaces

    Indian Academy of Sciences (India)

    In the present paper we introduce the concepts of strongly ideal convergent sequence and strong ideal Cauchy sequence in a probabilistic metric (PM) space endowed with the strong topology, and establish some basic facts. Next, we define the strong ideal limit points and the strong ideal cluster points of a sequence in this ...

  19. Intra- and interobserver agreement in the diagnosis of malocclusion in sleep-disordered breathing.

    Science.gov (United States)

    Carvalho, Fernando Rodrigues; Lentini-Oliveira, Débora Aparecida; Carvalho, Graziele Maria Missiano; Singer, Julio Motta; Prado, Lucila Bizari Fernandes; Prado, Gilmar Fernandes; Carvalho, Luciane Bizari Coin

    2014-02-01

    Sleep-disordered breathing (SDB) is often related to malocclusion, and dentists should be able to recognize occlusal changes that may be associated with the development, onset, or persistence of SDB. Although clinical examination is routinely used by specialists in orthodontics and functional jaw orthopedics, differences in diagnosis are very common. Two observers, both dentists specializing in functional jaw orthopedics, examined 56 children aged 7 to 9 years. Intra- and interobserver agreement in identification of functional orthopedic and orthodontic conditions were assessed. Intraobserver agreement was strong for all variables. Interobserver agreement was also strong, except for the variable overbite, which showed good agreement. Diagnostic criteria provide an opportunity for dentists to recognize dental malocclusions that may be associated with sleep-disordered breathing.

  20. Intra- and interobserver agreement in the diagnosis of malocclusion in sleep-disordered breathing

    Directory of Open Access Journals (Sweden)

    Fernando Rodrigues Carvalho

    2014-02-01

    Full Text Available Sleep-disordered breathing (SDB is often related to malocclusion, and dentists should be able to recognize occlusal changes that may be associated with the development, onset, or persistence of SDB. Although clinical examination is routinely used by specialists in orthodontics and functional jaw orthopedics, differences in diagnosis are very common. Method : Two observers, both dentists specializing in functional jaw orthopedics, examined 56 children aged 7 to 9 years. Intra- and interobserver agreement in identification of functional orthopedic and orthodontic conditions were assessed. Results : Intraobserver agreement was strong for all variables. Interobserver agreement was also strong, except for the variable overbite, which showed good agreement. Conclusion : Diagnostic criteria provide an opportunity for dentists to recognize dental malocclusions that may be associated with sleep-disordered breathing.

  1. 76 FR 2114 - Notice of Agreements Filed

    Science.gov (United States)

    2011-01-12

    ... corporate address of American President Line's corporate address. Agreement No.: 201207-002. Title: Terminal... Strategy to improve the air quality in the PONYNJ community. The parties have requested expedited review...

  2. Innovative approaches to structuring the transaction agreement

    International Nuclear Information System (INIS)

    Droppo, D.L.

    1999-01-01

    Several issues regarding the negotiation and structuring of oil and gas property transactions are reviewed. They include: (1) areas of mutual exclusion covenants, (2) use of the short-form term sheet or letter agreement or the longer, more comprehensive formal offer or letter agreement, (3) coping with standard form purchase and sale agreements and property bid packages, (4) allocations of purchase price and their effect on ROFRs, (5) interim operations covenants, including maintaining insurance, contractual relationships and operational integrity, (6) structuring the transaction to facilitate unique financing requirements, (7) making effective use of adjustment clauses, (8) dealing with the cyclicity of commodity prices in the purchase and sale agreement, and (9) using escrow and trust arrangements to meet closure deadlines

  3. Material Transfer Agreement (MTA) | FNLCR Staging

    Science.gov (United States)

    Material Transfer Agreements are appropriate for exchange of materials into or out of the Frederick National Labfor research or testing purposes, with no collaborative research by parties involving the materials.

  4. 75 FR 6397 - Notice of Agreements Filed

    Science.gov (United States)

    2010-02-09

    ... manage a joint venture limited liability company to provide stevedoring and other services for the... Agreement. Parties: A.P. Moller-Maersk A/S; Maersk Line Limited; and Zim Integrated Shipping Services, Ltd...

  5. The rise of number agreement in Nheengatu

    Directory of Open Access Journals (Sweden)

    Aline da Cruz

    Full Text Available Abstract: Number agreement systems often present traces of older elements common to different languages of the same family; thus, their emergence is difficult to reconstruct. One possible origin of such systems is the grammaticalization of plural words into bound morphemes, which, as a result of a long process, develop into agreement markers and may become obligatory. Various investigations have provided evidence for this hypothesis. However, the complete process of change from a system with no number as grammatical category into a number agreement system in a single language has not been documented. This paper analyses documents covering different stages of the development of the Nheengatu language from Tupinambá in order to observe how the number agreement system emerged in modern Nheengatu. By doing so, this paper supports the idea that grammaticalization may have occurred rapidly in intense contact situations.

  6. 77 FR 10743 - Notice of Agreements Filed

    Science.gov (United States)

    2012-02-23

    ... trade between countries in the Mediterranean Sea and the Atlantic Coast of the United States and Canada... regarding the calculation of rates for containers and minimum guarantee payments. Agreement No.: 201212...

  7. Climate Justice and the Paris Agreement

    International Nuclear Information System (INIS)

    Michelot, Agnes

    2016-01-01

    The concept of climate justice has been, for the first time, used in an international agreement - namely, the Paris Agreement. But this recognition of the notion of climate justice is extremely restricted by the very way it is formulated. Preamble of the Paris Agreement 'notes' that climate justice is recognized by 'certain cultures'. Does it mean that particular and concrete stakes of climate justice of the pre-COP21 agenda have been recognized or, on the contrary, that the notion so introduced is actually an empty shell without any genuine legal perspective? Considering this uncertainty, it appears relevant to analyze the Paris Agreement through the claims of various groups and coalitions, which influenced the COP21 negotiations

  8. Benefits and costs of programmatic agreements

    Science.gov (United States)

    2015-02-01

    The performing organization, on behalf of the FHWA Office of Planning, Environment, and Realty, conducted a benefit-cost assessment of programmatic agreements and approaches. The assessment consisted of a case study approach that evaluated three agre...

  9. 78 FR 3424 - Notice of Agreements Filed

    Science.gov (United States)

    2013-01-16

    ....A.G.) as shareholder parties, and Alianca Navegacao e Logistica Ltda.; China Shipping Container... No.: 011961-013. Title: The Maritime Credit Agreement. Parties Alianca Navegacao e Logistica Ltda...

  10. 78 FR 35649 - Negotiated Service Agreement

    Science.gov (United States)

    2013-06-13

    ... whether the 2013 Agreement (1) Improves the net financial position of the Postal Service or enhances the... CFR 3015.5 (filed under seal); a public Excel file containing redacted versions of financial...

  11. Power sales contract/energy supply agreements

    International Nuclear Information System (INIS)

    Wallace, R.B.

    1999-01-01

    The factors involved in negotiating power purchase/sales arrangements in Ontario's newly deregulated electricity market are described, and the ways in which they will evolve in the future are predicted. Indications are that the trends that will govern the changes in the electric power industry will be the same as those that existed in the natural gas industry. For this reason, a comparative evaluation of purchase and sale agreements in the two industries was provided. Traditional power purchase arrangements, including requests for proposals, the seller's response, the memorandum of understanding, and the principal terms of a traditional bilateral power purchase agreement were examined. The author predicted that over time, and probably fairly fast in power pool jurisdictions, the traditional power purchase agreement will give way to the concept of energy as a pure commodity and to a standard form of agreement. 1 appendix

  12. Remnants of strong tidal interactions

    International Nuclear Information System (INIS)

    Mcglynn, T.A.

    1990-01-01

    This paper examines the properties of stellar systems that have recently undergone a strong tidal shock, i.e., a shock which removes a significant fraction of the particles in the system, and where the shocked system has a much smaller mass than the producer of the tidal field. N-body calculations of King models shocked in a variety of ways are performed, and the consequences of the shocks are investigated. The results confirm the prediction of Jaffe for shocked systems. Several models are also run where the tidal forces on the system are constant, simulating a circular orbit around a primary, and the development of tidal radii under these static conditions appears to be a mild process which does not dramatically affect material that is not stripped. The tidal radii are about twice as large as classical formulas would predict. Remnant density profiles are compared with a sample of elliptical galaxies, and the implications of the results for the development of stellar populations and galaxies are considered. 38 refs

  13. John Strong - 1941-2006

    CERN Document Server

    2006-01-01

    Our friend and colleague John Strong was cruelly taken from us by a brain tumour on 31 July, a few days before his 65th birthday. John started his career and obtained his PhD in a group from Westfield College, initially working on experiments at Rutherford Appleton Laboratory (RAL). From the early 1970s onwards, however, his research was focused on experiments in CERN, with several particularly notable contributions. The Omega spectrometer adopted a system John had originally developed for experiments at RAL using vidicon cameras (a type of television camera) to record the sparks in the spark chambers. This highly automated system allowed Omega to be used in a similar way to bubble chambers. He contributed to the success of NA1 and NA7, where he became heavily involved in the electronic trigger systems. In these experiments the Westfield group joined forces with Italian colleagues to measure the form factors of the pion and the kaon, and the lifetime of some of the newly discovered charm particles. Such h...

  14. Strong seismic ground motion propagation

    International Nuclear Information System (INIS)

    Seale, S.; Archuleta, R.; Pecker, A.; Bouchon, M.; Mohammadioun, G.; Murphy, A.; Mohammadioun, B.

    1988-10-01

    At the McGee Creek, California, site, 3-component strong-motion accelerometers are located at depths of 166 m, 35 m and 0 m. The surface material is glacial moraine, to a depth of 30.5 m, overlying homfels. Accelerations were recorded from two California earthquakes: Round Valley, M L 5.8, November 23, 1984, 18:08 UTC and Chalfant Valley, M L 6.4, July 21, 1986, 14:42 UTC. By separating out the SH components of acceleration, we were able to determine the orientations of the downhole instruments. By separating out the SV component of acceleration, we were able to determine the approximate angle of incidence of the signal at 166 m. A constant phase velocity Haskell-Thomson model was applied to generate synthetic SH seismograms at the surface using the accelerations recorded at 166 m. In the frequency band 0.0 - 10.0 Hz, we compared the filtered synthetic records to the filtered surface data. The onset of the SH pulse is clearly seen, as are the reflections from the interface at 30.5 m. The synthetic record closely matches the data in amplitude and phase. The fit between the synthetic accelerogram and the data shows that the seismic amplification at the surface is a result of the contrast of the impedances (shear stiffnesses) of the near surface materials

  15. Statement of Agreements Registered With The Agency

    International Nuclear Information System (INIS)

    1960-01-01

    This document contains a statement of all the agreements which had been registered with the Agency by 30 June 1960 under the Regulations for the Registration of Agreements adopted by the Board of Governors in implementation of Article XXII. B of the Statute. In compliance with Article VI of the Regulations this statement is hereby transmitted to all Members of the Agency for their information. A copy is also being sent to the Secretary-General of the United Nations

  16. Dividends Provisions in Croatian Double Taxation Agreements

    OpenAIRE

    Tomulić Vehovec, Marjeta

    2007-01-01

    This paper analyzes the provisions concerning dividends in the double taxation avoidance agreements concluded by the Republic of Croatia. Since the base for taxation is necessarily laid down in domestic law, Croatian legislation is examined as well. The author primarily discusses dividends provisions in four agreements signed with Germany, Austria, Switzerland and Slovenia, in addition to analyzing the differences from and similarities with the OECD Model Convention. Second, the paper briefly...

  17. Strongly interacting photons and atoms

    International Nuclear Information System (INIS)

    Alge, W.

    1999-05-01

    This thesis contains the main results of the research topics I have pursued during the my PhD studies at the University of Innsbruck and partly in collaboration with the Institut d' Optique in Orsay, France. It is divided into three parts. The first and largest part discusses the possibility of using strong standing waves as a tool to cool and trap neutral atoms in optical cavities. This is very important in the field of nonlinear optics where several successful experiments with cold atoms in cavities have been performed recently. A discussion of the optical parametric oscillator in a regime where the nonlinearity dominates the evolution is the topic of the second part. We investigated mainly the statistical properties of the cavity output of the three interactive cavity modes. Very recently a system has been proposed which promises fantastic properties. It should exhibit a giant Kerr nonlinearity with negligible absorption thus leading to a photonic turnstile device based on cold atoms in cavity. We have shown that this model suffers from overly simplistic assumptions and developed several more comprehensive approaches to study the behavior of this system. Apart from the division into three parts of different contents the thesis is divided into publications, supplements and invisible stuff. The intention of the supplements is to reach researchers which work in related areas and provide them with more detailed information about the concepts and the numerical tools we used. It is written especially for diploma and PhD students to give them a chance to use the third part of our work which is actually the largest one. They consist of a large number of computer programs we wrote to investigate the behavior of the systems in parameter regions where no hope exists to solve the equations analytically. (author)

  18. Topics in strong Langmuir turbulence

    International Nuclear Information System (INIS)

    Skoric, M.M.

    1981-01-01

    This thesis discusses certain aspects of the turbulence of a fully ionised non-isothermal plasma dominated by the Langmuir mode. Some of the basic properties of strongly turbulent plasmas are reviewed. In particular, interest is focused on the state of Langmuir turbulence, that is the turbulence of a simple externally unmagnetized plasma. The problem of the existence and dynamics of Langmuir collapse is discussed, often met as a non-linear stage of the modulational instability in the framework of the Zakharov equations (i.e. simple time-averaged dynamical equations). Possible macroscopic consequences of such dynamical turbulent models are investigated. In order to study highly non-linear collapse dynamics in its advanced stage, a set of generalized Zakharov equations are derived. Going beyond the original approximation, the author includes the effects of higher electron non-linearities and a breakdown of slow-timescale quasi-neutrality. He investigates how these corrections may influence the collapse stabilisation. Recently, it has been realised that the modulational instability in a Langmuir plasma will be accompanied by the collisionless-generation of a slow-timescale magnetic field. Accordingly, a novel physical situation has emerged which is investigated in detail. The stability of monochromatic Langmuir waves in a self-magnetized Langmuir plasma, is discussed, and the existence of a novel magneto-modulational instability shown. The wave collapse dynamics is investigated and a physical interpretation of the basic results is given. A problem of the transient analysis of an interaction of time-dependent electromagnetic pulses with linear cold plasma media is investigated. (Auth.)

  19. Promoting Strong Written Communication Skills

    Science.gov (United States)

    Narayanan, M.

    2015-12-01

    The reason that an improvement in the quality of technical writing is still needed in the classroom is due to the fact that universities are facing challenging problems not only on the technological front but also on the socio-economic front. The universities are actively responding to the changes that are taking place in the global consumer marketplace. Obviously, there are numerous benefits of promoting strong written communication skills. They can be summarized into the following six categories. First, and perhaps the most important: The University achieves learner satisfaction. The learner has documented verbally, that the necessary knowledge has been successfully acquired. This results in learner loyalty that in turn will attract more qualified learners.Second, quality communication lowers the cost per pupil, consequently resulting in increased productivity backed by a stronger economic structure and forecast. Third, quality communications help to improve the cash flow and cash reserves of the university. Fourth, having high quality communication enables the university to justify the need for high costs of tuition and fees. Fifth, better quality in written communication skills result in attracting top-quality learners. This will lead to happier and satisfied learners, not to mention greater prosperity for the university as a whole. Sixth, quality written communication skills result in reduced complaints, thus meaning fewer hours spent on answering or correcting the situation. The University faculty and staff are thus able to devote more time on scholarly activities, meaningful research and productive community service. References Boyer, Ernest L. (1990). Scholarship reconsidered: Priorities of the Professorate.Princeton, NJ: Carnegie Foundation for the Advancement of Teaching. Hawkins, P., & Winter, J. (1997). Mastering change: Learning the lessons of the enterprise.London: Department for Education and Employment. Buzzel, Robert D., and Bradley T. Gale. (1987

  20. Mitotic Figure Recognition: Agreement among Pathologists and Computerized Detector

    Directory of Open Access Journals (Sweden)

    Christopher Malon

    2012-01-01

    Full Text Available Despite the prognostic importance of mitotic count as one of the components of the Bloom – Richardson grade [3], several studies ([2, 9, 10] have found that pathologists’ agreement on the mitotic grade is fairly modest. Collecting a set of more than 4,200 candidate mitotic figures, we evaluate pathologists' agreement on individual figures, and train a computerized system for mitosis detection, comparing its performance to the classifications of three pathologists. The system’s and the pathologists’ classifications are based on evaluation of digital micrographs of hematoxylin and eosin stained breast tissue. On figures where the majority of pathologists agree on a classification, we compare the performance of the trained system to that of the individual pathologists. We find that the level of agreement of the pathologists ranges from slight to moderate, with strong biases, and that the system performs competitively in rating the ground truth set. This study is a step towards automatic mitosis count to accelerate a pathologist's work and improve reproducibility.

  1. Quantitative Volumetric K-Means Cluster Segmentation of Fibroglandular Tissue and Skin in Breast MRI.

    Science.gov (United States)

    Niukkanen, Anton; Arponen, Otso; Nykänen, Aki; Masarwah, Amro; Sutela, Anna; Liimatainen, Timo; Vanninen, Ritva; Sudah, Mazen

    2017-10-18

    Mammographic breast density (MBD) is the most commonly used method to assess the volume of fibroglandular tissue (FGT). However, MRI could provide a clinically feasible and more accurate alternative. There were three aims in this study: (1) to evaluate a clinically feasible method to quantify FGT with MRI, (2) to assess the inter-rater agreement of MRI-based volumetric measurements and (3) to compare them to measurements acquired using digital mammography and 3D tomosynthesis. This retrospective study examined 72 women (mean age 52.4 ± 12.3 years) with 105 disease-free breasts undergoing diagnostic 3.0-T breast MRI and either digital mammography or tomosynthesis. Two observers analyzed MRI images for breast and FGT volumes and FGT-% from T1-weighted images (0.7-, 2.0-, and 4.0-mm-thick slices) using K-means clustering, data from histogram, and active contour algorithms. Reference values were obtained with Quantra software. Inter-rater agreement for MRI measurements made with 2-mm-thick slices was excellent: for FGT-%, r = 0.994 (95% CI 0.990-0.997); for breast volume, r = 0.985 (95% CI 0.934-0.994); and for FGT volume, r = 0.979 (95% CI 0.958-0.989). MRI-based FGT-% correlated strongly with MBD in mammography (r = 0.819-0.904, P K-means clustering-based assessments of the proportion of the fibroglandular tissue in the breast at MRI are highly reproducible. In the future, quantitative assessment of FGT-% to complement visual estimation of FGT should be performed on a more regular basis as it provides a component which can be incorporated into the individual's breast cancer risk stratification.

  2. Laryngoscopic and stroboscopic signs in the diagnosis of vocal fold paresis.

    Science.gov (United States)

    Estes, Christine; Sadoughi, Babak; Mauer, Elizabeth; Christos, Paul; Sulica, Lucian

    2017-09-01

    To identify strobolaryngoscopic findings significant in the diagnosis of paresis. Retrospective cohort study. Fellowship-trained laryngologists reviewed 34 videostroboscopic examinations (24 with paresis, eight without paresis, two repeat). They indicated presence or absence of paresis, including side and type, degree of confidence in diagnosis, and ranked clinical findings that influenced diagnosis by order of importance. Fleiss's κ was used to assess inter-rater agreement for paresis presence, side, and type. Clinical findings compelling in diagnosis were tabulated and described. Confidence levels for side and type were compared by analysis of variance/Kruskal-Wallis tests and post hoc pairwise comparisons. Thirty-one laryngologists completed the review. Inter-rater agreement on presence or absence of paresis was fair at 0.334 (Fleiss's κ). Fourteen examinations were diagnosed with paresis by >70% of raters and considered strong paresis-candidate exams. Diagnosis of paresis side and type were inconsistent, although with statistically significant differences in confidence ratings (unilateral vs. bilateral, recurrent laryngeal nerve [RLN] vs. superior laryngeal nerve [SLN], RLN vs. mixed RLN/SLN). Laryngoscopic and stroboscopic findings with the strongest association with paresis were vocal fold motion anomalies, vocal fold degeneration, glottic insufficiency, and mucosal wave anomalies. Most laryngologists use strobolaryngoscopy for diagnosis of paresis. Although certain clinical findings were found to be associated with diagnosis, most commonly vocal fold motion anomalies, these varied among raters, especially when determining sidedness and nerve involvement. Future studies should expand the discussion and consideration of strobolaryngoscopic factors and adjunct functional and objective measures to develop a heuristic algorithm for diagnosis of paresis. 4. Laryngoscope, 127:2100-2105, 2017. © 2017 The American Laryngological, Rhinological and Otological

  3. ESO and NSF Sign Agreement on ALMA

    Science.gov (United States)

    2003-02-01

    Green Light for World's Most Powerful Radio Observatory On February 25, 2003, the European Southern Observatory (ESO) and the US National Science Foundation (NSF) are signing a historic agreement to construct and operate the world's largest and most powerful radio telescope, operating at millimeter and sub-millimeter wavelength. The Director General of ESO, Dr. Catherine Cesarsky, and the Director of the NSF, Dr. Rita Colwell, act for their respective organizations. Known as the Atacama Large Millimeter Array (ALMA), the future facility will encompass sixty-four interconnected 12-meter antennae at a unique, high-altitude site at Chajnantor in the Atacama region of northern Chile. ALMA is a joint project between Europe and North America. In Europe, ESO is leading on behalf of its ten member countries and Spain. In North America, the NSF also acts for the National Research Council of Canada and executes the project through the National Radio Astronomy Observatory (NRAO) operated by Associated Universities, Inc. (AUI). The conclusion of the ESO-NSF Agreement now gives the final green light for the ALMA project. The total cost of approximately 650 million Euro (or US Dollars) is shared equally between the two partners. Dr. Cesarsky is excited: "This agreement signifies the start of a great project of contemporary astronomy and astrophysics. Representing Europe, and in collaboration with many laboratories and institutes on this continent, we together look forward towards wonderful research projects. With ALMA we may learn how the earliest galaxies in the Universe really looked like, to mention but one of the many eagerly awaited opportunities with this marvellous facility". "With this agreement, we usher in a new age of research in astronomy" says Dr. Colwell. "By working together in this truly global partnership, the international astronomy community will be able to ensure the research capabilities needed to meet the long-term demands of our scientific enterprise, and

  4. A comprehensive assessment of options for the legal form of the Paris Climate Agreement

    International Nuclear Information System (INIS)

    Maljean-Dubois, Sandrine; Wemaere, Matthieu; Thomas Spencer

    2014-01-01

    For many years, the issue of the legal form of the new climate agreement has hovered over the international negotiations. Countries have insisted on first discussing substance. Indeed, it is here that the main divergences remain. However, one year out from the Paris climate conference, it is time to open the discussion on the legal form of the final agreement. The issue of legal form is often reduced to the negotiation of a 'binding' or 'non-binding' agreement. The bindingness of an international environmental agreement however depends on multiple parameters. We propose four parameters to be considered: the form of the core agreement; the 'anchoring' of commitments; mechanisms for transparency, accountability and facilitation; and mechanisms for compliance. Parties should assess pros and cons of these options, and the agreement be optimised across all four. Negotiations appear to be heading towards a hybrid agreement. Some provisions would be contained in a core agreement, and some in implementing documents such as decisions or schedules. This structure can help to balance legal certainty with flexibility. The core agreement should contain a binding provision to implement and regularly update a 'nationally determined contribution' (NDC). If these NDCs were to be housed outside the agreement, this could give more flexibility on their content, submission and updating. The core agreement should contain strong provisions on transparency, accountability and facilitation, including independent institutional arrangements (a Transparency Committee). At this stage in global cooperation and given inherent weaknesses in international environmental law, a punitive compliance mechanism seems unfeasible. However, the agreement should contain a compliance mechanism regarding procedural obligations, such as submission and updating of NDCs. (authors)

  5. A juridical review of partnership agreements that have the elements of work agreements in Indonesia

    Science.gov (United States)

    Nugroho, A.; Sulistyowati, E.; Hikmah, N.

    2018-01-01

    The Partnership Agreements place the parties in an equal position each party has something as the bargaining power. In some cases, employers prefer to use Partnership Agreements to some individuals to complete the work in their company than Work agreements. Practicality and the absence of obligations to fulfil workers’ rights such as the right to join a Union and to get social security are some of the reasons why employers use the Partnership Agreements. Sometimes Partnership Agreement contains jobs, wages and orders which is the characteristic of work agreement. Based on the fact above, the legal issues arise whether the Partnership Agreement can be considered as the Work Agreement or not and which court is authorized to hear in the event of a dispute. To analyze the above legal issues, this research uses normative legal research type with the statute approach. The technique of legal material analysis uses prescriptive techniques to assess the issue and make recommendations. Based on the analysis, it can be concluded that the Partnership Agreement, of which the elements are: wages and orders can be categorized as Work Agreement and therefore in the event of a dispute, the authorized court is Industrial Relations Court.

  6. Challenges on preparing unitization agreements in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Ribeiro, Marilda Rosado de Sa [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Faculdade de Direito; Appi, Valeria Tiriba [PETROBRAS, Rio de Janeiro, RJ (Brazil)

    2004-07-01

    As a further stage of the new oil and gas industry in Brazil, various challenges are now faced as an outcome from the O and G projects progress, under the legal framework in force in Brazil. Among all are the first unitization processes, which require a set of steps to be performed in order to achieve a unitization agreement. The paper aims at analyzing the legal, technical and drafting issues to be dealt with in such agreements. After a brief introduction to the general issues at stake in the unitization agreements the study shall encompass a follow up of the sequence of events to be complied with. One could mention the settlement of the criteria onto calculations to serve as guidelines for the negotiations will be based on. That, is usually based on concepts as oil in place, possible O and G in the reservoir, or reserve, which must be agreed by all involved parties. Another possible step to be considered is the creation of a common database, in order to permit fast decisions and optimise E and P operations in the unitized area. Other concerns should be addressed, depending on the amount of O and G to be produced from the unitized area, as: the avoidance of multiple redeterminations aiming to decrease unnecessary expenditures, which could jeopardize the arising project profitability; and the recalculations of Government take, royalties and other incumbencies, to be shared by all involved parties. The paper shall also mention the experience of other countries trying to adopt, where applicable and compatible with the best practices of the oil industry, solutions adopted where tradition in oil and gas is more mature. It should be considered that, in each bidding round the Brazilian Concession Agreement has undergone changes, therefore during an unitization process with two different versions of the Concession Agreement differences between corresponding clauses will have to be faced. Comments should also be made about satellite agreements, encompassing O and G buying

  7. Reliability and concurrent validity of the iPhone® Compass application to measure thoracic rotation range of motion (ROM in healthy participants

    Directory of Open Access Journals (Sweden)

    James Furness

    2018-03-01

    Full Text Available Background Several water-based sports (swimming, surfing and stand up paddle boarding require adequate thoracic mobility (specifically rotation in order to perform the appropriate activity requirements. The measurement of thoracic spine rotation is problematic for clinicians due to a lack of convenient and reliable measurement techniques. More recently, smartphones have been used to quantify movement in various joints in the body; however, there appears to be a paucity of research using smartphones to assess thoracic spine movement. Therefore, the aim of this study is to determine the reliability (intra and inter rater and validity of the iPhone® app (Compass when assessing thoracic spine rotation ROM in healthy individuals. Methods A total of thirty participants were recruited for this study. Thoracic spine rotation ROM was measured using both the current clinical gold standard, a universal goniometer (UG and the Smart Phone Compass app. Intra-rater and inter-rater reliability was determined with a Intraclass Correlation Coefficient (ICC and associated 95% confidence intervals (CI. Validation of the Compass app in comparison to the UG was measured using Pearson’s correlation coefficient and levels of agreement were identified with Bland–Altman plots and 95% limits of agreement. Results Both the UG and Compass app measurements both had excellent reproducibility for intra-rater (ICC 0.94–0.98 and inter-rater reliability (ICC 0.72–0.89. However, the Compass app measurements had higher intra-rater reliability (ICC = 0.96 − 0.98; 95% CI [0.93–0.99]; vs. ICC = 0.94 − 0.98; 95% CI [0.88–0.99] and inter-rater reliability (ICC = 0.87 − 0.89; 95% CI [0.74–0.95] vs. ICC = 0.72 − 0.82; 95% CI [0.21–0.94]. A strong and significant correlation was found between the UG and the Compass app, demonstrating good concurrent validity (r = 0.835, p < 0.001. Levels of agreement between the two devices were 24.8° (LoA –9

  8. Reliability and concurrent validity of the iPhone® Compass application to measure thoracic rotation range of motion (ROM) in healthy participants.

    Science.gov (United States)

    Furness, James; Schram, Ben; Cox, Alistair J; Anderson, Sarah L; Keogh, Justin

    2018-01-01

    Several water-based sports (swimming, surfing and stand up paddle boarding) require adequate thoracic mobility (specifically rotation) in order to perform the appropriate activity requirements. The measurement of thoracic spine rotation is problematic for clinicians due to a lack of convenient and reliable measurement techniques. More recently, smartphones have been used to quantify movement in various joints in the body; however, there appears to be a paucity of research using smartphones to assess thoracic spine movement. Therefore, the aim of this study is to determine the reliability (intra and inter rater) and validity of the iPhone ® app (Compass) when assessing thoracic spine rotation ROM in healthy individuals. A total of thirty participants were recruited for this study. Thoracic spine rotation ROM was measured using both the current clinical gold standard, a universal goniometer (UG) and the Smart Phone Compass app. Intra-rater and inter-rater reliability was determined with a Intraclass Correlation Coefficient (ICC) and associated 95% confidence intervals (CI). Validation of the Compass app in comparison to the UG was measured using Pearson's correlation coefficient and levels of agreement were identified with Bland-Altman plots and 95% limits of agreement. Both the UG and Compass app measurements both had excellent reproducibility for intra-rater (ICC 0.94-0.98) and inter-rater reliability (ICC 0.72-0.89). However, the Compass app measurements had higher intra-rater reliability ( ICC  = 0.96 - 0.98; 95% CI [0.93-0.99]; vs. ICC  = 0.94 - 0.98; 95% CI [0.88-0.99]) and inter-rater reliability ( ICC  = 0.87 - 0.89; 95% CI [0.74-0.95] vs. ICC  = 0.72 - 0.82; 95% CI [0.21-0.94]). A strong and significant correlation was found between the UG and the Compass app, demonstrating good concurrent validity ( r  = 0.835, p  < 0.001). Levels of agreement between the two devices were 24.8° (LoA -9.5°, +15.3°). The UG was found to consistently

  9. Reliability and concurrent validity of the iPhone® Compass application to measure thoracic rotation range of motion (ROM) in healthy participants

    Science.gov (United States)

    Schram, Ben; Cox, Alistair J.; Anderson, Sarah L.; Keogh, Justin

    2018-01-01

    Background Several water-based sports (swimming, surfing and stand up paddle boarding) require adequate thoracic mobility (specifically rotation) in order to perform the appropriate activity requirements. The measurement of thoracic spine rotation is problematic for clinicians due to a lack of convenient and reliable measurement techniques. More recently, smartphones have been used to quantify movement in various joints in the body; however, there appears to be a paucity of research using smartphones to assess thoracic spine movement. Therefore, the aim of this study is to determine the reliability (intra and inter rater) and validity of the iPhone® app (Compass) when assessing thoracic spine rotation ROM in healthy individuals. Methods A total of thirty participants were recruited for this study. Thoracic spine rotation ROM was measured using both the current clinical gold standard, a universal goniometer (UG) and the Smart Phone Compass app. Intra-rater and inter-rater reliability was determined with a Intraclass Correlation Coefficient (ICC) and associated 95% confidence intervals (CI). Validation of the Compass app in comparison to the UG was measured using Pearson’s correlation coefficient and levels of agreement were identified with Bland–Altman plots and 95% limits of agreement. Results Both the UG and Compass app measurements both had excellent reproducibility for intra-rater (ICC 0.94–0.98) and inter-rater reliability (ICC 0.72–0.89). However, the Compass app measurements had higher intra-rater reliability (ICC = 0.96 − 0.98; 95% CI [0.93–0.99]; vs. ICC = 0.94 − 0.98; 95% CI [0.88–0.99]) and inter-rater reliability (ICC = 0.87 − 0.89; 95% CI [0.74–0.95] vs. ICC = 0.72 − 0.82; 95% CI [0.21–0.94]). A strong and significant correlation was found between the UG and the Compass app, demonstrating good concurrent validity (r = 0.835, p < 0.001). Levels of agreement between the two devices were 24.8° (LoA –9.5

  10. India has got the best possible agreement

    International Nuclear Information System (INIS)

    Sreenivasan, T.P.

    2008-01-01

    The Indians wanted an agreement that will be acceptable to their people and the IAEA wanted to make sure that Uncle Sam was on board. The positions of both are reflected in the balanced document that has been emerged from negotiations. The terms of the proposed inspections have been set without compromising India's sovereign right to manage its nuclear facilities in its best interests in the spirit of the India-US Joint Statement of 2005. The non-proliferationists complain that India got away with too much and the liberationists complain that India gave away too much in the negotiations on the safeguards agreement. The fact that India has nuclear weapons make the inspections less stringent. The expectations is that as India switches to indigenous fuel, the inspections will cease altogether. Much has been said about the reference to the 'corrective measures' that India may take in the event of disruption of supplies. The non- proliferationists and the liberationists find this provision too vague. One windfall that has come in India's way, whether by design or as logical consequence of the new approach, is that the other safeguards agreements, which are applicable to facilities that use imported fuel, will be suspended as long as the new safeguards agreement is in force. The goodwill of the IAEA and its Director General, Mohammed ElBaradei, has played a major role in the accomplish of this agreement.

  11. Reliability, validity and minimal detectable change of the Mini-BESTest in Greek participants with chronic stroke.

    Science.gov (United States)

    Lampropoulou, Sofia I; Billis, Evdokia; Gedikoglou, Ingrid A; Michailidou, Christina; Nowicky, Alexander V; Skrinou, Dimitra; Michailidi, Fotini; Chandrinou, Danae; Meligkoni, Margarita

    2018-02-23

    This study aimed to investigate the psychometric characteristics of reliability, validity and ability to detect change of a newly developed balance assessment tool, the Mini-BESTest, in Greek patients with stroke. A prospective, observational design study with test-retest measures was conducted. A convenience sample of 21 Greek patients with chronic stroke (14 male, 7 female; age of 63 ± 16 years) was recruited. Two independent examiners administered the scale, for the inter-rater reliability, twice within 10 days for the test-retest reliability. Bland Altman Analysis for repeated measures assessed the absolute reliability and the Standard Error of Measurement (SEM) and the Minimum Detectable Change at 95% confidence interval (MDC 95% ) were established. The Greek Mini-BESTest (Mini-BESTest GR ) was correlated with the Greek Berg Balance Scale (BBS GR ) for assessing the concurrent validity and with the Timed Up and Go (TUG), the Functional Reach Test (FRT) and the Greek Falls Efficacy Scale-International (FES-I GR ) for the convergent validity. The Mini-BESTestGR demonstrated excellent inter-rater reliability (ICC (95%CI) = 0.997 (0.995-0.999, SEM = 0.46) with the scores of two raters within the limits of agreement (mean dif  = -0.143 ± 0.727, p > 0.05) and test-retest reliability (ICC (95%CI) = 0.966 (0.926-0.988), SEM = 1.53). Additionally, the Mini-BESTest GR yielded very strong to moderate correlations with BBS GR (r = 0.924, p reliability and the equally good validity of the Mini-BESTest GR , strongly support its utility in Greek people with chronic stroke. Its ability to identify clinically meaningful changes and falls risk need further investigation.

  12. Vienna Agreement law 15.986 it approve Vienna Agreement for Protection ozone layer and annex

    International Nuclear Information System (INIS)

    1988-01-01

    The Agreement of Vienna is approved with respect to the protection of the Layer of Ozono, definitions,general duties, research and observations systematics, co-operation in the Spheres Scientific Juridical, and information, Technological Conference, transmission from the protocols, amends, secretariat, adoption to the agreement or the protocols, adoption and amendment of controversy, signing, ratify, approve annexes, solution or vote, relation approving, adhesion, rights between the present agreement and its protocols, entrance in vigor, reserves, retirement, deposition, exchange of information [es

  13. Agreement Execution Process Study: CRADAs and NF-WFO Agreements and the Speed of Business

    Energy Technology Data Exchange (ETDEWEB)

    Harrer, Bruce J.; Cejka, Cheryl L.; Macklin, Richard; Miksovic, Ann

    2011-02-01

    This report summarizes the findings of a study on the execution of Cooperative Research and Development Agreements (CRADAs) and Non-Federal Work for Others (NF-WFO) agreements across the U.S. Department of Energy (DOE) laboratory complex. The study provides quantitiative estimates of times required to negotiate and execute these agreements across the DOE complex. It identifies factors impacting on cycle times and describes best practicies used at various laboratories and site offices that reduce cycle times.

  14. Government Procurement Agreements and Telecommunications Business

    Directory of Open Access Journals (Sweden)

    Shin-Won Kang

    2001-12-01

    Full Text Available The opening of the telecommunications market is acceleration due to the world trends of deregulation and privatization under the WTO basic telecommunications agreements. Diversification of services and fast and efficient equipment procurement are becoming necessary conditions for the survival of telecommunications operators. However, the issue here is that telecommunications operators are still bound by the GPA (Government Procurement Agreement based on conditions of monopoly even though the procurement market in Korean is open substantially since 1997. Under such conditions, the continued application of the GPA on telecommunications operator who is highly competitive may result in a negative impact on the telecommunications business and quality of telecommunications service by undermining the autonomy of operator and decreasing operator’s procurement competitiveness. Therefore, this study examines the GPA and the issues raised by the agreement, and also attempts to suggest revisions or means of abrogating the unfair GPA with regards to the development and deregulation of the telecommunications business.

  15. International standards and agreements in food irradiation

    International Nuclear Information System (INIS)

    Cetinkaya, N.

    2004-01-01

    Full text: The economies of both developed and developing countries have been effected by their exported food and agricultural products. Trading policies of food and agricultural products are governed by international agreement as well as national regulations. Trade in food and agricultural commodities may be affected by both principal Agreements within the overall World Trade Organization (WTO) Agreement, though neither specifically refers to irradiation or irradiated foods. The principal Agreements are the Technical Barriers to Trade (TBT) Agreement and the Sanitary and Phyto sanitary (SPS) Agreement. The SPS of the WTO requires governments to harmonize their sanitary and phyto sanitary measures on as wide basis as possible. Related standards, guidelines and recommendations of international standard setting bodies such as the Codex Alimentarius Commission (food safety); the International Plant Protection Convention (IPPC) (plant health and quarantine); and International Office of Epizootic (animal health and zoo noses) should be used in such a harmonization. International Standards for Phyto sanitary Measures (ISPM) no.18 was published under the IPPC by FAO (April 2003, Rome-Italy). ISPM standard provides technical guidance on the specific procedure for the application of ionizing radiation as a phyto sanitary treatment for regulated pests or articles. Moreover, Codex Alimentarius Commission, Codex General Standard for Irradiated Foods (Stand 106-1983) and Recommended International Code of Practice were first published in 1983 and revised in March 2003. Scope of this standard applies to foods processed by ionizing radiation that is used in conjunction with applicable hygienic codes, food standards and transportation codes. It does not apply to foods exposed to doses imparted by measuring instruments used for inspection purposes. Codex documents on Principles and Guidelines for the Import/Export Inspection and Certification of Foods have been prepared to guide

  16. International standards and agreements in food irradiation

    International Nuclear Information System (INIS)

    Cetinkaya, N.

    2004-01-01

    The economies of both developed and developing countries have been effected by their exported food and agricultural products. Trading policies of food and agricultural products are governed by international agreement as well as national regulations. Trade in food and agricultural commodities may be affected by both principal Agreements within the overall World Trade Organization (WTO) Agreement, though neither specifically refers to irradiation or irradiated foods. The principal Agreements are the Technical Barriers to Trade (TBT) Agreement and the Sanitary and Phyto sanitary (SPS) Agreement. The SPS of the WTO requires governments to harmonize their sanitary and phyto sanitary measures on as wide basis as possible. Related standards, guidelines and recommendations of international standard setting bodies such as the Codex Alimentarius Commission (food safety); the International Plant Protection Convention (IPPC) (plant health and quarantine); and International Office of Epizootic (animal health and zoo noses) should be used in such a harmonization. International Standards for Phyto sanitary Measures (ISPM) no.18 was published under the IPPC by FAO (April 2003, Rome-Italy). ISPM standard provides technical guidance on the specific procedure for the application of ionizing radiation as a phyto sanitary treatment for regulated pests or articles. Moreover, Codex Alimentarius Commission, Codex General Standard for Irradiated Foods (Stand 106-1983) and Recommended International Code of Practice were first published in 1983 and revised in March 2003. Scope of this standard applies to foods processed by ionizing radiation that is used in conjunction with applicable hygienic codes, food standards and transportation codes. It does not apply to foods exposed to doses imparted by measuring instruments used for inspection purposes. Codex documents on Principles and Guidelines for the Import/Export Inspection and Certification of Foods have been prepared to guide international

  17. Response of the Strongly Driven Jaynes-Cummings Oscillator

    Science.gov (United States)

    Bishop, Lev S.; Ginossar, Eran; Girvin, S. M.

    2010-09-01

    We analyze the Jaynes-Cummings model of quantum optics, in the strong-dispersive regime. In the bad-cavity limit and on time scales short compared to the atomic coherence time, the dynamics are those of a nonlinear oscillator. A steady-state nonperturbative semiclassical analysis exhibits a finite region of bistability delimited by a pair of critical points, unlike the usual dispersive bistability from a Kerr nonlinearity. This analysis explains our quantum trajectory simulations that show qualitative agreement with recent experiments from the field of circuit quantum electrodynamics.

  18. Superconducting proximity effect in the strong-coupling limit

    International Nuclear Information System (INIS)

    Wilvert, W.

    1975-01-01

    A generalization of the theory of the superconducting proximity effect is presented which takes into account strong-coupling in the superconductors. The results are found to agree with a model of weak-coupled superconductors with differing Debye frequencies which are in proximity. It is found that logarithmic averaging of phonon frequencies is an improvement on the original McMillan theory (1968). Comparison of the theory with data on thin films and on eutectic alloys is found to give good agreement. 19 references

  19. Dividends Provisions in Croatian Double Taxation Agreements

    Directory of Open Access Journals (Sweden)

    Marjeta Tomulić Vehovec

    2007-03-01

    Full Text Available This paper analyzes the provisions concerning dividends in the double taxation avoidance agreements concluded by the Republic of Croatia. Since the base for taxation is necessarily laid down in domestic law, Croatian legislation is examined as well. The author primarily discusses dividends provisions in four agreements signed with Germany, Austria, Switzerland and Slovenia, in addition to analyzing the differences from and similarities with the OECD Model Convention. Second, the paper briefly explains the methods for eliminating double taxation on income from dividends. Finally, it addresses the changes necessary for accession to the European Union.

  20. AFRA. African Regional Co-operative Agreement

    International Nuclear Information System (INIS)

    1994-04-01

    This publication provides an outline of the African Regional Co-operation Agreement for research, development and training related to nuclear science and technology (AFRA). The agreement stems from an initiative of several African member states of the IAEA to get the agency to help establish an African regional arrangement which would be similar to arrangements which were already in place in the Asian and Latin American regions. Through this regional approach to development, AFRA seeks to accelerate moves toward self-sufficiency in scientific disciplines and appropriate technologies by coordinating intellectual and physical resources and disseminating innovative methods and practices in a cost-effective manner

  1. Cross-cultural agreement in facial attractiveness preferences: the role of ethnicity and gender.

    Directory of Open Access Journals (Sweden)

    Vinet Coetzee

    Full Text Available Previous work showed high agreement in facial attractiveness preferences within and across cultures. The aims of the current study were twofold. First, we tested cross-cultural agreement in the attractiveness judgements of White Scottish and Black South African students for own- and other-ethnicity faces. Results showed significant agreement between White Scottish and Black South African observers' attractiveness judgements, providing further evidence of strong cross-cultural agreement in facial attractiveness preferences. Second, we tested whether cross-cultural agreement is influenced by the ethnicity and/or the gender of the target group. White Scottish and Black South African observers showed significantly higher agreement for Scottish than for African faces, presumably because both groups are familiar with White European facial features, but the Scottish group are less familiar with Black African facial features. Further work investigating this discordance in cross-cultural attractiveness preferences for African faces show that Black South African observers rely more heavily on colour cues when judging African female faces for attractiveness, while White Scottish observers rely more heavily on shape cues. Results also show higher cross-cultural agreement for female, compared to male faces, albeit not significantly higher. The findings shed new light on the factors that influence cross-cultural agreement in attractiveness preferences.

  2. POLICY OF SOCIAL CONFLICT RESOLUTION: IMPLEMENTATION OF THE MALINO AGREEMENT IN MALUKU

    Directory of Open Access Journals (Sweden)

    Saidin Ernas

    2012-08-01

    Full Text Available Maluku conflict (Ambon occurred in 1999 to 2003 is one of the most heartbreaking human tragedies in the history of Modern Indonesia. Various attempts have been made by the government to resolve the conflict, including by carrying out Malino Agreement for Maluku. This paper discusses the process of implementation of the Malino Agreement and analyzes the impact on the resolution of Maluku conflict. By using methods of descriptive analysis and a qualitative approach, this study can present some important findings. First, the Malino Agreement is one strategy (policy to resolve SARA(racial conflict well and democratically. It is seen from the atmosphere of the negotiation which is peaceful, honest and democratic. Parties had 11 points of peace agreement due to a strong desire to end the conflict in Maluku. Second, the Malino Agreement has brought positive impacst, i.e lack of escalation of conflict and violence in Maluku, even a year since the Malino Agreement, the peace has been enforced in Maluku. However, this paper also found that conflict resolution model such as Malino agreement still needs refinement, as Malino Agreement factually succeeded in pushing the cessation of conflict, but substantively has not resolved various problems that trigger conflicts in Maluku.

  3. Inter-rater reliability, standard error of measurement and minimal detectable change of the 12-item WHODAS 2.0 and four performance tests in institutionalized ambulatory older adults.

    Science.gov (United States)

    Silva, Anabela G; Cerqueira, Margarida; Raquel Santos, Ana; Ferreira, Catarina; Alvarelhão, Joaquim; Queirós, Alexandra

    2017-10-24

    Self-reported and performance-based instruments are both necessary for a comprehensive view of the functioning of institutionalized older adults. Our aim was to assess the reliability and measurement error of the 12-item World Health Organization Disability assessment Schedule and compare these indexes against performance-based tests. One hundred participants from Nursing Homes and Day Care Centers were assessed twice (two days to one week apart) by two independent assessors. Reliability and measurement error indexes were calculated. Reliability of the World Health Organization Disability assessment Schedule total score, and of three performance tests was appropriate for individual comparisons (ICC ≥ 0.92). Reliability for the five times seat to stand test was appropriate for group comparisons only (ICC = 0.84). The high measurement error of the timed up and go test (SEM = 4.25; MDC = 11.78) and of the five times seat to stand test (SEM = 3.47; MDC = 9.62) and the number of participants unable to perform them (TUG: n = 11; FTSST: n = 41) suggest that these tests are less suitable to monitor individual changes. The 12-item World Health Organization Disability Assessment Schedule total score, the gait speed and hand grip tests could be used to monitor changes at both the individual and group level in a population with decreased functioning. Implications for Rehabilitation The 12-item World Health Organization Disability assessment Schedule, could be used to monitor changes in perceived functioning both at the individual and group level in institutionalized ambulatory older adults. The gait speed and hand grip tests could be used to monitor changes in performance both at the individual and group level in institutionalized ambulatory older adults' functioning. The utility of the time up and go and of the five times seat to stand test might be of limited value when aiming to monitor changes in institutionalized older adults' functioning.

  4. 78 FR 80379 - Federal Acquisition Regulation; Trade Agreements Thresholds

    Science.gov (United States)

    2013-12-31

    ..., Sequence No. 1] RIN 9000-AM67 Federal Acquisition Regulation; Trade Agreements Thresholds AGENCIES... Organization Government Procurement Agreement and the Free Trade Agreements, as determined by the United States... trade agreements thresholds are adjusted according to a pre-determined formula under the agreements...

  5. 76 FR 14570 - Federal Acquisition Regulation; Trade Agreements Thresholds

    Science.gov (United States)

    2011-03-16

    ... 1] RIN 9000-AL57 Federal Acquisition Regulation; Trade Agreements Thresholds AGENCIES: Department of... application of the World Trade Organization Government Procurement Agreement and the Free Trade Agreements, as... Procurement Agreement and the Free Trade Agreements, as determined by the United States Trade Representative...

  6. 75 FR 14245 - Voluntary Intermodal Sealift Agreement

    Science.gov (United States)

    2010-03-24

    ... issued in accordance with law and administrative due process. Although Participants may withdraw from..., Leases and Other Contractual Arrangements D. Modification/Amendment of This Agreement E. Administrative.... Stage I E. Stage II F. Stage III G. Partial Activation VI. Terms and Conditions [[Page 14246

  7. 32 CFR 536.63 - Settlement agreements.

    Science.gov (United States)

    2010-07-01

    ... attorney fees will be included. (4) Claims involving an estate or personal representative of an estate. On... agreement. (f) Claims involving workers' compensation carriers. The settlement of a claim involving a... has authority over workers' compensation awards. Accordingly, claims approval and settlement...

  8. 48 CFR 31.109 - Advance agreements.

    Science.gov (United States)

    2010-10-01

    ... allowability of the costs covered in this part applies broadly to many accounting systems in varying contract... sampling methodologies at 31.201-6(c). However, an advance agreement is not an absolute requirement and the...) Precontract costs; (5) Independent research and development and bid and proposal costs; (6) Royalties and...

  9. Risk-sharing agreements in the EU

    DEFF Research Database (Denmark)

    Traulsen, Janine Marie; Traulsen, Janine Marie; Holm-Larsen, Tove

    2017-01-01

    Abstract Objective Our objectives were to explore the changes in the level of interest in risk-sharing agreements (RSAs) in the EU during the last 15 years and the underlying reasons for these changes. Methods A systematic literature review was conducted using PubMed, Scopus, Web of Science...

  10. 31 CFR 540.305 - HEU Agreements.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false HEU Agreements. 540.305 Section 540.305 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Federation for Atomic Energy Concerning the Transfer of Source Material to the Russian Federation signed at...

  11. 7 CFR 3431.18 - Service agreement.

    Science.gov (United States)

    2010-01-01

    ..., AND EXTENSION SERVICE, DEPARTMENT OF AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Administration of the Veterinary Medicine Loan Repayment Program § 3431.18 Service agreement. (a) The service... the position must still be considered a veterinarian shortage situation at the time of application for...

  12. Corporate Social Responsibility Agreements Model for Community ...

    African Journals Online (AJOL)

    Corporate Social Responsibility Agreements Model for Community Development: The Case of Golden Star (Bogoso/Prestea) Limited and its Mine Local Community. ... of making voluntary contributions towards community development to making sustainable community development an integral part of the mining business.

  13. Peace agreements and durable peace in Africa

    African Journals Online (AJOL)

    the final conclusion, is the failure factor of unwillingness. This is however clearly emphasised in the introduction (pp. 5, 10):. Most of the contributions to this volume discuss the central role of regime character and the issue of political will in the success or failure of peace agreements. The successful implementation of an ...

  14. 77 FR 68121 - Notice of Agreements Filed

    Science.gov (United States)

    2012-11-15

    ...-5793 or [email protected] . Agreement No.: 011275-034. Title: Australia and New Zealand-United...-Lloyd AG; and Mediterranean Shipping Company S.A. Filing Party: Wayne R. Rohde, Esq.; Cozen O'Connor LLP... Services, LLC and Marine Express, Inc. Filing Party: Carlos E. Bayron; Bayron Law Offices, P.S.C.; P.O. Box...

  15. 78 FR 49784 - Negotiated Service Agreement

    Science.gov (United States)

    2013-08-15

    ... noticing a recent Postal Service filing concerning the modification of Global Plus 1C negotiated service... Commercial ePacket service is available. Notice at 1, Attachment 1 at 2. This Order provides the public with... United States Postal Service of Filing Modification to Global Plus 1C Negotiated Service Agreement...

  16. 48 CFR 242.002 - Interagency agreements.

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES 242.002 Interagency.../Chief Financial Officer), from non-DoD organizations, except for— (A) Quality assurance, contract administration, and audit services provided under a no-charge reciprocal agreement; (B) Services performed under...

  17. US EPA SmartWay License Agreement

    Science.gov (United States)

    This SmartWay Tractor and Trailer trademark license agreement is for manufacturers who intend to display the SmartWay designated logo (brand) in the interior of eligible trucks and trailers (e.g. having met the SmartWay specifications established by EPA).

  18. CERN signs agreement with New Zealand

    CERN Multimedia

    2003-01-01

    "New Zealand's particle physicists have joined the world's most ambitious scientific undertaking with the signing of a Memorandum of Understanding (MoU) between their government and CERN . This agreement formalises the participation of New Zealand scientists in the laboratory's Large Hadron Collider (LHC) project" (1 page).

  19. 10 CFR 950.10 - Conditional agreement.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Conditional agreement. 950.10 Section 950.10 Energy DEPARTMENT OF ENERGY STANDBY SUPPORT FOR CERTAIN NUCLEAR PLANT DELAYS Standby Support Contract Process § 950... applicable laws and regulations. Effective Date Note: At 71 FR 46325, Aug. 11, 2006, § 950.10 was revised...

  20. The Trans-Pacific Partnership Agreement

    Science.gov (United States)

    2010-06-25

    11 Pharmaceuticals ............................................................................................................ 12 Government...during the week of June 14, 2010, in San Francisco. Topics such as the “architecture” of the agreement (i.e. whether there would be a common market ...appear to be within reach. Also due to various difficulties surrounding each of the pending FTAs with Colombia , Panama, and Korea, the Administration

  1. 12 CFR 614.4345 - Guaranty agreements.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Guaranty agreements. 614.4345 Section 614.4345 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM LOAN POLICIES AND OPERATIONS Loss... risk associated with specific loans is assumed may be entered into by or among System banks and...

  2. Agreement between direct fluorescent microscopy and Ziehl ...

    African Journals Online (AJOL)

    Background: The sensitivity of smear microscopy for diagnosis of tuberculosis might be improved through treatment of sputum with sodium hypochlorite and application of fluorescent microscopy. This study aimed to determine the agreement between direct Fluorescent Microscopy and Ziehl-Neelsen concentration technique ...

  3. Atomic energy: agreement between Canada and Australia

    International Nuclear Information System (INIS)

    1983-01-01

    This agreement provides for the exchange of nuclear materials and equipment between Canada and Australia and specifies the safeguards and other protective measures that shall be employed to ensure the peaceful use of the nuclear technology shared between the two countries

  4. 31 CFR 20.620 - Cooperative agreement.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Cooperative agreement. 20.620 Section 20.620 Money and Finance: Treasury Office of the Secretary of the Treasury GOVERNMENTWIDE... enter into the same kind of relationship as a grant (see definition of grant in § 20.650), except that...

  5. Mainstreaming International Forestry Related Agreements at ...

    African Journals Online (AJOL)

    The case study provides in-sights on initiation, negotiation and implementation of International Forestry Related Agreements (IFRAs). It is observed and concluded that (i) there is low and inconsistent participation by Africa in international forest processes that lead to IFRAs, ostensibly due to lack of funds, (ii) Africa is not ...

  6. Political Economy of International Environmental Agreements

    NARCIS (Netherlands)

    Altamirano-Cabrera, J.C.; Wangler, L.; Weikard, H.P.; Kroll, S.

    2013-01-01

    International environmental agreements (IEAs) are treaties negotiated, signed, and ratified by individual nation-states to address transboundary environmental issues. This article provides an overview of the recent state of the art in the domain of the political economy of the formation of IEAs.

  7. 78 FR 17234 - Negotiated Service Agreement

    Science.gov (United States)

    2013-03-20

    ... statutory requirements of improving the net financial position of the Postal Service, while not causing any... Postal Service filing concerning an amendment to Discover Financial Services Negotiated Service Agreement... U.S.C. 3622 and 3642, as well as 39 CFR 3010 and 3020, et seq., to add a Discover Financial Services...

  8. 75 FR 70005 - Notice of Agreement Filed

    Science.gov (United States)

    2010-11-16

    ... operations, including RFID technology; obtain and administer government grants to fund technology-related activities; meet with stakeholders to discuss deployment of RFID technologies; and to establish and manage an entity to implement and administer agreements reached regarding RFID and/or other similar technologies...

  9. 14 CFR 141.26 - Training agreements.

    Science.gov (United States)

    2010-01-01

    ... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SCHOOLS AND OTHER CERTIFICATED AGENCIES PILOT SCHOOLS General § 141.26 Training agreements. A training center certificated under part 142 of this chapter may provide the training, testing, and checking for pilot schools...

  10. 76 FR 61704 - Notice of Agreements Filed

    Science.gov (United States)

    2011-10-05

    ... ports and ports in Panama, Australia, and New Zealand. The parties requested expedited review. By Order... & Cie. KG. Filing Party: Wade S. Hooker, Esq.; 211 Central Park W; New York, NY 10024. Synopsis: The... Agreement authorizes EUKOR to charter space to FOML in the trade from the port of Tacoma, WA to Vladivostok...

  11. 46 CFR 390.5 - Agreement vessels.

    Science.gov (United States)

    2010-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS UNDER PUBLIC LAW 91-469 CAPITAL CONSTRUCTION FUND § 390... in the waterborne carriage of men, materials, goods or wares; and (v) Designated in the agreement as... water-borne carriage of men, materials, goods or wares between: (i) Two points in the United States; (ii...

  12. Exploring hubness in Regional Trade Agreements

    NARCIS (Netherlands)

    Vaal, A. de

    2016-01-01

    In the plethora of Regional Trade Agreements (RTAs) some countries take in a more central position than others in the sense that some countries are much more engaged with other countries through RTAs. Furthermore, the position of some countries is that of a hub: they have (many) trade

  13. 76 FR 63618 - Notice of Agreements Filed

    Science.gov (United States)

    2011-10-13

    ... services in the trade between the U.S. Pacific Coast and Korea, China, Taiwan, Thailand, Vietnam, and.... Lion, Esq.; McLaughlin & Stern, LLP; 260 Madison Avenue; New York, NY 10016. Synopsis: The agreement authorizes the parties to charter space on vessels in the trade between U.S. Gulf ports and ports in...

  14. Making Education Markets through Global Trade Agreements

    Science.gov (United States)

    Robertson, Susan L.

    2017-01-01

    This paper uses the global trade negotiations and agreements, which include education sectors as potentially tradable services, to show the complex processes at work in making global education markets. Drawing on the work of Jens Beckert and others, I focus on the micro-processes of making capitalist orders and the challenges at hand in bringing…

  15. 77 FR 60433 - Notice of Agreements Filed

    Science.gov (United States)

    2012-10-03

    ... Express, Inc. and Great White Fleet Liner Services Ltd. Filing Party: Wade S. Hooker, Esq., 211 Central... White Fleet Liner Services Ltd. and Crowley Latin American Services, LLC. Filing Party: Wade S. Hooker... principal office of Great White Fleet and Crowley Latin American Services. Agreement No.: 012055-002. Title...

  16. Agreement and Kappa-Type Indices

    NARCIS (Netherlands)

    de Mast, J.

    2007-01-01

    Kappa-type indices use the concept of agreement to express the reproducibility of nominal measurements. This article grounds kappa-type indices in statistical modeling, making explicit the underlying premises and assumptions. We critically review whether the interpretation of the kappa index as a

  17. The Text of the Safeguards Transfer Agreement relating to the Bilateral Agreement between Pakistan and Canada

    International Nuclear Information System (INIS)

    1969-01-01

    The text of the Safeguard Transfer Agreement between Pakistan, Canada and the Agency relating to the agreement of 14 May 1959 between the two Governments for co-operation in the peaceful uses of atomic energy is reproduced in this document for the information of all Members

  18. The Text of the Safeguards Transfer Agreement relating to the Bilateral Agreement between Canada and Japan

    International Nuclear Information System (INIS)

    1966-01-01

    The text of the Safeguards Transfer Agreement between the Agency, Canada and Japan relating to the agreement between those Governments concerning co-operation in the promotion and development of the peaceful uses of atomic energy is reproduced in this document for the information of all Members

  19. The Text of a Safeguards Agreement relating to the Bilateral Agreement between Japan and Australia

    International Nuclear Information System (INIS)

    1973-01-01

    The text of a Safeguards Agreement between the Agency, Japan and Australia relating to the agreement of 21 February 1972 between the two Governments for co-operation in the peaceful uses of atomic energy is reproduced in this document for the information of all Members

  20. 7 CFR 1779.64 - Issuance of Lender's Agreement, Loan Note Guarantee, and Assignment Guarantee Agreement.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false Issuance of Lender's Agreement, Loan Note Guarantee, and Assignment Guarantee Agreement. 1779.64 Section 1779.64 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) WATER AND...

  1. 31 CFR 215.4 - Relationship of Withholding Agreement to prior agreements.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Relationship of Withholding Agreement to prior agreements. 215.4 Section 215.4 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE...

  2. Effects of parallel planning on agreement production.

    Science.gov (United States)

    Veenstra, Alma; Meyer, Antje S; Acheson, Daniel J

    2015-11-01

    An important issue in current psycholinguistics is how the time course of utterance planning affects the generation of grammatical structures. The current study investigated the influence of parallel activation of the components of complex noun phrases on the generation of subject-verb agreement. Specifically, the lexical interference account (Gillespie & Pearlmutter, 2011b; Solomon & Pearlmutter, 2004) predicts more agreement errors (i.e., attraction) for subject phrases in which the head and local noun mismatch in number (e.g., the apple next to the pears) when nouns are planned in parallel than when they are planned in sequence. We used a speeded picture description task that yielded sentences such as the apple next to the pears is red. The objects mentioned in the noun phrase were either semantically related or unrelated. To induce agreement errors, pictures sometimes mismatched in number. In order to manipulate the likelihood of parallel processing of the objects and to test the hypothesized relationship between parallel processing and the rate of agreement errors, the pictures were either placed close together or far apart. Analyses of the participants' eye movements and speech onset latencies indicated slower processing of the first object and stronger interference from the related (compared to the unrelated) second object in the close than in the far condition. Analyses of the agreement errors yielded an attraction effect, with more errors in mismatching than in matching conditions. However, the magnitude of the attraction effect did not differ across the close and far conditions. Thus, spatial proximity encouraged parallel processing of the pictures, which led to interference of the associated conceptual and/or lexical representation, but, contrary to the prediction, it did not lead to more attraction errors. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Psychometrics and utility of Psycho-Educational Profile-Revised as a developmental quotient measure among children with the dual disability of intellectual disability and autism.

    Science.gov (United States)

    Alwinesh, Merlin Thanka Jemi; Joseph, Rachel Beulah Jansirani; Daniel, Anna; Abel, Julie Sandra; Shankar, Satya Raj; Mammen, Priya; Russell, Sushila; Russell, Paul Swamidhas Sudhakar

    2012-09-01

    There is no agreement about the measure to quantify the intellectual/developmental level in children with the dual disability of intellectual disability and autism. Therefore, we studied the psychometric properties and utility of Psycho-Educational Profile-Revised (PEP-R) as a developmental test in this population. We identified 116 children with dual disability from the day care and inpatient database of a specialised Autism Clinic. Scale and domain level scores of PEP-R were collected and analyzed. We examined the internal consistency, domain-total correlation of PEP-R and concurrent validity of PEP-R against Gesell's Developmental Schedule, inter-rater and test-retest reliability and utility of PEP-R among children with dual disability in different ages, functional level and severity of autism. Besides the adequate face and content validity, PEP-R demonstrates a good internal consistency (Cronbach's α ranging from 0.91 to 0.93) and domain-total correlation (ranging from 0.75 to 0.90). The inter-rater reliability (intraclass correlation coefficient, ICC = 0.96) and test-retest reliability (ICC = 0.87) for PEP-R is good. There is moderate-to-high concurrent validity with GDS (r ranging from 0.61 to 0.82; all Ps = 0.001). The utility of PEP-R as a developmental measure was good with infants, toddlers, pre-school and primary school children. The ability of PEP-R to measure the developmental age was good, irrespective of the severity of autism but was better with high-functioning children. The PEP-R as an intellectual/developmental test has strong psychometric properties in children with dual disability. It could be used in children with different age groups and severity of autism. PEP-R should be used with caution as a developmental test in children with dual disability who are low functioning.

  4. Development and psychometric evaluation of a clinical global impression for schizoaffective disorder scale.

    Science.gov (United States)

    Allen, Michael H; Daniel, David G; Revicki, Dennis A; Canuso, Carla M; Turkoz, Ibrahim; Fu, Dong-Jing; Alphs, Larry; Ishak, K Jack; Bartko, John J; Lindenmayer, Jean-Pierre

    2012-01-01

    The Clinical Global Impression for Schizoaffective Disorder scale is a new rating scale adapted from the Clinical Global Impression scale for use in patients with schizoaffective disorder. The psychometric characteristics of the Clinical Global Impression for Schizoaffective Disorder are described. Content validity was assessed using an investigator questionnaire. Inter-rater reliability was determined with 12 sets of videotaped interviews rated independently by two trained individuals. Test-retest reliability was assessed using 30 randomly selected raters from clinical trials who evaluated the same videos on separate occasions two weeks apart. Convergent and divergent validity and effect size were evaluated by comparing scores between the Clinical Global Impression for Schizoaffective Disorder and the Positive and Negative Syndrome Scale, 21-item Hamilton Rating Scale for Depression, and Young Mania Rating Scale scales using pooled patient data from two clinical trials. Clinical Global Impression for Schizoaffective Disorder scores were then linked to corresponding Positive and Negative Syndrome Scale scores. Content validity was strong. Inter-rater agreement was good to excellent for most scales and subscales (intra-class correlation coefficient ≥ 0.50). Test-retest showed good reproducibility, with intraclass correlation coefficients ranging from 0.444 to 0.898. Spearman correlations between Clinical Global Impression for Schizoaffective Disorder domains and corresponding symptom scales were 0.60 or greater, and effect sizes for Clinical Global Impression for Schizoaffective Disorder overall and domain scores were similar to Positive and Negative Syndrome Scale Young Mania Rating Scale, and 21-item Hamilton Rating Scale for Depression scores. Raters anticipated that the scale might be less effective in distinguishing negative from depressive symptoms, and, in fact, the results here may reflect that clinical reality. Multiple lines of evidence support the

  5. Hand-held dynamometry strength measures for internal and external rotation demonstrate superior reliability, lower minimal detectable change and higher correlation to isokinetic dynamometry than externally-fixed dynamometry of the shoulder.

    Science.gov (United States)

    Holt, K L; Raper, D P; Boettcher, C E; Waddington, G S; Drew, M K

    2016-09-01

    To investigate inter and intra-rater reliability of hand held (HHD) and externally fixed (EFD) dynamometry for shoulder internal (IR) and external rotation (ER) strength and their correlation to isokinetic testing. Within participant, inter and intra-rater reliability study. Twenty active, healthy male and female participants underwent testing by two examiners. Intra-class coefficients (ICC), percentage standard error of measurement (%SEM), and percentage minimal detectable change (%MDC) were calculated for inter-rater, intra-day and intra-rater, inter-week reliability. Maximum and average of three repetitions were compared to the isokinetic results at three speeds (60°/sec, 180°/sec, 240°/sec) for both concentric and eccentric contractions. Inter and intra-tester values demonstrated good to high agreement (HHD, ICC range = 0.89-0.97, %SEM = 4.80-8.60%, %MDC = 13.29-23.70%; EFD, ICC = 0.88-0.96, %SEM = 6.60-11.00%, %MDC = 18.40-30.04%). HHD and EFD showed moderate to very strong correlations to the isokinetic testing (HHD, r = 0.45-0.86; EFD, r = 0.49-0.83). The results of this study indicate that both EFD and HHD are suitable for clinical practice and research. Hand-held dynamometry is preferred due to its higher intra- and inter-rater reliability and smaller MDC and lower SEM. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. A method for quantitative measurement of lumbar intervertebral disc structures

    DEFF Research Database (Denmark)

    Tunset, Andreas; Kjær, Per; Samir Chreiteh, Shadi

    2013-01-01

    There is a shortage of agreement studies relevant for measuring changes over time in lumbar intervertebral disc structures. The objectives of this study were: 1) to develop a method for measurement of intervertebral disc height, anterior and posterior disc material and dural sac diameter using MRI......, 2) to evaluate intra- and inter-rater agreement and reliability for the measurements included, and 3) to identify factors compromising agreement....

  7. Atoms and clusters in strong laser fields

    NARCIS (Netherlands)

    Marchenko, T.

    2008-01-01

    This thesis describes experimental and theoretical studies on the interaction of strong infrared laser fields with atoms and atomic clusters. Part I provides an overview of the main strong-field phenomena in atoms, molecules and clusters and describes the state-of-the-art in strong-field science.

  8. Strong Bisimilarity of Simple Process Algebras

    DEFF Research Database (Denmark)

    Srba, Jirí

    2003-01-01

    We study bisimilarity and regularity problems of simple process algebras. In particular, we show PSPACE-hardness of the following problems: (i) strong bisimilarity of Basic Parallel Processes (BPP), (ii) strong bisimilarity of Basic Process Algebra (BPA), (iii) strong regularity of BPP, and (iv) ...

  9. 78 FR 15710 - Strong Sensitizer Guidance

    Science.gov (United States)

    2013-03-12

    ... definition of ``strong sensitizer'' found at 16 CFR 1500.3(c)(5). The Commission is proposing to revise the supplemental definition of ``strong sensitizer'' due to advancements in the science of sensitization that have... document is intended to clarify the ``strong sensitizer'' definition, assist manufacturers in understanding...

  10. Signalling in international environmental agreements: Using pre-agreement emission level as a signalling device

    International Nuclear Information System (INIS)

    Steiner, U.

    1997-01-01

    This paper addresses the question about strategic incentives in international environmental agreements and tries to give a positive description of how the design of the agreement influences the strategic behaviour of potential participants before they enter the treaty. A common feature of the design of agreements is that the reduction obligations (RO) are made contingent on a pre-agreement or baseline emission. As it is assumed that countries posses better information about their reduction costs than does the international body in charge of deciding the RO, countries might have incentives to signal higher costs by increasing their baseline emission, and thereby reducing the costs of entering the agreement. The appropriate analytical framework is to use a signalling game approach, where the pre-agreement emission level conveys information about the privately informed country's reduction cost. In this paper two types of agreement design are considered, one with uniform obligations, and one with differentiated obligations. This enables us to make a comparison between two different reduction regimes. The result is that the predicted outcomes vary with regard to both the environmental effectiveness and the associated expected costs for the participating countries. This means that when private information is considered, the anticipation of a given institutional framework has significant impact on the resulting distortion of the total emission level, highlighting the necessity of taking this into consideration when future designs are proposed. (au)

  11. Signalling in international environmental agreements. Using pre-agreement emission level as a signalling device

    Energy Technology Data Exchange (ETDEWEB)

    Steiner, U.

    1997-12-31

    This paper addresses the question about strategic incentives in international environmental agreements and tries to give a positive description of how the design of the agreement influences the strategic behaviour of potential participants before they enter the treaty. A common feature of the design of agreements is that the reduction obligations (RO) are made contingent on a pre-agreement or baseline emission. As it is assumed that countries posses better information about their reduction costs than does the international body in charge of deciding the RO, countries might have incentives to signal higher costs by increasing their baseline emission, and thereby reducing the costs of entering the agreement. The appropriate analytical framework is to use a signalling game approach, where the pre-agreement emission level conveys information about the privately informed country`s reduction cost. In this paper two types of agreement design are considered, one with uniform obligations, and one with differentiated obligations. This enables us to make a comparison between two different reduction regimes. The result is that the predicted outcomes vary with regard to both the environmental effectiveness and the associated expected costs for the participating countries. This means that when private information is considered, the anticipation of a given institutional framework has significant impact on the resulting distortion of the total emission level, highlighting the necessity of taking this into consideration when future designs are proposed. (au)

  12. Agreement between children and parents demonstrated that illness-related absenteeism was validly reported by children

    DEFF Research Database (Denmark)

    Denbæk, Anne Maj; Bonnesen, Camilla Thørring; Andersen, Anette

    2016-01-01

    OBJECTIVES: To examine the agreement between children's and parents' reporting of illness-related absenteeism from school and to examine predictors for disagreement between children and parents. STUDY DESIGN AND SETTING: A total of 8,438 schoolchildren aged from 5 to 15 years (grade 0-8) and one...... of 22 weeks. Text messages and questionnaire data were linked at the individual level, leaving 2,269 child-parent pairs in the analysis, corresponding to 27% of the eligible sample. RESULTS: The agreement between children's and parents' reports of illness-related absenteeism was good, with high absolute...... agreement and slight to moderate Ƙ values. Agreement was lowest for 6- to 8-year-olds and highest for 11- to 12-year-olds. Children's reports of illness symptoms and parents' reports of their children's illnesses in the preceding week were strong predictors for children reporting illness-related absenteeism...

  13. Allocating environmental liabilities within a facilities agreement

    International Nuclear Information System (INIS)

    Harvie, A.

    2000-01-01

    Some environmental issues at jointly owned oil and gas facilities in Alberta are examined, including ways to allocate liability for those issues among the facility's owners, and between the facility's owners and custom users. Causes of environmental contamination, the scope of clean-up costs and some industry initiatives to sort out the question of who pays the environmental costs are also discussed. Some aspects of the legislation in Alberta imposing environmental liabilities on parties to a construction, ownership and operation (CO and O) agreement, and relevant provisions of the Petroleum Joint Venture Association (PJVA)'s Model Operating Procedure are also explained. The author concludes by regretting the industry's failure to develop adequate mechanisms to allocate the costs of environmental damage resulting from operations, and by recommending that agreements pertaining to joint ownership of a facility should address the issues involved in allocating environmental liabilities

  14. China and nuclear arms limitation agreements

    International Nuclear Information System (INIS)

    Roberts, E.V.

    1980-01-01

    The Chinese attitudes from 1949 to 1980 towards nuclear arms limitation are divided into four distinct periods: 1949-1956, 1957-1963, 1964-1972 and 1973-1980. During 1949-1956, China held the view that an atom bomb or nuclear weapons are not decisive for the outcome of any war. It is the people who decide the outcome of a war. The period 1957-1963, after Soviet refusal to transfer nuclear technology, is marked by the development of the nuclear programme which led to the explosion of a nuclear device in 1964. China continued to build nuclear capability during 1964-1972. Mao died in 1976 and the relations with the U.S.A. were normalised in 1979. Taking an anti-Soviet stance China now takes the view that any nuclear arms agreement with Soviet Union is futile and describes SALT II agreement as an absolute farce. (M.G.B.)

  15. Agreement dynamics on directed random graphs

    Science.gov (United States)

    Lipowski, Adam; Lipowska, Dorota; Ferreira, António Luis

    2017-06-01

    We examine some agreement-dynamics models that are placed on directed random graphs. In such systems, a fraction of sites \\exp(-z) , where z is the average degree, become permanently fixed or flickering. In the voter model, which has no surface tension, such zealots or flickers freely spread their opinions and that makes the system disordered. For models with a surface tension, like the Ising model or the Naming Game model, their role is limited, and such systems are ordered at large z. However, when z decreases, the density of zealots or flickers increases, and below a certain threshold (z∼ 1.9-2.0 ) the system becomes disordered. On undirected random graphs, agreement dynamics is very different and ordering appears as soon the graph is above the percolation threshold at z  =  1.

  16. Collaborative practice agreement in solid organ transplantation.

    Science.gov (United States)

    Ravichandran, Bharath R; Gillespie, Matthew W; Sparkes, Tracy M; Williams, Carla; Bartlett, Stephen T; Haririan, Abdolreza; Masters, Brian M

    2018-02-21

    Background Given the complexity of solid organ transplant recipients, a multidisciplinary approach is required. To promote medication safety and enable providers to focus on the medical and surgical needs of these patients, our department of pharmacy created a collaborative practice agreement between physicians and pharmacists. Through this agreement, credentialed pharmacists are empowered to provide inpatient services including initiation and adjustment of medications through independent review of laboratory results after multidisciplinary rounds. Objective To evaluate the effect of our collaborative practice agreement on clinical care and institutional finances. Setting An inpatient setting at a large academic medical center. Methods Three transplant pharmacists entered all clinical interventions made on abdominal transplant recipients between September and October 2013 into Quantifi ® , a software application that categorizes and assigns a cost savings value based on impact and type of intervention. Main outcome measure The main outcome measures in this study were number and categorization of interventions, as well as estimated cost savings to the institution. Results There were 1060 interventions recorded, an average of 20 interventions per pharmacist per day. The most common interventions were pharmacokinetic evaluations (36%) and dose adjustments (19%). Over the time period, these interventions translated into an estimated savings of $107,634.00, or an annual cost savings of $373,131.20 per pharmacist, or a cost-benefit ratio of 2.65 to the institution. Conclusions Based on our study, implementation of a collaborative practice agreement enables credentialed pharmacists to make clinically and financially meaningful interventions in a complex patient population.

  17. Attraction Effects in Honorific Agreement in Korean.

    Science.gov (United States)

    Kwon, Nayoung; Sturt, Patrick

    2016-01-01

    Previous studies have suggested that sentence processing is mediated by content-addressable direct retrieval processes (McElree, 2000; McElree et al., 2003). However, the memory retrieval processes may differ as a function of the type of dependency. For example, while many studies have reported facilitatory intrusion effects associated with a structurally illicit antecedent during the processing of subject-verb number or person agreement and negative polarity items (Pearlmutter et al., 1999; Xiang et al., 2009; Dillon et al., 2013), studies investigating reflexives have not found consistent evidence of intrusion effects (Parker et al., 2015; Sturt and Kwon, 2015; cf. Nicol and Swinney, 1989; Sturt, 2003). Similarly, the memory retrieval processes could be also sensitive to cross-linguistic differences (cf. Lago et al., 2015). We report one self-paced reading experiment and one eye-tracking experiment that examine the processing of subject-verb honorific agreement, a dependency that is different from those that have been studied to date, in Korean, a typologically different language from those previously studied. The overall results suggest that the retrieval processes underlying the processing of subject-verb honorific agreement in Korean are susceptible to facilitatory intrusion effects from a structurally illicit but feature-matching subject, with a pattern that is similar to subject-verb agreement in English. In addition, the attraction effect was not limited to the ungrammatical sentences but was also found in grammatical sentences. The clear attraction effect in the grammatical sentences suggest that the attraction effect does not solely arise as the result of an error-driven process (cf. Wagers et al., 2009), but is likely also to result from general mechanisms of retrieval processes of activating of potential items in memory (Vasishth et al., 2008).

  18. Attraction effects in honorific agreement in Korean

    Directory of Open Access Journals (Sweden)

    Nayoung Kwon

    2016-08-01

    Full Text Available Previous studies have suggested that sentence processing is mediated by content-addressable direct retrieval processes (McElree, 2000; McElree, Foraker, & Dyer, 2003. However, the memory retrieval processes may differ as a function of the type of dependency. For example, while many studies have reported facilitatory intrusion effects associated with a structurally illicit antecedent during the processing of subject-verb number or person agreement and negative polarity items (Dillon, Mishler, Sloggett, & Phillips, 2013; Pearlmutter, Garnsey & Bock, 1999; Xiang, Dillon, & Phillips, 2009, studies investigating reflexives have not found consistent evidence of intrusion effects (Parker & Lago, & Phillips, 2015; Sturt & Kwon, 2015; cf. Nicol & Swinney, 1989; Sturt, 2003. Similarly, the memory retrieval processes could be also sensitive to cross-linguistic differences (cf. Lago, Shalom, Sigman, Lau & Phillips, 2015. We report one self-paced reading experiment and one eye-tracking experiment that examine the processing of subject-verb honorific agreement, a dependency that is different from those that have been studied to date, in Korean, a typologically different language from those previously studied. The overall results suggest that the retrieval processes underlying the processing of subject-verb honorific agreement in Korean are susceptible to facilitatory intrusion effects from a structurally illicit but feature-matching subject, with a pattern that is similar to subject-verb agreement in English. In addition, the attraction effect was not limited to the ungrammatical sentences but was also found in grammatical sentences. The clear attraction effect in the grammatical sentences suggest that the attraction effect does not solely arise as the result of an error-driven process (cf. Wagers, Lau & Phillips, 2009, but is likely also to result from general mechanisms of retrieval processes of activating of potential items in memory (Vasishth, Br

  19. Should Trade Agreements Include Environmental Policy?

    OpenAIRE

    Josh Ederington

    2010-01-01

    This article examines the extent to which environmental and trade policies should be treated equally, or symmetrically, in international negotiations. It reviews the recent economics literature on trade and the environment to address two questions. First, should trade negotiations include negotiations over environmental policies and the setting of binding environmental standards? Second, if there are grounds for international environmental negotiations, should environmental agreements b...

  20. Negotiated agreements - blueprint for energy saving

    International Nuclear Information System (INIS)

    Stacey, K.

    2001-01-01

    A 5-step model for achieving energy saving targets which are set out in Climate Change Levy (CCL) Negotiated Agreements is presented. The model for energy management and conservation entails the development of an energy policy, planning and organising involving formalised responsibilities for achieving the objectives of the energy policy, monitoring and control of plans, management reports on energy use, and regular reviews. Web addresses for CCL documents and information are provided