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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

    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, i...

  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. 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...

  5. Inter-Rater Agreement of Auscultation, Palpable Fremitus, and Ventilator Waveform Sawtooth Patterns Between Clinicians.

    Science.gov (United States)

    Berry, Marc P; Martí, Joan-Daniel; Ntoumenopoulos, George

    2016-10-01

    Clinicians often use numerous bedside assessments for secretion retention in participants who are receiving invasive mechanical ventilation. This study aimed to evaluate inter-rater agreement between clinicians when using standard clinical assessments of secretion retention and whether differences in clinician experience influenced inter-rater agreement. Seventy-one mechanically ventilated participants were assessed by a research clinician and by one of 13 ICU clinicians. Each clinician conducted a standardized assessment of lung auscultation, palpation for chest-wall (rhonchal) fremitus, and ventilator inspiratory/expiratory flow-time waveforms for the sawtooth pattern. On the presence of breath sounds, agreement ranged from absolute to moderate in the upper zones and the lower zones, respectively. Kappa values for abnormal and adventitious lung sounds achieved moderate agreement in the upper zones, less than chance agreement to substantial agreement in the middle zones, and moderate agreement to almost perfect agreement in the lower zones. Moderate to almost perfect agreement was established for palpable fremitus in the upper zones, moderate to substantial agreement in the middle zones, and less than chance to moderate agreement in the lower zones. Inter-rater agreement on the presence of expiratory sawtooth pattern identification showed moderate agreement. The level of percentage agreement between the research and ICU clinicians for each respiratory assessment studied did not relate directly to level of clinical experience. Inter-rater agreement for all assessments showed variability between lung regions but maintained reasonable percentage agreement in mechanically ventilated participants. The level of percentage agreement achieved between clinicians did not directly relate to clinical experience for all respiratory assessments. Therefore, these respiratory assessments should not necessarily be viewed in isolation but interpreted within the context of a full

  6. Inter-rater agreement on PIVC-associated phlebitis signs, symptoms and scales.

    Science.gov (United States)

    Marsh, Nicole; Mihala, Gabor; Ray-Barruel, Gillian; Webster, Joan; Wallis, Marianne C; Rickard, Claire M

    2015-10-01

    Many peripheral intravenous catheter (PIVC) infusion phlebitis scales and definitions are used internationally, although no existing scale has demonstrated comprehensive reliability and validity. We examined inter-rater agreement between registered nurses on signs, symptoms and scales commonly used in phlebitis assessment. Seven PIVC-associated phlebitis signs/symptoms (pain, tenderness, swelling, erythema, palpable venous cord, purulent discharge and warmth) were observed daily by two raters (a research nurse and registered nurse). These data were modelled into phlebitis scores using 10 different tools. Proportions of agreement (e.g. positive, negative), observed and expected agreements, Cohen's kappa, the maximum achievable kappa, prevalence- and bias-adjusted kappa were calculated. Two hundred ten patients were recruited across three hospitals, with 247 sets of paired observations undertaken. The second rater was blinded to the first's findings. The Catney and Rittenberg scales were the most sensitive (phlebitis in >20% of observations), whereas the Curran, Lanbeck and Rickard scales were the most restrictive (≤2% phlebitis). Only tenderness and the Catney (one of pain, tenderness, erythema or palpable cord) and Rittenberg scales (one of erythema, swelling, tenderness or pain) had acceptable (more than two-thirds, 66.7%) levels of inter-rater agreement. Inter-rater agreement for phlebitis assessment signs/symptoms and scales is low. This likely contributes to the high degree of variability in phlebitis rates in literature. We recommend further research into assessment of infrequent signs/symptoms and the Catney or Rittenberg scales. New approaches to evaluating vein irritation that are valid, reliable and based on their ability to predict complications need exploration. © 2015 John Wiley & Sons, Ltd.

  7. Inter-rater agreement of the PEWS tools used in Central Denmark Region

    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...... agreement. The nurses assigned the exact same aggregated score for both PEWS models in 76% of the cases. In 98% of the PEWS assessments, the aggregated PEWS scores assigned by the nurses were equal to or below 1 point in both models. CONCLUSION: The study showed good to very good inter-rater reliability...

  8. Inter-rater Agreement of Clinicians' Treatment Recommendations Based on Modified Barium Swallow Study Reports.

    Science.gov (United States)

    Slovarp, Laurie; Danielson, Jennifer; Liss, Julie

    2018-06-07

    The modified barium swallow study (MBSS) is a commonly used radiographic procedure for diagnosis and treatment of swallowing disorders. Despite attempts by dysphagia specialists to standardize the MBSS, most institutions have not adopted such standardized procedures. High variability of assessment patterns arguably contribute to variability of treatment recommendations made from diagnostic information derived from the MBSS report. An online survey was distributed to speech-language pathologists (SLPs) participating in American Speech Language Hearing Association (ASHA) listservs. Sixty-three SLPs who treat swallowing disorders participated. Participating SLPs reviewed two MBSS reports and chose physiologic treatment targets (e.g., tongue base retraction) based on each report. One report primarily contained symptomatology (e.g., aspiration, pharyngeal residue) with minimal information on impaired physiology (e.g., laryngeal incompetence, reduced hyolaryngeal elevation/excursion). In contrast, the second report contained a clear description of impaired physiology to explain the dysphagia symptoms. Fleiss kappa coefficients were used to analyze inter-rater agreement across the high and low physiology report types. Results revealed significantly higher inter-rater agreement across clinicians when reviewing reports with clear explanation(s) of physiologic impairment relative to reports that primarily focused on symptomatology. Clinicians also reported significantly greater satisfaction and treatment confidence following review of reports with clear description(s) of impaired physiology.

  9. 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.

  10. International inter-rater agreement in scoring acne severity utilizing cloud-based image sharing of mobile phone photographs.

    Science.gov (United States)

    Foolad, Negar; Ornelas, Jennifer N; Clark, Ashley K; Ali, Ifrah; Sharon, Victoria R; Al Mubarak, Luluah; Lopez, Andrés; Alikhan, Ali; Al Dabagh, Bishr; Firooz, Alireza; Awasthi, Smita; Liu, Yu; Li, Chin-Shang; Sivamani, Raja K

    2017-09-01

    Cloud-based image sharing technology allows facilitated sharing of images. Cloud-based image sharing technology has not been well-studied for acne assessments or treatment preferences, among international evaluators. We evaluated inter-rater variability of acne grading and treatment recommendations among an international group of dermatologists that assessed photographs. This is a prospective, single visit photographic study to assess inter-rater agreement of acne photographs shared through an integrated mobile device, cloud-based, and HIPAA-compliant platform. Inter-rater agreements for global acne assessment and acne lesion counts were evaluated by the Kendall's coefficient of concordance while correlations between treatment recommendations and acne severity were calculated by Spearman's rank correlation coefficient. There was good agreement for the evaluation of inflammatory lesions (KCC = 0.62, P cloud-based image sharing for acne assessment. Cloud-based sharing may facilitate acne care and research among international collaborators. © 2017 The International Society of Dermatology.

  11. 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.

  12. 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.

  13. 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

    BACKGROUND: The Constant score (CS) has been the primary endpoint in most studies on clavicle fractures. However, the CS was not developed to assess patients with clavicle fractures. Our aim was to examine inter-rater reliability and agreement of the CS in patients with clavicle fractures...... standardized CS assessment at a mean of 6.8 weeks (SD, 1.0 weeks) after injury. Reliability and agreement of the CS were determined by 2 raters. The interclass correlation coefficient (ICC2,1), standard error of measurement, minimal detectable change, Cronbach α coefficient, and Pearson correlation coefficient...... were estimated. RESULTS: Inter-rater reliability of the total CS was excellent (interclass correlation coefficient, 0.94; 95% confidence interval, 0.88-0.97), with no systematic difference between the 2 raters (P = .75). The standard error of measurement (measurement error at the group level) was 4...

  14. Systematic reviews need to consider applicability to disadvantaged populations: inter-rater agreement for a health equity plausibility algorithm.

    Science.gov (United States)

    Welch, Vivian; Brand, Kevin; Kristjansson, Elizabeth; Smylie, Janet; Wells, George; Tugwell, Peter

    2012-12-19

    Systematic reviews have been challenged to consider effects on disadvantaged groups. A priori specification of subgroup analyses is recommended to increase the credibility of these analyses. This study aimed to develop and assess inter-rater agreement for an algorithm for systematic review authors to predict whether differences in effect measures are likely for disadvantaged populations relative to advantaged populations (only relative effect measures were addressed). A health equity plausibility algorithm was developed using clinimetric methods with three items based on literature review, key informant interviews and methodology studies. The three items dealt with the plausibility of differences in relative effects across sex or socioeconomic status (SES) due to: 1) patient characteristics; 2) intervention delivery (i.e., implementation); and 3) comparators. Thirty-five respondents (consisting of clinicians, methodologists and research users) assessed the likelihood of differences across sex and SES for ten systematic reviews with these questions. We assessed inter-rater reliability using Fleiss multi-rater kappa. The proportion agreement was 66% for patient characteristics (95% confidence interval: 61%-71%), 67% for intervention delivery (95% confidence interval: 62% to 72%) and 55% for the comparator (95% confidence interval: 50% to 60%). Inter-rater kappa, assessed with Fleiss kappa, ranged from 0 to 0.199, representing very low agreement beyond chance. Users of systematic reviews rated that important differences in relative effects across sex and socioeconomic status were plausible for a range of individual and population-level interventions. However, there was very low inter-rater agreement for these assessments. There is an unmet need for discussion of plausibility of differential effects in systematic reviews. Increased consideration of external validity and applicability to different populations and settings is warranted in systematic reviews to meet this

  15. The Smile Esthetic Index (SEI): A method to measure the esthetics of the smile. An intra-rater and inter-rater agreement study.

    Science.gov (United States)

    Rotundo, Roberto; Nieri, Michele; Bonaccini, Daniele; Mori, Massimiliano; Lamberti, Elena; Massironi, Domenico; Giachetti, Luca; Franchi, Lorenzo; Venezia, Piero; Cavalcanti, Raffaele; Bondi, Elena; Farneti, Mauro; Pinchi, Vilma; Buti, Jacopo

    2015-01-01

    To propose a method to measure the esthetics of the smile and to report its validation by means of an intra-rater and inter-rater agreement analysis. Ten variables were chosen as determinants for the esthetics of a smile: smile line and facial midline, tooth alignment, tooth deformity, tooth dischromy, gingival dischromy, gingival recession, gingival excess, gingival scars and diastema/missing papillae. One examiner consecutively selected seventy smile pictures, which were in the frontal view. Ten examiners, with different levels of clinical experience and specialties, applied the proposed assessment method twice on the selected pictures, independently and blindly. Intraclass correlation coefficient (ICC) and Fleiss' kappa) statistics were performed to analyse the intra-rater and inter-rater agreement. Considering the cumulative assessment of the Smile Esthetic Index (SEI), the ICC value for the inter-rater agreement of the 10 examiners was 0.62 (95% CI: 0.51 to 0.72), representing a substantial agreement. Intra-rater agreement ranged from 0.86 to 0.99. Inter-rater agreement (Fleiss' kappa statistics) calculated for each variable ranged from 0.17 to 0.75. The SEI was a reproducible method, to assess the esthetic component of the smile, useful for the diagnostic phase and for setting appropriate treatment plans.

  16. Inter-rater and intra-rater agreement on the Nordic Orofacial Test--Screening examination in children, adolescents and young adults with cerebral palsy.

    Science.gov (United States)

    Edvinsson, Siv Elisabet; Lundqvist, Lars-Olov

    2014-02-01

    To evaluate inter-rater and intra-rater agreement on the Nordic Orofacial Test-Screening (NOT-S) examination applied to children, adolescents and young adults with cerebral palsy (CP). Using the NOT-S examination, two speech and language pathologists independently assessed video recordings of 48 subjects with CP aged 5-22 years and representing all CP sub-diagnoses and levels of gross motor function and manual ability. Thirty-one subjects were reassessed. Fifteen out of 17 items in the NOT-S examination domains (1) Face at rest, (2) Nose breathing, (3) Facial expression, (4) Masticatory muscle and jaw function, (5) Oral motor function and (6) Speech were rated using a 'yes' (dysfunction observed)/'no' format, generating an overall score of 0-6. Inter-rater agreement: Twelve out of 15 items and five out of six domains showed acceptable unweighted kappa values (κ = 0.46-1.00). The lowest kappa value was found for domain 4 (κ = -0.04), although it had high inter-rater agreement (92%). The linear weighted kappa value for the overall NOT-S examination score was 0.65 (95% CI = 0.49-0.82). Intra-rater agreement: All items and domains showed acceptable unweighted kappa values (items 0.58-1.00 and 0.59-1.00, domains 0.81-1.00 and 0.62-0.89) for both raters. The linear weighted kappa value for the overall NOT-S examination score was 0.81 (95% CI = 0.63-0.99) for rater A and 0.54 (95% CI = 0.25-0.82) for rater B. The NOT-S examination has acceptable inter-rater and intra-rater agreement when used in young individuals with CP.

  17. Intra- and Inter-rater Agreement of Superior Vena Cava Flow and Right Ventricular Outflow Measurements in Late Preterm and Term Neonates.

    Science.gov (United States)

    Mahoney, Liam; Fernandez-Alvarez, Jose R; Rojas-Anaya, Hector; Aiton, Neil; Wertheim, David; Seddon, Paul; Rabe, Heike

    2018-02-24

    To explore the intra- and inter-rater agreement of superior vena cava (SVC) flow and right ventricular (RV) outflow in healthy and unwell late preterm neonates (33-37 weeks' gestational age), term neonates (≥37 weeks' gestational age), and neonates receiving total-body cooling. The intra- and inter-rater agreement (n = 25 and 41 neonates, respectively) rates for SVC flow and RV outflow were determined by echocardiography in healthy and unwell late preterm and term neonates with the use of Bland-Altman plots, the repeatability coefficient, the repeatability index, and intraclass correlation coefficients. The intra-rater repeatability index values were 41% for SVC flow and 31% for RV outflow, with intraclass correlation coefficients indicating good agreement for both measures. The inter-rater repeatability index values for SVC flow and RV outflow were 63% and 51%, respectively, with intraclass correlation coefficients indicating moderate agreement for both measures. If SVC flow or RV outflow is used in the hemodynamic treatment of neonates, sequential measurements should ideally be performed by the same clinician to reduce potential variability. © 2018 by the American Institute of Ultrasound in Medicine.

  18. 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...... (SD) age of 78.1 ± 5.9 years performed the test within a mean of 31.5 ± 5.8 days post-surgery; 10 had a cervical and 10 a trochanteric fracture. Excellent inter-rater reliability; ICC2.1 = 0.92 (95% CI, 0.81 - 0.97) was found, and the standard error of measurement (SEM) and smallest real difference.......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 during the second (P = 0.25). Excellent inter-rater reliability was found...

  19. 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...... was assessed with the Verbal Ranking Scale. Results: Participants (all women) with a mean (SD) age of 78.1 ± 5.9 years performed the test within a mean of 31.5 ± 5.8 days post-surgery; 10 had a cervical and 10 a trochanteric fracture. Excellent inter-rater reliability; ICC2.1 =0.92 (95% CI, 0.81 - 0...... = -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...

  20. Inter-Rater Agreement of Pressure Ulcer Risk and Prevention Measures in the National Database of Nursing Quality Indicators(®) (NDNQI).

    Science.gov (United States)

    Waugh, Shirley Moore; Bergquist-Beringer, Sandra

    2016-06-01

    In this descriptive multi-site study, we examined inter-rater agreement on 11 National Database of Nursing Quality Indicators(®) (NDNQI(®) ) pressure ulcer (PrU) risk and prevention measures. One hundred twenty raters at 36 hospitals captured data from 1,637 patient records. At each hospital, agreement between the most experienced rater and each other team rater was calculated for each measure. In the ratings studied, 528 patients were rated as "at risk" for PrU and, therefore, were included in calculations of agreement for the prevention measures. Prevalence-adjusted kappa (PAK) was used to interpret inter-rater agreement because prevalence of single responses was high. The PAK values for eight measures indicated "substantial" to "near perfect" agreement between most experienced and other team raters: Skin assessment on admission (.977, 95% CI [.966-.989]), PrU risk assessment on admission (.978, 95% CI [.964-.993]), Time since last risk assessment (.790, 95% CI [.729-.852]), Risk assessment method (.997, 95% CI [.991-1.0]), Risk status (.877, 95% CI [.838-.917]), Any prevention (.856, 95% CI [.76-.943]), Skin assessment (.956, 95% CI [.904-1.0]), and Pressure-redistribution surface use (.839, 95% CI [.763-.916]). For three intervention measures, PAK values fell below the recommended value of ≥.610: Routine repositioning (.577, 95% CI [.494-.661]), Nutritional support (.500, 95% CI [.418-.581]), and Moisture management (.556, 95% CI [.469-.643]). Areas of disagreement were identified. Findings provide support for the reliability of 8 of the 11 measures. Further clarification of data collection procedures is needed to improve reliability for the less reliable measures. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  1. 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......, the smallest detectable difference was calculated. RESULTS: TP examination was performed twice by two consultants in rheumatology and rehabilitation at 20 min intervals and repeated 1 week later. Intrarater reliability in the more and less experienced rater was ICC 0.84 (95% CI 0.69 to 0.98) and 0.72 (95% CI 0.......49 to 0.95), respectively. The figures for inter-rater reliability were intermediate between these figures. In more than 70% of the cases, the raters agreed within ±3 TPs in both men and women and between test days. The smallest detectable difference between raters was 5, and for the more and less...

  2. 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...

  3. 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

    -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......The Bath ankylosing spondylitis metrology index (BASMI; range 0-10) has gained widespread use in daily clinical practice as an objective measure of spinal stiffness not only in patients with ankylosing spondylitis (AS) but also in patients with other spondylarthropathies (SpA). We examined intra...... (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...

  4. 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

  5. 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.

  6. 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.

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

    Science.gov (United States)

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

    2014-05-01

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

  8. [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.

  9. 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.

  10. 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.

  11. Inter-rater and intra-rater reliability of the Bahasa Melayu version of Rose Angina Questionnaire.

    Science.gov (United States)

    Hassan, N B; Choudhury, S R; Naing, L; Conroy, R M; Rahman, A R A

    2007-01-01

    The objective of the study is to translate the Rose Questionnaire (RQ) into a Bahasa Melayu version and adapt it cross-culturally, and to measure its inter-rater and intrarater reliability. This cross sectional study was conducted in the respondents' homes or workplaces in Kelantan, Malaysia. One hundred respondents aged 30 and above with different socio-demographic status were interviewed for face validity. For each inter-rater and intra-rater reliability, a sample of 150 respondents was interviewed. Inter-rater and intra-rater reliabilities were assessed by Cohen's kappa. The overall inter-rater agreements by the five pair of interviewers at point one and two were 0.86, and intrarater reliability by the five interviewers on the seven-item questionnaire at poinone and two was 0.88, as measured by kappa coefficient. The translated Malay version of RQ demonstrated an almost perfect inter-rater and intra-rater reliability and further validation such as sensitivity and specificity analysis of this translated questionnaire is highly recommended.

  12. 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

  13. 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

  14. 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

  15. Inter-Rater Reliability of Cyclotorsion Measurements Using Fundus Photography.

    Science.gov (United States)

    Dysli, Muriel; Kanku, Madeleine; Traber, Ghislaine L

    2018-04-01

    The foveo-papillary angle (FPA) on fundus photographs is the accepted standard for the measurement of ocular cyclotorsion. We assessed the inter-rater reliability of this method in healthy subjects and in patients with trochlear nerve palsies. In this methodological study, fundus photographs of healthy subjects and of patients with trochlear nerve palsies were made with a fundus camera (Zeiss Fundus Camera FF 450 plus, Jena, Germany). Three independent observers measured the FPA on the fundus photographs of all subjects in synedra View (synedra View 16, Version 16.0.0.11, Innsbruck, Austria). One hundred and four eyes of 52 subjects (26 healthy controls and 26 patients) were assessed. The mean FPA of the healthy controls was 5.80 degrees (°) [± 0.44 standard error of the mean (SEM)] compared to 11.55° (± 0.80 SEM) for patients with trochlear nerve palsies. The inter-rater reliability of all measured FPAs showed an intraclass correlation coefficient (ICC) of 0.98 (95% CI 0.97 - 0.98). The inter-rater reliability of objective cyclotorsion measurements using fundus photographs was very high. Georg Thieme Verlag KG Stuttgart · New York.

  16. 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.

  17. 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.

  18. 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.

  19. Grant Peer Review: Improving Inter-Rater Reliability with Training.

    Science.gov (United States)

    Sattler, David N; McKnight, Patrick E; Naney, Linda; Mathis, Randy

    2015-01-01

    This study developed and evaluated a brief training program for grant reviewers that aimed to increase inter-rater reliability, rating scale knowledge, and effort to read the grant review criteria. Enhancing reviewer training may improve the reliability and accuracy of research grant proposal scoring and funding recommendations. Seventy-five Public Health professors from U.S. research universities watched the training video we produced and assigned scores to the National Institutes of Health scoring criteria proposal summary descriptions. For both novice and experienced reviewers, the training video increased scoring accuracy (the percentage of scores that reflect the true rating scale values), inter-rater reliability, and the amount of time reading the review criteria compared to the no video condition. The increase in reliability for experienced reviewers is notable because it is commonly assumed that reviewers--especially those with experience--have good understanding of the grant review rating scale. The findings suggest that both experienced and novice reviewers who had not received the type of training developed in this study may not have appropriate understanding of the definitions and meaning for each value of the rating scale and that experienced reviewers may overestimate their knowledge of the rating scale. The results underscore the benefits of and need for specialized peer reviewer training.

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

    Energy Technology Data Exchange (ETDEWEB)

    Heuvel, D.A.V. den; Es, H.W. van; Heesewijk, J.P. van; Spee, M. [St. Antonius Hospital Nieuwegein, Department of Radiology, Nieuwegein (Netherlands); Jong, P.A. de [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Zanen, P.; Grutters, J.C. [University Medical Center Utrecht, Division Heart and Lungs, Utrecht (Netherlands); St. Antonius Hospital Nieuwegein, Center of Interstitial Lung Diseases, Department of Pulmonology, Nieuwegein (Netherlands)

    2015-09-15

    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.)

  1. 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.

  2. 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.

  3. 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.)

  4. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Inter-Rater Reliability of Neck Reflex Points in Women with Chronic Neck Pain.

    Science.gov (United States)

    Weinschenk, Stefan; Göllner, Richard; Hollmann, Markus W; Hotz, Lorenz; Picardi, Susanne; Hubbert, Katharina; Strowitzki, Thomas; Meuser, Thomas

    2016-01-01

    Neck reflex points (NRP) are tender soft tissue areas of the cervical region that display reflectory changes in response to chronic inflammations of correlated regions in the visceral cranium. Six bilateral areas, NRP C0, C1, C2, C3, C4 and C7, are detectable by palpating the lateral neck. We investigated the inter-rater reliability of NRP to assess their potential clinical relevance. 32 consecutive patients with chronic neck pain were examined for NRP tenderness by an experienced physician and an inexperienced medical student in a blinded design. A detailed description of the palpation technique is included in this section. Absence of pain was defined as pain index (PI) = 0, slight tenderness = 1, and marked pain = 2. Findings were evaluated either by pair-wise Cohen's kappa (ĸ) or by percentage of agreement (PA). Examiners identified 40% and 41% of positive NRP, respectively (PI > 0, physician: 155, student: 157) with a slight preference for the left side (1.2:1). The number of patients identified with >6 positive NRP by the examiners was similar (13 vs. 12 patients). ĸ values ranged from 0.52 to 0.95. The overall kappa was ĸ = 0.80 for the left and ĸ = 0.74 for the right side. PA varied from 78.1% to 96.9% with strongest agreement at NRP C0, NRP C2, and NRP C7. Inter-rater agreement was independent of patients' age, gender, body mass index and examiner's experience. The high reproducibility suggests the clinical relevance of NRP in women. © 2016 S. Karger GmbH, Freiburg.

  7. Measurement of the Inter-Rater Reliability Rate Is Mandatory for Improving the Quality of a Medical Database: Experience with the Paulista Lung Cancer Registry.

    Science.gov (United States)

    Lauricella, Leticia L; Costa, Priscila B; Salati, Michele; Pego-Fernandes, Paulo M; Terra, Ricardo M

    2018-06-01

    Database quality measurement should be considered a mandatory step to ensure an adequate level of confidence in data used for research and quality improvement. Several metrics have been described in the literature, but no standardized approach has been established. We aimed to describe a methodological approach applied to measure the quality and inter-rater reliability of a regional multicentric thoracic surgical database (Paulista Lung Cancer Registry). Data from the first 3 years of the Paulista Lung Cancer Registry underwent an audit process with 3 metrics: completeness, consistency, and inter-rater reliability. The first 2 methods were applied to the whole data set, and the last method was calculated using 100 cases randomized for direct auditing. Inter-rater reliability was evaluated using percentage of agreement between the data collector and auditor and through calculation of Cohen's κ and intraclass correlation. The overall completeness per section ranged from 0.88 to 1.00, and the overall consistency was 0.96. Inter-rater reliability showed many variables with high disagreement (>10%). For numerical variables, intraclass correlation was a better metric than inter-rater reliability. Cohen's κ showed that most variables had moderate to substantial agreement. The methodological approach applied to the Paulista Lung Cancer Registry showed that completeness and consistency metrics did not sufficiently reflect the real quality status of a database. The inter-rater reliability associated with κ and intraclass correlation was a better quality metric than completeness and consistency metrics because it could determine the reliability of specific variables used in research or benchmark reports. This report can be a paradigm for future studies of data quality measurement. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  8. 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.

  9. 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…

  10. Inter-rater reliability of PATH observations for assessment of ergonomic risk factors in hospital work.

    Science.gov (United States)

    Park, Jung-Keun; Boyer, Jon; Tessler, Jamie; Casey, Jeffrey; Schemm, Linda; Gore, Rebecca; Punnett, Laura

    2009-07-01

    This study examined the inter-rater reliability of expert observations of ergonomic risk factors by four analysts. Ten jobs were observed at a hospital using a newly expanded version of the PATH method (Buchholz et al. 1996), to which selected upper extremity exposures had been added. Two of the four raters simultaneously observed each worker onsite for a total of 443 observation pairs containing 18 categorical exposure items each. For most exposure items, kappa coefficients were 0.4 or higher. For some items, agreement was higher both for the jobs with less rapid hand activity and for the analysts with a higher level of ergonomic job analysis experience. These upper extremity exposures could be characterised reliably with real-time observation, given adequate experience and training of the observers. The revised version of PATH is applicable to the analysis of jobs where upper extremity musculoskeletal strain is of concern.

  11. THE INTRA- AND INTER-RATER RELIABILITY OF THE SOCCER INJURY MOVEMENT SCREEN (SIMS).

    Science.gov (United States)

    McCunn, Robert; Aus der Fünten, Karen; Govus, Andrew; Julian, Ross; Schimpchen, Jan; Meyer, Tim

    2017-02-01

    The growing volume of movement screening research reveals a belief among practitioners and researchers alike that movement quality may have an association with injury risk. However, existing movement screening tools have not considered the sport-specific movement and injury patterns relevant to soccer. The present study introduces the Soccer Injury Movement Screen (SIMS), which has been designed specifically for use within soccer. Furthermore, the purpose of the present study was to assess the intra- and inter-rater reliability of the SIMS and determine its suitability for use in further research. The study utilized a test-retest design to discern reliablility. Twenty-five (11 males, 14 females) healthy, recreationally active university students (age 25.5 ± 4.0 years, height 171 ± 9 cm, weight 64.7 ± 12.6 kg) agreed to participate. The SIMS contains five sub-tests: the anterior reach, single-leg deadlift, in-line lunge, single-leg hop for distance and tuck jump. Each movement was scored out of 10 points and summed to produce a composite score out of 50. The anterior reach and single-leg hop for distance were scored in real-time while the remaining tests were filmed and scored retrospectively. Three raters conducted the SIMS with each participant on three occasions separated by an average of three and a half days (minimum one day, maximum seven days). Rater 1 re-scored the filmed movements for all participants on all occasions six months later to establish the 'pure' intra-rater (intra-occasion) reliability for those movements. Intraclass correlation coefficient (ICC) values for intra- and inter-rater composite score reliability ranged from 0.66-0.72 and 0.79-0.86 respectively. Weighted kappa values representing the intra- and inter-rater reliability of the individual sub-tests ranged from 0.35-0.91 indicating fair to almost perfect agreement. Establishing the reliability of the SIMS is a prerequisite for further research seeking to investigate

  12. Inter-rater Reliability for Metrics Scored in a Binary Fashion-Performance Assessment for an Arthroscopic Bankart Repair.

    Science.gov (United States)

    Gallagher, Anthony G; Ryu, Richard K N; Pedowitz, Robert A; Henn, Patrick; Angelo, Richard L

    2018-05-02

    To determine the inter-rater reliability (IRR) of a procedure-specific checklist scored in a binary fashion for the evaluation of surgical skill and whether it meets a minimum level of agreement (≥0.8 between 2 raters) required for high-stakes assessment. In a prospective randomized and blinded fashion, and after detailed assessment training, 10 Arthroscopy Association of North America Master/Associate Master faculty arthroscopic surgeons (in 5 pairs) with an average of 21 years of surgical experience assessed the video-recorded 3-anchor arthroscopic Bankart repair performance of 44 postgraduate year 4 or 5 residents from 21 Accreditation Council for Graduate Medical Education orthopaedic residency training programs from across the United States. No paired scores of resident surgeon performance evaluated by the 5 teams of faculty assessors dropped below the 0.8 IRR level (mean = 0.93; range 0.84-0.99; standard deviation = 0.035). A comparison between the 5 assessor groups with 1 factor analysis of variance showed that there was no significant difference between the groups (P = .205). Pearson's product-moment correlation coefficient revealed a strong and statistically significant negative correlation, that is, -0.856 (P fashion meet the need and can show a high (>80%) IRR. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  13. Inter-rater reliability of assessment of levator ani muscle strength and attachment to the pubic bone in nulliparous women.

    Science.gov (United States)

    van Delft, K; Schwertner-Tiepelmann, N; Thakar, R; Sultan, A H

    2013-09-01

    The modified Oxford scale (MOS) has been found previously to have poor inter-rater reliability, whereas digital assessment of levator ani muscle (LAM) attachment to the pubic bone has been shown to have acceptable reliability. Our aim was to evaluate inter-rater reliability of the validated MOS and to develop a reliable classification system for digital assessment of LAM attachment, correlating this to findings on transperineal ultrasound (TPUS) examination. Evaluation of the MOS by palpation was performed in nulliparous women by two investigators. LAM attachment was evaluated using digital palpation, for which a novel classification system was developed with four grades based on the position of the attachment and presence of discernible muscle. Findings were compared with those on TPUS examination. Inter-rater reliability was assessed using Cohen's kappa statistic. Twenty-five nulliparous women were examined. There was agreement in MOS scores between the investigators in 64% of women (n = 16), with a kappa of 0.66 (indicating substantial agreement). There was agreement in palpation of LAM attachment using the new grading system in 96% of women (n = 24), with a kappa of 0.90 (indicating almost perfect agreement). TPUS examination did not show LAM avulsion in any woman, with the exception of one with a partial avulsion. In this group of nulliparous patients, there was substantial agreement between the two investigators in evaluation of the MOS and there was good agreement between grades of LAM attachment using the new classification system, which correlated with findings on TPUS examination. It therefore appears that these results are reproducible in nulliparous women and the techniques can be readily learned and reliably incorporated into clinical practice and research after appropriate training. Further research is required to establish clinical utility of the grading system for LAM attachment in postpartum women and in women with symptomatic pelvic organ

  14. 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.

  15. 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.

  16. Intra-rater and inter-rater reliability of a medical record abstraction study on transition of care after childhood cancer.

    Directory of Open Access Journals (Sweden)

    Micòl E Gianinazzi

    Full Text Available The abstraction of data from medical records is a widespread practice in epidemiological research. However, studies using this means of data collection rarely report reliability. Within the Transition after Childhood Cancer Study (TaCC which is based on a medical record abstraction, we conducted a second independent abstraction of data with the aim to assess a intra-rater reliability of one rater at two time points; b the possible learning effects between these two time points compared to a gold-standard; and c inter-rater reliability.Within the TaCC study we conducted a systematic medical record abstraction in the 9 Swiss clinics with pediatric oncology wards. In a second phase we selected a subsample of medical records in 3 clinics to conduct a second independent abstraction. We then assessed intra-rater reliability at two time points, the learning effect over time (comparing each rater at two time-points with a gold-standard and the inter-rater reliability of a selected number of variables. We calculated percentage agreement and Cohen's kappa.For the assessment of the intra-rater reliability we included 154 records (80 for rater 1; 74 for rater 2. For the inter-rater reliability we could include 70 records. Intra-rater reliability was substantial to excellent (Cohen's kappa 0-6-0.8 with an observed percentage agreement of 75%-95%. In all variables learning effects were observed. Inter-rater reliability was substantial to excellent (Cohen's kappa 0.70-0.83 with high agreement ranging from 86% to 100%.Our study showed that data abstracted from medical records are reliable. Investigating intra-rater and inter-rater reliability can give confidence to draw conclusions from the abstracted data and increase data quality by minimizing systematic errors.

  17. 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.

  18. Intra and Inter-Rater Reliability of Screening for Movement Impairments: Movement Control Tests from The Foundation Matrix

    Science.gov (United States)

    Mischiati, Carolina R.; Comerford, Mark; Gosford, Emma; Swart, Jacqueline; Ewings, Sean; Botha, Nadine; Stokes, Maria; Mottram, Sarah L.

    2015-01-01

    Pre-season screening is well established within the sporting arena, and aims to enhance performance and reduce injury risk. With the increasing need to identify potential injury with greater accuracy, a new risk assessment process has been produced; The Performance Matrix (battery of movement control tests). As with any new method of objective testing, it is fundamental to establish whether the same results can be reproduced between examiners and by the same examiner on consecutive occasions. This study aimed to determine the intra-rater test re-test and inter-rater reliability of tests from a component of The Performance Matrix, The Foundation Matrix. Twenty participants were screened by two experienced musculoskeletal therapists using nine tests to assess the ability to control movement during specific tasks. Movement evaluation criteria for each test were rated as pass or fail. The therapists observed participants real-time and tests were recorded on video to enable repeated ratings four months later to examine intra-rater reliability (videos rated two weeks apart). Overall test percentage agreement was 87% for inter-rater reliability; 98% Rater 1, 94% Rater 2 for test re-test reliability; and 75% for real-time versus video. Intraclass-correlation coefficients (ICCs) were excellent between raters (0.81) and within raters (Rater 1, 0.96; Rater 2, 0.88) but poor for real-time versus video (0.23). Reliability for individual components of each test was more variable: inter-rater, 68-100%; intra-rater, 88-100% Rater 1, 75-100% Rater 2; and real-time versus video 31-100%. Cohen’s Kappa values for inter-rater reliability were 0.0-1.0; intra-rater 0.6-1.0 for Rater 1; -0.1-1.0 for Rater 2; and -0.1-1 for real-time versus video. It is concluded that both inter and intra-rater reliability of tests in The Foundation Matrix are acceptable when rated by experienced therapists. Recommendations are made for modifying some of the criteria to improve reliability where

  19. 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.

  20. 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.

  1. Intra- and inter-rater reliability of the Knee Society Knee Score when used by two physiotherapists in patients post total knee arthroplasty

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    S. Gopal

    2010-01-01

    Full Text Available Background and Purpose: It has yet to be shown whether routine physiotherapy plays a role in the rehabilitation of patients post totalknee arthroplasty (Rajan et al 2004. Physiotherapists should be using validoutcome measures to provide evidence of the benefit of their intervention. The aim of this study was to establish the intra and inter-rater reliability of the Knee Society Knee Score, a scoring system developed by Insall et al(1989. The Knee Society Knee Score can be used to assess the integrity of theknee joint of patients undergoing total knee arthroplasty. Since the scoreinvolves clinical testing, the intra-rater reliability of the clinician should be established prior to using the scores as datain clinical research. W here multiple clinicians are involved, inter-rater reliability should also be established.Design: This was a correlation study.Subjects: A  sample of thirty patients post total knee arthroplasty attending the arthroplasty clinic at Johannesburg Hospital between six weeks and twelve months postoperatively.M ethod: Recruited patients were evaluated twice with a time interval of one hour between each assessment. Statistical A nalysis: The intra- and inter-rater reliability were estimated using Intraclass Correlation Coefficient (ICC. R esults: The intra-rater reliability showed excellent reliability (h= 0.95 for Examiner A  and good reliability (h= 0.71for Examiner B. The inter-rater reliability showed moderate reliability (h= 0.67 during test one and h= 0.66 during test two.Conclusion: The KSKS has good intra-rater reliability when tested within a period of one hour. The KSKS demonstrated moderate agreement for inter rater reliability.

  2. Inter-Rater Reliability and Validity of the Australian Football League’s Kicking and Handball Tests

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    Cripps, Ashley J.; Hopper, Luke S.; Joyce, Christopher

    2015-01-01

    Talent identification tests used at the Australian Football League’s National Draft Combine assess the capacities of athletes to compete at a professional level. Tests created for the National Draft Combine are also commonly used for talent identification and athlete development in development pathways. The skills tests created by the Australian Football League required players to either handball (striking the ball with the hand) or kick to a series of 6 randomly generated targets. Assessors subjectively rate each skill execution giving a 0-5 score for each disposal. This study aimed to investigate the inter-rater reliability and validity of the skills tests at an adolescent sub-elite level. Male Australian footballers were recruited from sub-elite adolescent teams (n = 121, age = 15.7 ± 0.3 years, height = 1.77 ± 0.07 m, mass = 69.17 ± 8.08 kg). The coaches (n = 7) of each team were also recruited. Inter-rater reliability was assessed using Inter-class correlations (ICC) and Limits of Agreement statistics. Both the kicking (ICC = 0.96, p handball tests (ICC = 0.89, p handball test. Key points The skill tests created by the AFL demonstrated acceptable levels of relative and absolute inter-rater reliability. Both the AFL’s skills tests are able to differentiate between athletes dominant and non-dominant limbs. However, only the kicking test could consistently differentiated between score outcomes over a range of Australian Football specific disposal distances. Both tests demonstrated poor concurrent validity, with no correlation found between coaches’ perceptions of technical skills and actual skill outcomes measured. PMID:26336356

  3. 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.

  4. The Use of Bayesian Networks to Assess the Quality of Evidence from Research Synthesis: 2. Inter-Rater Reliability and Comparison with Standard GRADE Assessment.

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    Alexis Llewellyn

    Full Text Available The grades of recommendation, assessment, development and evaluation (GRADE approach is widely implemented in systematic reviews, health technology assessment and guideline development organisations throughout the world. We have previously reported on the development of the Semi-Automated Quality Assessment Tool (SAQAT, which enables a semi-automated validity assessment based on GRADE criteria. The main advantage to our approach is the potential to improve inter-rater agreement of GRADE assessments particularly when used by less experienced researchers, because such judgements can be complex and challenging to apply without training. This is the first study examining the inter-rater agreement of the SAQAT.We conducted two studies to compare: a the inter-rater agreement of two researchers using the SAQAT independently on 28 meta-analyses and b the inter-rater agreement between a researcher using the SAQAT (who had no experience of using GRADE and an experienced member of the GRADE working group conducting a standard GRADE assessment on 15 meta-analyses.There was substantial agreement between independent researchers using the Quality Assessment Tool for all domains (for example, overall GRADE rating: weighted kappa 0.79; 95% CI 0.65 to 0.93. Comparison between the SAQAT and a standard GRADE assessment suggested that inconsistency was parameterised too conservatively by the SAQAT. Therefore the tool was amended. Following amendment we found fair-to-moderate agreement between the standard GRADE assessment and the SAQAT (for example, overall GRADE rating: weighted kappa 0.35; 95% CI 0.09 to 0.87.Despite a need for further research, the SAQAT may aid consistent application of GRADE, particularly by less experienced researchers.

  5. Computerized back postural assessment in physiotherapy practice: Intra-rater and inter-rater reliability of the MIDAS system.

    Science.gov (United States)

    McAlpine, R T; Bettany-Saltikov, J A; Warren, J G

    2009-01-01

    Assessment of spinal posture during physiotherapy practice is routine, yet few objective measures exist to this end. The Middlesbrough Integrated Digital Assessment System (MIDAS) is a low cost portable system able to record 3D information on posture. The purpose of this study was to assess both the intra-rater and inter-rater reliability of the MIDAS system. Twenty-five healthy subjects were recruited. A repeated measures design was used to record fifteen pre-palpated landmarks on the back of each subject. To limit the sources of variability, the principal researcher palpated the landmarks for each subject. Each of three raters took two measurements on each subject in a standardized upright posture. X (medio-lateral), Y (antero-posterior) and Z (height) landmark positions were recorded via a computer interface. Both intra-rater agreement (mean ICCs - rater 1 r=0.970, rater 2 r=0.965 and rater 3 r=0.965, pMIDAS demonstrated both high inter-rater and intra-rater reliability and provides an objective method for the assessment of posture in physiotherapy practice.

  6. 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

  7. IRR (Inter-Rater Reliability) of a COP (Classroom Observation Protocol)--A Critical Appraisal

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    Rui, Ning; Feldman, Jill M.

    2012-01-01

    Notwithstanding broad utility of COPs (classroom observation protocols), there has been limited documentation of the psychometric properties of even the most popular COPs. This study attempted to fill this void by closely examining the item and domain-level IRR (inter-rater reliability) of a COP that was used in a federally funded striving readers…

  8. 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

    Aim To evaluate the inter-rater reliability of measuring structural changes in the tendon of patients, clinically diagnosed with supraspinatus tendinopathy (cases) and healthy participants (controls), on ultrasound (US) images captured by standardised procedures. Methods A total of 40 participant...

  9. 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.

  10. 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.

  11. Inter-rater reliability of three musculoskeletal physical examination techniques used to assess motion in three planes while standing.

    Science.gov (United States)

    Prather, Heidi; Hunt, Devyani; Steger-May, Karen; Hayes, Marcie Harris; Knaus, Evan; Clohisy, John

    2009-07-01

    The objective of the study was to measure the reliability between examiners of 3 basic maneuvers of the Total Body Functional Profile physical examination test. The hypothesis was musculoskeletal health care providers of different disciplines could reliably use the 3 basic maneuvers as part of the musculoskeletal physical examination. A prospective observational study was conducted. Twenty-eight adult volunteers were measured on both the left and right side by 2 independent raters on a single occasion. The subjects were recruited through advertisements placed by the orthopedic department at a tertiary university. Twenty-eight volunteers were recruited and completed the study. The volunteers were between the ages of 18 and 51 years of age, had no symptoms in the lower extremity or spine, had no previous history of surgery or tumor involving the lower extremity, and no medical conditions that would preclude participation. On a single occasion, 2 examiners per 1 volunteer were blinded to their own and each others' measurements. Each examiner assessed the distance of frontal and sagittal plane lunge and angle of motion for transverse plane testing. Inter-rater agreement is expressed with intraclass correlation coefficients (ICCs) and corresponding 95% confidence intervals (CIs). The difference between raters is reported with 95% CIs. Baseline demographics, University of California Los Angeles (UCLA), and Harris hip questionnaires were completed by all participants. The UCLA and Harris hip scores showed no significant activity restrictions or pain limitations in all participants. The inter-rater reliability for sagittal, frontal, and transverse plane matrix testing was good with ICCs of 0.86 (95% CI 0.77-0.91), 0.90 (95% CI 0.84-0.94), and 0.85 (95% CI 0.75-0.91), respectively. The rater reliability between disciplines for transverse, sagittal, and frontal plane matrix testing was good with ICCs of 0.89 (95% CI 0.80-0.94), 0.88 (95% CI 0.79-0.94), and 0.90 (95% CI 0

  12. Effects of questionnaire-based diagnosis and training on inter-rater reliability among practitioners of traditional Chinese medicine.

    Science.gov (United States)

    Mist, Scott; Ritenbaugh, Cheryl; Aickin, Mikel

    2009-07-01

    To investigate whether a training process that focused on a questionnaire-based diagnosis in Traditional Chinese Medicine (TCM), and developing diagnostic consensus, would improve the agreement of TCM diagnoses among 10 TCM practitioners evaluating patients with temporomandibular joint disorder (TMJD). Evaluation of a diagnostic training program at the Department of Family and Community Medicine, University of Arizona, Tucson, Arizona, and the Oregon College of Oriental Medicine, Portland, Oregon. Screened participants for a study of TCM for TMJD. PRACTITIONERS: Ten (10) licensed acupuncturists with a minimum of 5 years licensure and education in Chinese herbs. A training session using a questionnaire-based diagnostic form was conducted, followed by waves of diagnostic sessions. Between sessions, practitioners discussed the results of the previous round of participants with a focus on reducing variability in primary diagnosis and severity rating of each diagnosis: 3 waves of 5 patients were assessed by 4 practitioner pairs for a total of 120 diagnoses. At 18 months, practitioners completed a recalibration exercise with a similar format with a total of 32 diagnoses. These diagnoses were then examined with respect to the rate of agreement among the 10 practitioners using inter-rater correlations and kappas. The inter-rater correlation with respect to the TCM diagnoses among the 10 practitioners increased from 0.112 to 0.618 with training. Statistically significant improvements were found between the baseline and 18 month exercises (p reliability of TCM diagnosis may be improved through a training process and a questionnaire-based diagnosis process. The improvements varied by diagnosis, with the greatest congruence among primary and more severe diagnoses. Future TCM studies should consider including calibration training to improve the validity of results.

  13. 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

  14. 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

  15. Inter-rater and test-retest reliability of quality assessments by novice student raters using the Jadad and Newcastle-Ottawa Scales.

    Science.gov (United States)

    Oremus, Mark; Oremus, Carolina; Hall, Geoffrey B C; McKinnon, Margaret C

    2012-01-01

    Quality assessment of included studies is an important component of systematic reviews. The authors investigated inter-rater and test-retest reliability for quality assessments conducted by inexperienced student raters. Student raters received a training session on quality assessment using the Jadad Scale for randomised controlled trials and the Newcastle-Ottawa Scale (NOS) for observational studies. Raters were randomly assigned into five pairs and they each independently rated the quality of 13-20 articles. These articles were drawn from a pool of 78 papers examining cognitive impairment following electroconvulsive therapy to treat major depressive disorder. The articles were randomly distributed to the raters. Two months later, each rater re-assessed the quality of half of their assigned articles. McMaster Integrative Neuroscience Discovery and Study Program. 10 students taking McMaster Integrative Neuroscience Discovery and Study Program courses. The authors measured inter-rater reliability using κ and the intraclass correlation coefficient type 2,1 or ICC(2,1). The authors measured test-retest reliability using ICC(2,1). Inter-rater reliability varied by scale question. For the six-item Jadad Scale, question-specific κs ranged from 0.13 (95% CI -0.11 to 0.37) to 0.56 (95% CI 0.29 to 0.83). The ranges were -0.14 (95% CI -0.28 to 0.00) to 0.39 (95% CI -0.02 to 0.81) for the NOS cohort and -0.20 (95% CI -0.49 to 0.09) to 1.00 (95% CI 1.00 to 1.00) for the NOS case-control. For overall scores on the six-item Jadad Scale, ICC(2,1)s for inter-rater and test-retest reliability (accounting for systematic differences between raters) were 0.32 (95% CI 0.08 to 0.52) and 0.55 (95% CI 0.41 to 0.67), respectively. Corresponding ICC(2,1)s for the NOS cohort were -0.19 (95% CI -0.67 to 0.35) and 0.62 (95% CI 0.25 to 0.83), and for the NOS case-control, the ICC(2,1)s were 0.46 (95% CI -0.13 to 0.92) and 0.83 (95% CI 0.48 to 0.95). Inter-rater reliability was generally poor

  16. 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 reliabi......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...

  17. 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.

  18. 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

  19. Intra- and inter-rater reliability of 3D passive intervertebral motion in subjects with nonspecific neck pain assessed by physical therapy students: A pilot study.

    Science.gov (United States)

    Rossettini, Giacomo; Rondoni, Angie; Lovato, Tommaso; Strobe, Marco; Verzè, Elisa; Vicentini, Marco; Testa, Marco

    2016-06-03

    Passive Intervertebral Movements (PIVMs) are commonly used to assess and treat patients with nonspecific neck pain. Only very few studies have investigated 3D movements until now. This study assessed intra- and inter-rater reliability of three-dimensional (3D) cervical PIVMs performed by physical therapy students in patients with nonspecific neck pain. Thirty-one patients, mean age 47.2 ± 7.2 years, were independently evaluated by 2 physical therapy students. The raters (A and B) assessed mobility, end-feel and pain provocation performing bilaterally the 3D cervical segmental side-bending test (3D CSSB) from levels C2-C3 to C6-C7. Percentage agreement (raw, positive and negative), Cohen's kappa (95% CI), prevalence index and bias index were calculated to estimate intra- and inter-reliability. Intra-rater reliability showed kappa values ranging between fair and substantial (k 0.29-0.80) for pain provocation, mobility and end-feel, with percentage agreements between 61%-90%. Inter-rater reliability presented kappa values ranging between fair and substantial (k 0.22-0.62) for pain provocation, mobility and end-feel, with percentage agreements between 61% and 80%. Intra-rater reliability of 3D PIVMs was superior to inter-rater reliability in patients with nonspecific neck pain. The most repeatable evaluation parameter was pain. However overall poor reliability suggests avoiding the use of these techniques alone to examine patients and measure their outcome. Further studies are needed to investigate PIVMs reliability in combination with other assessment procedure in symptomatic patients.

  20. 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.

  1. 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

    -YPAS to Danish cultural and linguistic conditions and to test face validity and inter-reliability in a clinical setting. Materials and methods The translation was performed in accordance with WHO guidelines. Face validity as well as linguistic difficulties of the Danish version was tested and solved in a focus...... of the m-YPAS as suitable and relevant, i.e. the face validity satisfactory. Inter-rater reliability analysis revealed that inter-observer agreement at induction 1 were good to very good (kw: 0.63–0.98) and at induction 2, the agreement was good to very good (kw: 0.72–0.96). ICC for the overall weighted...... 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...

  2. The inter-rater reliability of the incontinence-associated dermatitis intervention tool-D (IADIT-D) between two independent registered nurses of nursing home residents in long-term care facilities.

    Science.gov (United States)

    Braunschmidt, Brigitte; Müller, Gerhard; Jukic-Puntigam, Margareta; Steininger, Alfred

    2013-01-01

    Incontinence-associated dermatitis (IAD) is the clinical manifestation of moisture related skin damage (Beeckman, Woodward, & Gray, 2011). Valid assessment instruments are needed for risk assessment and classification of IAD. Aim of the quantitative-descriptive cross-sectional study was to determine the inter-rater reliability of the item scores of the German Incontinence Associated Dermatitis Intervention Tool (IADIT-D) between two independent assessors of nursing home residents (n = 381) in long-term care facilities. The 19 pairs of assessors consisted of registered nurses. The data analysis was computed first with the calculation of the total percentage of agreement. Because this value is not randomly adjusted, the calculation of the Kappa-coefficients and AC1-Statistic was done as well. The total percentage of the inter-rater agreement was 84% (n = 319). In a second step of analysis, the calculation of all items determined high (kappa = .70) and very high agreement (AC1 = .83) levels, respectively. For the risk assessment (kappa = .82; AC1 = .94), the values amounted to very high agreement levels and for the classification (kappa(w) = .70; AC1 = .76) to high agreement levels. The high to very high agreement values of IADIT-D demonstrate that the items can be regarded as stable in regards to the inter-rater reliability for the use in long-term care facilities. In addition, further validation studies are needed.

  3. 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

  4. [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.

  5. 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.

  6. 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.

  7. 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.

  8. Inter-rater reliability of nursing home quality indicators in the U.S

    Directory of Open Access Journals (Sweden)

    Roy Jason

    2003-11-01

    Full Text Available Abstract Background In the US, Quality Indicators (QI's profiling and comparing the performance of hospitals, health plans, nursing homes and physicians are routinely published for consumer review. We report the results of the largest study of inter-rater reliability done on nursing home assessments which generate the data used to derive publicly reported nursing home quality indicators. Methods We sampled nursing homes in 6 states, selecting up to 30 residents per facility who were observed and assessed by research nurses on 100 clinical assessment elements contained in the Minimum Data Set (MDS and compared these with the most recent assessment in the record done by facility nurses. Kappa statistics were generated for all data items and derived for 22 QI's over the entire sample and for each facility. Finally, facilities with many QI's with poor Kappa levels were compared to those with many QI's with excellent Kappa levels on selected characteristics. Results A total of 462 facilities in 6 states were approached and 219 agreed to participate, yielding a response rate of 47.4%. A total of 5758 residents were included in the inter-rater reliability analyses, around 27.5 per facility. Patients resembled the traditional nursing home resident, only 43.9% were continent of urine and only 25.2% were rated as likely to be discharged within the next 30 days. Results of resident level comparative analyses reveal high inter-rater reliability levels (most items >.75. Using the research nurses as the "gold standard", we compared composite quality indicators based on their ratings with those based on facility nurses. All but two QI's have adequate Kappa levels and 4 QI's have average Kappa values in excess of .80. We found that 16% of participating facilities performed poorly (Kappa .75 on 12 or more QI's. No facility characteristics were related to reliability of the data on which Qis are based. Conclusion While a few QI's being used for public reporting

  9. 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.

  10. 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.

  11. 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

  12. Towards criterion validity in classroom language analysis: methodological constraints of metadiscourse and inter-rater agreement

    Directory of Open Access Journals (Sweden)

    Douglas Altamiro Consolo

    2001-02-01

    Full Text Available

    This paper reports on a process to validate a revised version of a system for coding classroom discourse in foreign language lessons, a context in which the dual role of language (as content and means of communication and the speakers' specific pedagogical aims lead to a certain degree of ambiguity in language analysis. The language used by teachers and students has been extensively studied, and a framework of concepts concerning classroom discourse well-established. Models for coding classroom language need, however, to be revised when they are applied to specific research contexts. The application and revision of an initial framework can lead to the development of earlier models, and to the re-definition of previously established categories of analysis that have to be validated. The procedures followed to validate a coding system are related here as guidelines for conducting research under similar circumstances. The advantages of using instruments that incorporate two types of data, that is, quantitative measures and qualitative information from raters' metadiscourse, are discussed, and it is suggested that such procedure can contribute to the process of validation itself, towards attaining reliability of research results, as well as indicate some constraints of the adopted research methodology.

  13. Inter-rater and test–retest reliability of quality assessments by novice student raters using the Jadad and Newcastle–Ottawa Scales

    Science.gov (United States)

    Oremus, Carolina; Hall, Geoffrey B C; McKinnon, Margaret C

    2012-01-01

    ,1)s were 0.46 (95% CI −0.13 to 0.92) and 0.83 (95% CI 0.48 to 0.95). Conclusions Inter-rater reliability was generally poor to fair and test–retest reliability was fair to excellent. A pilot rating phase following rater training may be one way to improve agreement. PMID:22855629

  14. 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.

  15. Inter-rater reliability of a modified version of Delitto et al.’s classification-based system for low back pain : a pilot study

    NARCIS (Netherlands)

    Apeldoorn, Adri T.; van Helvoirt, Hans; Ostelo, Raymond W.; Meihuizen, Hanneke; Kamper, Steven J.; van Tulder, Maurits W.; de Vet, Henrica C W

    2016-01-01

    Study design:: Observational inter-rater reliability study. Objectives: To examine: (1) the inter-rater reliability of a modified version of Delitto et al.’s classification-based algorithm for patients with low back pain; (2) the influence of different levels of familiarity with the system; and (3)

  16. 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

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

    NARCIS (Netherlands)

    Daalen, E. van; Kemner, C.; Dietz, C.; Swinkels, S.H.N.; Buitelaar, J.K.; Engeland, H.M. van

    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

  18. 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.

  19. Inter-rater reliability of the Sødring Motor Evaluation of Stroke patients (SMES).

    Science.gov (United States)

    Halsaa, K E; Sødring, K M; Bjelland, E; Finsrud, K; Bautz-Holter, E

    1999-12-01

    The Sødring Motor Evaluation of Stroke patients is an instrument for physiotherapists to evaluate motor function and activities in stroke patients. The rating reflects quality as well as quantity of the patient's unassisted performance within three domains: leg, arm and gross function. The inter-rater reliability of the method was studied in a sample of 30 patients admitted to a stroke rehabilitation unit. Three therapists were involved in the study; two therapists assessed the same patient on two consecutive days in a balanced design. Cohen's weighted kappa and McNemar's test of symmetry were used as measures of item reliability, and the intraclass correlation coefficient was used to express the reliability of the sumscores. For 24 out of 32 items the weighted kappa statistic was excellent (0.75-0.98), while 7 items had a kappa statistic within the range 0.53-0.74 (fair to good). The reliability of one item was poor (0.13). The intraclass correlation coefficient for the three sumscores was 0.97, 0.91 and 0.97. We conclude that the Sødring Motor Evaluation of Stroke patients is a reliable measure of motor function in stroke patients undergoing rehabilitation.

  20. Inter-rater reliability of postnatal ultrasound interpretation in infants with congenital hydronephrosis.

    Science.gov (United States)

    Vemulakonda, V M; Wilcox, D T; Torok, M R; Hou, A; Campbell, J B; Kempe, A

    2015-09-01

    The most common measurements of hydronephrosis are the anterior-posterior (AP) diameter and the Society for Fetal Urology (SFU) grading systems. To date, the inter-rater reliability (IRR) of these measures has not been compared in the postnatal period. The objectives of this study were to compare the IRR of the AP diameter and the SFU grading system in infants and to determine whether ultrasound findings other than pelvicalyceal dilation are associated with higher SFU grades. Initial postnatal ultrasounds of infants seen from February 1, 2011, to January 31, 2012, with a primary diagnosis of congenital hydronephrosis were included for review. Ultrasound images were de-identified and reviewed by four pediatric urologists. IRR was calculated using the intraclass correlation (ICC) measure. A paired t test was used to compare ICCs. Associations between SFU grade and other ultrasound findings were tested using Chi-square or Fisher's exact tests. A total of 112 kidneys in 56 patients were reviewed. IRR of the SFU grading system was high (right kidney ICC = 0.83, left kidney ICC = 0.85); however, IRR of AP diameter measurement was higher (right kidney ICC = 00.97, left kidney ICC = 0.98; p hydronephrosis on bivariable and multivariable analysis. The SFU grading system is associated with excellent IRR, although the AP diameter appears to have higher IRR. Physicians may consider ultrasound findings that are not explicitly included in the SFU system when assigning hydronephrosis grade, which may lead to variability in use of this classification system.

  1. 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.

  2. Qualitative soil moisture assessment in semi-arid Africa - the role of experience and training on inter-rater reliability

    Science.gov (United States)

    Rinderer, M.; Komakech, H. C.; Müller, D.; Wiesenberg, G. L. B.; Seibert, J.

    2015-08-01

    Soil and water management is particularly relevant in semi-arid regions to enhance agricultural productivity. During periods of water scarcity, soil moisture differences are important indicators of the soil water deficit and are traditionally used for allocating water resources among farmers of a village community. Here we present a simple, inexpensive soil wetness classification scheme based on qualitative indicators which one can see or touch on the soil surface. It incorporates the local farmers' knowledge on the best soil moisture conditions for seeding and brick making in the semi-arid environment of the study site near Arusha, Tanzania. The scheme was tested twice in 2014 with farmers, students and experts (April: 40 persons, June: 25 persons) for inter-rater reliability, bias of individuals and functional relation between qualitative and quantitative soil moisture values. During the test in April farmers assigned the same wetness class in 46 % of all cases, while students and experts agreed on about 60 % of all cases. Students who had been trained in how to apply the method gained higher inter-rater reliability than their colleagues with only a basic introduction. When repeating the test in June, participants were given improved instructions, organized in small subgroups, which resulted in a higher inter-rater reliability among farmers. In 66 % of all classifications, farmers assigned the same wetness class and the spread of class assignments was smaller. This study demonstrates that a wetness classification scheme based on qualitative indicators is a robust tool and can be applied successfully regardless of experience in crop growing and education level when an in-depth introduction and training is provided. The use of a simple and clear layout of the assessment form is important for reliable wetness class assignments.

  3. Qualitative soil moisture assessment in semi-arid Africa: the role of experience and training on inter-rater reliability

    Science.gov (United States)

    Rinderer, M.; Komakech, H.; Müller, D.; Seibert, J.

    2015-03-01

    Soil and water management is particularly relevant in semi-arid regions to enhance agricultural productivity. During periods of water scarcity soil moisture differences are important indicators of the soil water deficit and are traditionally used for allocating water resources among farmers of a village community. Here we present a simple, inexpensive soil wetness classification scheme based on qualitative indicators which one can see or touch on the soil surface. It incorporates the local farmers' knowledge on the best soil moisture conditions for seeding and brick making in the semi-arid environment of the study site near Arusha, Tanzania. The scheme was tested twice in 2014 with farmers, students and experts (April: 40 persons, June: 25 persons) for inter-rater reliability, bias of individuals and functional relation between qualitative and quantitative soil moisture values. During the test in April farmers assigned the same wetness class in 46% of all cases while students and experts agreed in about 60% of all cases. Students who had been trained in how to apply the method gained higher inter-rater reliability than their colleagues with only a basic introduction. When repeating the test in June, participants were given improved instructions, organized in small sub-groups, which resulted in a higher inter-rater reliability among farmers. In 66% of all classifications farmers assigned the same wetness class and the spread of class assignments was smaller. This study demonstrates that a wetness classification scheme based on qualitative indicators is a robust tool and can be applied successfully regardless of experience in crop growing and education level when an in-depth introduction and training is provided. The use of a simple and clear layout of the assessment form is important for reliable wetness class assignments.

  4. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 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

    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 ......, 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....

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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 (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 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.

  9. Development and inter-rater reliability of a standardized verbal instruction manual for the Chinese Geriatric Depression Scale-short form.

    Science.gov (United States)

    Wong, M T P; Ho, T P; Ho, M Y; Yu, C S; Wong, Y H; Lee, S Y

    2002-05-01

    The Geriatric Depression Scale (GDS) is a common screening tool for elderly depression in Hong Kong. This study aimed at (1) developing a standardized manual for the verbal administration and scoring of the GDS-SF, and (2) comparing the inter-rater reliability between the standardized and non-standardized verbal administration of GDS-SF. Two studies were reported. In Study 1, the process of developing the manual was described. In Study 2, we compared the inter-rater reliabilities of GDS-SF scores using the standardized verbal instructions and the traditional non-standardized administration. Results of Study 2 indicated that the standardized procedure in verbal administration and scoring improved the inter-rater reliabilities of GDS-SF. Copyright 2002 John Wiley & Sons, Ltd.

  10. INTER-RATER RELIABILITY FOR MOVEMENT PATTERN ANALYSIS (MPA: MEASURING PATTERNING OF BEHAVIORS VERSUS DISCRETE BEHAVIOR COUNTS AS INDICATORS OF DECISION-MAKING STYLE

    Directory of Open Access Journals (Sweden)

    Brenda L Connors

    2014-06-01

    Full Text Available The unique yield of collecting observational data on human movement has received increasing attention in a number of domains, including the study of decision-making style. As such, interest has grown in the nuances of core methodological issues, including the best ways of assessing inter-rater reliability. In this paper we focus on one key topic – the distinction between establishing reliability for the patterning of behaviors as opposed to the computation of raw counts – and suggest that reliability for each be compared empirically rather than determined a priori. We illustrate by assessing inter-rater reliability for key outcome measures derived from Movement Pattern Analysis (MPA, an observational methodology that records body movements as indicators of decision-making style with demonstrated predictive validity. While reliability ranged from moderate to good for raw counts of behaviors reflecting each of two Overall Factors generated within MPA (Assertion and Perspective, inter-rater reliability for patterning (proportional indicators of each factor was significantly higher and excellent (ICC = .89. Furthermore, patterning, as compared to raw counts, provided better prediction of observable decision-making process assessed in the laboratory. These analyses support the utility of using an empirical approach to inform the consideration of measuring discrete behavioral counts versus patterning of behaviors when determining inter-rater reliability of observable behavior. They also speak to the substantial reliability that may be achieved via application of theoretically grounded observational systems such as MPA that reveal thinking and action motivations via visible movement patterns.

  11. Inter-Rater and Test-Retest (Between-Sessions) Reliability of the 4-Skills Scan for Dutch Elementary School Children

    Science.gov (United States)

    van Kernebeek, Willem G.; de Schipper, Antoine W.; Savelsbergh, Geert J. P.; Toussaint, Huub M.

    2018-01-01

    In The Netherlands, the 4-Skills Scan is an instrument for physical education teachers to assess gross motor skills of elementary school children. Little is known about its reliability. Therefore, in this study the test-retest and inter-rater reliability was determined. Respectively, 624 and 557 Dutch 6- to 12-year-old children were analyzed for…

  12. Can Physicians Identify Inappropriate Nuclear Stress Tests? An Examination of Inter-rater Reliability for the 2009 Appropriate Use Criteria for Radionuclide Imaging

    Science.gov (United States)

    Ye, Siqin; Rabbani, LeRoy E.; Kelly, Christopher R.; Kelly, Maureen R.; Lewis, Matthew; Paz, Yehuda; Peck, Clara L.; Rao, Shaline; Bokhari, Sabahat; Weiner, Shepard D.; Einstein, Andrew J.

    2014-01-01

    Background We sought to determine inter-rater reliability of the 2009 Appropriate Use Criteria (AUC) for radionuclide imaging (RNI) and whether physicians at various levels of training can effectively identify nuclear stress tests with inappropriate indications. Methods and Results Four hundred patients were randomly selected from a consecutive cohort of patients undergoing nuclear stress testing at an academic medical center. Raters with different levels of training (including cardiology attending physicians, cardiology fellows, internal medicine hospitalists, and internal medicine interns) classified individual nuclear stress tests using the 2009 AUC. Consensus classification by two cardiologists was considered the operational gold standard, and sensitivity and specificity of individual raters for identifying inappropriate tests was calculated. Inter-rater reliability of the AUC was assessed using Cohen’s kappa statistics for pairs of different raters. The mean age of patients was 61.5 years; 214 (54%) were female. The cardiologists rated 256 (64%) of 400 NSTs as appropriate, 68 (18%) as uncertain, 55 (14%) as inappropriate; 21 (5%) tests were unable to be classified. Inter-rater reliability for non-cardiologist raters was modest (unweighted Cohen’s kappa, 0.51, 95% confidence interval, 0.45 to 0.55). Sensitivity of individual raters for identifying inappropriate tests ranged from 47% to 82%, while specificity ranged from 85% to 97%. Conclusions Inter-rater reliability for the 2009 AUC for RNI is modest, and there is considerable variation in the ability of raters at different levels of training to identify inappropriate tests. PMID:25563660

  13. Inter-rater reliability of the South African Triage Scale: Assessing two different cadres of health care workers in a real time environment

    Directory of Open Access Journals (Sweden)

    Michèle Twomey

    2011-09-01

    Conclusion: The inter-rater reliability of SATS ratings is excellent within individual HCWs, but significantly lower between different HCWs. This confirms previous reliability studies of the SATS using vignettes and if validated by larger studies would support the feasibility of further implementation of the SATS in primary health care settings across the Western Cape.

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

    Science.gov (United States)

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

    2009-11-01

    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 reliability of the diagnosis of ASD was measured through an independent assessment of a randomly selected subsample of 38 patients by two other psychiatrists. The diagnoses at 23 months and 42 months of 131 patients, based on the clinical assessment and the diagnostic classifications of standardised instruments, were compared to evaluate stability of the diagnosis of ASD. Inter-rater reliability on a diagnosis of ASD versus non-ASD at 23 months was 87% with a weighted kappa of 0.74 (SE 0.11). The stability of the different diagnoses in the autism spectrum was 63% for autistic disorder, 54% for pervasive developmental disorder, not otherwise specified (PDD-NOS), and 91% for the whole category of ASD. Most diagnostic changes at 42 months were within the autism spectrum from autistic disorder to PDD-NOS and were mainly due to diminished symptom severity. Children who moved outside the ASD category at 42 months made significantly larger gains in cognitive and language skills than children with a stable ASD diagnosis. In conclusion, the inter-rater reliability and stability of the diagnoses of ASD established at 23 months in this population-based sample of very young children are good.

  15. 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...

  16. [Quality assurance in coding expertise of hospital cases in the German DRG system. Evaluation of inter-rater reliability in MDK expertise].

    Science.gov (United States)

    Huber, H; Brambrink, M; Funk, R; Rieger, M

    2012-10-01

    The purpose of this study was to evaluate differences in the D-DRG results of a hospital case by 2 independently coding MKD raters. Calculation of the 2-inter-rater reliability was performed by examination of the coding of individual hospital cases. The reasons for the non-agreement of the expert evaluations and suggestions to improve the process are discussed. From the expert evaluation pool of the MDK-WL a random sample of 0.7% of the 57,375 expertises was taken. Distribution equality with the basic total was tested by the χ² test or, respectively, Fisher's exact test. For the total of 402 individual hospital cases, the G-DRG case sums of 2 experts of the MDK were determined independently and the results checked for each individual case for agreement or non-agreement. The corresponding confidence intervals with standard errors were analysed to test if certain major diagnosis categories (MDC) were statistically significantly more affected by differing expertise results than others. In 280 of the total 402 tested hospital cases, the 2 MDK raters independently reached the same G-DRG results; in 122 cases the G-DRG case sums determined by the 2 raters differed (agreement 70%; CI 65.2-74.1). Different DRG results between the 2 experts occurred regularly in the entire MDC spectrum. No MDC chapter in which significant differences between the 2 raters arose could be identified. The results of our study demonstrate an almost 70% agreement in the evaluation of hospital cost accounts by 2 independently operating MDK. This result leaves room for improvement. Optimisation potentials can be recognised on the basis of the results. Potential for improvement was established in combination with regular further training and the expansion of binding internal code recommendations as well as exchange of code-relevant information among experts in internal forums. The presented model is in principle suitable for cross-border examinations within the MDK system with the advantage that

  17. 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.

  18. BurnCase 3D software validation study: Burn size measurement accuracy and inter-rater reliability.

    Science.gov (United States)

    Parvizi, Daryousch; Giretzlehner, Michael; Wurzer, Paul; Klein, Limor Dinur; Shoham, Yaron; Bohanon, Fredrick J; Haller, Herbert L; Tuca, Alexandru; Branski, Ludwik K; Lumenta, David B; Herndon, David N; Kamolz, Lars-P

    2016-03-01

    The aim of this study was to compare the accuracy of burn size estimation using the computer-assisted software BurnCase 3D (RISC Software GmbH, Hagenberg, Austria) with that using a 2D scan, considered to be the actual burn size. Thirty artificial burn areas were pre planned and prepared on three mannequins (one child, one female, and one male). Five trained physicians (raters) were asked to assess the size of all wound areas using BurnCase 3D software. The results were then compared with the real wound areas, as determined by 2D planimetry imaging. To examine inter-rater reliability, we performed an intraclass correlation analysis with a 95% confidence interval. The mean wound area estimations of the five raters using BurnCase 3D were in total 20.7±0.9% for the child, 27.2±1.5% for the female and 16.5±0.1% for the male mannequin. Our analysis showed relative overestimations of 0.4%, 2.8% and 1.5% for the child, female and male mannequins respectively, compared to the 2D scan. The intraclass correlation between the single raters for mean percentage of the artificial burn areas was 98.6%. There was also a high intraclass correlation between the single raters and the 2D Scan visible. BurnCase 3D is a valid and reliable tool for the determination of total body surface area burned in standard models. Further clinical studies including different pediatric and overweight adult mannequins are warranted. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Chris Beardsley

    2016-03-01

    Full Text Available 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.

  20. 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.

  1. Transcultural Adaptation of GRID Hamilton Rating Scale For Depression (GRID-HAMD) to Brazilian Portuguese and Evaluation of the Impact of Training Upon Inter-Rater Reliability.

    Science.gov (United States)

    Henrique-Araújo, Ricardo; Osório, Flávia L; Gonçalves Ribeiro, Mônica; Soares Monteiro, Ivandro; Williams, Janet B W; Kalali, Amir; Alexandre Crippa, José; Oliveira, Irismar Reis De

    2014-07-01

    GRID-HAMD is a semi-structured interview guide developed to overcome flaws in HAM-D, and has been incorporated into an increasing number of studies. Carry out the transcultural adaptation of GRID-HAMD into the Brazilian Portuguese language, evaluate the inter-rater reliability of this instrument and the training impact upon this measure, and verify the raters' opinions of said instrument. The transcultural adaptation was conducted by appropriate methodology. The measurement of inter-rater reliability was done by way of videos that were evaluated by 85 professionals before and after training for the use of this instrument. The intraclass correlation coefficient (ICC) remained between 0.76 and 0.90 for GRID-HAMD-21 and between 0.72 and 0.91 for GRID-HAMD-17. The training did not have an impact on the ICC, except for a few groups of participants with a lower level of experience. Most of the participants showed high acceptance of GRID-HAMD, when compared to other versions of HAM-D. The scale presented adequate inter-rater reliability even before training began. Training did not have an impact on this measure, except for a few groups with less experience. GRID-HAMD received favorable opinions from most of the participants.

  2. 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.

  3. The Berg Balance Scale has high intra- and inter-rater reliability but absolute reliability varies across the scale: a systematic review.

    Science.gov (United States)

    Downs, Stephen; Marquez, Jodie; Chiarelli, Pauline

    2013-06-01

    What is the intra-rater and inter-rater relative reliability of the Berg Balance Scale? What is the absolute reliability of the Berg Balance Scale? Does the absolute reliability of the Berg Balance Scale vary across the scale? Systematic review with meta-analysis of reliability studies. Any clinical population that has undergone assessment with the Berg Balance Scale. Relative intra-rater reliability, relative inter-rater reliability, and absolute reliability. Eleven studies involving 668 participants were included in the review. The relative intrarater reliability of the Berg Balance Scale was high, with a pooled estimate of 0.98 (95% CI 0.97 to 0.99). Relative inter-rater reliability was also high, with a pooled estimate of 0.97 (95% CI 0.96 to 0.98). A ceiling effect of the Berg Balance Scale was evident for some participants. In the analysis of absolute reliability, all of the relevant studies had an average score of 20 or above on the 0 to 56 point Berg Balance Scale. The absolute reliability across this part of the scale, as measured by the minimal detectable change with 95% confidence, varied between 2.8 points and 6.6 points. The Berg Balance Scale has a higher absolute reliability when close to 56 points due to the ceiling effect. We identified no data that estimated the absolute reliability of the Berg Balance Scale among participants with a mean score below 20 out of 56. The Berg Balance Scale has acceptable reliability, although it might not detect modest, clinically important changes in balance in individual subjects. The review was only able to comment on the absolute reliability of the Berg Balance Scale among people with moderately poor to normal balance. Copyright © 2013 Australian Physiotherapy Association. Published by .. All rights reserved.

  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. 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

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

    OpenAIRE

    Chris Beardsley; Tim Egerton; Brendon Skinner

    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.\\ud \\ud 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.\\ud \\ud Results. For measuring pel...

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. Content Validity Index and Intra- and Inter-Rater Reliability of a New Muscle Strength/Endurance Test Battery for Swedish Soldiers.

    Directory of Open Access Journals (Sweden)

    Helena Larsson

    Full Text Available The objective of this study was to examine the content validity of commonly used muscle performance tests in military personnel and to investigate the reliability of a proposed test battery. For the content validity investigation, thirty selected tests were those described in the literature and/or commonly used in the Nordic and North Atlantic Treaty Organization (NATO countries. Nine selected experts rated, on a four-point Likert scale, the relevance of these tests in relation to five different work tasks: lifting, carrying equipment on the body or in the hands, climbing, and digging. Thereafter, a content validity index (CVI was calculated for each work task. The result showed excellent CVI (≥0.78 for sixteen tests, which comprised of one or more of the military work tasks. Three of the tests; the functional lower-limb loading test (the Ranger test, dead-lift with kettlebells, and back extension, showed excellent content validity for four of the work tasks. For the development of a new muscle strength/endurance test battery, these three tests were further supplemented with two other tests, namely, the chins and side-bridge test. The inter-rater reliability was high (intraclass correlation coefficient, ICC2,1 0.99 for all five tests. The intra-rater reliability was good to high (ICC3,1 0.82-0.96 with an acceptable standard error of mean (SEM, except for the side-bridge test (SEM%>15. Thus, the final suggested test battery for a valid and reliable evaluation of soldiers' muscle performance comprised the following four tests; the Ranger test, dead-lift with kettlebells, chins, and back extension test. The criterion-related validity of the test battery should be further evaluated for soldiers exposed to varying physical workload.

  14. 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

  15. 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

  16. Construct validity and inter-rater reliability of the Dutch activity measure for post-acute care "6-clicks" basic mobility form to assess the mobility of hospitalized patients.

    Science.gov (United States)

    Geelen, Sven Jacobus Gertruda; Valkenet, Karin; Veenhof, Cindy

    2018-05-12

    To evaluate the construct validity and the inter-rater reliability of the Dutch Activity Measure for Post-Acute Care "6-clicks" Basic Mobility short form measuring the patient's mobility in Dutch hospital care. First, the "6-clicks" was translated by using a forward-backward translation protocol. Next, 64 patients were assessed by the physiotherapist to determine the validity while being admitted to the Internal Medicine wards of a university medical center. Six hypotheses were tested regarding the construct "mobility" which showed that: Better "6-clicks" scores were related to less restrictive pre-admission living situations (p = 0.011), less restrictive discharge locations (p = 0.001), more independence in activities of daily living (p = 0.001) and less physiotherapy visits (p Dutch "6-clicks" shows a good construct validity and moderate-to-excellent inter-rater reliability when used to assess the mobility of hospitalized patients. Implications for Rehabilitation Even though various measurement tools have been developed, it appears the majority of physiotherapists working in a hospital currently do not use these tools as a standard part of their care. The Activity Measure for Post-Acute Care "6-clicks" Basic Mobility is the only tool which is designed to be short, easy to use within usual care and has been validated in the entire hospital population. This study shows that the Dutch version of the Activity Measure for Post-Acute Care "6-clicks" Basic Mobility form is a valid, easy to use, quick tool to assess the basic mobility of Dutch hospitalized patients.

  17. 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)

  18. 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.

  19. 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

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

    Science.gov (United States)

    Leschied, Jessica R; Mazza, Michael B; Davenport, Matthew; Chong, Suzanne T; Smith, Ethan A; Hoff, Carrie N; Ladino-Torres, Maria F; Khalatbari, Shokoufeh; Ehrlich, Peter F; Dillman, Jonathan R

    2016-02-01

    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.

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

    International Nuclear Information System (INIS)

    Leschied, Jessica R.; Smith, Ethan A.; Ladino-Torres, Maria F.; Dillman, Jonathan R.; Mazza, Michael B.; Chong, Suzanne T.; Hoff, Carrie N.; Davenport, Matthew S.; Khalatbari, Shokoufeh; Ehrlich, Peter F.

    2016-01-01

    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.)

  2. 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.)

  3. 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

  4. 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

  5. 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.

  6. Agreement between physicians and non-physician clinicians in starting antiretroviral therapy in rural Uganda

    Directory of Open Access Journals (Sweden)

    Vasan Ashwin

    2009-08-01

    Full Text Available Abstract Background The scarcity of physicians in sub-Saharan Africa – particularly in rural clinics staffed only by non-physician health workers – is constraining access to HIV treatment, as only they are legally allowed to start antiretroviral therapy in the HIV-positive patient. Here we present a pilot study from Uganda assessing agreement between non-physician clinicians (nurses and clinical officers and physicians in their decisions as to whether to start therapy. Methods We conducted the study at 12 government antiretroviral therapy sites in three regions of Uganda, all of which had staff trained in delivery of antiretroviral therapy using the WHO Integrated Management of Adult and Adolescent Illness guidelines for chronic HIV care. We collected seven key variables to measure patient assessment and the decision as to whether to start antiretroviral therapy, the primary variable of interest being the Final Antiretroviral Therapy Recommendation. Patients saw either a clinical officer or nurse first, and then were screened identically by a blinded physician during the same clinic visit. We measured inter-rater agreement between the decisions of the non-physician health workers and physicians in the antiretroviral therapy assessment variables using simple and weighted Kappa analysis. Results Two hundred fifty-four patients were seen by a nurse and physician, while 267 were seen by a clinical officer and physician. The majority (> 50% in each arm of the study were in World Health Organization Clinical Stages I and II and therefore not currently eligible for antiretroviral therapy according to national antiretroviral therapy guidelines. Nurses and clinical officers both showed moderate to almost perfect agreement with physicians in their Final Antiretroviral Therapy Recommendation (unweighted κ = 0.59 and κ = 0.91, respectively. Agreement was also substantial for nurses versus physicians for assigning World Health Organization Clinical

  7. Application of good practices as described by the NEPSI agreement coincides with a strong decline in the exposure to respiratory crystalline silica in Finnish workplaces.

    Science.gov (United States)

    Tuomi, Tapani; Linnainmaa, Markku; Väänänen, Virpi; Reijula, Kari

    2014-08-01

    To protect the health of those occupationally exposed to respirable crystalline silica, the main industries in European Union associated with exposure to respirable silica, agreed on appropriate measures for the improvement of working conditions through the application of good practices, as part of 'The Agreement on Workers Health Protection through the Good Handling and Use of Crystalline Silica and Products Containing it' (NEPSI agreement), signed in April 2006. The present paper examines trends in exposure to respirable crystalline silica in Finland prior to and following the implementation of the NEPSI agreement and includes a working example of the NEPSI approach in the concrete industry. Data derived from workplace exposure assessments during the years 1994-2013 are presented, including 2556 air samples collected mostly indoors, from either the breathing zone of workers or from stationary points usually at a height of 1.5 m above the floor, with the aim to estimate average exposure of workers to respiratory crystalline silica during an 8-h working day. The aim was, to find out how effective this unique approach has been in the management of one of the major occupational hazards in the concerned industries. Application of good practices as described by the NEPSI agreement coincides with a strong decline in the exposure to respirable crystalline silica in Finnish workplaces, as represented by the clientele of Finnish Institute of Occupational Health. During the years followed in the present study, we see a >10-fold decrease in the average and median exposures to respirable silica. Prior to the implementation of the NEPSI agreement, >50% of the workplace measurements yielded results above the OEL8 h (0.2mg m(-3)). As of present (2013), circa 10% of the measurements are above of or identical to the OEL8 h (0.05mg m(-3)). © The Author 2014. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

  8. Predictors of parent-child agreement on child anxiety diagnoses on the ADIS-IV-C/P.

    Science.gov (United States)

    Hamblin, Rebecca J; Salloum, Alison; Andel, Ross; Nadeau, Joshua M; McBride, Nicole M; Lewin, Adam B; Storch, Eric A

    2016-11-30

    Diagnostic agreement between parents' and children's reports on children's anxiety problems is notoriously poor; however, very few investigations have examined specific predictors of inter-rater agreement on child anxiety diagnoses. This study examined predictors of categories of parent and child diagnostic endorsement on the Anxiety Disorders Interview Schedule for Children-IV. One hundred eight children (ages 7-13) and their parents completed structured diagnostic interviews for non-OCD/PTSD anxiety diagnoses and paper and pencil measures of functioning and impairment in a variety of domains. Parent-child agreement was statistically significant for social phobia and separation anxiety disorder, but was overall poor for all anxiety diagnoses. Externalizing disorder status, family accommodation frequency, and child rated impairment in various domains differentially predicted informant discrepancies for different anxiety disorders. These data are among the first to suggest variables that may explain parent-child concordance. Copyright © 2016. Published by Elsevier Ireland Ltd.

  9. The Radiographic Union Score for Hip (RUSH): the use of a checklist to evaluate hip fracture healing improves agreement between radiologists and orthopedic surgeons

    International Nuclear Information System (INIS)

    Chiavaras, Mary M.; Bains, Simrit; Choudur, Hema; Parasu, Naveen; Jacobson, Jon; Ayeni, Olufemi; Petrisor, Brad; Sprague, Sheila; Bhandari, Mohit; Chakravertty, Rajesh

    2013-01-01

    The assessment of fracture healing following intertrochanteric fracture fixation is highly variable with no validated standards. Agreement with respect to fracture healing following surgery is important for optimal patient management. The purpose of this study was to (1) assess reliability of intertrochanteric fracture healing assessment and (2) determine if a novel radiographic scoring system for hip fractures improves agreement between radiologists and orthopedic surgeons. A panel of three radiologists and three orthopedic surgeons assessed fracture healing in 150 cases of intertrochanteric fractures at two separate time points to determine inter-rater and intra-rater agreement. Reviewers, blinded to the time after injury, first subjectively assessed overall healing using frontal and lateral radiographs for each patient at a single time point. Reviewers then scored each fracture using a Radiographic Union Score for Hip (RUSH) form to determine whether this improves agreement regarding hip fracture healing. Inter-rater agreement for the overall subjective impression of fracture healing between reviewer groups was only fair (intraclass coefficient [ICC] = 0.34, 95 % CI: 0.11-0.52). Use of the RUSH score improved overall agreement between groups to substantial (ICC = 0.66, 95 % CI: 0.53-0.75). Across reviewers, healing of the medial cortex and overall RUSH score itself demonstrated high correlations with overall perceptions of healing (r = 0.53 and r = 0.72, respectively).??The RUSH score improves agreement of fracture healing assessment between orthopedic surgeons and radiologists, offers a systematic approach to evaluating intertrochanteric hip fracture radiographs, and may ultimately provide prognostic information that could predict healing outcomes in patients with femoral neck fractures. (orig.)

  10. The Radiographic Union Score for Hip (RUSH): the use of a checklist to evaluate hip fracture healing improves agreement between radiologists and orthopedic surgeons

    Energy Technology Data Exchange (ETDEWEB)

    Chiavaras, Mary M. [McMaster University, Department of Radiology, Hamilton, Ontario (Canada); Hamilton General Hospital, Department of Diagnostic Imaging, Hamilton, Ontario (Canada); Bains, Simrit [University of Western Ontario Medical School, London, Ontario (Canada); Choudur, Hema; Parasu, Naveen [McMaster University, Department of Radiology, Hamilton, Ontario (Canada); Jacobson, Jon [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Ayeni, Olufemi; Petrisor, Brad; Sprague, Sheila; Bhandari, Mohit [McMaster University, Department of Orthopedic Surgery, Hamilton, Ontario (Canada); Chakravertty, Rajesh [University of Toronto, Department of Orthopedic Surgery, Toronto, Ontario (Canada)

    2013-08-15

    The assessment of fracture healing following intertrochanteric fracture fixation is highly variable with no validated standards. Agreement with respect to fracture healing following surgery is important for optimal patient management. The purpose of this study was to (1) assess reliability of intertrochanteric fracture healing assessment and (2) determine if a novel radiographic scoring system for hip fractures improves agreement between radiologists and orthopedic surgeons. A panel of three radiologists and three orthopedic surgeons assessed fracture healing in 150 cases of intertrochanteric fractures at two separate time points to determine inter-rater and intra-rater agreement. Reviewers, blinded to the time after injury, first subjectively assessed overall healing using frontal and lateral radiographs for each patient at a single time point. Reviewers then scored each fracture using a Radiographic Union Score for Hip (RUSH) form to determine whether this improves agreement regarding hip fracture healing. Inter-rater agreement for the overall subjective impression of fracture healing between reviewer groups was only fair (intraclass coefficient [ICC] = 0.34, 95 % CI: 0.11-0.52). Use of the RUSH score improved overall agreement between groups to substantial (ICC = 0.66, 95 % CI: 0.53-0.75). Across reviewers, healing of the medial cortex and overall RUSH score itself demonstrated high correlations with overall perceptions of healing (r = 0.53 and r = 0.72, respectively).??The RUSH score improves agreement of fracture healing assessment between orthopedic surgeons and radiologists, offers a systematic approach to evaluating intertrochanteric hip fracture radiographs, and may ultimately provide prognostic information that could predict healing outcomes in patients with femoral neck fractures. (orig.)

  11. 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.

  12. 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.

  13. 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

  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 1.5 ye...... is appropriate for assessing physical and psychosocial risk factors for MSD among eldercare workers.......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...

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

    African Journals Online (AJOL)

    Key words: Microscopic Evaluation, Quality Control, Laboratory Technologist Malaria, Rwanda. Introduction ... testing and evaluation program, regular training of laboratory ... referred from them to different hospitals in the Province. A minimum ...

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

    Science.gov (United States)

    2017-09-19

    return-to-duty. Performance on the tasks is rated by a non-commissioned officer (NCO), occupational therapist, physical therapist, and mental health ...and additional ratings are provided on a subset of the tasks by an occupational therapist (OT), physical therapist (PT), and mental health (MH...3National Intrepid Center of Excellence United States Army Aeromedical Research Laboratory Aircrew Health and Performance Division September 2017

  17. Pneumothorax size measurements on digital chest radiographs: Intra- and inter- rater reliability.

    Science.gov (United States)

    Thelle, Andreas; Gjerdevik, Miriam; Grydeland, Thomas; Skorge, Trude D; Wentzel-Larsen, Tore; Bakke, Per S

    2015-10-01

    Detailed and reliable methods may be important for discussions on the importance of pneumothorax size in clinical decision-making. Rhea's method is widely used to estimate pneumothorax size in percent based on chest X-rays (CXRs) from three measure points. Choi's addendum is used for anterioposterior projections. The aim of this study was to examine the intrarater and interrater reliability of the Rhea and Choi method using digital CXR in the ward based PACS monitors. Three physicians examined a retrospective series of 80 digital CXRs showing pneumothorax, using Rhea and Choi's method, then repeated in a random order two weeks later. We used the analysis of variance technique by Eliasziw et al. to assess the intrarater and interrater reliability in altogether 480 estimations of pneumothorax size. Estimated pneumothorax sizes ranged between 5% and 100%. The intrarater reliability coefficient was 0.98 (95% one-sided lower-limit confidence interval C 0.96), and the interrater reliability coefficient was 0.95 (95% one-sided lower-limit confidence interval 0.93). This study has shown that the Rhea and Choi method for calculating pneumothorax size has high intrarater and interrater reliability. These results are valid across gender, side of pneumothorax and whether the patient is diagnosed with primary or secondary pneumothorax. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Inter-Rater Reliability and Downstream Financial Implications of Electrocardiography Screening in Young Athletes.

    Science.gov (United States)

    Dhutia, Harshil; Malhotra, Aneil; Yeo, Tee Joo; Ster, Irina Chis; Gabus, Vincent; Steriotis, Alexandros; Dores, Helder; Mellor, Greg; García-Corrales, Carmen; Ensam, Bode; Jayalapan, Viknesh; Ezzat, Vivienne Anne; Finocchiaro, Gherardo; Gati, Sabiha; Papadakis, Michael; Tome-Esteban, Maria; Sharma, Sanjay

    2017-08-01

    Preparticipation screening for cardiovascular disease in young athletes with electrocardiography is endorsed by the European Society of Cardiology and several major sporting organizations. One of the concerns of the ECG as a screening test in young athletes relates to the potential for variation in interpretation. We investigated the degree of variation in ECG interpretation in athletes and its financial impact among cardiologists of differing experience. Eight cardiologists (4 with experience in screening athletes) each reported 400 ECGs of consecutively screened young athletes according to the 2010 European Society of Cardiology recommendations, Seattle criteria, and refined criteria. Cohen κ coefficient was used to calculate interobserver reliability. Cardiologists proposed secondary investigations after ECG interpretation, the costs of which were based on the UK National Health Service tariffs. Inexperienced cardiologists were more likely to classify an ECG as abnormal compared with experienced cardiologists (odds ratio, 1.44; 95% confidence interval, 1.03-2.02). Modification of ECG interpretation criteria improved interobserver reliability for categorizing an ECG as abnormal from poor (2010 European Society of Cardiology recommendations; κ=0.15) to moderate (refined criteria; κ=0.41) among inexperienced cardiologists; however, interobserver reliability was moderate for all 3 criteria among experienced cardiologists (κ=0.40-0.53). Inexperienced cardiologists were more likely to refer athletes for further evaluation compared with experienced cardiologists (odds ratio, 4.74; 95% confidence interval, 3.50-6.43) with poorer interobserver reliability (κ=0.22 versus κ=0.47). Interobserver reliability for secondary investigations after ECG interpretation ranged from poor to fair among inexperienced cardiologists (κ=0.15-0.30) and fair to moderate among experienced cardiologists (κ=0.21-0.46). The cost of cardiovascular evaluation per athlete was $175 (95% confidence interval, $142-$228) and $101 (95% confidence interval, $83-$131) for inexperienced and experienced cardiologists, respectively. Interpretation of the ECG in athletes and the resultant cascade of investigations are highly physician dependent even in experienced hands with important downstream financial implications, emphasizing the need for formal training and standardized diagnostic pathways. © 2017 American Heart Association, Inc.

  19. 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....

  20. 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

    quantifying the rater variation as a suitable measure of the variation of the rater odds ratios. An important example that will serve to motivate and illustrate the proposed model, is the study of Umbilical artery Doppler velocimetry used by obstetricians to assess the status of a foetus. The purpose...... of the assessment is to improve the foetus' chance of survival by choosing the optimal time of elective delivery. In the study, data related to 139 perinatal deaths were sent to 32 experts who were asked whether the use of Doppler velocimetry might have prevented each death....

  1. 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

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

    Directory of Open Access Journals (Sweden)

    Makris Demosthenes

    2010-03-01

    Full Text Available Abstract Background We evaluated pulmonologists variability in the interpretation of Vibration response imaging (VRI obtained from healthy subjects and patients hospitalized for community acquired pneumonia. Methods 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. Results 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. Conclusions 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.

  3. 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.)

  4. 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.)

  5. Training less-experienced faculty improves reliability of skills assessment in cardiac surgery.

    Science.gov (United States)

    Lou, Xiaoying; Lee, Richard; Feins, Richard H; Enter, Daniel; Hicks, George L; Verrier, Edward D; Fann, James I

    2014-12-01

    Previous work has demonstrated high inter-rater reliability in the objective assessment of simulated anastomoses among experienced educators. We evaluated the inter-rater reliability of less-experienced educators and the impact of focused training with a video-embedded coronary anastomosis assessment tool. Nine less-experienced cardiothoracic surgery faculty members from different institutions evaluated 2 videos of simulated coronary anastomoses (1 by a medical student and 1 by a resident) at the Thoracic Surgery Directors Association Boot Camp. They then underwent a 30-minute training session using an assessment tool with embedded videos to anchor rating scores for 10 components of coronary artery anastomosis. Afterward, they evaluated 2 videos of a different student and resident performing the task. Components were scored on a 1 to 5 Likert scale, yielding an average composite score. Inter-rater reliabilities of component and composite scores were assessed using intraclass correlation coefficients (ICCs) and overall pass/fail ratings with kappa. All components of the assessment tool exhibited improvement in reliability, with 4 (bite, needle holder use, needle angles, and hand mechanics) improving the most from poor (ICC range, 0.09-0.48) to strong (ICC range, 0.80-0.90) agreement. After training, inter-rater reliabilities for composite scores improved from moderate (ICC, 0.76) to strong (ICC, 0.90) agreement, and for overall pass/fail ratings, from poor (kappa = 0.20) to moderate (kappa = 0.78) agreement. Focused, video-based anchor training facilitates greater inter-rater reliability in the objective assessment of simulated coronary anastomoses. Among raters with less teaching experience, such training may be needed before objective evaluation of technical skills. Published by Elsevier Inc.

  6. Canadian seismic agreement

    International Nuclear Information System (INIS)

    Wetmiller, R.J.; Lyons, J.A.; Shannon, W.E.; Munro, P.S.; Thomas, J.T.; Andrew, M.D.; Lamontagne, M.; Wong, C.; Anglin, F.M.; Plouffe, M.; Lapointe, S.P.; Adams, J.; Drysdale, J.A.

    1990-04-01

    This is the twenty-first progress report under the agreement entitled Canadian Seismic Agreement between the US Nuclear Regulatory Commission (NRC) and the Canadian Commercial Corporation. Activities undertaken by the Geophysics Division of the Geological Survey of Canada (GD/GSC) during the period from July 01, 1988 to June 30, 1989 and supported in part by the NRC agreement are described below under four headings; Eastern Canada Telemetred Network and local network developments, Datalab developments, strong motion network developments and earthquake activity. In this time period eastern Canada experienced its largest earthquake in over 50 years. This earthquake, which has been christened the Saguenay earthquake, has provided a wealth of new data pertinent to earthquake engineering studies in eastern North America and is the subject of many continuing studies, which are presently being carried out at GD and elsewhere. 41 refs., 21 figs., 7 tabs

  7. <strong>Mini-project>

    DEFF Research Database (Denmark)

    Katajainen, Jyrki

    2008-01-01

    In this project the goal is to develop the safe * family of containers for the CPH STL. The containers to be developed should be safer and more reliable than any of the existing implementations. A special focus should be put on strong exception safety since none of the existing prototypes available...

  8. Strong interactions

    International Nuclear Information System (INIS)

    Froissart, Marcel

    1976-01-01

    Strong interactions are introduced by their more obvious aspect: nuclear forces. In hadron family, the nucleon octet, OMEGA - decuplet, and quark triply are successively considered. Pion wave having been put at the origin of nuclear forces, low energy phenomena are described, the force being explained as an exchange of structure corresponding to a Regge trajectory in a variable rotating state instead of the exchange of a well defined particle. At high energies the concepts of pomeron, parton and stratons are introduced, pionization and fragmentation are briefly differentiated [fr

  9. 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.

  10. 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…

  11. 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...... 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.......-term test-retest). A total of 24 patients with chronic stroke (mean age; 59.7 years, mean time since stroke onset 29.6 months) participated. The examiners simultaneously assessed the patients' ability to perform 20 subtests. Both ordinal data (generalized kappa) and total sum scores (Spearman's rank...

  12. Inter-rater and test-retest reliability, internal consistency, and factorial structure of the instrument for forensic treatment evaluation

    NARCIS (Netherlands)

    Schuringa, E.; Spreen, M.; Bogaerts, S.

    2014-01-01

    In this study, the Instrument for Forensic Treatment Evaluation (IFTE) is introduced. The IFTE includes 14 dynamic items of the risk assessment scheme HKT-R and eight items specifically related to the treatment of forensic psychiatric patients. The items are divided over three factors: protective

  13. 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.

  14. 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

  15. 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

  16. 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

  17. 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.

  18. 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

    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...

  19. Ecologically relevant outcome measure for post-inpatient rehabilitation.

    Science.gov (United States)

    Marquez de la Plata, Carlos; Qualls, Devin; Plenger, Patrick; Malec, James F; Hayden, Mary Ellen

    2017-01-01

    Transfer of skills learned within the clinic environment to patients' home or community is important in post-inpatient brain injury rehabilitation (PBIR). Outcome measures used in PBIR assess level of independence during functional tasks; however, available functional instruments do not quantitate the environment in which the behaviors occur. To examine the reliability and validity of an instrument used to assess patients' functional abilities while quantifying the amount of structure and distractions in the environment. 2501 patients who sustained a traumatic brain injury (TBI) or cerebrovascular accident (CVA) and participated in a multidisciplinary PBIR program between 2006 and 2014 were identified retrospectively for this study. The PERPOS and MPAI-4 were used to assess functional abilities at admission and at discharge. Construct validity was assessed using a bivariate Spearman rho analysis A subsample of 56 consecutive admissions during 2014 were examined to determine inter-rater reliability. Intra-class correlation coefficient (ICC) and Kappa coefficients assessed inter-rater agreement of the total PERPOS and PERPOS subscales respectively. The PERPOS and MPAI-4 demonstrated a strong negative association among both TBI and CVA patients. Kappa scores for the three PERPOS scales each demonstrated good to excellent inter-rater agreement. The ICC for overall PERPOS scores fell in the good agreement range. The PERPOS can be used reliably in PBIR to quantify patients' functional abilities within the context of environmental demands.

  20. 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...

  1. The Orientation of Gastric Biopsy Samples Improves the Inter-observer Agreement of the OLGA Staging System.

    Science.gov (United States)

    Cotruta, Bogdan; Gheorghe, Cristian; Iacob, Razvan; Dumbrava, Mona; Radu, Cristina; Bancila, Ion; Becheanu, Gabriel

    2017-12-01

    Evaluation of severity and extension of gastric atrophy and intestinal metaplasia is recommended to identify subjects with a high risk for gastric cancer. The inter-observer agreement for the assessment of gastric atrophy is reported to be low. The aim of the study was to evaluate the inter-observer agreement for the assessment of severity and extension of gastric atrophy using oriented and unoriented gastric biopsy samples. Furthermore, the quality of biopsy specimens in oriented and unoriented samples was analyzed. A total of 35 subjects with dyspeptic symptoms addressed for gastrointestinal endoscopy that agreed to enter the study were prospectively enrolled. The OLGA/OLGIM gastric biopsies protocol was used. From each subject two sets of biopsies were obtained (four from the antrum, two oriented and two unoriented, two from the gastric incisure, one oriented and one unoriented, four from the gastric body, two oriented and two unoriented). The orientation of the biopsy samples was completed using nitrocellulose filters (Endokit®, BioOptica, Milan, Italy). The samples were blindly examined by two experienced pathologists. Inter-observer agreement was evaluated using kappa statistic for inter-rater agreement. The quality of histopathology specimens taking into account the identification of lamina propria was analyzed in oriented vs. unoriented samples. The samples with detectable lamina propria mucosae were defined as good quality specimens. Categorical data was analyzed using chi-square test and a two-sided p value <0.05 was considered statistically significant. A total of 350 biopsy samples were analyzed (175 oriented / 175 unoriented). The kappa index values for oriented/unoriented OLGA 0/I/II/III and IV stages have been 0.62/0.13, 0.70/0.20, 0.61/0.06, 0.62/0.46, and 0.77/0.50, respectively. For OLGIM 0/I/II/III stages the kappa index values for oriented/unoriented samples were 0.83/0.83, 0.88/0.89, 0.70/0.88 and 0.83/1, respectively. No case of OLGIM IV

  2. Technology Partnership Agreements | NREL

    Science.gov (United States)

    Partnership Agreements Technology Partnership Agreements Looking for Funding? We do not fund any projects under a technology partnership agreement. The partner provides the necessary resources and, in using technology partnership agreements. See a summary of our Fiscal Year 2017 technology partnership

  3. Flexible climate agreements after 2012

    International Nuclear Information System (INIS)

    Vevatne, Jonas

    2004-01-01

    The Kyoto agreement is only a small step towards much stronger and broader commitments and new creativity is needed to further develop a really global climate policy. A flexible approach is necessary to obtain broad participation and substantial reduction of the emissions of greenhouse gases. Flexibility is also important to ease negotiations, to ensure cost-effectiveness and implement a global climate agreement. The US withdrawal from the Kyoto Protocol has rendered the agreement much less effective than the original goal of five per cent reduction of the emission from the industrialized countries. In addition the emissions are increasing much faster in countries that have not committed themselves to the agreement. The agreement runs out in 2012 and should be followed by a new agreement, the negotiations about which are to start up no later than 2005. Attempts by the European Union to begin a discussion about future commitments were very quickly wrecked by the G77 group with strong support from the U.S.A. To formulate a practical climate policy the general goal in the Climate Convention must be interpreted and specified. It may seem impossible to agree upon a long-term goal. But the clarity it provides will be very useful. It will be a guide for short-term goals and a reference for evaluation of success

  4. 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

  5. Shareholders' agreements in Denmark

    DEFF Research Database (Denmark)

    Werlauff, Erik

    2010-01-01

    ’ agreements”) cannot bind the company within the sense of company law under the new state of law, and voting rights agreements, agreements on right of pre-emption etc. will therefore only apply at the level of contract law between the parties to the agreement. This article for European Business Law Review......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...... analyses the consequences of this. Rights and duties in the owners’ agreements must now be reiterated to the greatest possible extent in the company’s articles of association so that the precepts become binding on the company and its management. Whether the parties to the owners’ agreement can be required...

  6. Reliability of visual and instrumental color matching.

    Science.gov (United States)

    Igiel, Christopher; Lehmann, Karl Martin; Ghinea, Razvan; Weyhrauch, Michael; Hangx, Ysbrand; Scheller, Herbert; Paravina, Rade D

    2017-09-01

    The aim of this investigation was to evaluate intra-rater and inter-rater reliability of visual and instrumental shade matching. Forty individuals with normal color perception participated in this study. The right maxillary central incisor of a teaching model was prepared and restored with 10 feldspathic all-ceramic crowns of different shades. A shade matching session consisted of the observer (rater) visually selecting the best match by using VITA classical A1-D4 (VC) and VITA Toothguide 3D Master (3D) shade guides and the VITA Easyshade Advance intraoral spectrophotometer (ES) to obtain both VC and 3D matches. Three shade matching sessions were held with 4 to 6 weeks between sessions. Intra-rater reliability was assessed based on the percentage of agreement for the three sessions for the same observer, whereas the inter-rater reliability was calculated as mean percentage of agreement between different observers. The Fleiss' Kappa statistical analysis was used to evaluate visual inter-rater reliability. The mean intra-rater reliability for the visual shade selection was 64(11) for VC and 48(10) for 3D. The corresponding ES values were 96(4) for both VC and 3D. The percentages of observers who matched the same shade with VC and 3D were 55(10) and 43(12), respectively, while corresponding ES values were 88(8) for VC and 92(4) for 3D. The results for visual shade matching exhibited a high to moderate level of inconsistency for both intra-rater and inter-rater comparisons. The VITA Easyshade Advance intraoral spectrophotometer exhibited significantly better reliability compared with visual shade selection. This study evaluates the ability of observers to consistently match the same shade visually and with a dental spectrophotometer in different sessions. The intra-rater and inter-rater reliability (agreement of repeated shade matching) of visual and instrumental tooth color matching strongly suggest the use of color matching instruments as a supplementary tool in

  7. Financing petroleum agreements

    International Nuclear Information System (INIS)

    Robson, C.J.V.

    1994-01-01

    This chapter describes the typical type of financing agreements which are currently used to finance North Sea petroleum projects whether they are in the cause of development or have been developed and are producing. It deals with the agreements which are entered into to finance borrowings for petroleum projects on a non-resource or limited resource basis. (UK)

  8. 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

  9. 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...... and stability of international fisheries agreements. A key message that emerges from this literature strand is that self-enforcing cooperative management of internationally shared fish stocks is generally difficult to achieve. Hence, the international legal framework and regulations play a decisive role...

  10. 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...

  11. Production sharing agreements

    International Nuclear Information System (INIS)

    1994-01-01

    This paper, which was presented at the Production Sharing Agreement seminar, discusses economic rent, negotiations, trends in fiscal system development, and concessionary systems. Production sharing contracts, risk service contracts, joint ventures and the global market are examined. (UK)

  12. Multilateral and bilateral agreements

    International Nuclear Information System (INIS)

    Koponen, H.

    1993-01-01

    Finland has made both multilateral and bilateral agreements on the exchange of information related to radiation safety. The first arrangements for international agreements and exchange of information were made after the Chernobyl accident. In 1987, Finland joined the convention on early notification of a nuclear power accident coordinated by International Atomic Energy Agency. The convention is applied to accidents that cause of may cause emissions of radioactive substances that might affect the radiation safety of another country. Besides the convention on early notification, some other individual agreements have also been made. These include the International Nuclear Event Scale (INES) system and power companies own information exchange systems. Finland has conducted bilateral agreements with the Nordic countries and the Soviet Union on the notification of accidents and exchange of nuclear power plant information. Today, Russia answers for the Soviet Union's contractual obligations. (orig.)

  13. FFTF Authorization Agreement

    International Nuclear Information System (INIS)

    DAUTEL, W.A.

    2000-01-01

    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 in the Fast Flux Test Facility (FFTF). Work must be accomplished in a manner that achieves high levels of quality while protecting the environment and the safety and health of workers and the public, and complying with applicable contractual and regulatory requirements. It is the intent of this Agreement to address those items of significant importance in establishing and supporting the FFTF Authorization Envelope, but this Agreement in no way alters the terms and conditions of the Project Hanford Management Contract (PHMC), Contract Number DE-AC06-96RL13200

  14. 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.

  15. 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.

  16. 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

  17. FFTF Authorization Agreement

    International Nuclear Information System (INIS)

    DAUTEL, W.A.

    2000-01-01

    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

  18. 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.)

  19. 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......), was to the benefit of the policy preferences of the IMF and the World Bank. This case thus indicates that since China’s own aspirations are changeable, its emergence as an alternative development partner may not bring about any substantive change of direction for the DRC’s international relations. Furthermore......The Sicomines multibillion minerals-for-infrastructure deal was struck in 2007 between the Democratic Republic of Congo (DRC) and China. The paper investigates the drivers behind the original conception of the agreement, outlines the structure of the contract, analyses the dynamics at play during...

  20. Agreements in Virtual Organizations

    Science.gov (United States)

    Pankowska, Malgorzata

    This chapter is an attempt to explain the important impact that contract theory delivers with respect to the concept of virtual organization. The author believes that not enough research has been conducted in order to transfer theoretical foundations for networking to the phenomena of virtual organizations and open autonomic computing environment to ensure the controllability and management of them. The main research problem of this chapter is to explain the significance of agreements for virtual organizations governance. The first part of this chapter comprises explanations of differences among virtual machines and virtual organizations for further descriptions of the significance of the first ones to the development of the second. Next, the virtual organization development tendencies are presented and problems of IT governance in highly distributed organizational environment are discussed. The last part of this chapter covers analysis of contracts and agreements management for governance in open computing environments.

  1. 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.

  2. The reliability and validity of the Turkish version of Fullerton Advanced Balance (FAB-T) scale.

    Science.gov (United States)

    Iyigun, Gozde; Kirmizigil, Berkiye; Angin, Ender; Oksuz, Sevim; Can, Filiz; Eker, Levent; Rose, Debra J

    2018-06-04

    The aim of this study was to evaluate the reliability and validity of the Turkish version of the FAB(FAB-T) scale in the older Turkish adults. The reliability and validity of the scale was tested on 200 community-dwelling older adults. FAB-T scale was scored by different physiotherapists on different days to evaluate inter-rater and intrarater reliability. The Berg Balance Scale (BBS) was used for the evaluation of convergent validity, and the content validity of the FAB-T scale was investigated. The FAB-T scale showed very high inter- and intra-rater reliability. For inter-rater agreement, on the individual test items and total score ICC values were 0.92 (95 %CI; 0.90-0.94) and 0.96 (95% CI; 0.95-0.97) respectively. The intra-rater agreement, on the individual test items and total score ICC values were 0.93 (95 %CI; 0.91- 0.95) and 0.96 (95% CI; 0.95- 0.97) respectively. There was a good agreement between the FAB-T and BBS scales. A high correlation was found between the BBS and FAB-T scales [rho = 0.70 (%95 CI; 0.62-0.76)] indicating good convergent validity. Considering the content validity of the FAB-T scale, no floor (floor score: 0%) or ceiling (ceiling score: 6.5%) effect was detected. The FAB-T scale was successfully translated from the original English version (FAB) and demonstrated strong psychometric features. It was found that the FAB-T scale has very high inter-rater and intra-rater reliability. Considering the convergent validity, the scale has high correlation with the BBS. The FAB-T has no floor and ceiling effect. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. 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

  4. 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.

  5. License agreement, employee work

    OpenAIRE

    Poncová, Veronika

    2012-01-01

    The rigorous thesis is focused on license agreement and employee work. The aim of the thesis is not only an analysis of the use of a copyrighted work by a person different from the author of the work, but also an analysis of the performance of copyright by a person different from the author of the work. The thesis consists of five chapters. The opening chapter provides a summary of the notion of copyright, its sources at the national and international levels, but also the European Union legis...

  6. 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...

  7. Strong Langmuir turbulence

    International Nuclear Information System (INIS)

    Goldman, M.V.

    1984-01-01

    After a brief discussion of beam-excited Langmuir turbulence in the solar wind, we explain the criteria for wave-particle, three-wave and strong turbulence interactions. We then present the results of a numerical integration of the Zakharov equations, which describe the strong turbulence saturation of a weak (low-density) high energy, bump-on-tail beam instability. (author)

  8. An Inter-Rater Comparison of DoD Human Factors Analysis and Classification System (HFACS) and Human Factors Analysis and Classification System-Maritime (HFACS-M)

    Science.gov (United States)

    2013-09-01

    LEFT BLANK vii TABLE OF CONTENTS I.  INTRODUCTION ............................................................................................. 1...Adams, Brent DeVore, John Zuzich, and Cory Blaser. xviii THIS PAGE INTENTIONALLY LEFT BLANK 1 I. INTRODUCTION A. OVERVIEW Human error has...Behavioral Factors Perceptual Factors Condition of Individuals Crew Resource Mangement Self Imposed Stress Personnel Factors PRECONDITIONS Figure 7

  9. Inter-rater Reliability on the Individual Music-Centered Assessment Profile for Neurodevelopmental Disorders (IMCAP-ND) for autism spectrum disorder. Nordic Journal of Music Therapy

    DEFF Research Database (Denmark)

    Carpente, John; Gattino, Gustavo

    2018-01-01

    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. Inter-rater reliability of direct observations of the physical and psychosocial working conditions in eldercare: An evaluation in the DOSES project

    NARCIS (Netherlands)

    Karstad, K. (Kristina); Rugulies, R. (Reiner); Skotte, J. (Jørgen); Munch, P.K. (Pernille Kold); Greiner, B.A. (Birgit A.); Burdorf, A. (Alex); Søgaard, K. (Karen); A. Holtermann (Andreas)

    2018-01-01

    textabstractThe 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.

  11. An evaluation of the predictive validity and inter-rater reliability of clinical diagnostic criteria for senile dementia of Lewy body type.

    Science.gov (United States)

    McKeith, I G; Fairbairn, A F; Bothwell, R A; Moore, P B; Ferrier, I N; Thompson, P; Perry, R H

    1994-05-01

    Several recent autopsy studies suggest that senile dementia of Lewy body type (SDLT) may be the second most common neuropathologic cause of dementia in the elderly, accounting for 7 to 30% of all cases. Operational criteria for the antemortem clinical diagnosis of SDLT have already been proposed by our group. The performance of these is now examined by randomizing the case notes from a new series of SDLT, Alzheimer, and multi-infarct dementia patients for psychiatric assessment by four raters of varying clinical experience and blind to pathologic diagnosis. Using the SDLT criteria, the two most experienced raters agreed in 94% of cases (kappa = 0.87), with the least experienced rater agreeing in 78% (kappa = 0.50). Diagnostic specificity for SDLT was uniformly high (90.0 to 97.0%), with a mean sensitivity of detection of 74%, and was greater by the experienced (90.0%) than the least experienced (55%) clinician. The antemortem identification of SDLT patients can therefore be achieved with a high degree of diagnostic specificity using such operationalized criteria, although there remains a minority of patients who present with either "typical" Alzheimer-type symptoms or with paranoid or delusional symptoms in the absence of substantial cognitive impairment. Sensitivity to neuroleptics may be a useful diagnostic pointer in these patients.

  12. A study examining inter-rater and intrarater reliability of a novel instrument for assessment of psoriasis: the Copenhagen Psoriasis Severity Index.

    NARCIS (Netherlands)

    Berth-Jones, J.; Thompson, J.; Papp, K.

    2008-01-01

    BACKGROUND: There is a perceived need for a better method for clinical assessment of the severity of psoriasis vulgaris. The most frequently used system is the Psoriasis Area and Severity Index (PASI), which has significant disadvantages, including the requirement for assessment of the percentage of

  13. Strong intrinsic motivation

    OpenAIRE

    Dessi, Roberta; Rustichini, Aldo

    2015-01-01

    A large literature in psychology, and more recently in economics, has argued that monetary rewards can reduce intrinsic motivation. We investigate whether the negative impact persists when intrinsic motivation is strong, and test this hypothesis experimentally focusing on the motivation to undertake interesting and challenging tasks, informative about individual ability. We find that this type of task can generate strong intrinsic motivation, that is impervious to the effect of monetary incen...

  14. Bitcoin Meets Strong Consistency

    OpenAIRE

    Decker, Christian; Seidel, Jochen; Wattenhofer, Roger

    2014-01-01

    The Bitcoin system only provides eventual consistency. For everyday life, the time to confirm a Bitcoin transaction is prohibitively slow. In this paper we propose a new system, built on the Bitcoin blockchain, which enables strong consistency. Our system, PeerCensus, acts as a certification authority, manages peer identities in a peer-to-peer network, and ultimately enhances Bitcoin and similar systems with strong consistency. Our extensive analysis shows that PeerCensus is in a secure state...

  15. Strong gravity and supersymmetry

    International Nuclear Information System (INIS)

    Chamseddine, Ali H.; Salam, A.; Strathdee, J.

    1977-11-01

    A supersymmetric theory is constructed for a strong f plus a weak g graviton, together with their accompanying massive gravitinos, by gaugin the gradel 0Sp(2,2,1)x 0Sp(2,2,1) structure. The mixing term between f and g fields, which makes the strong graviton massive, can be introduced through a spontaneous symmetry-breaking mechanism implemented in this note by constructing a non-linear realization of the symmetry group

  16. Regional trade agreements & procurement rules : facilitators or hindrances?

    OpenAIRE

    ANDERSON, Robert D.; MÜLLER, Anna Caroline; PELLETIER, Philippe

    2015-01-01

    This Working Paper considers the significance of government procurement chapters in regional trade agreements (RTAs), both in their own right and vis-à-vis the WTO Agreement on Government Procurement (GPA). The paper finds, inter alia, that: (i) a strong complementarity exists between government procurement trade commitments and general goods and services trade commitments, making integration of procurement commitments in a more general system such as the WTO Agreements desirable; (ii) govern...

  17. 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...

  18. Systems management of facilities agreements

    International Nuclear Information System (INIS)

    Blundell, A.

    1998-01-01

    The various types of facilities agreements, the historical obstacles to implementation of agreement management systems and the new opportunities emerging as industry is beginning to make an effort to overcome these obstacles, are reviewed. Barriers to computerized agreement management systems (lack of consistency, lack of standards, scarcity of appropriate computer software) are discussed. Characteristic features of a model facilities agreement management system and the forces driving the changing attitudes towards such systems (e.g. mergers) are also described

  19. Why are Trade Agreements Regional?

    OpenAIRE

    Zissimos, Ben

    2007-01-01

    This paper shows how distance may be used to coordinate on a unique equilibrium in which trade agreements are regional. Trade agreement formation is modeled as coalition formation. In a standard trade model with no distance between countries, a familiar problem of coordination failure arises giving rise to multiple equilibria; any one of many possible trade agreements can form. With distance between countries, and through strategic interaction in tariff setting, regional trade agreements gene...

  20. 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

  1. 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 reliable tool for measuring thoracic spine rotation which produces greater

  2. 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...

  3. Description and pilot results from a novel method for evaluating return of incidental findings from next-generation sequencing technologies.

    Science.gov (United States)

    Goddard, Katrina A B; Whitlock, Evelyn P; Berg, Jonathan S; Williams, Marc S; Webber, Elizabeth M; Webster, Jennifer A; Lin, Jennifer S; Schrader, Kasmintan A; Campos-Outcalt, Doug; Offit, Kenneth; Feigelson, Heather Spencer; Hollombe, Celine

    2013-09-01

    The aim of this study was to develop, operationalize, and pilot test a transparent, reproducible, and evidence-informed method to determine when to report incidental findings from next-generation sequencing technologies. Using evidence-based principles, we proposed a three-stage process. Stage I "rules out" incidental findings below a minimal threshold of evidence and is evaluated using inter-rater agreement and comparison with an expert-based approach. Stage II documents criteria for clinical actionability using a standardized approach to allow experts to consistently consider and recommend whether results should be routinely reported (stage III). We used expert opinion to determine the face validity of stages II and III using three case studies. We evaluated the time and effort for stages I and II. For stage I, we assessed 99 conditions and found high inter-rater agreement (89%), and strong agreement with a separate expert-based method. Case studies for familial adenomatous polyposis, hereditary hemochromatosis, and α1-antitrypsin deficiency were all recommended for routine reporting as incidental findings. The method requires definition of clinically actionable incidental findings and provide documentation and pilot testing of a feasible method that is scalable to the whole genome.

  4. Strongly interacting Fermi gases

    Directory of Open Access Journals (Sweden)

    Bakr W.

    2013-08-01

    Full Text Available Strongly interacting gases of ultracold fermions have become an amazingly rich test-bed for many-body theories of fermionic matter. Here we present our recent experiments on these systems. Firstly, we discuss high-precision measurements on the thermodynamics of a strongly interacting Fermi gas across the superfluid transition. The onset of superfluidity is directly observed in the compressibility, the chemical potential, the entropy, and the heat capacity. Our measurements provide benchmarks for current many-body theories on strongly interacting fermions. Secondly, we have studied the evolution of fermion pairing from three to two dimensions in these gases, relating to the physics of layered superconductors. In the presence of p-wave interactions, Fermi gases are predicted to display toplogical superfluidity carrying Majorana edge states. Two possible avenues in this direction are discussed, our creation and direct observation of spin-orbit coupling in Fermi gases and the creation of fermionic molecules of 23Na 40K that will feature strong dipolar interactions in their absolute ground state.

  5. 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

  6. 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,...

  7. 75 FR 79069 - Anti-Counterfeiting Trade Agreement: Request for Comments From the Public

    Science.gov (United States)

    2010-12-17

    ... proposed agreement to strengthen international cooperation, enforcement practices and legal frameworks for... international cooperation and to promote strong enforcement practices. Together these provisions will help to... OFFICE OF THE UNITED STATES TRADE REPRESENTATIVE Anti-Counterfeiting Trade Agreement: Request for...

  8. 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.

  9. Exploring rater agreement: configurations of agreement and disagreement

    Directory of Open Access Journals (Sweden)

    ALEXANDER VON EYE

    2006-03-01

    Full Text Available At the level of manifest categorical variables, a large number of coefficients and models for the examination of rater agreement has been proposed and used for descriptive and explanatory purposes. This article focuses on exploring rater agreement. Configural Frequency Analysis (CFA is proposed as a method of exploration of cross-classifications of raters’ judgements. CFA allows researchers to (1 examine individual cells and sets of cells in agreement tables; (2 examine cells that indicate disagreement; and (3 explore agreement and disagreement among three or more raters. Four CFA base models are discussed. The first is the model of rater agreement that is also used for Cohen’s (1960  (kappa. This model proposes independence of raters’ judgements. Deviations from this model suggest agreement or disagreement beyond chance. The second CFA model is based on a log-linear null model. This model is also used for Brennan and Prediger’s (1981 n. It proposes a uniform distribution of ratings. The third model is that of Tanner and Young (1985. This model proposes equal weights for agreement cases and independence otherwise. The fourth model is the quasi-independence model. This model allows one to blank out agreement cells and thus to focus solely on patterns of disagreement. Examples use data from applicant selection.

  10. 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...

  11. 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

  12. Strongly intensive quantities

    International Nuclear Information System (INIS)

    Gorenstein, M. I.; Gazdzicki, M.

    2011-01-01

    Analysis of fluctuations of hadron production properties in collisions of relativistic particles profits from use of measurable intensive quantities which are independent of system size variations. The first family of such quantities was proposed in 1992; another is introduced in this paper. Furthermore we present a proof of independence of volume fluctuations for quantities from both families within the framework of the grand canonical ensemble. These quantities are referred to as strongly intensive ones. Influence of conservation laws and resonance decays is also discussed.

  13. 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

  14. Strongly disordered superconductors

    International Nuclear Information System (INIS)

    Muttalib, K.A.

    1982-01-01

    We examine some universal effects of strong non-magnetic disorder on the electron-phonon and electron-electron interactions in a superconductor. In particular we explicitly take into account the effect of slow diffusion of electrons in a disordered medium by working in an exact impurity eigenstate representation. We find that the normal diffusion of electrons characterized by a constant diffusion coefficient does not lead to any significant correction to the electron-phonon or the effective electron-electron interactions in a superconductor. We then consider sufficiently strong disorder where Anderson localization of electrons becomes important and determine the effect of localization on the electron-electron interactions. We find that due to localization, the diffusion of electrons becomes anomalous in the sense that the diffusion coefficient becomes scale dependent. This results in an increase in the effective electron-electron interaction with increasing disorder. We propose that this provides a natural explanation for the unusual sensitivity of the transition temperature T/sub c/ of the high T/sub c/ superconductors (T/sub c/ > 10 0 K) to damage effects

  15. 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 ...

  16. Facial Angiofibroma Severity Index (FASI): reliability assessment of a new tool developed to measure severity and responsiveness to therapy in tuberous sclerosis-associated facial angiofibroma.

    Science.gov (United States)

    Salido-Vallejo, R; Ruano, J; Garnacho-Saucedo, G; Godoy-Gijón, E; Llorca, D; Gómez-Fernández, C; Moreno-Giménez, J C

    2014-12-01

    Tuberous sclerosis complex (TSC) is an autosomal dominant neurocutaneous disorder characterized by the development of multisystem hamartomatous tumours. Topical sirolimus has recently been suggested as a potential treatment for TSC-associated facial angiofibroma (FA). To validate a reproducible scale created for the assessment of clinical severity and treatment response in these patients. We developed a new tool, the Facial Angiofibroma Severity Index (FASI) to evaluate the grade of erythema and the size and extent of FAs. In total, 30 different photographs of patients with TSC were shown to 56 dermatologists at each evaluation. Three evaluations using the same photographs but in a different random order were performed 1 week apart. Test and retest reliability and interobserver reproducibility were determined. There was good agreement between the investigators. Inter-rater reliability showed strong correlations (> 0.98; range 0.97-0.99) with inter-rater correlation coefficients (ICCs) for the FASI. The global estimated kappa coefficient for the degree of intra-rater agreement (test-retest) was 0.94 (range 0.91-0.97). The FASI is a valid and reliable tool for measuring the clinical severity of TSC-associated FAs, which can be applied in clinical practice to evaluate the response to treatment in these patients. © 2014 British Association of Dermatologists.

  17. 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...

  18. Strongly interacting Higgs bosons

    International Nuclear Information System (INIS)

    Appelquist, T.; Bernard, C.

    1980-01-01

    The sensitivity of present-energy weak interactions to a strongly interacting heavy-Higgs-boson sector is discussed. The gauged nonlinear sigma model, which is the limit of the linear model as the Higgs-boson mass goes to infinity, is used to organize and catalogue all possible heavy-Higgs-boson effects. As long as the SU(2)/sub L/ x SU(2)/sub R/ symmetry of the Higgs sector is preserved, these effects are found to be small, of the order of the square of the gauge coupling times logarithms (but not powers) of the Higgs-boson mass divided by the W mass. We work in the context of a simplified model with gauge group SU(2)/sub L/; the extension to SU(2)/sub L/ x U(1) is briefly discussed

  19. 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

  20. 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...

  1. 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...

  2. 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.

  3. 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

  4. 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.

  5. 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...

  6. Rater agreement in lung scintigraphy

    International Nuclear Information System (INIS)

    Christiansen, F.; Andersson, T.; Rydman, H.; Qvarner, N.; Maare, K.

    1996-01-01

    Purpose: The PIOPED criteria in their original and revised forms are today's standards in the interpretation of ventilation-perfusion scintigraphy. When the PIOPED criteria are used by experienced raters with training in consensus interpretation, the agreement rates have been demonstrated to be excellent. Our purpose was to investigate the rates of agreement between 2 experienced raters from different hospitals who had no training in consensus interpretation. Material and Methods: The 2 raters investigated a population of 195 patients. This group included 72 patients from a previous study who had an intermediate probability of pulmonary embolism and who had also been examined by pulmonary angiography. Results: The results demonstrated moderate agreement rates with a kappa value of 0.54 (0.45-0.63 in a 95% confidence interval), which is similar to the kappa value of the PIOPED study but significantly lower than the kappa values of agreement rates among consensus-trained raters. There was a low consistency in the intermediate probability category, with a proportional agreement rate of 0.39 between the experienced raters. Conclusion: The moderate agreement rates between raters from different hospitals make it difficult to compare study populations of a certain scintigraphic category in different hospitals. Further investigations are mandatory for accurate diagnosis when the scintigrams are in the category of intermediate probability of pulmonary embolism. (orig.)

  7. Trade agreements, domestic environmental regulation, and transboundary pollution

    Energy Technology Data Exchange (ETDEWEB)

    Lai, Yu-Bong; Hu, Chia-Hsien [Department of Public Finance, National Taipei University (China)

    2008-05-15

    This paper investigates a second-best trade agreement between two countries that takes the distortion arising from their non-coordinated environmental policies into consideration. In a reciprocal-markets model with bidirectional transboundary pollution, we find that if the transboundary pollution is sufficiently strong, the second-best trade agreement requires that both countries subsidize the imported goods whose consumption gives rise to pollution. We also find that a bilateral tariff reduction is beneficial to the global environment. (author)

  8. Trade agreements, domestic environmental regulation, and transboundary pollution

    International Nuclear Information System (INIS)

    Lai, Yu-Bong; Hu, Chia-Hsien

    2008-01-01

    This paper investigates a second-best trade agreement between two countries that takes the distortion arising from their non-coordinated environmental policies into consideration. In a reciprocal-markets model with bidirectional transboundary pollution, we find that if the transboundary pollution is sufficiently strong, the second-best trade agreement requires that both countries subsidize the imported goods whose consumption gives rise to pollution. We also find that a bilateral tariff reduction is beneficial to the global environment. (author)

  9. Simulation of weak and strong Langmuir collapse regimes

    International Nuclear Information System (INIS)

    Hadzievski, L.R.; Skoric, M.M.; Kono, M.; Sato, T.

    1998-01-01

    In order to check the validity of the self-similar solutions and the existence of weak and strong collapse regimes, direct two dimensional simulation of the time evolution of a Langmuir soliton instability is performed. Simulation is based on the Zakharov model of strong Langmuir turbulence in a weakly magnetized plasma accounting for the full ion dynamics. For parameters considered, agreement with self-similar dynamics of the weak collapse type is found with no evidence of the strong Langmuir collapse. (author)

  10. 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.

  11. CHARACTERISTICS OF MANAGED ENTRY AGREEMENTS IN AUSTRALIA.

    Science.gov (United States)

    Robinson, Maxine F; Mihalopoulos, Cathrine; Merlin, Tracy; Roughead, Elizabeth

    2018-01-01

    Australia relies on managed entry agreements (MEAs) for many medicines added to the national Pharmaceutical Benefits Scheme (PBS). Previous studies of Australian MEAs examined public domain documents and were not able to provide a comprehensive assessment of the types and operation of MEAs. This study used government documents approved for release to examine the implementation and administration of MEAs implemented January 2012 to May 2016. We accessed documents for medicines with MEAs on the PBS between January 2012 and May 2016. Data were extracted on Anatomical Therapeutic Classification (ATC), type of MEA (financial, financial with outcomes, outcomes, and subcategories within each group), implementation and administration methods, source of MEA recommendation, and type of economic analysis. Of all medication indication pairs (MIPs) recommended for listing, one-third had MEAs implemented. Our study of eighty-seven MIPs had 170 MEAs in place. The Government's expert health technology assessment (HTA) committee recommended MEAs for 90 percent of the eighty-seven MIPs. A total of 81 percent of MEAs were simple financial agreements: the majority either discounts (32 percent) or reimbursement caps (43 percent). Outcome-based MEAs were least common (5 percent). Ninety-two percent of MEAs were implemented and operated through legal agreements. Approximately half of the MIPs were listed on the basis of accepted claims of cost-minimization. Forty-nine percent of medicines were in ATC L group. Advice from HTA evaluations strongly influences the implementation of ways to manage uncertainties while providing access to medicines. The government relied primarily on simple financial agreements for the managed entry of medicines for which there were perceived risks.

  12. 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.

  13. MRMC analysis of agreement studies

    Science.gov (United States)

    Gallas, Brandon D.; Anam, Amrita; Chen, Weijie; Wunderlich, Adam; Zhang, Zhiwei

    2016-03-01

    The purpose of this work is to present and evaluate methods based on U-statistics to compare intra- or inter-reader agreement across different imaging modalities. We apply these methods to multi-reader multi-case (MRMC) studies. We measure reader-averaged agreement and estimate its variance accounting for the variability from readers and cases (an MRMC analysis). In our application, pathologists (readers) evaluate patient tissue mounted on glass slides (cases) in two ways. They evaluate the slides on a microscope (reference modality) and they evaluate digital scans of the slides on a computer display (new modality). In the current work, we consider concordance as the agreement measure, but many of the concepts outlined here apply to other agreement measures. Concordance is the probability that two readers rank two cases in the same order. Concordance can be estimated with a U-statistic and thus it has some nice properties: it is unbiased, asymptotically normal, and its variance is given by an explicit formula. Another property of a U-statistic is that it is symmetric in its inputs; it doesn't matter which reader is listed first or which case is listed first, the result is the same. Using this property and a few tricks while building the U-statistic kernel for concordance, we get a mathematically tractable problem and efficient software. Simulations show that our variance and covariance estimates are unbiased.

  14. 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...

  15. 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

  16. 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...

  17. 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...

  18. 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

  19. EPA perspective on federal facility agreements

    International Nuclear Information System (INIS)

    Grundler, C.

    1988-01-01

    Although DOE's image with Congress and the media concerning environmental compliance may be poor, EPA sees the Department's recent attitude toward the environment as good. DOE and EPA must continue to move forward. In particular, EPA would like to emphasize less study of a problem and more clean-up. Strong, enforceable agreements will allow this goal to be met by letting EPA take more risks in its decision making. Currently EPA is developing an enforcement strategy for Federal facilities. This strategy will address identifying Federal facilities of concern, increasing enforcement and compliance monitoring activities at those facilities, implementing the model agreements, resource planning, and the establishment of an Agency Management System for Federal facilities. There are over 1000 Federal facilities which are listed on the EPA compliance docket. Over 200 Federal facilities are expected to be included on the NPL. Increased EPA attention may increase the ability of the various Federal agencies to obtain the necessary funding. Another subject being addressed by EPA is the liability of government contractors under the environmental statutes. The Agency is developing a GoCo enforcement strategy. In the hazardous waste enforcement program, three criteria are being considered for determining when to proceed against a contractor: Degree of contractor control over the hazardous waste management activity. Who is actually performing the work, and Degree of Departmental cooperation

  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. Instabilities in strongly coupled plasmas

    CERN Document Server

    Kalman, G J

    2003-01-01

    The conventional Vlasov treatment of beam-plasma instabilities is inappropriate when the plasma is strongly coupled. In the strongly coupled liquid state, the strong correlations between the dust grains fundamentally affect the conditions for instability. In the crystalline state, the inherent anisotropy couples the longitudinal and transverse polarizations, and results in unstable excitations in both polarizations. We summarize analyses of resonant and non-resonant, as well as resistive instabilities. We consider both ion-dust streaming and dust beam-plasma instabilities. Strong coupling, in general, leads to an enhancement of the growth rates. In the crystalline phase, a resonant transverse instability can be excited.

  2. 48 CFR 1642.7001 - Management agreement.

    Science.gov (United States)

    2010-10-01

    ... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION CONTRACT MANAGEMENT CONTRACT ADMINISTRATION Management Agreement (in Lieu of Novation Agreement) 1642.7001 Management agreement. When it is in the best interest of... day-to-day performance of the contract. Examples of situations in which a Management Agreement may be...

  3. 76 FR 63618 - Notice of Agreements Filed

    Science.gov (United States)

    2011-10-13

    ...; Washington, DC 20036. Synopsis: The amendment removes Korea from the geographic scope of them agreement and... geographic scope of the Agreement to include Taiwan. The parties requested expedited review. Agreement No... and Korea, China, Taiwan, Thailand, Vietnam, and Singapore. Agreement No.: 012138. Title: CSAV/CCNI...

  4. 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...

  5. 76 FR 553 - Notice of Agreements Filed

    Science.gov (United States)

    2011-01-05

    ... obsolete language on the duration of Agreement, and changes the name and restates the Agreement. By Order... agreement's governing board and would update the corporate addresses of American President Lines, Ltd.; APL.... as a party to the agreement and updates the corporate addresses of American President Lines, Ltd...

  6. 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...

  7. 48 CFR 2831.109 - Advance agreements.

    Science.gov (United States)

    2010-10-01

    ... proposed agreement. The approved determination will be placed in the contract file. (c) All advance... the agreements. Advance agreements will be signed by both the contractor and the contracting officer, and made a part of the contract file. Copies of executed advance agreements will be distributed to the...

  8. CEC/NRPB Association Agreement

    International Nuclear Information System (INIS)

    DeBeger, D.

    1993-01-01

    In January 1990 the National Radiological Protection Board signed an 'Agreement of Association' with the European Atomic Energy Community, represented by the Commission of the European Communities, to carry out research work in fields covered by the Radiation Protection Research Programme. Under the terms of the contract the Board assumed overall responsibility for the coordination of work involving a number of European organisations, 25 in total and covering 9 countries stretching from Greece to Sweden. The contract provided for funding of research work relating to the assessment of human exposure to natural, medical and occupational radiation and the associated risks. (Author)

  9. Malignant renal cysts: Diagnostic performance and strong predictors at MDCT

    International Nuclear Information System (INIS)

    Kim, Dae Yoon; Kim, Jeong Kon; Cho, Kyoung-Sik; Min, Gyeong-Eun; Ahn, Han-Jong

    2010-01-01

    Background: Utilization of multidetector-row CT (MDCT) is anticipated to improve the diagnostic accuracy and reliability for determining malignant cysts. Purpose: To assess the diagnostic accuracy, interobserver agreement, benefit of consensus reading, and strong predictors of malignancy in determining malignant cystic renal masses at MDCT. Material and Methods: Two radiologists independently rated the probability of malignancy at MDCT in 72 benign and 53 malignant cysts. The accuracy and interobserver agreement for determining malignant cysts were evaluated. The strong predictors of malignancy were determined, and in patients with interobserver disagreement for determining malignant cysts, consensus readings were performed. Results: Az value of the two readers was 0.905-0.936 and the sensitivity and specificity were 85-89% and 83-93%, respectively. The overall interobserver agreement for determining the malignant cyst was good as the κ value was 0.696 (% agreement, 61% (76/125)). Thickened irregular wall, thickened irregular septa, and enhancing soft tissue component were strong predictors for malignancy with both readers. In the 17 patients with interobserver disagreement for determining malignant cysts, the sensitivity was improved from 38-63% to 89% by the consensus reading. Conclusion: At MDCT, some false negative decisions for determining malignant cysts can be corrected by consensus reading, and thickened irregular septa, thickened irregular wall, and enhancing soft tissue component are the strong predictors of malignant cysts

  10. Short proofs of strong normalization

    OpenAIRE

    Wojdyga, Aleksander

    2008-01-01

    This paper presents simple, syntactic strong normalization proofs for the simply-typed lambda-calculus and the polymorphic lambda-calculus (system F) with the full set of logical connectives, and all the permutative reductions. The normalization proofs use translations of terms and types to systems, for which strong normalization property is known.

  11. 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

  12. 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...

  13. Strongly Correlated Electron Systems: An Operatorial Perspective

    Science.gov (United States)

    Di Ciolo, Andrea; Avella, Adolfo

    2018-05-01

    We discuss the operatorial approach to the study of strongly correlated electron systems and show how the exact solution of target models on small clusters chosen ad-hoc (minimal models) can suggest very efficient bulk approximations. We use the Hubbard model as case study (target model) and we analyze and discuss the crucial role of spin fluctuations in its 2-site realization (minimal model). Accordingly, we devise a novel three-pole approximation for the 2D case, including in the basic field an operator describing the dressing of the electronic one by the nearest-neighbor spin-fluctuations. Such a solution is in very good agreement with the exact one in the minimal model (2-site case) and performs very well once compared to advanced (semi-)numerical methods in the 2D case, being by far less computational-resource demanding.

  14. Electromagnetic radiation from strong Langmuir turbulence

    International Nuclear Information System (INIS)

    Akimoto, K.; Rowland, H.L.; Papadopoulos, K.

    1988-01-01

    A series of computer simulations is reported showing the generation of electromagnetic radiation by strong Langmuir turbulence. The simulations were carried out with a fully electromagnetic 2 1/2 -dimensional fluid code. The radiation process takes place in two stages that reflect the evolution of the electrostatic turbulence. During the first stage while the electrostatic turbulence is evolving from an initial linear wave packet into a planar soliton, the radiation is primarily at ω/sub e/. During the second stage when transverse instabilities lead to the collapse and dissipation of the solitons, 2ω/sub e/ and ω/sub e/ radiation are comparable, and 3ω/sub e/ is also present. The radiation power at ω = 2ω/sub e/ is in good agreement with theoretical predictions for electromagnetic emissions by collapsing solitons

  15. Strong correlation effects on surfaces of topological insulators via holography

    Science.gov (United States)

    Seo, Yunseok; Song, Geunho; Sin, Sang-Jin

    2017-07-01

    We investigate the effects of strong correlation on the surface state of a topological insulator (TI). We argue that electrons in the regime of crossover from weak antilocalization to weak localization are strongly correlated, and calculate the magnetotransport coefficients of TIs using the gauge-gravity principle. Then, we examine the magnetoconductivity (MC) formula and find excellent agreement with the data of chrome-doped Bi2Te3 in the crossover regime. We also find that the cusplike peak in MC at low doping is absent, which is natural since quasiparticles disappear due to the strong correlation.

  16. The Brazil agreement - quo vadis

    International Nuclear Information System (INIS)

    Hossner, R.

    1981-01-01

    After an analysis of the power requirements of Brazil as well as of the options for covering these requirements an important nuclear power program for peaceful uses was decided. It is performed on the basis of a bilateral agreement between Brazil and the Federal Republic of Germany of 1975 by co-operation between the German and the Brazilian industry. German firms make their know-how available as well as experts for a limited period of time, in order to establish during about 20 years an independent Brazilian infrastructure for nuclear power plants and their requirements, and to realize the transfer of technology which at the same time shall transmit impulses to the industrial development of the country. (orig.) [de

  17. Implementation of nuclear reduction agreements

    International Nuclear Information System (INIS)

    Scheinman, L.

    1994-01-01

    The collapse of the Soviet Union not only created a new political environment conductive to arms control and disarmament. It also raised unique and unprecedent non-proliferation problems which bear on the implementation of Start I and even on the Non-proliferation treaty insofar as a failure to rein in Ukraine would create a case of instant proliferation and raise questions about whether somehow Russia as a successor of the Soviet Union failed to meet its Non-proliferation Treaty obligation not to 'assist' any other state in acquiring nuclear weapons. The significance of implementing the agreements concerned with non-proliferation, production of highly enriched uranium outside IAEA safeguards, transparency relevance to the international arena, particularly to nuclear issues are discussed as crucial to progress towards a more stable and secure world order. The importance of the Non-proliferation Treaty extension Conference is underlined

  18. Validating the Danish adaptation of the World Health Organization's International Classification for Patient Safety classification of patient safety incident types

    DEFF Research Database (Denmark)

    Mikkelsen, Kim Lyngby; Thommesen, Jacob; Andersen, Henning Boje

    2013-01-01

    Objectives Validation of a Danish patient safety incident classification adapted from the World Health Organizaton's International Classification for Patient Safety (ICPS-WHO). Design Thirty-three hospital safety management experts classified 58 safety incident cases selected to represent all types.......513 (range: 0.193–0.804). Kappa and ICC showed high correlation (r = 0.99). An inverse correlation was found between the prevalence of type and inter-rater reliability. Results are discussed according to four factors known to determine the inter-rater agreement: skill and motivation of raters; clarity...

  19. 48 CFR 225.403 - World Trade Organization Government Procurement Agreement and Free Trade Agreements.

    Science.gov (United States)

    2010-10-01

    ... 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... Government Procurement Agreement, acquire only U.S.-made, qualifying country, or designated country end...

  20. 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

  1. Caviton dynamics in strong Langmuir turbulence

    Science.gov (United States)

    DuBois, Don; Rose, Harvey A.; Russell, David

    1990-01-01

    Recent studies based on long time computer simulations of Langmuir turbulence as described by Zakharov's model will be reviewed. These show that for strong to moderate ion sound damping the turbulent energy is dominantly in non-linear "caviton" excitations which are localized in space and time. A local caviton model will be presented which accounts for the nucleation-collapse-burnout cycles of individual cavitons as well as their space-time correlations. This model is in detailed agreement with many features of the electron density fluctuation spectra in the ionosphere modified by powerful HF waves as measured by incoherent scatter radar. Recently such observations have verified a prediction of the theory that "free" Langmuir waves are emitted in the caviton collapse process. These observations and theoretical considerations also strongly imply that cavitons in the heated ionosphere, under certain conditions, evolve to states in which they are ordered in space and time. The sensitivity of the high frequency Langmuir field dynamics to the low frequency ion density fluctuations and the related caviton nucleation process will be discussed.

  2. Caviton dynamics in strong Langmuir turbulence

    International Nuclear Information System (INIS)

    DuBois, D.; Rose, H.A.; Russell, D.

    1990-01-01

    Recent studies based on long time computer simulations of Langmuir turbulence as described by Zakharov's model will be reviewed. These show that for strong to moderate ion sound damping the turbulent energy is dominantly in non-linear ''caviton'' excitations which are localized in space and time. A local caviton model will be presented which accounts for the nucleation-collapse-burnout cycles of individual cavitons as well as their space-time correlations. This model is in detailed agreement with many features of the electron density fluctuation spectra in the ionosphere modified by powerful HF waves as measured by incoherent scatter radar. Recently such observations have verified a prediction of the theory that ''free'' Langmuir waves are emitted in the caviton collapse process. These observations and theoretical considerations also strongly imply that cavitons in the heated ionosphere, under certain conditions, evolve to states in which they are ordered in space and time. The sensitivity of the high frequency Langmuir field dynamics to the low frequency ion density fluctuations and the related caviton nucleation process will be discussed. (orig.)

  3. Caviton dynamics in strong Langmuir turbulence

    International Nuclear Information System (INIS)

    DuBois, D.; Rose, H.A.; Russell, D.

    1989-01-01

    Recent studies based on long time computer simulations of Langmuir turbulence as described by Zakharov's model will be reviewed. These show that for strong to moderate ion sound samping the turbulent energy is dominantly in nonlinear ''caviton'' excitations which are localized in space and time. A local caviton model will be presented which accounts for the nucleation-collapse-burnout cycles of individual cavitons as well as their space-time correlations. This model is in detailed agreement with many features of the electron density fluctuation spectra in the ionosphere modified by powerful hf waves as measured by incoherent scatter radar. Recently such observations have verified a prediction of the theory that ''free'' Langmuir waves are emitted in the caviton collapse process. These observations and theoretical considerations also strongly imply that cavitons in the heated ionosphere, under certain conditions, evolve to states in which they are ordered in space and time. The sensitivity of the high frequency Langmuir field dynamics to the low frequency ion density fluctuations and the related caviton nucleation process will be discussed. 40 refs., 19 figs

  4. Strong correlations in few-fermion systems

    Energy Technology Data Exchange (ETDEWEB)

    Bergschneider, Andrea

    2017-07-26

    In this thesis, I report on the deterministic preparation and the observation of strongly correlated few-fermion systems in single and double-well potentials. In a first experiment, we studied a system of one impurity interacting with a number of majority atoms which we prepared in a single potential well in the one-dimensional limit. With increasing number of majority particles, we observed a decrease in the quasi-particle residue which is in agreement with expectations from the Anderson orthogonality catastrophe. In a second experiment, we prepared two fermions in a double-well potential which represents the fundamental building block of the Fermi-Hubbard model. By increasing the repulsion between the two fermions, we observed the crossover into the antiferromagnetic Mott-insulator regime. Furthermore, I describe a new imaging technique, which allows spin-resolved single-atom detection both in in-situ and in time-of-flight. We use this technique to investigate the emergence of momentum correlations of two repulsive fermions in the ground state of the double well. With the methods developed in this thesis, we have established a framework for quantum simulation of strongly correlated many-body systems in tunable potentials.

  5. 23 CFR 635.115 - Agreement estimate.

    Science.gov (United States)

    2010-04-01

    ... CONSTRUCTION AND MAINTENANCE Contract Procedures § 635.115 Agreement estimate. (a) Following the award of contract, an agreement estimate based on the contract unit prices and estimated quantities shall be...

  6. 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...

  7. 76 FR 72408 - Notice of Agreements Filed

    Science.gov (United States)

    2011-11-23

    .... Synopsis: The amendment adds Korea to the geographic scope of the agreement and removes some historical... agreement authorizes the parties to exchange space in the trade between China, Singapore, Vietnam and the U...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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.

  14. 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)

  15. 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...

  16. 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...

  17. 40 CFR 35.3010 - Delegation agreement.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Delegation agreement. 35.3010 Section... STATE AND LOCAL ASSISTANCE Construction Grants Program Delegation to States § 35.3010 Delegation agreement. (a) Before execution of the delegation agreement, the Regional Administrator must determine that...

  18. 23 CFR 140.606 - Project agreements.

    Science.gov (United States)

    2010-04-01

    ... Reimbursement for Bond Issue Projects § 140.606 Project agreements. Project Agreements, Form PR-2, shall be... 23 Highways 1 2010-04-01 2010-04-01 false Project agreements. 140.606 Section 140.606 Highways... projects. 1 The text of FHWA Form PR-2 is found in 23 CFR part 630, subpart C, appendix A. ...

  19. 75 FR 78245 - Notice of Agreements Filed

    Science.gov (United States)

    2010-12-15

    ... Mexico, Panama, Jamaica, Colombia, and the Far East, including China, Hong Kong, and Korea. Agreement No.../CSAV Slot Swap Agreement. Parties: China Shipping Container Lines Co. Ltd., China Shipping Container... trade between United States ports and ports in China and Vietnam. Agreement No.: 201208-001. Title...

  20. 76 FR 67440 - Market Access Agreement

    Science.gov (United States)

    2011-11-01

    ... FARM CREDIT ADMINISTRATION Market Access Agreement AGENCY: Farm Credit Administration. ACTION: Notice of Draft Second Amended and Restated Market Access Agreement; request for comments. SUMMARY: The... Market Access Agreement (the ``Restated MAA'') is entered into among AgFirst Farm Credit Bank, AgriBank...

  1. 75 FR 76729 - Market Access Agreement

    Science.gov (United States)

    2010-12-09

    ... FARM CREDIT ADMINISTRATION Market Access Agreement AGENCY: Farm Credit Administration. ACTION: Notice of approval of the draft amendment to the amended and restated market access agreement. SUMMARY... Credit Bank of Wichita and the Western Farm Credit Bank under Section 7.12 of the Market Access Agreement...

  2. 50 CFR 81.3 - Cooperative Agreement.

    Science.gov (United States)

    2010-10-01

    ...) FINANCIAL ASSISTANCE-WILDLIFE SPORT FISH RESTORATION PROGRAM CONSERVATION OF ENDANGERED AND THREATENED SPECIES OF FISH, WILDLIFE, AND PLANTS-COOPERATION WITH THE STATES § 81.3 Cooperative Agreement. Upon... Project Agreement can be approved for endangered or threatened species projects. A cooperative agreement...

  3. 43 CFR 24.5 - International agreements.

    Science.gov (United States)

    2010-10-01

    ... WILDLIFE POLICY: STATE-FEDERAL RELATIONSHIPS § 24.5 International agreements. (a) International conventions... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false International agreements. 24.5 Section 24... shall be to recommend that the United States negotiate and accede to only those international agreements...

  4. 75 FR 14159 - Notice of Agreements Filed

    Science.gov (United States)

    2010-03-24

    ... parties to exchange slots in the trade between U.S. East Coast ports and ports in Turkey. Agreement No.: 201048-005. Title: Lease and Operating Agreement between Philadelphia Regional Port Authority and... FEDERAL MARITIME COMMISSION Notice of Agreements Filed The Commission hereby gives notice of the...

  5. 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...

  6. Strong interactions at high energy

    International Nuclear Information System (INIS)

    Anselmino, M.

    1995-01-01

    Spin effects in strong interaction high energy processes are subtle phenomena which involve both short and long distance physics and test perturbative and non perturbative aspects of QCD. Moreover, depending on quantities like interferences between different amplitudes and relative phases, spin observables always test a theory at a fundamental quantum mechanical level; it is then no surprise that spin data are often difficult to accommodate within the existing models. A report is made on the main issues and contributions discussed in the parallel Session on the open-quote open-quote Strong interactions at high energy close-quote close-quote in this Conference. copyright 1995 American Institute of Physics

  7. Strong-field dissociation dynamics

    International Nuclear Information System (INIS)

    DiMauro, L.F.; Yang, Baorui.

    1993-01-01

    The strong-field dissociation behavior of diatomic molecules is examined under two distinctive physical scenarios. In the first scenario, the dissociation of the isolated hydrogen and deuterium molecular ions is discussed. The dynamics of above-threshold dissociation (ATD) are investigated over a wide range of green and infrared intensities and compared to a dressed-state model. The second situation arises when strong-field neutral dissociation is followed by ionization of the atomic fragments. The study results in a direct measure of the atomic fragment's ac-Stark shift by observing the intensity-dependent shifts in the electron or nuclear fragment kinetic energy. 8 figs., 14 refs

  8. 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.

  9. 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...... of a discrete random variable....

  10. Strong coupling electroweak symmetry breaking

    International Nuclear Information System (INIS)

    Barklow, T.L.; Burdman, G.; Chivukula, R.S.

    1997-04-01

    The authors review models of electroweak symmetry breaking due to new strong interactions at the TeV energy scale and discuss the prospects for their experimental tests. They emphasize the direct observation of the new interactions through high-energy scattering of vector bosons. They also discuss indirect probes of the new interactions and exotic particles predicted by specific theoretical models

  11. Strong coupling electroweak symmetry breaking

    Energy Technology Data Exchange (ETDEWEB)

    Barklow, T.L. [Stanford Linear Accelerator Center, Menlo Park, CA (United States); Burdman, G. [Univ. of Wisconsin, Madison, WI (United States). Dept. of Physics; Chivukula, R.S. [Boston Univ., MA (United States). Dept. of Physics

    1997-04-01

    The authors review models of electroweak symmetry breaking due to new strong interactions at the TeV energy scale and discuss the prospects for their experimental tests. They emphasize the direct observation of the new interactions through high-energy scattering of vector bosons. They also discuss indirect probes of the new interactions and exotic particles predicted by specific theoretical models.

  12. The colours of strong interaction

    International Nuclear Information System (INIS)

    1995-01-01

    The aim of this session is to draw a consistent framework about the different ways to consider strong interaction. A large part is dedicated to theoretical work and the latest experimental results obtained at the first electron collider HERA are discussed. (A.C.)

  13. Strong cosmic censorship and the strong curvature singularities

    International Nuclear Information System (INIS)

    Krolak, A.

    1987-01-01

    Conditions are given under which any asymptotically simple and empty space-time that has a partial Cauchy surface with an asymptotically simple past is globally hyperbolic. It is shown that this result suggests that the Cauchy horizons of the type occurring in Reissner--Nordstroem and Kerr space-times are unstable. This in turn gives support for the validity of the strong cosmic censorship hypothesis

  14. Translation, cultural adaptation and psychometric evaluation of the Leganés cognitive test in a low educated elderly Brazilian population

    Directory of Open Access Journals (Sweden)

    Vescia Vieira de Alencar Caldas

    2012-01-01

    Full Text Available OBJECTIVE: To validate the Leganés cognitive test (LCT for cognitive screening in low educated elderly Brazilians. METHODS: The study sample was composed of 59 elderly residents from the city of Santa Cruz, in Brazil, with low schooling levels. Reliability was analyzed with a two-day interval between assessments, and concurrent validity was assessed using the Mini Mental State Examination (MMSE. RESULTS: According to the LCT, the prevalence of dementia was 11.8%. The scale items showed a moderate to strong correlation between domains (p<0.01, and inter-rater reliability exhibited ICC=0.81, 95%CI=0.72-0.88. The factor analysis resulted in two factors: memory and orientation. Interscale agreement was considered poor (k=-0.02, supporting the hypothesis of an educational impact on final MMSE scores. CONCLUSION: The results suggest that LCT has acceptable levels of reliability for use in low-educated Brazilian elderly.

  15. 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...... they contain. These results indicate that the parties play an important role in crafting the substance of their agreements. However, we also found that the wording of the agreements is characterised by legal and bureaucratic language to the extent that people without legal training find it difficult to read...

  16. 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...

  17. 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...

  18. 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...

  19. The Health Informatics Trial Enhancement Project (HITE: Using routinely collected primary care data to identify potential participants for a depression trial

    Directory of Open Access Journals (Sweden)

    Lyons Ronan A

    2010-04-01

    Full Text Available Abstract Background Recruitment to clinical trials can be challenging. We identified anonymous potential participants to an existing pragmatic randomised controlled depression trial to assess the feasibility of using routinely collected data to identify potential trial participants. We discuss the strengths and limitations of this approach, assess its potential value, report challenges and ethical issues encountered. Methods Swansea University's Health Information Research Unit's Secure Anonymised Information Linkage (SAIL database of routinely collected health records was interrogated, using Structured Query Language (SQL. Read codes were used to create an algorithm of inclusion/exclusion criteria with which to identify suitable anonymous participants. Two independent clinicians rated the eligibility of the potential participants' identified. Inter-rater reliability was assessed using the kappa statistic and inter-class correlation. Results The study population (N = 37263 comprised all adults registered at five general practices in Swansea UK. Using the algorithm 867 anonymous potential participants were identified. The sensitivity and specificity results > 0.9 suggested a high degree of accuracy from the algorithm. The inter-rater reliability results indicated strong agreement between the confirming raters. The Intra Class Correlation Coefficient (Cronbach's Alpha > 0.9, suggested excellent agreement and Kappa coefficient > 0.8; almost perfect agreement. Conclusions This proof of concept study showed that routinely collected primary care data can be used to identify potential participants for a pragmatic randomised controlled trial of folate augmentation of antidepressant therapy for the treatment of depression. Further work will be needed to assess generalisability to other conditions and settings and the inclusion of this approach to support Electronic Enhanced Recruitment (EER.

  20. 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.

  1. 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.

  2. String dynamics at strong coupling

    International Nuclear Information System (INIS)

    Hull, C.M.

    1996-01-01

    The dynamics of superstring, supergravity and M-theories and their compactifications are probed by studying the various perturbation theories that emerge in the strong and weak-coupling limits for various directions in coupling constant space. The results support the picture of an underlying non-perturbative theory that, when expanded perturbatively in different coupling constants, gives different perturbation theories, which can be perturbative superstring theories or superparticle theories. The p-brane spectrum is considered in detail and a criterion found to establish which p-branes govern the strong-coupling dynamics. In many cases there are competing conjectures in the literature, and this analysis decides between them. In other cases, new results are found. The chiral 6-dimensional theory resulting from compactifying the type IIB string on K 3 is studied in detail and it is found that certain strong-coupling limits appear to give new theories, some of which hint at the possibility of a 12-dimensional origin. (orig.)

  3. Correlation between obesity and fat-infiltrated axillary lymph nodes visualized on mammography.

    Science.gov (United States)

    diFlorio Alexander, Roberta M; Haider, Steffen J; MacKenzie, Todd; Goodrich, Martha E; Weiss, Julie; Onega, Tracy

    2018-01-05

    Using screening mammography, this study investigated the association between obesity and axillary lymph node (LN) size and morphology. We conducted a retrospective review of 188 females who underwent screening mammography at an academic medical centre. Length and width of the LN and hilum were measured in the largest, mammographically visible axillary node. The hilo-cortical ratio (HCR) was calculated as the hilar width divided by the cortical width. Measurements were performed by a board certified breast radiologist and a resident radiology physician. Inter-rater agreement was assessed with Pearson correlation coefficient. We performed multivariable regression analysis for associations of LN measurements with body mass index (BMI), breast density and age. There was a strong association between BMI and LN dimensions, hilum dimensions and HCR (p < 0.001 for all metrics). There was no significant change in cortex width with increasing BMI (p = 0.15). Increases in LN length and width were found with increasing BMI [0.6 mm increase in length per unit BMI, 95% CI (0.4-0.8), p < 0.001 and0.3 mm increase in width per unit BMI, 95% CI(0.2-0.4), p < 0.001, respectively]. Inter-rater reliability for lymph node and hilum measurements was 0.57-0.72. We found a highly significant association between increasing BMI and axillary LN dimensions independent of age and breast density with strong interobserver agreement. The increase in LN size was driven by expansion of the LN hilum secondary to fat infiltration. Advances in knowledge: This preliminary work determined a relationship between fat infiltrated axillary lymph nodes and obesity.

  4. Forecasting the Student-Professor Matches That Result in Unusually Effective Teaching

    Science.gov (United States)

    Gross, Jennifer; Lakey, Brian; Lucas, Jessica L.; LaCross, Ryan; Plotkowski, Andrea R.; Winegard, Bo

    2015-01-01

    Background: Two important influences on students' evaluations of teaching are relationship and professor effects. Relationship effects reflect unique matches between students and professors such that some professors are unusually effective for some students, but not for others. Professor effects reflect inter-rater agreement that some professors…

  5. Seven Reliability Indices for High-Stakes Decision Making: Description, Selection, and Simple Calculation

    Science.gov (United States)

    Smith, Stacey L.; Vannest, Kimberly J.; Davis, John L.

    2011-01-01

    The reliability of data is a critical issue in decision-making for practitioners in the school. Percent Agreement and Cohen's kappa are the two most widely reported indices of inter-rater reliability, however, a recent Monte Carlo study on the reliability of multi-category scales found other indices to be more trustworthy given the type of data…

  6. 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.

  7. How Effective Are Self- and Peer Assessment of Oral Presentation Skills Compared with Teachers' Assessments?

    Science.gov (United States)

    De Grez, Luc; Valcke, Martin; Roozen, Irene

    2012-01-01

    Assessment of oral presentation skills is an underexplored area. The study described here focuses on the agreement between professional assessment and self- and peer assessment of oral presentation skills and explores student perceptions about peer assessment. The study has the merit of paying attention to the inter-rater reliability of the…

  8. The Dutch Activity Card Sort institutional version was reproducible, but biased against women

    NARCIS (Netherlands)

    Jong, A. M.; van Nes, F. A.; Lindeboom, R.

    2012-01-01

    Purpose: To examine the reproducibility of the institutional version of the Dutch Activity Card Sort (ACS-NL) and the possible presence of gender bias. Methods: Older rehabilitation inpatients (N = 52) were included. Intra-and inter-rater agreement for the ACS-NL total and subscale scores was

  9. The Dutch Activity Card Sort institutional version was reproducible, but biased against women

    NARCIS (Netherlands)

    Jong, A. M.; van Nes, F. A.; Lindeboom, R.

    2012-01-01

    PURPOSE: To examine the reproducibility of the institutional version of the Dutch Activity Card Sort (ACS-NL) and the possible presence of gender bias. METHODS: Older rehabilitation inpatients (N = 52) were included. Intra- and inter-rater agreement for the ACS-NL total and subscale scores was

  10. 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,…

  11. Quality control for retinal OCT in multiple sclerosis

    DEFF Research Database (Denmark)

    Schippling, S; Balk, Lj; Costello, F

    2015-01-01

    to provide guidance on the use of validated quality control (QC) criteria for the use of OCT in MS research and clinical trials. METHODS: A prospective multi-centre (n = 13) study. Peripapillary ring scan QC rating of an OCT training set (n = 50) was followed by a test set (n = 50). Inter-rater agreement...

  12. 48 CFR 25.403 - World Trade Organization Government Procurement Agreement and Free Trade Agreements.

    Science.gov (United States)

    2010-10-01

    ... Government Procurement Agreement and Free Trade Agreements. 25.403 Section 25.403 Federal Acquisition... 25.403 World Trade Organization Government Procurement Agreement and Free Trade Agreements. (a... in 25.402(a)(1). The WTO GPA and FTAs specify procurement procedures designed to ensure fairness (see...

  13. 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)

  14. Orbit losses of strongly ICRF-heated ions

    International Nuclear Information System (INIS)

    Anderson, A.; Dillner, Oe.; Lisak, M.

    1992-01-01

    An approximate analytical investigation is made to assess the importance of orbit losses of strongly ICRF-heated minority ions. Explicit expressions for the fraction of lost minority ions are derived and shown to be in good agreement with numerical simulation results. The results indicate that present day ICRF heating power density levels cannot be raised significantly without causing important particle and energy losses due to unconfined particle orbits. 6 refs., 5 figs

  15. Statics and thermodynamics of strongly coupled multicomponent plasmas

    International Nuclear Information System (INIS)

    Rosenfeld, Y.

    1980-01-01

    A description of strongly coupled plasmas, in which the direct correlation functions, c/sub i/j(r), are obtained by simple scaling from a universal function, is derived and found to be in full agreement with available computer simulation data, which it thus extends for arbitrary mixtures. It is thermodynamically consistent with the ''ion-sphere'' charge-averaging prediction for the enhancement factors for nuclear reaction rates, the results for which confirm the universality of the bridge functions for mixtures

  16. 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

  17. 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...

  18. 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.)

  19. Safeguards agreements - Their legal and conceptual basis

    International Nuclear Information System (INIS)

    Sanders, B.; Rainer, R.H.

    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. On the basis of the statutory provisions safeguards principles and procedures have been elaborated. These have been laid down in: The Agency's Safeguards System 1965, extended in 1966 and 1968; and the basis for negotiating safeguards agreements with NNWS pursuant to NPT. 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 ensured through the application of various safeguards measures. Containment and surveillance measures are expected to play an increasingly important role. One of the specific features of NPT Safeguards Agreements is the establishment of national systems of accounting and control of nuclear material. The majority of the agreements concluded under 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 regarding the circumstances under which safeguards should be applied. Thus, the concepts used in the non-NPT safeguards agreements and the Safeguards System document, which is incorporated in these agreements by reference, are in continuous evolution. The Agency's Safeguards System 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 this document, and further provision for notification, inventories and financial matters, legal and political provisions such as sanctions in the case of non-compliance, and privileges and immunities. The paper discusses the

  20. 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

  1. Strong versions of Bell's theorem

    International Nuclear Information System (INIS)

    Stapp, H.P.

    1994-01-01

    Technical aspects of a recently constructed strong version of Bell's theorem are discussed. The theorem assumes neither hidden variables nor factorization, and neither determinism nor counterfactual definiteness. It deals directly with logical connections. Hence its relationship with modal logic needs to be described. It is shown that the proof can be embedded in an orthodox modal logic, and hence its compatibility with modal logic assured, but that this embedding weakens the theorem by introducing as added assumptions the conventionalities of the particular modal logic that is adopted. This weakening is avoided in the recent proof by using directly the set-theoretic conditions entailed by the locality assumption

  2. 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.

  3. Weak consistency and strong paraconsistency

    Directory of Open Access Journals (Sweden)

    Gemma Robles

    2009-11-01

    Full Text Available In a standard sense, consistency and paraconsistency are understood as, respectively, the absence of any contradiction and as the absence of the ECQ (“E contradictione quodlibet” rule that allows us to conclude any well formed formula from any contradiction. The aim of this paper is to explain the concepts of weak consistency alternative to the standard one, the concepts of paraconsistency related to them and the concept of strong paraconsistency, all of which have been defined by the author together with José M. Méndez.

  4. On the strong CP problem

    Energy Technology Data Exchange (ETDEWEB)

    Dowrick, N.J. (Dept. of Physics, Oxford (United Kingdom)); McDougall, N.A. (National Lab. for High Energy Physics, Tsukuba, Ibaraki (Japan))

    1992-07-09

    We show that two well-known solutions to the strong CP problem, the axion and a massless quark, may be understood in terms of the mechanism recently proposed by Samuel where long-range interactions between topological charges may be responsible for the removal of CP violation. We explain how the axion and a QCD meson (identified as the {eta}' if all quarks are massless) suppress fluctuations in global topological charge by almost identical dynamical although the masses, couplings and relevant length scales are very different. Furthermore, we elucidate the precise origin of the {eta}' mass. (orig.).

  5. 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.

  6. Estimation of strong ground motion

    International Nuclear Information System (INIS)

    Watabe, Makoto

    1993-01-01

    Fault model has been developed to estimate a strong ground motion in consideration of characteristics of seismic source and propagation path of seismic waves. There are two different approaches in the model. The first one is a theoretical approach, while the second approach is a semi-empirical approach. Though the latter is more practical than the former to be applied to the estimation of input motions, it needs at least the small-event records, the value of the seismic moment of the small event and the fault model of the large event

  7. Strong Mechanoluminescence from Oxynitridosilicate Phosphors

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Lin; Xu Chaonan; Yamada, Hiroshi, E-mail: cn-xu@aist.go.jp [National Institute of Advanced Industrial Science and Technology (AIST), 807-1 Shuku, Tosu, Saga 841-0052 (Japan)

    2011-10-29

    We successfully developed a novel Mechanoluminescence (ML) material with water resistance, oxynitridosilicate; BaSi{sub 2}O{sub 2}N{sub 2}: Eu{sup 2+}. The crystal structure, photoluminescence (PL) and ML properties were characterized. The ML of BaSi{sub 2}O{sub 2}N{sub 2}: Eu{sup 2+} is so strong that the blue-green emission can be observed by the naked eyes clearly. In addition, it shows superior water resistance property. No changes were found in the ML intensities during the total water treatment test.

  8. A framework for nuclear agreement and verification

    International Nuclear Information System (INIS)

    Ali, A.

    1991-01-01

    This chapter assesses the prospects for a nuclear agreement between India and Pakistan. The chapter opens with a review of past and present political environments of the two countries. The discussion proceeds to describe the linkage of global arms control agreements, prospects for verification of a Comprehensive Test Ban Treaty, the role of nuclear power in any agreements, the intrusiveness of verification, and possible post-proliferation agreements. Various monitoring and verification technologies are described (mainly satellite oriented). The chapter concludes with an analysis of the likelihood of persuading India and Pakistan to agree to a nonproliferation arrangement

  9. 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

  10. 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...

  11. Effective lagrangian for strong interactions

    International Nuclear Information System (INIS)

    Jain, P.

    1988-01-01

    We attempt to construct a realistic phenomenological Lagrangian in order to describe strong interactions. This is in general a very complicated problem and we shall explore its various aspects. We first include the vector mesons by writing down the most general chiral invariant terms proportional to the Levi-Civita symbol ε μναβ . These terms involve three unknown coefficients, which are calculated by using the experimental results of strong interaction processes. We then calculate the static nucleon properties by finding the solitonic excitations of this model. The results turn out to be, as is also the case for most other vector-pseudoscalar Lagrangians, better than the Skyrme model but are still somewhat different from the experiments. Another aspect that we shall study is the incorporation of scale anomaly of QCD into the Skyrme model. We thus introduce a scalar glueball in our Lagrangian. Here we find an interesting result that the effective glue field dynamically forms a bag for the soliton. Depending on the values of the parameters, we get either a deep bag or a shallow bag. However by including the scalar meson, we find that to get realistic scalar sector we must have the shallow bag. Finally we show some intriguing connections between the chiral quark model, in which the nucleon is described as a solitonic excitation, and the ordinary potential binding quark model

  12. 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

  13. Strong Selective Adsorption of Polymers.

    Science.gov (United States)

    Ge, Ting; Rubinstein, Michael

    2015-06-09

    A scaling theory is developed for selective adsorption of polymers induced by the strong binding between specific monomers and complementary surface adsorption sites. By "selective" we mean specific attraction between a subset of all monomers, called "sticky", and a subset of surface sites, called "adsorption sites". We demonstrate that, in addition to the expected dependence on the polymer volume fraction ϕ bulk in the bulk solution, selective adsorption strongly depends on the ratio between two characteristic length scales, the root-mean-square distance l between neighboring sticky monomers along the polymer, and the average distance d between neighboring surface adsorption sites. The role of the ratio l / d arises from the fact that a polymer needs to deform to enable the spatial commensurability between its sticky monomers and the surface adsorption sites for selective adsorption. We study strong selective adsorption of both telechelic polymers with two end monomers being sticky and multisticker polymers with many sticky monomers between sticky ends. For telechelic polymers, we identify four adsorption regimes at l / d 1, we expect that the adsorption layer at exponentially low ϕ bulk consists of separated unstretched loops, while as ϕ bulk increases the layer crosses over to a brush of extended loops with a second layer of weakly overlapping tails. For multisticker chains, in the limit of exponentially low ϕ bulk , adsorbed polymers are well separated from each other. As l / d increases, the conformation of an individual polymer changes from a single-end-adsorbed "mushroom" to a random walk of loops. For high ϕ bulk , adsorbed polymers at small l / d are mushrooms that cover all the adsorption sites. At sufficiently large l / d , adsorbed multisticker polymers strongly overlap. We anticipate the formation of a self-similar carpet and with increasing l / d a two-layer structure with a brush of loops covered by a self-similar carpet. As l / d exceeds the

  14. 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.

  15. Strong growth for Queensland mining

    Energy Technology Data Exchange (ETDEWEB)

    1990-10-01

    The Queensland mining industry experienced strong growth during 1989-90 as shown in the latest statistics released by the Department of Resource Industries. The total value of Queensland mineral and energy production rose to a new record of $5.1 billion, an increase of 16.5% on 1988-89 production. A major contributing factor was a 20.9 percent increase in the value of coal production. While the quantity of coal produced rose only 1.1 percent, the substantial increase in the value of coal production is attributable to higher coal prices negotiated for export contracts. In Australian dollar terms coal, gold, lead, zinc and crude oil on average experienced higher international prices than in the previous year. Only copper and silver prices declined. 3 tabs.

  16. Strong moduli stabilization and phenomenology

    CERN Document Server

    Dudas, Emilian; Mambrini, Yann; Mustafayev, Azar; Olive, Keith A

    2013-01-01

    We describe the resulting phenomenology of string theory/supergravity models with strong moduli stabilization. The KL model with F-term uplifting, is one such example. Models of this type predict universal scalar masses equal to the gravitino mass. In contrast, A-terms receive highly suppressed gravity mediated contributions. Under certain conditions, the same conclusion is valid for gaugino masses, which like A-terms, are then determined by anomalies. In such models, we are forced to relatively large gravitino masses (30-1000 TeV). We compute the low energy spectrum as a function of m_{3/2}. We see that the Higgs masses naturally takes values between 125-130 GeV. The lower limit is obtained from the requirement of chargino masses greater than 104 GeV, while the upper limit is determined by the relic density of dark matter (wino-like).

  17. Strongly interacting W's and Z's

    International Nuclear Information System (INIS)

    Gaillard, M.K.

    1984-01-01

    The study focussed primarily on the dynamics of a strongly interacting W, Z(SIW) sector, with the aim of sharpening predictions for total W, Z yield and W, Z multiplicities expected from WW fusion for various scenarios. Specific issues raised in the context of the general problem of modeling SIW included the specificity of the technicolor (or, equivalently, QCD) model, whether or not a composite scalar model can be evaded, and whether the standard model necessarily implies an I = J = O state (≅ Higgs particle) that is relatively ''light'' (M ≤ hundreds of TeV). The consensus on the last issue was that existing arguments are inconclusive. While the author shall briefly address compositeness and alternatives to the technicolor model, quantitative estimates will be of necessity based on technicolor or an extrapolation of pion data

  18. Uniquely Strongly Clean Group Rings

    Institute of Scientific and Technical Information of China (English)

    WANG XIU-LAN

    2012-01-01

    A ring R is called clean if every element is the sum of an idempotent and a unit,and R is called uniquely strongly clean (USC for short) if every element is uniquely the sum of an idempotent and a unit that commute.In this article,some conditions on a ring R and a group G such that RG is clean are given.It is also shown that if G is a locally finite group,then the group ring RG is USC if and only if R is USC,and G is a 2-group.The left uniquely exchange group ring,as a middle ring of the uniquely clean ring and the USC ring,does not possess this property,and so does the uniquely exchange group ring.

  19. Electrophoresis in strong electric fields.

    Science.gov (United States)

    Barany, Sandor

    2009-01-01

    Two kinds of non-linear electrophoresis (ef) that can be detected in strong electric fields (several hundred V/cm) are considered. The first ("classical" non-linear ef) is due to the interaction of the outer field with field-induced ionic charges in the electric double layer (EDL) under conditions, when field-induced variations of electrolyte concentration remain to be small comparatively to its equilibrium value. According to the Shilov theory, the non-linear component of the electrophoretic velocity for dielectric particles is proportional to the cubic power of the applied field strength (cubic electrophoresis) and to the second power of the particles radius; it is independent of the zeta-potential but is determined by the surface conductivity of particles. The second one, the so-called "superfast electrophoresis" is connected with the interaction of a strong outer field with a secondary diffuse layer of counterions (space charge) that is induced outside the primary (classical) diffuse EDL by the external field itself because of concentration polarization. The Dukhin-Mishchuk theory of "superfast electrophoresis" predicts quadratic dependence of the electrophoretic velocity of unipolar (ionically or electronically) conducting particles on the external field gradient and linear dependence on the particle's size in strong electric fields. These are in sharp contrast to the laws of classical electrophoresis (no dependence of V(ef) on the particle's size and linear dependence on the electric field gradient). A new method to measure the ef velocity of particles in strong electric fields is developed that is based on separation of the effects of sedimentation and electrophoresis using videoimaging and a new flowcell and use of short electric pulses. To test the "classical" non-linear electrophoresis, we have measured the ef velocity of non-conducting polystyrene, aluminium-oxide and (semiconductor) graphite particles as well as Saccharomice cerevisiae yeast cells as a

  20. 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.

  1. 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...

  2. Rater Agreement Indexes for Performance Assessment.

    Science.gov (United States)

    Burry-Stock, Judith A.; And Others

    1996-01-01

    It is argued that interrater agreement is a psychometric property which is theoretically different from classic reliability. Formulas are presented to illustrate a set of algebraically equivalent rater agreement indices that are intended to provide educational and psychological researchers with a practical way to establish a measure of rater…

  3. 7 CFR 3021.620 - Cooperative agreement.

    Science.gov (United States)

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL OFFICER, DEPARTMENT OF AGRICULTURE GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Definitions § 3021.620 Cooperative agreement. Cooperative agreement means an award of financial assistance...

  4. 8 CFR 217.6 - Carrier agreements.

    Science.gov (United States)

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Carrier agreements. 217.6 Section 217.6 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS VISA WAIVER PROGRAM § 217... may notify a carrier of the existence of a basis for termination of a carrier agreement under this...

  5. 48 CFR 16.702 - Basic agreements.

    Science.gov (United States)

    2010-10-01

    ... attachment the required and applicable clauses agreed upon in the basic agreement. A basic agreement is not a... Government to place future contracts or orders with the contractor; or (3) Be used in any manner to restrict... (including reference to each amendment) or by attachment. (2) The contracting officer shall include clauses...

  6. 75 FR 40837 - Notice of Agreements Filed

    Science.gov (United States)

    2010-07-14

    ... filing of the following agreements under the Shipping Act of 1984. Interested parties may submit comments... & Construction Co., Ltd. and Discovery Sun Partnership Space Agreement. Parties: Discovery Sun Partnership and... Discovery Sun Partnership to provide space to Tropical Shipping & Construction Co., Ltd. in the trade...

  7. 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...

  8. 76 FR 77998 - Market Access Agreement

    Science.gov (United States)

    2011-12-15

    ... FARM CREDIT ADMINISTRATION Market Access Agreement AGENCY: Farm Credit Administration. ACTION: Notice of approval of the Draft Second Amended and Restated Market Access Agreement. SUMMARY: The Farm Credit Administration (FCA) announces that it has approved the Draft Second Amended and Restated Market...

  9. 7 CFR 1290.8 - Grant agreements.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Grant agreements. 1290.8 Section 1290.8 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... minimum the following: (1) The projects in the approved State plan. (2) Total amount of Federal financial...

  10. 7 CFR 1291.8 - Grant agreements.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Grant agreements. 1291.8 Section 1291.8 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... minimum the following: (1) The projects in the approved State plan. (2) Total amount of Federal financial...

  11. Agreement Attraction in Comprehension: Representations and Processes

    Science.gov (United States)

    Wagers, Matthew W.; Lau, Ellen F.; Phillips, Colin

    2009-01-01

    Much work has demonstrated so-called attraction errors in the production of subject-verb agreement (e.g., "The key to the cabinets are on the table", [Bock, J. K., & Miller, C. A. (1991). "Broken agreement." "Cognitive Psychology, 23", 45-93]), in which a verb erroneously agrees with an intervening noun. Six self-paced reading experiments examined…

  12. 75 FR 69079 - Notice of Agreements Filed

    Science.gov (United States)

    2010-11-10

    ... World Liner Data Agreement. Parties: A.P. Moller-Maersk A/S; CMA CGM S.A.; Compania Chilena de... from ports in Mexico to the U.S. Atlantic ports. Agreement No.: 012110. Title: Trailer Bridge/HLUSA...

  13. 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...

  14. 5 CFR 1655.12 - Loan agreement.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Loan agreement. 1655.12 Section 1655.12 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD LOAN PROGRAM § 1655.12 Loan agreement. (a) Upon determining that a loan application meets the requirements of this part, the TSP record keeper...

  15. 47 CFR 73.1650 - International agreements.

    Science.gov (United States)

    2010-10-01

    ... Agreements for the Broadcasting Service in Region 2: (i) MF Broadcasting 535-1605 kHz, Rio de Janeiro, 1981. (ii) MF Broadcasting 1605-1705 kHz, Rio de Janeiro, 1988. (3) Bi-lateral Agreements between the United...

  16. 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...

  17. 48 CFR 2131.109 - Advance agreements.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Advance agreements. 2131... PRINCIPLES AND PROCEDURES Applicability 2131.109 Advance agreements. FAR 31.109 is applicable to FEGLI Program contracts, except that precontract costs and nonrecurring costs that exceed $100,000 will not be...

  18. Opening the Black Box of Trade Agreements

    NARCIS (Netherlands)

    Kohl, Tristan; De Lombaerde, Philippe; Saucedo Accosta, Edgar J.

    2017-01-01

    In this chapter the author presents a coding methodology to capture the heterogeneity of trade agreements and to facilitate quantitative analysis departing from qualitative legal differences in trade agreements. The coding is based on whether the provisions of the World Trade Organization (WTO) are

  19. 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

  20. Physical attractiveness, issue agreement, and assimilation effects in candidate appraisal.

    Science.gov (United States)

    Schubert, James N; Curran, Margaret Ann; Strungaru, Carmen

    2011-01-01

    This study examines the cognitive and affective factors of candidate appraisal by manipulating candidate attractiveness and levels of issue agreement with voters. Drawing upon research in evolutionary psychology and cognitive neuroscience, this analysis proposes that automatic processing of physical appearance predisposes affective disposition toward more attractive candidates, thereby influencing cognitive processing of issue information. An experimental design presented attractive and unattractive candidates who were either liberal or conservative in a mock primary election. The data show strong partial effects for appearance on vote intention, an interaction between appearance and issue agreement, and a tendency for voters to assimilate the dissimilar views of attractive candidates. We argue that physical appearance is important in primary elections when the differences in issue positions and ideology between candidates is small.

  1. Incentives to participate in an international environmental agreement

    International Nuclear Information System (INIS)

    Hoel, M.; Schneider, K.

    1997-01-01

    For international environmental problems involving many countries, such as the climate problem, it is unlikely that all countries will participate in an international environmental agreement. If some countries commit themselves to cooperate, while the remaining countries act independently and in pure self-interest, it appears to be possible to achieve a Pareto improvement if the non-signatory countries reduce their emissions, in exchange for transfers from the countries which sign an agreement. However, the paper shows that the prospect of receiving a transfer for reducing one's emissions provided the country does not commit itself to cooperation, tends to reduce the incentive a country might have to commit itself to cooperation. Moreover, if the disincentive effect of such side payments is strong, total emissions will be higher in a situation with side payments than in a situation in which the signatory countries commit themselves to not give transfers to free riding countries. 4 figs., 2 tabs., 2 appendices, 13 refs

  2. Transatlantic Cooperation in Space: Eu-Canada Free Trade Agreement

    Directory of Open Access Journals (Sweden)

    Luise Weber-Steinhaus

    2014-12-01

    Full Text Available National governments are keenly aware of the need for investment in space. Canada, as a formal cooperating state in the European Space Agency (ESA, and Germany, as a leading member state of ESA, are interlinked in Europe’s space endeavours. Beyond ESA, Germany and Canada additionally have a strong history of bilateral cooperation on a range of space projects. This paper discusses the novel interdependencies between clear national and now supranational space policies, using the examples of the Canada-European Union (EU Comprehensive Economic and Trade Agreement (CETA. The agreement covers most aspects of the EU-Canada bilateral economic relationship and includes space. The paper focuses on international space policies, strategic bilateral co-operation, and technical accomplishments. It takes a closer look at German-Canadian collaboration in space programs and offers some reflection on the effect of both the EU and ESA’S transatlantic involvement in space.

  3. 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

  4. New Danish Company Act on Shareholders' Agreements

    DEFF Research Database (Denmark)

    Werlauff, Erik

    2011-01-01

    ) 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....... 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......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...

  5. [Innovative medicines and market access agreements].

    Science.gov (United States)

    Toumi, M; Zard, J; Duvillard, R; Jommi, C

    2013-09-01

    Market Access Agreements (MAA) for drugs have emerged in response to the need to control health expenditures, as well as to the uncertainty about the true benefit of a drug. It is possible to group MAA in two types of agreements: financial agreements and outcome-based agreements. MAA is a growing trend and is shifting towards conditional access. However, the willingness to use these contracts and their implementation differ across countries, and some are still resistant to put them in place. The MAA challenges to overcome encompass the complexity of the schemes, the administrative burden and the difficulty of evaluating MAA. It is likely that these agreements might experience further evolution in the future to become a faster pathway for therapeutic innovations, at a fair price. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  6. 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.

  7. 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.

  8. 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.

  9. Connection between strong and weak coupling in the mean spherical model in 1 + 1 dimensions

    International Nuclear Information System (INIS)

    Banks, J.L.

    1980-01-01

    I extend the strong-coupling expansion obtained by Srednicki, for the β-function of the mean spherical model in 1 + 1 dimensions, in the hamiltonian formulation. I use ordinary and two-point Pade approximants to extrapolate this result to weak coupling. I find a reasonably smooth connection between strong and weak coupling, and good numerical agreement with the exact solution. (orig.)

  10. 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

  11. 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 ...

  12. Strong Statistical Convergence in Probabilistic Metric Spaces

    OpenAIRE

    Şençimen, Celaleddin; Pehlivan, Serpil

    2008-01-01

    In this article, we introduce the concepts of strongly statistically convergent sequence and strong statistically Cauchy sequence in a probabilistic metric (PM) space endowed with the strong topology, and establish some basic facts. Next, we define the strong statistical limit points and the strong statistical cluster points of a sequence in this space and investigate the relations between these concepts.

  13. 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

  14. John Strong - 1941-2006

    CERN Multimedia

    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...

  15. 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

  16. Strongly correlated perovskite fuel cells

    Science.gov (United States)

    Zhou, You; Guan, Xiaofei; Zhou, Hua; Ramadoss, Koushik; Adam, Suhare; Liu, Huajun; Lee, Sungsik; Shi, Jian; Tsuchiya, Masaru; Fong, Dillon D.; Ramanathan, Shriram

    2016-06-01

    Fuel cells convert chemical energy directly into electrical energy with high efficiencies and environmental benefits, as compared with traditional heat engines. Yttria-stabilized zirconia is perhaps the material with the most potential as an electrolyte in solid oxide fuel cells (SOFCs), owing to its stability and near-unity ionic transference number. Although there exist materials with superior ionic conductivity, they are often limited by their ability to suppress electronic leakage when exposed to the reducing environment at the fuel interface. Such electronic leakage reduces fuel cell power output and the associated chemo-mechanical stresses can also lead to catastrophic fracture of electrolyte membranes. Here we depart from traditional electrolyte design that relies on cation substitution to sustain ionic conduction. Instead, we use a perovskite nickelate as an electrolyte with high initial ionic and electronic conductivity. Since many such oxides are also correlated electron systems, we can suppress the electronic conduction through a filling-controlled Mott transition induced by spontaneous hydrogen incorporation. Using such a nickelate as the electrolyte in free-standing membrane geometry, we demonstrate a low-temperature micro-fabricated SOFC with high performance. The ionic conductivity of the nickelate perovskite is comparable to the best-performing solid electrolytes in the same temperature range, with a very low activation energy. The results present a design strategy for high-performance materials exhibiting emergent properties arising from strong electron correlations.

  17. 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

  18. 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.

  19. 12 CFR 533.5 - Related agreements considered a single agreement.

    Science.gov (United States)

    2010-01-01

    ... DISCLOSURE AND REPORTING OF CRA-RELATED AGREEMENTS § 533.5 Related agreements considered a single agreement... entered into within the same 12-month period; and (3) Are each in fulfillment of the CRA. (b... in fulfillment of the CRA, if the contracts were negotiated in a coordinated fashion and a NGEP is a...

  20. 12 CFR 35.5 - Related agreements considered a single agreement.

    Science.gov (United States)

    2010-01-01

    ... DISCLOSURE AND REPORTING OF CRA-RELATED AGREEMENTS § 35.5 Related agreements considered a single agreement... into within the same 12-month period; and (3) Are each in fulfillment of the CRA. (b) Substantively... the CRA, if the contracts were negotiated in a coordinated fashion and a NGEP is a party to each...

  1. 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... liability company agreements. Partnership and limited liability company agreements must be in form and...) Duration of the entity; (b) Adequate partnership or limited liability company funding requirements and...

  2. 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

  3. Negotiation and Monitoring of Service Level Agreements

    Science.gov (United States)

    Quillinan, Thomas B.; Clark, Kassidy P.; Warnier, Martijn; Brazier, Frances M. T.; Rana, Omer

    Service level agreements (SLAs) provide a means to define specific Quality of Service (QoS) guarantees between providers and consumers of services. Negotiation and definition of these QoS characteristics is an area of significant research. However, defining the actions that take place when an agreement is violated is a topic of more recent focus. This paper discusses recent advances in this field and propose some additional features that can help both consumers and producers during the enactment of services. These features include the ability to (re)negotiate penalties in an agreement, and specifically focuses on the renegotiation of penalties during enactment to reflect ongoing violations.

  4. Versão Brasileira da Avaliação Sensorial de Nottingham: validade, concordância e confiabilidade Brazilian version of the Nottingham Sensory Assessment: validity, agreement and reliability

    Directory of Open Access Journals (Sweden)

    Daniela H. F. Lima

    2010-04-01

    Full Text Available OBJETIVO: Verificar a concordância inter e intraexaminador, validade construtiva e consistência interna da versão brasileira do instrumento Nottingham Sensory Assessment para hemiparéticos após acidente vascular encefálico (AVE. MÉTODOS: O instrumento foi traduzido para língua portuguesa com base na sua versão original em Inglês por um tradutor bilíngue e, posteriormente, revertido para a língua inglesa. Vinte e um hemiparéticos foram avaliados por dois examinadores pela Avaliação Sensorial de Nottingham para pacientes pós-AVE (ASN e pelo Protocolo de Desempenho Físico de Fugl-Meyer (FM. RESULTADOS: Foi encontrada correlação entre os instrumentos FM e ASN (0,752; excelente consistência interna da ASN (0,86; excelentes coeficientes de concordância interexaminador e intraexaminador para todos os itens da ASN, exceto temperatura e efeito teto significativo para ASN e FM. CONCLUSÃO: A versão brasileira da Nottingham Sensory Assessment cumpriu os critérios de concordância, consistência interna e validade concorrente, sendo um instrumento de rápida e fácil aplicação, podendo ser utilizada nos ambulatórios de neuroreabilitação para avaliar a função sensorial pós-AVE. O efeito teto significativo da ASN não limita seu uso, tendo em vista que, para os mesmos pacientes, o Protocolo de Fugl-Meyer também revelou efeito teto.OBJECTIVES: To investigate the inter-rater and intra-rater reliability, construct validity and internal consistency of the Brazilian version of the Nottingham Sensory Assessment for Stroke Patients (NSA. METHODS: The instrument was translated into Portuguese from its original in English by a bilingual translator and was then back-translated into English. Twenty-one hemiparetics were evaluated by two examiners using the NSA and the Fugl-Meyer Assessment (FMA of physical performance. RESULTS: Significant correlation were found between the FMA and the NSA (r=0.752. The NSA showed excellent internal

  5. 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)

  6. 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.)

  7. 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

  8. A Spanish validation of the Coma Recovery Scale-Revised (CRS-R).

    Science.gov (United States)

    Tamashiro, Mercedes; Rivas, Maria Elisa; Ron, Melania; Salierno, Fernando; Dalera, Marisol; Olmos, Lisandro

    2014-01-01

    Analysis of inter-rater reliability and concurrent validity. To determine measurement properties of a Spanish version of The Coma Recovery Scale-Revised (CRS-R). A sample of 35 in-patients with severe acquired brain injury. To test concurrent validity of the translated scale, the Glasgow Coma Scale (GSC) and Disability Rating Scale (DRS) were also administered. Two experts in the field were recruited to assess inter-rater agreement. Inter-rater reliability was good for total CRS-R scores (Cronbach α = 0.973, p = 0.001). Sub-scale analysis showed moderate-to-high inter-rater agreement. Total CRS-R scores correlated significantly (p < 0.05) with total GCS (r = 0.74) and DRS (r = 0.54) scores, indicating acceptable concurrent validity. The Spanish version of CRS-R can be administered reliably by trained and experienced examiners. CRS-R appears capable of differentiating patients in Emergence from Minimally Conscious State (EMCS) or in Minimally Conscious State (MCS) from those in a Vegetative State (VS).

  9. 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.

  10. 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

  11. 76 FR 30360 - Notice of Agreements Filed

    Science.gov (United States)

    2011-05-25

    ... Agreement. Parties: BBC Chartering & Logistic GMBH & Co. KG; Industrial Maritime Carriers (U.S.A.) Inc.; and..., 1983 Concerning Assessments to Pay ILWU-PMA Employee Benefit Costs, As Amended, Through May 12, 2011...

  12. 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...

  13. 78 FR 21364 - Notice of Agreements Filed

    Science.gov (United States)

    2013-04-10

    ... the trade between Vietnam, China (including Hong Kong), Singapore, Spain, and Sri Lanka, on the one... Line Space Charter, Sailing and Cooperative Working Agreement Asia to USEC and PNW-Suez/PNW & Panama...

  14. 76 FR 64944 - Notice of Agreements Filed

    Science.gov (United States)

    2011-10-19

    ..., DC 20006-4007. Synopsis: The amendment would delete Venezuela from the geographic scope of the... slots in the trades between Vietnam, China, and the United States. Agreement No.: 201165-001. Title...

  15. Cooperative Agreement on Pesticide Safety Education

    Science.gov (United States)

    EPA is awarding the eXtension Foundation with a cooperative agreement to establish a system to distribute EPA funds to Pesticide Safety Education Programs (PSEPs) in State Cooperative Extension Services at Land Grant Universities.

  16. 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

  17. 7 CFR 1720.9 - Guarantee Agreement.

    Science.gov (United States)

    2010-01-01

    ... bonds. (b) The guaranteed bonds shall refer to the guarantee agreement as controlling the terms of the... the holder of the guaranteed bonds; (11) Claim procedures; (12) What constitutes a failure by the...

  18. 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...

  19. 77 FR 1689 - Notice of Agreements Filed

    Science.gov (United States)

    2012-01-11

    .... West Coast ports and ports in China and Vietnam. Agreement No.: 012151. Title: Maersk Line/MSC WCCA... Angeles and ports in Mexico and Panama. Dated: January 6, 2012. By Order of the Federal Maritime...

  20. 7 CFR 1599.5 - Agreements.

    Science.gov (United States)

    2010-01-01

    ... designed to ensure that the participant is aware of, and has the capacity to complete, all required... provide donated commodities and FAS-provided funds under a multiyear agreement contingent upon the...

  1. 7 CFR 1499.5 - Agreements.

    Science.gov (United States)

    2010-01-01

    ... designed to ensure that the participant is aware of, and has the capacity to complete, all required... provide donated commodities and CCC-provided funds under a multiyear agreement contingent upon the...

  2. 75 FR 366 - Notice of Agreement Filed

    Science.gov (United States)

    2010-01-05

    ...) 523-5793 or [email protected] . Agreement No.: 012088. Title: Hanjin and WHS Transpacific Vessel... vessel space in the trade between the U.S. ports and ports in Malaysia, Vietnam, Japan, Korea, People's...

  3. 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...

  4. Effective construction of environmental protection agreements

    International Nuclear Information System (INIS)

    French, H.F.

    1995-01-01

    By now 170 international agreements are designed to protect air, ground, water and organisms from man-made hazards. Nevertheless are innovative approaches required for global conventions to make the Earth a sanctuary of life for good. (orig.) [de

  5. 49 CFR 212.105 - Agreements.

    Science.gov (United States)

    2010-10-01

    ... TRANSPORTATION STATE SAFETY PARTICIPATION REGULATIONS State/Federal Roles § 212.105 Agreements. (a) Scope. The... facilities, equipment, and operating practices through planned routine compliance inspections for all, or a...

  6. 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.

  7. 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...

  8. 78 FR 17234 - Negotiated Service Agreement

    Science.gov (United States)

    2013-03-20

    ... (DFS) Negotiated Service Agreement (NSA) to the market dominant product list.\\1\\ After a [[Page 17235... dominant product list.\\2\\ On March 8, 2013, the Postal Service filed an amendment to the DFS NSA with the...

  9. 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

  10. Russia needs a strong counterpart

    International Nuclear Information System (INIS)

    Slovak, K.; Marcan, P.

    2008-01-01

    In this paper an interview with the head of OMV, Wolfgang Ruttenstorfer is published. There is extract from this interview: Q: There have been attempts to take over MOL for a quite long time. Do you think you can still succeed? Since the beginning we kept saying that this would not happen from one day to another. But it may take two to three years. But we are positive that it is justified. Q: Resistance from MOL and the Hungarian government is strong. We have tried to persuade the Hungarian government. We offered them a split company management. A part of the management would be in Budapest. We would locate the management of the largest division - the refinery, there. And of course only the best could be part of the management. We would not nominate people according to their nationality, it would not matter whether the person was Austrian, Hungarian or Slovak. We want a Central European company, not Hungarian, Romanian or Slovak company. Q: Would the transaction still be attractive if, because of pressure exercised by Brussels, you had to sell Slovnaft or your refinery in Szazhalobatta? We do not intend to sell any refineries. Q: Rumours are spreading that the Commission may ask you to sell a refinery? We do not want to speculate. Let us wait and see what happens. We do not want to sell refineries. Q: It is said that OMV is coordinating or at least consulting its attempts to acquire MOL with Gazprom. There are many rumours in Central Europe. But I can tell you this is not true. We are interested in this merger because we feel the increasing pressure exercised by Kazakhstan and Russia. We, of course, have a good relationship with Gazprom which we have had enjoyed for over forty years. As indeed Slovakia has. Q: A few weeks ago Austrian daily Wirtschaftsblatt published an article about Gazprom's interest in OMV shares. That is gossip that is more than ten years' old. Similarly to the rumours that Gazprom is a shareholder of MOL. There are no negotiations with Gazprom

  11. The political economy of services trade agreements

    OpenAIRE

    FIORINI, Matteo; LEBRAND, Mathilde

    2016-01-01

    Why do governments sign services trade agreements? This paper focuses on the role of international agreements in the context of trade in services when services are used as intermediate inputs in downstream industries. Compared to goods, services inputs are mostly non-tradable and complementary to other factors of production. We build a theoretical trade policy framework in which firms use foreign investment to contest foreign markets in services sectors and governments can restrict the entry ...

  12. 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

  13. Statement of Agreements Registered With The Agency

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1960-09-23

    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.

  14. The Paris Agreement to Ignore Reality

    OpenAIRE

    Spash, Clive L.

    2016-01-01

    At the 21st session of the Conference of the Parties to the United Nations Framework Convention on Climate Change held in Paris, France, 30 November to 11 December 2015, an Agreement was reached by the international community including 195 countries. The Agreement has been hailed, by participants and the media, as a major turning point for policy in the struggle to address human induced climate change. The following is a short critical commentary in which I briefly explain why ...

  15. Hermann agreement updates IRS guidelines for incentives.

    Science.gov (United States)

    Broccolo, B M; Peregrine, M W

    1995-01-01

    The October 1994 agreement between the Internal Revenue Service (IRS) and Hermann Hospital of Houston, Texas, elucidates current IRS policy on physician recruitment incentives. The IRS distinguishes between the recruiting and the retention of physicians and perimts incentives beyond reasonable compensation in the former but not the latter circumstance. This new agreement, while not legally precedential, nevertheless provides guidance for healthcare organizations seeking safe harbor protection.

  16. The administrative review of concession agreements

    Directory of Open Access Journals (Sweden)

    Fatmira Hajdari

    2014-01-01

    The practice of concessionary agreements in Albania is only in its early steps of development. Furthermore, the legislation that provides for the concession agreements has suffered changes to reflect the international legislation. All of which have led to the case law encountering various issues, which we have only humbly tried to reflect in this paper, while also providing our opinion with regard to addressing them.

  17. Agency Agreements Process Champion Support Intern

    Science.gov (United States)

    Miksa, Ember

    2018-01-01

    This document will provide information on the 2018 Spring semester NIFS Intern who represented the Office of Chief Financial Officer (OCFO) as a Reimbursable Accountant at Kennedy Space Center (KSC). This intern supported the Agency Agreements Process Champions and Team Lead, Susan Kroskey, Sandy Massey and Mecca Murphy, with major initiatives to advance the KSC OCFO's vision of creating and innovating healthy financial management practices that maximize the value of resources entrusted to NASA. These initiatives include, but are not limited to: updating the Agency Guidance and NASA Procedural Guidance 9090.1 Agreements, implementing a new budget structure to be utilized across all centers, submitting a Call Request (CRQ) to enhance non-federal customer reporting, initiating a discussion to incorporate a 3-year funding program for NASA agreements, and undertaking the Office of Inspector General (OIG) Audit. In support of these initiatives, this intern identified technical methods to enhance and reduce the workload of financial processes for reimbursable and non-reimbursable agreements, prepared reports in support of accounting functions, and performed administrative work and miscellaneous technical tasks in support of the OCFO as requested. In conclusion of the internship, the intern will become knowledgeable on reimbursable accounting, reimbursable policy, types of reimbursable agreements, the agreements process, estimated pricing reports, and the roles and responsibilities of the Financial Accounting and Financial Services offices.

  18. The practical outfall of DOE compliance agreements

    International Nuclear Information System (INIS)

    Smith, Leanne; Henrie, Gregory O.

    1992-01-01

    Perhaps the significant regulatory issue facing the Department of Energy (DOE or the Department) is the compliant treatment, storage, and disposal of mixed (radioactive and hazardous) waste. Since DOE'S By-Product Rulemaking in 1987, when the Department acknowledged that the Resource Conservation and Recovery Act (RCRA) applied to the hazardous component of mixed waste, DOE has repeatedly communicated to the Environmental Protection Agency (EPA) and host States that, for mixed waste, DOE is not always able to strictly comply with RCRA standards and that bringing treatment on-line in an expeditious manner is proving very difficult. One of the most effective methods used between DOE and its regulators to address mixed waste management issues is the negotiation of compliance agreements. These agreements establish formal mile stones for bringing DOE sites into compliance. The milestones are not completed without overcoming technical roadblocks and a struggle for funding. However, agreements can establish technically attainable compliance methods that take into account the special problems radiation introduces into RCRA waste management. Compliance agreements help promote a cooperative relationship within the Department and between DOE and its regulators in that all parties have reached agreement and have a stake in attaining the same goal. Where agreements exist, mixed waste compliance efforts can proceed in a situation where all parties have a full understanding of each other's needs and expectations. (author)

  19. Profile agreement indices in Rietveld and pattern-fitting analysis

    International Nuclear Information System (INIS)

    Hill, R.J.; Fischer, R.X.

    1990-01-01

    Two definitions of profile agreement indices are now in common use for estimating the degree of fit in Rietveld refinement and in structure-independent pattern-fitting methods of powder diffraction analysis. In the original program written by Rietveld, the background was subtracted and the 'non-peak' regions of the pattern were removed from further consideration in a preliminary data-reduction stage prior to structure refinement. However, the agreement indices used in many of the more recent programs retain the background counts in the observed step intensities and include all portions of the pattern in the sums. These latter definitions are strongly dependent on the signal-to-noise ratio and on the relative amount of 'background-only' regions and do not, therefore, provide a sound basis for comparing the degree of fit of peak profile and crystal structure model refinements in the general case. The extent of this dependence is illustrated quantitatively using conventional and synchrotron X-ray and constant-wavelength and time-of-flight neutron data sets with different inherent background levels and peak densities. The unweighted background-corrected peak-only profile agreement index R' p =Σ i vertical strokeY io -Y ic vertical stroke/Σ i vertical strokeY io -Y ib vertical stroke (and, to a lesser extent, its weighted equivalent) is recommended as the most appropriate criterion of fit for comparative work between diffraction patterns of all kinds. (orig.)

  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. Current and future role of agreements for cooperation as the framework for international nuclear commerce

    International Nuclear Information System (INIS)

    Brush, P.N.

    1976-01-01

    An agreement for cooperation in the civil use of atomic energy was established by Congress as the primary vehicle for ensuring that the benefits of cooperation outweigh the risks. The elements and nature of the agreement for cooperation are reviewed in this article. The evolution of some of the more significant provisions of the agreements and the type of activities conducted under them are discussed. The question is raised as to whether or not these agreements for cooperation are strong enough in the light of nations of the world becoming more concerned with the implications of burgeoning nuclear power activities. The question, ''Should these agreements be elevated to the status of treaties.'' is asked also

  2. 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

  3. 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)

  4. 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

  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. 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.

  7. The Wisconsin Assessment of the Social and Built Environment (WASABE): a multi-dimensional objective audit instrument for examining neighborhood effects on health.

    Science.gov (United States)

    Malecki, Kristen C; Engelman, Corinne D; Peppard, Paul E; Nieto, F Javier; Grabow, Maggie L; Bernardinello, Milena; Bailey, Erin; Bersch, Andrew J; Walsh, Matthew C; Lo, Justin Y; Martinez-Donate, Ana

    2014-11-13

    Growing evidence suggests that mixed methods approaches to measuring neighborhood effects on health are needed. The Wisconsin Assessment of the Social and Built Environment (WASABE) is an objective audit tool designed as an addition to a statewide household-based health examination survey, the Survey of the Health of Wisconsin (SHOW), to objectively measure participant's neighborhoods. This paper describes the development and implementation of the WASABE and examines the instrument's ability to capture a range of social and built environment features in urban and rural communities. A systematic literature review and formative research were used to create the tool. Inter-rater reliability parameters across items were calculated. Prevalence and density of features were estimated for strata formed according to several sociodemographic and urbanicity factors. The tool is highly reliable with over 81% of 115 derived items having percent agreement above 95%. It captured variance in neighborhood features in for a diverse sample of SHOW participants. Sidewalk density in neighborhoods surrounding households of participants living at less than 100% of the poverty level was 67% (95% confidence interval, 55-80%) compared to 34% (25-44%) for those living at greater than 400% of the poverty level. Walking and biking trails were present in 29% (19-39%) of participant buffer in urban areas compared to only 7% (2-12%) in rural communities. Significant environmental differences were also observed for white versus non-white, high versus low income, and college graduates versus individuals with lower level of education. The WASABE has strong inter-rater reliability and validity properties. It builds on previous work to provide a rigorous and standardized method for systematically gathering objective built and social environmental data in a number of geographic settings. Findings illustrate the complex milieu of built environment features found in participants neighborhoods and have

  8. 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

  9. The myriad challenges of the Paris Agreement

    Science.gov (United States)

    Mitchell, Dann; Allen, Myles R.; Hall, Jim W.; Muller, Benito; Rajamani, Lavanya; Le Quéré, Corinne

    2018-05-01

    The much awaited and intensely negotiated Paris Agreement was adopted on 12 December 2015 by the Parties to the United Nations Framework Convention on Climate Change. The agreement set out a more ambitious long-term temperature goal than many had anticipated, implying more stringent emissions reductions that have been under-explored by the research community. By its very nature a multidisciplinary challenge, filling the knowledge gap requires not only climate scientists, but the whole Earth system science community, as well as economists, engineers, lawyers, philosophers, politicians, emergency planners and others to step up. To kick start cross-disciplinary discussions, the University of Oxford's Environmental Change Institute focused its 25th anniversary conference upon meeting the challenges of the Paris Agreement for science and society. This theme issue consists of review papers, opinion pieces and original research from some of the presentations within that meeting, covering a wide range of issues underpinning the Paris Agreement. This article is part of the theme issue `The Paris Agreement: understanding the physical and social challenges for a warming world of 1.5°C above pre-industrial levels'.

  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. Agreement and Anti-Agreement in Berber: A Multiple-Feature Inheritance Account

    Directory of Open Access Journals (Sweden)

    Saleem Abdelhady

    2017-10-01

    Full Text Available This study proposes understanding Agreement and Anti-Agreement in Berber from Multi-Feature Inheritance (MFI account following Branigan’s (2016 recent approach. The study aims to bridge a misunderstanding in the literature where it has been assumed that Feature Inheritance (FI can only account for Agreement relations while Anti-agreement relations can only be established by a direct Agree between C as a probe and its goal. Under MFI, it can be argued that FI can account for all aspects of Agreement/Anti-agreement. The study, therefore, presents a unification of the three mechanisms proposed by Ouali (2008. The new approach is tested on data from Berber.

  12. The Texts of The Agency's Agreements with the Republic of Austria. I. Headquarters Agreement. Amendments

    International Nuclear Information System (INIS)

    1970-01-01

    The text of the Agreement between the International Atomic Energy Agency and the Republic of Austria Amending the Agreement of 11 December 1957 Regarding the Headquarters of the International Atomic Energy Agency, which was signed on 4 June 1970, is reproduced in this document for the information of all Members. Members will be informed of the entry into force of the Amendments to the Headquarters Agreement

  13. The Texts of The Agency's Agreements with the Republic of Austria. I. Headquarters Agreement. Amendments

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1970-09-04

    The text of the Agreement between the International Atomic Energy Agency and the Republic of Austria Amending the Agreement of 11 December 1957 Regarding the Headquarters of the International Atomic Energy Agency, which was signed on 4 June 1970, is reproduced in this document for the information of all Members. Members will be informed of the entry into force of the Amendments to the Headquarters Agreement.

  14. 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.

  15. 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

  16. 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.

  17. Strong trade unions meet EEC workers

    DEFF Research Database (Denmark)

    Andersen, Søren Kaj; Hansen, Jens Arnholtz

    2008-01-01

    (EEC) workers. The argument is that migrant and, in particular, posted workers' conditions of employment often are characterised by evasions of collective agreements, whether in the form of underpayment or other violations of terms and conditions specified in the agreements. However, the trade union...... response is not straightforward: they could pursue a strategy of surveillance and control, leading to closer cooperation with public authorities (e.g., tax and immigration authorities) in order to impose sanctions and fines on employers violating existing agreements and legislation - a strategy often met...

  18. 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

  19. 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

  20. 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.

  1. Iran and Russia signed nuclear agreement

    International Nuclear Information System (INIS)

    Anon

    2006-01-01

    This paper deals with signing of agreement between Russian Federation and Iran about nuclear fuel for nuclear power plant which is constructed. It was happened only three days after Bratislava Summit between presidents G. Bush and V. Putin. Supply of nuclear fuel should be started up to two months and the nuclear power plant with value eight hundred U. S. dollars should be commissioned next year. According to this agreement spent fuel will be sent back to Russia. After this manner it should be prevented the possibility that Iran will use spent fuel for producing of nuclear bomb

  2. 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

  3. The Danish agreements on energy efficiency

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-05-01

    CO{sub 2}-taxes for industry were introduced in 1993. In 1996, the taxes were increased and an agreement system for energy-intensive companies was implemented. The main purpose of the agreement system has been to allow energy-intensive industry to pay a reduced tax rate, while at the same time improving energy efficiency. The evaluation of the energy tax system has shown that it has been possible to establish an energy tax that has led to a decrease in CO{sub 2}-emissions, without causing a decrease in the competitiveness of trade, industry and services. The agreement system has been a very important element in that it has improved energy efficiency in companies in which taxes would not have been a realistic instrument. In the case of companies with agreements, several studies suggest improvements of approximately 2.7% of the total energy use per agreement (three years). The three sources (concrete projects, special investigation and energy management) contribute approximately one third of this reduction each. The values for special investigation and energy management must be used with great care. It is also predicted that a continuation of the agreement system by 2005, relative to a situation without agreements, can lead to a decrease in CO{sub 2}-emissions corresponding to 6% of total emissions in industry and trade. Of this reduction, the highest amount is due to energy management. However, maintaining the positive effects of energy management systems will require that companies give higher priority to the managerial part of the system and not only focus on energy accounting. Some companies have argued that it is costly to carry out energy audits and to have to audits verified. Therefore, consideration should be given to possibilities for reducing the administrative costs of entering into an agreement, without this causing reduced efforts to save energy. A means of achieving these objectives could be to reduce the requirement for energy audits and verification

  4. Cross-Cultural Agreement in Facial Attractiveness Preferences: The Role of Ethnicity and Gender

    Science.gov (United States)

    Coetzee, Vinet; Greeff, Jaco M.; Stephen, Ian D.; Perrett, David I.

    2014-01-01

    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. PMID:24988325

  5. 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.

  6. 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.

  7. 78 FR 68444 - Notice of Agreements Filed

    Science.gov (United States)

    2013-11-14

    ...; Oceania Cruises; Paul Gauguin Cruises; Pearl Seas Cruises; Princess Cruises; Regent Seven Seas Cruises.... Agreement No.: 012232. Title: MSC/CMA CGM North West European Continent-US East Coast Service Space Charter... authorizes MSC to charter space to CMA CGM in the trade between the North West European Continent and the U.S...

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

    African Journals Online (AJOL)

    ... capacitated, and prepared to engage in meaningful negotiations regarding how the investor's operations should benefit local stakeholders. This article reviews existing research on CDAs, as well as available agreements from the extractive sector in Australia, Canada, Laos, Papua New Guinea, Ghana and Greenland.

  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. 75 FR 14245 - Voluntary Intermodal Sealift Agreement

    Science.gov (United States)

    2010-03-24

    ... measures so that Contingency planning information can be shared with Participants to enable them to plan... Intermodal Sealift Agreement (VISA) Table of Contents Abbreviations Definitions Preface I. Purpose II... of VISA Contingency Provisions A. General B. Notification of Activation C. Voluntary Capacity D...

  11. Regulations for the Registration of Agreements

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1959-11-06

    The Regulations for the Registration of Agreements adopted by the Board of Governors on 25 April 1958 in implementation of Article XXII.B of the Statute of the Agency are reproduced in this document for the information of all Members.

  12. 7 CFR 1415.11 - Restoration agreements.

    Science.gov (United States)

    2010-01-01

    ... functions and values of the grassland to meet both USDA and the participant's objective and the purposes of... restoration agreement at that time to improve the functions and values with USDA approval and when funds are... grassland resources are adequate to meet the participant's objectives and the purposes of the program, or if...

  13. Regulatory domain limits of unilateral agreements

    International Nuclear Information System (INIS)

    Grenier, M.

    1986-06-01

    Simple in its principle unilateral agreement application in practice arise nevertheless some problems, not only for international transport when interpretation is somewhat different between countries, but also in domestic transport. This report tries to determine what being misapprehension and to propose a way to solve misapprehension which does not facilitate radioactive materials transport [fr

  14. 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...

  15. 75 FR 31438 - Notice of Agreements Filed

    Science.gov (United States)

    2010-06-03

    ..., Panama, Colombia, Venezuela, Brazil, Argentina, Uruguay, Paraguay, Chile, and Peru. Dated: May 28, 2010... Berhad; Mitsui O.S.K. Lines Ltd.; Nippon Yusen Kaisha; Safmarine Container Lines N.V.; Norasia Container... ports in Asia. Agreement No.: 012097. Title: Mitsui O.S.K. Lines/Kawasaki Kisen Kaisha U.S. Atlantic...

  16. 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... Joint Service Agreement and Mitsui O.S.K. Lines, Ltd. Filing Party: Robert B. Yoshitomi, Esq., Nixon... Co. Pte. Ltd.; Hyundai Merchant Marine; and Mitsui O.S.K. Lines, Ltd. Filing Party: Robert Yoshitomi...

  17. 77 FR 58140 - Notice of Agreements Filed

    Science.gov (United States)

    2012-09-19

    ... Colombia, Ecuador, Peru, and Chile, on the other hand. Agreement No.: 201112-004. Title: Lease and... O'Connor; 1627 I Street NW., Suite 1100; Washington, DC 20006-4007. Synopsis: The amendment corrects... R. Rohde, Esq.; Cozen O'Connor; 1627 I Street NW., Suite 1100; Washington, DC 20006-4007. Synopsis...

  18. 50 CFR 81.6 - Project Agreement.

    Science.gov (United States)

    2010-10-01

    ...) FINANCIAL ASSISTANCE-WILDLIFE SPORT FISH RESTORATION PROGRAM CONSERVATION OF ENDANGERED AND THREATENED..., the period of time necessary to accomplish the objectives, and both the Federal and State costs. All... Office of Management and Budget Circular No. A-95 (as revised). (d) The Project Agreement will follow...

  19. 76 FR 17653 - Notice of Agreements Filed

    Science.gov (United States)

    2011-03-30

    ...: CSCL/ELJSA Vessel Sharing Agreement-Asia and Mexico, US East Coast Service. Parties: China Shipping Container Lines Co., Ltd.; China Shipping Container Lines (Hong Kong) Co., Ltd.; and Evergreen Lines Joint... coordinate sailings in the trades between Japan, China, and the Pacific coast of the United States. By Order...

  20. 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...

  1. 77 FR 13604 - Notice of Agreements Filed

    Science.gov (United States)

    2012-03-07

    ...: Maersk Line/New World Alliance Slot Exchange Agreement. Parties: A.P. Moller-Maersk A/S trading under the... exchange space on their respective services in the trade between the U.S. Atlantic Coast and ports in Panama, the United Kingdom, Germany, the Netherlands and Mediterranean ports in France, Italy and Spain...

  2. 78 FR 53455 - Notice of Agreements Filed

    Science.gov (United States)

    2013-08-29

    .... Parties: Zim Integrated Shipping Services, Ltd.; China Shipping Container Line Co., Ltd. and China Shipping Container Lines (Hong Kong) Co., Ltd. (acting as a single party). Filing Party: Mark E. Newcomb.... Synopsis: The agreement authorizes Hamburg Sud to charter space to Hapag-Lloyd in the trade between the U.S...

  3. 78 FR 76624 - Notice of Agreements Filed

    Science.gov (United States)

    2013-12-18

    ... Agreement. Parties: BBC Chartering & Logistic GmbH & Co. KG; Industrial Maritime Carriers LLC; Seaboard... amendment clarifies that BBC Chartering Carriers GmbH & Co. KG (BBC Carriers) and BBC Chartering & Logistic GmbH & Co. KG (BBC Logistic), both common carrier members of BBC Chartering Group, are to be treated...

  4. 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

  5. ACHP | News | St. Elizabeths Programmatic Agreement Signed

    Science.gov (United States)

    Search skip specific nav links Home arrow News arrow St. Elizabeths Programmatic Agreement Signed St redevelopment of the St. Elizabeths West Campus, which is part of the St. Elizabeths National Historic Landmark this project, due to the historic significance of the NHL. GSA's client for the St. Elizabeths

  6. 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…

  7. 46 CFR 356.41 - Management agreements.

    Science.gov (United States)

    2010-10-01

    ... which the management company provides marketing services, consulting services or other services that are... otherwise effectively gain control over the management and operation of the vessel or vessel-owning entity... 46 Shipping 8 2010-10-01 2010-10-01 false Management agreements. 356.41 Section 356.41 Shipping...

  8. 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

  9. Corporate Social Responsibility Agreements Model for Community ...

    African Journals Online (AJOL)

    Corporate Social Responsibility Agreements Model for Community ... their host communities with concomitant adverse effect on mining operations. ... sustainable community development an integral part of the mining business. This paper presents the evolutionary strategic models, with differing principles and action plans, ...

  10. What agreement in Paris in 2015?

    International Nuclear Information System (INIS)

    Colombier, Michel; Ribera, Teresa

    2015-01-01

    In Warsaw, countries agreed to a process whereby each will unilaterally design and communicate its contribution toward reducing greenhouse gas emissions in the atmosphere. This process is to be ratified in late 2015 in Paris. Will the Paris agreement mark a turning point in climate policy? Will it measure up to the ambitions proclaimed by the international community at the Durban meeting?

  11. The Kyoto Agreement: Trade and Design

    DEFF Research Database (Denmark)

    Svendsen, Gert Tinggaard

    1999-01-01

    The Kyoto Agreement from 1997 allows trade of CO2 emission quotas between the 38 industrialized countries which have committed themselves to an emission ceiling. However, it does not define how this potential trade system should be designed. The intention was to clarify these matters during the 1...

  12. 23 CFR 630.110 - Modification of original agreement.

    Science.gov (United States)

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Modification of original agreement. 630.110 Section 630... OPERATIONS PRECONSTRUCTION PROCEDURES Project Authorization and Agreements § 630.110 Modification of original agreement. (a) When changes are needed to the original project agreement, a modification of agreement shall...

  13. The Text of a Safeguards Transfer Agreement relating to the Bilateral Agreement between France and Japan

    International Nuclear Information System (INIS)

    1973-01-01

    The text of a Safeguards Transfer Agreement between the Agency, France and Japan relating to the agreement of 26 February 1972 between the two Governments for co-operation in the peaceful uses of nuclear energy is reproduced in this document for the information or all Members

  14. 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

  15. The Text of the Safeguards Transfer Agreement relating to the Bilateral Agreement between Pakistan and Canada

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1969-11-13

    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.

  16. 48 CFR 1642.1204 - Agreement to recognize a successor in interest (novation agreement).

    Science.gov (United States)

    2010-10-01

    ... that the corporate name of (insert old corporate name) was changed to (insert new corporate name) on... MANAGEMENT CONTRACT ADMINISTRATION Novation and Change-of-Name Agreements 1642.1204 Agreement to recognize a... corporate name) (Transferor), a corporation duly organized and existing under the laws of (insert State...

  17. 12 CFR 346.5 - Related agreements considered a single agreement.

    Science.gov (United States)

    2010-01-01

    ... STATEMENTS OF GENERAL POLICY DISCLOSURE AND REPORTING OF CRA-RELATED AGREEMENTS § 346.5 Related agreements...; (2) Were entered into within the same 12-month period; and (3) Are each in fulfillment of the CRA. (b... in fulfillment of the CRA, if the contracts were negotiated in a coordinated fashion and a NGEP is a...

  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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1973-01-26

    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. The Text of a Safeguards Transfer Agreement relating to the Bilateral Agreement between France and Japan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1973-01-31

    The text of a Safeguards Transfer Agreement between the Agency, France and Japan relating to the agreement of 26 February 1972 between the two Governments for co-operation in the peaceful uses of nuclear energy is reproduced in this document for the information or all Members.