WorldWideScience

Sample records for unit review validated

  1. Model Validation Status Review

    Energy Technology Data Exchange (ETDEWEB)

    E.L. Hardin

    2001-11-28

    The primary objective for the Model Validation Status Review was to perform a one-time evaluation of model validation associated with the analysis/model reports (AMRs) containing model input to total-system performance assessment (TSPA) for the Yucca Mountain site recommendation (SR). This review was performed in response to Corrective Action Request BSC-01-C-01 (Clark 2001, Krisha 2001) pursuant to Quality Assurance review findings of an adverse trend in model validation deficiency. The review findings in this report provide the following information which defines the extent of model validation deficiency and the corrective action needed: (1) AMRs that contain or support models are identified, and conversely, for each model the supporting documentation is identified. (2) The use for each model is determined based on whether the output is used directly for TSPA-SR, or for screening (exclusion) of features, events, and processes (FEPs), and the nature of the model output. (3) Two approaches are used to evaluate the extent to which the validation for each model is compliant with AP-3.10Q (Analyses and Models). The approaches differ in regard to whether model validation is achieved within individual AMRs as originally intended, or whether model validation could be readily achieved by incorporating information from other sources. (4) Recommendations are presented for changes to the AMRs, and additional model development activities or data collection, that will remedy model validation review findings, in support of licensing activities. The Model Validation Status Review emphasized those AMRs that support TSPA-SR (CRWMS M&O 2000bl and 2000bm). A series of workshops and teleconferences was held to discuss and integrate the review findings. The review encompassed 125 AMRs (Table 1) plus certain other supporting documents and data needed to assess model validity. The AMRs were grouped in 21 model areas representing the modeling of processes affecting the natural and

  2. Compiler validates units and dimensions

    Science.gov (United States)

    Levine, F. E.

    1980-01-01

    Software added to compiler for automated test system for Space Shuttle decreases computer run errors by providing offline validation of engineering units used system command programs. Validation procedures are general, though originally written for GOAL, a free-form language that accepts "English-like" statements, and may be adapted to other programming languages.

  3. 20 CFR 404.2121 - Validation reviews.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Validation reviews. 404.2121 Section 404.2121...- ) Payments for Vocational Rehabilitation Services Administrative Provisions § 404.2121 Validation reviews. (a) General. We will conduct a validation review of a sample of the claims for payment filed by each State VR...

  4. United Kingdom: Health System Review.

    Science.gov (United States)

    Cylus, Jonathan; Richardson, Erica; Findley, Lisa; Longley, Marcus; O'Neill, Ciaran; Steel, David

    2015-01-01

    This analysis of the United Kingdom health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. It provides an overview of how the national health services operate in the four nations that make up the United Kingdom, as responsibility for organizing health financing and services was devolved from 1997. With devolution, the health systems in the United Kingdom have diverged in the details of how services are organized and paid for, but all have maintained national health services which provide universal access to a comprehensive package of services that are mostly free at the point of use. These health services are predominantly financed from general taxation and 83.5% of total health expenditure in the United Kingdom came from public sources in 2013. Life expectancy has increased steadily across the United Kingdom, but health inequalities have proved stubbornly resistant to improvement, and the gap between the most deprived and the most privileged continues to widen, rather than close. The United Kingdom faces challenges going forward, including how to cope with the needs of an ageing population, how to manage populations with poor health behaviours and associated chronic conditions, how to meet patient expectations of access to the latest available medicines and technologies, and how to adapt a system that has limited resources to expand its workforce and infrastructural capacity so it can rise to these challenges.

  5. Environmental performance reviews: United States

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-01-15

    This book presents OECD assessments and recommendations regarding the United States' effort to manage its environment including air, water nature, and biodiversity to do this in a sustainable manner; and to do this in co-operation with its global neighbours. In particular, it assesses progress made since 1996, when OECD's previous review on the US was done. 40 figs., 21 tabs.

  6. Unit testing, model validation, and biological simulation

    Science.gov (United States)

    Watts, Mark D.; Ghayoomie, S. Vahid; Larson, Stephen D.; Gerkin, Richard C.

    2016-01-01

    The growth of the software industry has gone hand in hand with the development of tools and cultural practices for ensuring the reliability of complex pieces of software. These tools and practices are now acknowledged to be essential to the management of modern software. As computational models and methods have become increasingly common in the biological sciences, it is important to examine how these practices can accelerate biological software development and improve research quality. In this article, we give a focused case study of our experience with the practices of unit testing and test-driven development in OpenWorm, an open-science project aimed at modeling Caenorhabditis elegans. We identify and discuss the challenges of incorporating test-driven development into a heterogeneous, data-driven project, as well as the role of model validation tests, a category of tests unique to software which expresses scientific models. PMID:27635225

  7. Validation studies in nursing: integrative review

    Directory of Open Access Journals (Sweden)

    Maria Andréia silva Ribeiro

    2013-05-01

    Full Text Available The aim of this study was to analyze the methods used for validation studies in nursing research considering the clinical investigation as phenomenon. We carried out literature at BIREME, CINAHL, PUBMED which contain the terms 'validation studies', 'nursing' and 'clinical' and 21 articles were included in the review. The majority of the studies were conducted in 2008; in North America (USA and European Community (62% in the area of adult health. Most of the phenomena investigated were related to nursing care involving physical and emotional aspects. The content validity has been cited in 71.4% of the articles, criterion validity in 28.5% and construct validity in 23.8%. The reliability by means of Cronbach's alpha was used in the majority of the studies. It was found a knowledge gap concerning the validation estudies in the area of public health, child health and the social phenomena related to nursing care.

  8. VALIDATION AND PROCESS DEVELOPMENT: A REVIEW

    Directory of Open Access Journals (Sweden)

    Rajpoot Brajendra singh

    2011-01-01

    Full Text Available Total Quality Management and specifications according to regulatory guidelines involved in pharmaceutical production has a great impact significantly on the quality of the products. The validation protocol includes inventory control and equipment inspections in the preliminary steps and in-process controls in the subsequent steps. Process controls are mandatory in good manufacturing practices (GMP. The purpose of setting validation parameters is to monitor the on-line and off-line performance of the manufacturing process, and hence, validate it1,2. Thus validation is an integral part of quality assurance. This review critically evaluates the need for pharmaceutical validation, the various approaches and steps involved, and other pertinent considerations.

  9. 20 CFR 416.2221 - Validation reviews.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Validation reviews. 416.2221 Section 416.2221 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND... demonstrates how the service was reasonably expected to motivate or assist the individual to return to...

  10. CASL Validation Data: An Initial Review

    Energy Technology Data Exchange (ETDEWEB)

    Nam Dinh

    2011-01-01

    The study aims to establish a comprehensive view of “data” needed for supporting implementation of the Consortium of Advanced Simulation of LWRs (CASL). Insights from this review (and its continual refinement), together with other elements developed in CASL, should provide the foundation for developing the CASL Validation Data Plan (VDP). VDP is instrumental to the development and assessment of CASL simulation tools as predictive capability. Most importantly, to be useful for CASL, the VDP must be devised (and agreed upon by all participating stakeholders) with appropriate account for nature of nuclear engineering applications, the availability, types and quality of CASL-related data, and novelty of CASL goals and its approach to the selected challenge problems. The initial review (summarized on the January 2011 report version) discusses a broad range of methodological issues in data review and Validation Data Plan. Such a top-down emphasis in data review is both needed to see a big picture on CASL data and appropriate when the actual data are not available for detailed scrutiny. As the data become available later in 2011, a revision of data review (and regular update) should be performed. It is expected that the basic framework for review laid out in this report will help streamline the CASL data review in a way that most pertinent to CASL VDP.

  11. Radiography Facility - Building 239 Independent Validation Review

    Energy Technology Data Exchange (ETDEWEB)

    Altenbach, T J; Beaulieu, R A; Watson, J F; Wong, H J

    2010-02-02

    The purpose of this task was to perform an Independent Validation Review to evaluate the successful implementation and effectiveness of Safety Basis controls, including new and revised controls, to support the implementation of a new DSA/TSR for B239. This task addresses Milestone 2 of FY10 PEP 7.6.6. As the first IVR ever conducted on a LLNL nuclear facility, it was designated a pilot project. The review follows the outline developed for Milestone 1 of the PEP, which is based on the DOE Draft Guide for Performance of Independent Verification Review of Safety Basis Controls. A formal Safety Basis procedure will be developed later, based on the lessons learned with this pilot project. Note, this review is termed a ''Validation'' in order to be consistent with the PEP definition and address issues historically raised about verification mechanisms at LLNL. Validation is intended to confirm that implementing mechanisms realistically establish the ability of TSR LCO, administrative control or safety management program to accomplish its intended safety function and that the controls are being implemented. This effort should not, however, be confused with a compliance assessment against all relevant DOE requirements and national standards. Nor is it used as a vehicle to question the derivation of controls already approved by LSO unless a given TSR statement simply cannot be implemented as stated.

  12. Radiography Facility - Building 239 Independent Validation Review

    Energy Technology Data Exchange (ETDEWEB)

    Altenbach, T J; Beaulieu, R A; Watson, J F; Wong, H J

    2010-02-02

    The purpose of this task was to perform an Independent Validation Review to evaluate the successful implementation and effectiveness of Safety Basis controls, including new and revised controls, to support the implementation of a new DSA/TSR for B239. This task addresses Milestone 2 of FY10 PEP 7.6.6. As the first IVR ever conducted on a LLNL nuclear facility, it was designated a pilot project. The review follows the outline developed for Milestone 1 of the PEP, which is based on the DOE Draft Guide for Performance of Independent Verification Review of Safety Basis Controls. A formal Safety Basis procedure will be developed later, based on the lessons learned with this pilot project. Note, this review is termed a ''Validation'' in order to be consistent with the PEP definition and address issues historically raised about verification mechanisms at LLNL. Validation is intended to confirm that implementing mechanisms realistically establish the ability of TSR LCO, administrative control or safety management program to accomplish its intended safety function and that the controls are being implemented. This effort should not, however, be confused with a compliance assessment against all relevant DOE requirements and national standards. Nor is it used as a vehicle to question the derivation of controls already approved by LSO unless a given TSR statement simply cannot be implemented as stated.

  13. Data validation report for the 100-HR-3 Operable Unit, fifth round groundwater samples

    Energy Technology Data Exchange (ETDEWEB)

    Vukelich, S.E. [Kearney (A.T.), Inc., Chicago, IL (United States)

    1994-01-20

    The data from the chemical analysis of 68 samples from the 100-HR-3 Operable Unit Third Quarter 1993 Groundwater Sampling Investigation and their related quality assurance samples were reviewed and validated to verify that reported sample results were of sufficient quality to support decisions regarding remedial actions performed at the site. Sample analysis included inorganics and general chemical parameters. Fifty three samples were validated for radiochemical parameters.

  14. ANALYTICAL METHOD VALIDATION: AN UPDATED REVIEW

    Directory of Open Access Journals (Sweden)

    G. Lavanya, M. Sunil, M.M. Eswarudu*, M. C. Eswaraiah, K. Harisudha and B. Naga Spandana

    2013-04-01

    Full Text Available ABSTRACT: The development of sound Analytical method(s is of supreme importance during the process of drug discovery, release to market and development, culminating in a marketing approval. The objective of this paper is to review the method development, optimize and validation of the method for the drug product from the developmental stage of the formulation to commercial batch of the product. Method development for the interested component in finished product or in process tests and the sample preparation of drug product and to provide practical approaches for determining selectivity, specificity, limit of detection, limit of quantitation, linearity, range accuracy, precision, recovery solution stability, ruggedness, and robustness of liquid chromatographic methods to support the Routine, in process and stability analysis.

  15. Development and validation of evaluation tools of nursing students’ clinical pharmacology unit

    Science.gov (United States)

    Navabi, Nasrin; Ghaffari, Fatemeh; Shamsalinia, Abbas; Faghani, Safieh

    2016-01-01

    Introduction The need for valid, reliable, and objective tools has always been emphasized in studies related to the clinical assessment of nursing students. The aims of this study were to develop and assess the validity and reliability of the tools used to evaluate the clinical pharmacology unit. Methods This study was a methodological one, conducted in 2016. An item pool was developed based on the literature review and personal interviews with faculty members. The tool’s validity was determined through assessment of face validity, content validity, and construct validity, using exploratory factor analysis on the data provided by 264 second- and third-semester nursing students of the Islamic Azad University of Babol University of Medical Sciences. Reliability was determined through internal and external consistency, using a Cronbach’s coefficient of the correlation between classes. Results Based on the exploratory factor analysis, all items with a special value of >1 were grouped into six factors: 1) professional behavior; 2) effective communication; 3) recognition of medical terminology; 4) nursing actions before administering medicine; 5) nursing actions while administering medicine; and 6) nursing actions after administering medicine. These factors explained 77% of the total variance of the concept of assessment of the clinical pharmacology unit. In this study, reliability was demonstrated by a Cronbach’s alpha coefficient of 0.96; the correlation coefficient between floors for the total tool was 0.91, ranging from 0.64 to 0.89 in its dimensions. Conclusion The evaluation tool of the clinical pharmacology unit has an acceptable construct validity and satisfactory reliability and validity. Therefore, it can be used to evaluate the clinical pharmacology unit in the nursing education system in Iran. PMID:28008285

  16. OECD environmental performance reviews: United States

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-01-15

    This book presents OECD assessments and recommendations regarding the United States' efforts to manage its environment including air, water, nature, and biodiversity; to do this in a sustainable manner; and to do this in co-operation with its global neighbours. In particular, it assesses progress made since 1996, when OECD's previous review on the US was done. 47 figs., 20 tabs.

  17. Validation of Fuqing Nuclear Power Plant Unit 1 Cycle 2 Refueling Design

    Institute of Scientific and Technical Information of China (English)

    PAN; Cui-jie; XIA; Zhao-dong; ZHU; Qing-fu

    2015-01-01

    Fuqing Nuclear Power Plant Unit 1Cycle 2refueling design was validated with the PWR core fuel management package CMS(CASMO5,CMSLINK5and SIMULATE5),including validating fuel management report,validating reload safety evaluation report,validating nuclear design report and validating physics tests report.

  18. The Leiter Scales: A Review of Validity Findings.

    Science.gov (United States)

    Ratcliffe, Kevin J.; Ratcliffe, Melanie Walton

    1979-01-01

    Past validity research involving the Leiter International Performance Scale and the Arthur Adaptation of the Leiter International Performance Scale is reviewed, particularly as it relates to evaluating intelligence of hearing impaired children. (Author)

  19. The Validity of Attribute-Importance Measurement: A Review

    NARCIS (Netherlands)

    Ittersum, van K.; Pennings, J.M.E.; Wansink, B.; Trijp, van J.C.M.

    2007-01-01

    A critical review of the literature demonstrates a lack of validity among the ten most common methods for measuring the importance of attributes in behavioral sciences. The authors argue that one of the key determinants of this lack of validity is the multi-dimensionality of attribute importance.

  20. The Validity of Attribute-Importance Measurement: A Review

    NARCIS (Netherlands)

    Ittersum, van K.; Pennings, J.M.E.; Wansink, B.; Trijp, van J.C.M.

    2007-01-01

    A critical review of the literature demonstrates a lack of validity among the ten most common methods for measuring the importance of attributes in behavioral sciences. The authors argue that one of the key determinants of this lack of validity is the multi-dimensionality of attribute importance. Bu

  1. Development and validation of an eye care educational programme for intensive care unit nurses.

    Science.gov (United States)

    Cho, Ok-Hee; Yoo, Yang-Sook; Yun, Sun-Hee; Hwang, Kyung-Hye

    2017-07-01

    To develop and validate an eye care educational programme for intensive care unit nurses. Eye care guidelines and protocols have been developed for increasing eye care implementation in intensive care units. However, the guidelines lack consistency in assessment or intervention methodology. This was a one-sample pre/postprogramme evaluation study design for testing the effects of the eye care educational programme, developed for and applied to intensive care unit nurses, on their levels of knowledge and awareness. The eye care educational programme was developed based on literature review and survey of educational needs. Thirty intensive care unit nurses served as subjects for the study. The levels of eye care-related knowledge, awareness and practice were enhanced following the implementation of the educational programme. Moreover, satisfaction with the educational programme was high. It is necessary to intensify eye care education aimed at new nurses who are inexperienced in intensive care unit nursing and provide continuing education on the latest eye care methods and information to experienced nurses. The eye care educational programme developed in this study can be used as a strategy to periodically assess the eye status of patients and facilitate the appropriate eye care. © 2016 John Wiley & Sons Ltd.

  2. Calculation method for the seasonal performance of heat pump compact units and validation. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Wemhoener, C.; Dott, R.; Afjei, Th. [University of Applied Sciences Northwestern Switzerland, Institute of Energy in Buildings, Muttenz (Switzerland); Huber, H.; Helfenfinger, D.; Keller, P.; Furter, R. [University of Applied Sciences Lucerne (HTA), Test center HLKS, Horw (Switzerland)

    2007-02-15

    This comprehensive final report for the Swiss Federal Office of Energy (SFOE) takes a look at compact heat pump units that have been developed for the heating of low energy consumption houses built to MINERGIE or MINERGIE-P standards. These units, which combine the functions of space heating, domestic hot water preparation and ventilation in one unit are described. A testing procedure developed at the University of Applied Science in Lucerne, Switzerland, using a test rig for the measurement of the seasonal performance factor (SPF) is described. A calculation method based on temperature classes for the calculation of the SPF of combined heat pump systems for space heating and domestic hot water preparation that was developed by the Institute of Energy in Buildings at the University of Applied Sciences Northwestern Switzerland is examined. Two pilot plants allowing detailed field monitoring of two compact units are described. One pilot plant installed in a single-family house built to MINERGIE standard in Gelterkinden, Switzerland, provided data on a compact unit. These results of measurements made on this and a further installation in a MINERGIE-P ultra-low energy consumption house in Zeiningen, Switzerland, are presented and discussed. Calculation methods, including exergy considerations are reviewed and their validation is discussed.

  3. Content validity of manual spinal palpatory exams - A systematic review

    Directory of Open Access Journals (Sweden)

    Reinsch Sibylle

    2003-05-01

    Full Text Available Abstract Background Many health care professionals use spinal palpatory exams as a primary and well-accepted part of the evaluation of spinal pathology. However, few studies have explored the validity of spinal palpatory exams. To evaluate the status of the current scientific evidence, we conducted a systematic review to assess the content validity of spinal palpatory tests used to identify spinal neuro-musculoskeletal dysfunction. Methods Review of eleven databases and a hand search of peer-reviewed literature, published between 1965–2002, was undertaken. Two blinded reviewers abstracted pertinent data from the retrieved papers, using a specially developed quality-scoring instrument. Five papers met the inclusion/exclusion criteria. Results Three of the five papers included in the review explored the content validity of motion tests. Two of these papers focused on identifying the level of fixation (decreased mobility and one focused on range of motion. All three studies used a mechanical model as a reference standard. Two of the five papers included in the review explored the validity of pain assessment using the visual analogue scale or the subjects' own report as reference standards. Overall the sensitivity of studies looking at range of motion tests and pain varied greatly. Poor sensitivity was reported for range of motion studies regardless of the examiner's experience. A slightly better sensitivity (82% was reported in one study that examined cervical pain. Conclusions The lack of acceptable reference standards may have contributed to the weak sensitivity findings. Given the importance of spinal palpatory tests as part of the spinal evaluation and treatment plan, effort is required by all involved disciplines to create well-designed and implemented studies in this area.

  4. Fast Pyrolysis Process Development Unit for Validating Bench Scale Data

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Robert C. [Iowa State Univ., Ames, IA (United States). Biorenewables Research Lab.. Center for Sustainable Environmental Technologies. Bioeconomy Inst.; Jones, Samuel T. [Iowa State Univ., Ames, IA (United States). Biorenewables Research Lab.. Center for Sustainable Environmental Technologies. Bioeconomy Inst.

    2010-03-31

    The purpose of this project was to prepare and operate a fast pyrolysis process development unit (PDU) that can validate experimental data generated at the bench scale. In order to do this, a biomass preparation system, a modular fast pyrolysis fluidized bed reactor, modular gas clean-up systems, and modular bio-oil recovery systems were designed and constructed. Instrumentation for centralized data collection and process control were integrated. The bio-oil analysis laboratory was upgraded with the addition of analytical equipment needed to measure C, H, O, N, S, P, K, and Cl. To provide a consistent material for processing through the fluidized bed fast pyrolysis reactor, the existing biomass preparation capabilities of the ISU facility needed to be upgraded. A stationary grinder was installed to reduce biomass from bale form to 5-10 cm lengths. A 25 kg/hr rotary kiln drier was installed. It has the ability to lower moisture content to the desired level of less than 20% wt. An existing forage chopper was upgraded with new screens. It is used to reduce biomass to the desired particle size of 2-25 mm fiber length. To complete the material handling between these pieces of equipment, a bucket elevator and two belt conveyors must be installed. The bucket elevator has been installed. The conveyors are being procured using other funding sources. Fast pyrolysis bio-oil, char and non-condensable gases were produced from an 8 kg/hr fluidized bed reactor. The bio-oil was collected in a fractionating bio-oil collection system that produced multiple fractions of bio-oil. This bio-oil was fractionated through two separate, but equally important, mechanisms within the collection system. The aerosols and vapors were selectively collected by utilizing laminar flow conditions to prevent aerosol collection and electrostatic precipitators to collect the aerosols. The vapors were successfully collected through a selective condensation process. The combination of these two mechanisms

  5. Data validation report for the 100-FR-3 Operable Unit, third round groundwater samples

    Energy Technology Data Exchange (ETDEWEB)

    Ayres, J.M.

    1994-03-31

    Westinghouse-Hanford has requested that a minimum of 20% of the total number of Sample Delivery Groups be validated for the 100-FR-3 operable Unit Third Round Groundwater sampling investigation. Therefore, the data from the chemical analysis of 51 samples from this sampling event and their related quality assurance samples were reviewed and validated to verify that reported sample results were of sufficient quality to support decisions regarding remedial actions performed at this site. The report is broken down into sections for each chemical analysis and radiochemical analysis type. Each section addresses the data package completeness, holding time adherence, instrument calibration and tuning acceptability, blank results, accuracy, precision, system performance, as well as the compound identification and quantitation. In addition, each section has an overall assessment and summary for the data packages reviewed for the particular chemical/radiochemical analyses. Detailed backup information is provided to the reader by SDG No. and sample number. For each data package, a matrix of chemical analyses per sample number is presented, as well as data qualification summaries.

  6. Reviewing Reliability and Validity of Information for University Educational Evaluation

    Science.gov (United States)

    Otsuka, Yusaku

    To better utilize evaluations in higher education, it is necessary to share the methods of reviewing reliability and validity of examination scores and grades, and to accumulate and share data for confirming results. Before the GPA system is first introduced into a university or college, the reliability of examination scores and grades, especially for essay examinations, must be assured. Validity is a complicated concept, so should be assured in various ways, including using professional audits, theoretical models, and statistical data analysis. Because individual students and teachers are continually improving, using evaluations to appraise their progress is not always compatible with using evaluations in appraising the implementation of accountability in various departments or the university overall. To better utilize evaluations and improve higher education, evaluations should be integrated into the current system by sharing the vision of an academic learning community and promoting interaction between students and teachers based on sufficiently reliable and validated evaluation tools.

  7. A REVIEW ON CONCEPT OF CLEANING VALIDATION IN PHARMACEUTICAL INDUSTRY

    National Research Council Canada - National Science Library

    Shashikant; Prashar Bharat; Kumar Satinder

    2012-01-01

    .... This article provide introduction on cleaning validation and the associated regulations, level/degree of cleaning, approaches to cleaning validation, elements of cleaning validation, validation...

  8. Review of Labour Statistics for the United Nations Statistical Commission

    OpenAIRE

    Catherine Barham

    2008-01-01

    Describes the Review, whose recommendations will be taken forward by UN Statistical Division and the International Labour OrganisationEarly in 2007, the Office for National Statistics was asked by United Nations Statistics Division (UNSD) to carry out a Review of Labour Statistics on behalf of the UK. The Review was carried out during 2007 and was presented at the annual UN Statistics Commission session in February 2008 in New York. The Review was very well received and recommendations in the...

  9. The United States Department of Energy's Regional Carbon Sequestration Partnerships Program Validation Phase.

    Science.gov (United States)

    Litynski, John T; Plasynski, Sean; McIlvried, Howard G; Mahoney, Christopher; Srivastava, Rameshwar D

    2008-01-01

    This paper reviews the Validation Phase (Phase II) of the Department of Energy's Regional Carbon Sequestration Partnerships initiative. In 2003, the U.S. Department of Energy created a nationwide network of seven Regional Carbon Sequestration Partnerships (RCSP) to help determine and implement the technology, infrastructure, and regulations most appropriate to promote carbon sequestration in different regions of the nation. The objectives of the Characterization Phase (Phase I) were to characterize the geologic and terrestrial opportunities for carbon sequestration; to identify CO(2) point sources within the territories of the individual partnerships; to assess the transportation infrastructure needed for future deployment; to evaluate CO(2) capture technologies for existing and future power plants; and to identify the most promising sequestration opportunities that would need to be validated through a series of field projects. The Characterization Phase was highly successful, with the following achievements: established a national network of companies and professionals working to support sequestration deployment; created regional and national carbon sequestration atlases for the United States and portions of Canada; evaluated available and developing technologies for the capture of CO(2) from point sources; developed an improved understanding of the permitting requirements that future sequestration activities will need to address as well as defined the gap in permitting requirements for large scale deployment of these technologies; created a raised awareness of, and support for, carbon sequestration as a greenhouse gas (GHG) mitigation option, both within industry and among the general public; identified the most promising carbon sequestration opportunities for future field tests; and established protocols for project implementation, accounting, and management. Economic evaluation was started and is continuing and will be a factor in project selection. During the

  10. Calibration and Validation of Inertial Measurement Unit for Wave Resolving Drifters

    Science.gov (United States)

    2013-12-01

    multiple microelectromechanical systems ( MEMS ), including a triaxial accelerometer, a triaxial gyroscope , and a triaxial magnetometer. The...14. SUBJECT TERMS Ocean waves, wave buoys, drifters, inertial measurement units, MEMS , sensor validation, reference frames...GPS-based buoy GPS global positioning system GUI graphical user interface IMU inertial measurement unit MCR mouth of the Columbia River MEMS

  11. United Kingdom (Wales): Health system review.

    Science.gov (United States)

    Longley, Marcus; Riley, Neil; Davies, Paul; Hernandez-Quevedo, Cristina

    2012-01-01

    Wales is situated to the west of England, with a population of approximately 3 million (5% of the total for the United Kingdom), and a land mass of just over 20 000 km2. For several decades, Wales had a health system largely administered through the United Kingdom Governments Welsh Office, but responsibility for most aspects of health policy was devolved to Wales in a process beginning in 1999. Since then, differences between the policy approach and framework in England and Wales have widened. The internal market introduced in the United Kingdom National Health Service (NHS) has been abandoned in Wales, and seven local health boards (LHBs; supported by three specialist NHS trusts) now plan and provide all health services for their resident populations. Wales currently has more than 120 hospitals as part of an overall estate valued at 2.3 billion pounds. Total spending on health services increased in the first decade of the 21st century, but Wales now faces a period of financial retrenchment greater than in other parts of the United Kingdom as a result of the Welsh Governments decision not to afford the same degree of protection to health spending as that granted elsewhere. The health system in Wales continues to face some structural weaknesses that have proved resistant to reform for some time. However, there has been substantial improvement in service quality and outcomes since the end of the 1990s, in large part facilitated by substantial real growth in health spending. Life expectancy has continued to increase, but health inequalities have proved stubbornly resistant to improvement.

  12. The validity of peer review in a general medicine journal.

    Directory of Open Access Journals (Sweden)

    Jeffrey L Jackson

    Full Text Available UNLABELLED: All the opinions in this article are those of the authors and should not be construed to reflect, in any way, those of the Department of Veterans Affairs. BACKGROUND: Our study purpose was to assess the predictive validity of reviewer quality ratings and editorial decisions in a general medicine journal. METHODS: Submissions to the Journal of General Internal Medicine (JGIM between July 2004 and June 2005 were included. We abstracted JGIM peer review quality ratings, verified the publication status of all articles and calculated an impact factor for published articles (Rw by dividing the 3-year citation rate by the average for this group of papers; an Rw>1 indicates a greater than average impact. RESULTS: Of 507 submissions, 128 (25% were published in JGIM, 331 rejected (128 with review and 48 were either not resubmitted after revision was requested or were withdrawn by the author. Of 331 rejections, 243 were published elsewhere. Articles published in JGIM had a higher citation rate than those published elsewhere (Rw: 1.6 vs. 1.1, p = 0.002. Reviewer quality ratings of article quality had good internal consistency and reviewer recommendations markedly influenced publication decisions. There was no quality rating cutpoint that accurately distinguished high from low impact articles. There was a stepwise increase in Rw for articles rejected without review, rejected after review or accepted by JGIM (Rw 0.60 vs. 0.87 vs. 1.56, p<0.0005. However, there was low agreement between reviewers for quality ratings and publication recommendations. The editorial publication decision accurately discriminated high and low impact articles in 68% of submissions. We found evidence of better accuracy with a greater number of reviewers. CONCLUSIONS: The peer review process largely succeeds in selecting high impact articles and dispatching lower impact ones, but the process is far from perfect. While the inter-rater reliability between individual

  13. Is Bowen theory valid? A review of basic research.

    Science.gov (United States)

    Miller, Richard B; Anderson, Shayne; Keala, Davelyne Kaulana

    2004-10-01

    In the last 15 years, a substantial number of studies have tested the theoretical validity of Bowen family systems theory. A review of this basic research provided empirical support for the relationship between differentiation and chronic anxiety, marital satisfaction, and psychological distress. Bowen's assumption that couples with the same level of differentiation marry was not supported. His specific theories of sibling position and triangulation also received little empirical support. Research on multigenerational transmission has generally ignored Bowen's theoretical perspective, and more research needs to test Bowen's claim that his theory is universal. In addition, researchers still need to examine the effect of differentiation on child functioning, physical health problems, and adaptability.

  14. United Kingdom (Northern Ireland): Health system review.

    Science.gov (United States)

    O'Neill, Ciaran; McGregor, Pat; Merkur, Sherry

    2012-01-01

    The political context within which Northern Irelands integrated health and social care system operates has changed since the establishment of a devolved administration (the Northern Ireland Assembly, set up in 1998 but suspended between 2002 and 2007). A locally elected Health Minister now leads the publicly financed system and has considerable power to set policy and, in principle, to determine the operation of other health and social care bodies. The system underwent major reform following the passing of the Health and Social Care (Reform) Act (Northern Ireland) in 2009. The reform maintained the quasi purchaser provider split already in place but reduced the number and increased the size of many of the bodies involved in purchasing (known locally as commissioning) and delivering services. Government policy has generally placed greater emphasis on consultation and cooperation among health and social care bodies (including the department, commissioners and care providers) than on competition. The small size of the population (1.8 million) and Northern Irelands geographical isolation from the rest of the United Kingdom provide a rationale for eschewing a more competitive model. Without competition, effective control over the system requires information and transparency to ensure provider challenge, and a body outside the system to hold it to account. The restoration of the locally elected Assembly in 2007 has created such a body, but it remains to be seen how effectively it will exercise accountability.

  15. Model selection, identification and validation in anaerobic digestion: a review.

    Science.gov (United States)

    Donoso-Bravo, Andres; Mailier, Johan; Martin, Cristina; Rodríguez, Jorge; Aceves-Lara, César Arturo; Vande Wouwer, Alain

    2011-11-01

    Anaerobic digestion enables waste (water) treatment and energy production in the form of biogas. The successful implementation of this process has lead to an increasing interest worldwide. However, anaerobic digestion is a complex biological process, where hundreds of microbial populations are involved, and whose start-up and operation are delicate issues. In order to better understand the process dynamics and to optimize the operating conditions, the availability of dynamic models is of paramount importance. Such models have to be inferred from prior knowledge and experimental data collected from real plants. Modeling and parameter identification are vast subjects, offering a realm of approaches and methods, which can be difficult to fully understand by scientists and engineers dedicated to the plant operation and improvements. This review article discusses existing modeling frameworks and methodologies for parameter estimation and model validation in the field of anaerobic digestion processes. The point of view is pragmatic, intentionally focusing on simple but efficient methods.

  16. VALIDATION OF ANALYTICAL METHODS AND INSTRUMENTATION FOR BERYLLIUM MEASUREMENT: REVIEW AND SUMMARY OF AVAILABLE GUIDES, PROCEDURES, AND PROTOCOLS

    Energy Technology Data Exchange (ETDEWEB)

    Ekechukwu, A.

    2008-12-17

    This document proposes to provide a listing of available sources which can be used to validate analytical methods and/or instrumentation for beryllium determination. A literature review was conducted of available standard methods and publications used for method validation and/or quality control. A comprehensive listing of the articles, papers, and books reviewed is given in Appendix 1. Available validation documents and guides are listed in the appendix; each has a brief description of application and use. In the referenced sources, there are varying approaches to validation and varying descriptions of validation at different stages in method development. This discussion focuses on validation and verification of fully developed methods and instrumentation that have been offered up for use or approval by other laboratories or official consensus bodies such as ASTM International, the International Standards Organization (ISO) and the Association of Official Analytical Chemists (AOAC). This review was conducted as part of a collaborative effort to investigate and improve the state of validation for measuring beryllium in the workplace and the environment. Documents and publications from the United States and Europe are included. Unless otherwise specified, all documents were published in English.

  17. Predictive Validity of Early Literacy Measures for Korean English Language Learners in the United States

    Science.gov (United States)

    Han, Jeanie Nam; Vanderwood, Michael L.; Lee, Catherine Y.

    2015-01-01

    This study examined the predictive validity of early literacy measures with first-grade Korean English language learners (ELLs) in the United States at varying levels of English proficiency. Participants were screened using Dynamic Indicators of Basic Early Literacy Skills (DIBELS) Phoneme Segmentation Fluency (PSF), DIBELS Nonsense Word Fluency…

  18. A review of United Nations tests for explosivity

    NARCIS (Netherlands)

    Brown, A.K.; Mak, W.A.; Whitmore, M.W.

    2000-01-01

    In attempting to develop a closed pressure vessel test for assessing explosivity, arising from propagation of detonation, deflagration or thermal explosion, some difficulties were encountered in relation to United Nations test methods. This led to a review of these methods and comparisons of their p

  19. VALIDATION OF ANALYTICAL METHODS AND INSTRUMENTATION FOR BERYLLIUM MEASUREMENT: REVIEW AND SUMMARY OF AVAILABLE GUIDES, PROCEDURES, AND PROTOCOLS

    Energy Technology Data Exchange (ETDEWEB)

    Ekechukwu, A

    2009-05-27

    Method validation is the process of evaluating whether an analytical method is acceptable for its intended purpose. For pharmaceutical methods, guidelines from the United States Pharmacopeia (USP), International Conference on Harmonisation (ICH), and the United States Food and Drug Administration (USFDA) provide a framework for performing such valications. In general, methods for regulatory compliance must include studies on specificity, linearity, accuracy, precision, range, detection limit, quantitation limit, and robustness. Elements of these guidelines are readily adapted to the issue of validation for beryllium sampling and analysis. This document provides a listing of available sources which can be used to validate analytical methods and/or instrumentation for beryllium determination. A literature review was conducted of available standard methods and publications used for method validation and/or quality control. A comprehensive listing of the articles, papers and books reviewed is given in the Appendix. Available validation documents and guides are listed therein; each has a brief description of application and use. In the referenced sources, there are varying approches to validation and varying descriptions of the valication process at different stages in method development. This discussion focuses on valication and verification of fully developed methods and instrumentation that have been offered up for use or approval by other laboratories or official consensus bodies such as ASTM International, the International Standards Organization (ISO) and the Association of Official Analytical Chemists (AOAC). This review was conducted as part of a collaborative effort to investigate and improve the state of validation for measuring beryllium in the workplace and the environment. Documents and publications from the United States and Europe are included. Unless otherwise specified, all referenced documents were published in English.

  20. Pharmacist-led medication review in an acute admissions unit

    DEFF Research Database (Denmark)

    Hansen, Trine Graabæk; Bonnerup, Dorthe Krogsgaard; Kjeldsen, Lene Juel

    2015-01-01

    Objectives Over the last decades, several papers have evaluated clinical pharmacy interventions in hospital settings with conflicting findings as results. Medication reviews are frequently a central component of these interventions. However, the term ‘medication review’ covers a plethora.......Methods A procedure was developed based on clinical experience and inspiration from previous studies and literature on medication review models. The procedure was developed to fit the busy workflow in acute admissions units.Results The procedure consists of five steps: (1) collection of clinical patient data, (2...... of principles and methodologies, and the practical procedure is seldom described in detail, which makes reproducing study findings difficult. The objective of this paper is to provide a detailed description of a procedure developed and used for pharmacist-led medication review in acute admissions units...

  1. Validity and reliability of eating disorder assessments used with athletes: A review

    Directory of Open Access Journals (Sweden)

    Zachary Pope

    2015-09-01

    Conclusion: Only seven studies calculated validity coefficients within the study whereas 47 cited the validity coefficient. Twenty-six calculated a reliability coefficient whereas 47 cited the reliability of the ED measures. Four studies found validity evidence for the EAT, EDI, BULIT-R, QEDD, and EDE-Q in an athlete population. Few studies reviewed calculated validity and reliability coefficients of ED measures. Cross-validation of these measures in athlete populations is clearly needed.

  2. INDUSTRIAL PROCESS VALIDATION OF SOLID ORAL DASAGE FORM: A REVIEW

    Directory of Open Access Journals (Sweden)

    Vishal Sharma

    2013-06-01

    Full Text Available Validation is the important step in gaining and maintaining the quality of the final product. Validation of the individual steps of the processes is called the process validation. Different dosage forms have different validation protocols. Validation is therefore is one element of quality assurance programs and is associated with a particular process therefore word validation simply means “assessment of validity” or action of proving effectiveness. Validation thus provides a higher degree of assurance that the manufacturing process consistently meets the pre-determined specifications and the quality products output can be used to increase productivity, its consistent quality and decreasing the need for processing and market complaints of the drug product. This overview examines the need for pharmaceutical validation, the various approaches and steps involved.

  3. Accuracy Validation for Medical Image Registration Algorithms: a Review

    Institute of Scientific and Technical Information of China (English)

    Zhe Liu; Xiang Deng; Guang-zhi Wang

    2012-01-01

    Accuracy validation is essential to clinical application of medical image registration techniques.Registration validation remains a challenging problem in practice mainly due to lack of 'ground truth'.In this paper,an overview of current validation methods for medical image registration is presented with detailed discussion of their benefits and drawbacks.Special focus is on non-rigid registration validation.Promising solution is also discussed.

  4. Single unit CAD/CAM restorations: a literature review.

    Science.gov (United States)

    Freedman, Michael; Quinn, Frank; O'Sullivan, Michael

    2007-01-01

    Computer-aided design/computer-aided manufacture (CAD/CAM) has been used in dentistry since 1987. Since then, many CAD/CAM systems have been described, which enable the production of chair-side single unit dental restorations. These restorations are of comparable quality to those made by conventional techniques and have some specific advantages, including rapid production, improved wear properties, decreased laboratory fee and improved cross infection control. This literature review investigates the evidence base for the use of single unit CAD/CAM restorations. Materials, marginal gap, aesthetics, post-operative sensitivity, cementation, cost-effectiveness and longevity are discussed.

  5. Systematic review and retrospective validation of prediction models for weight loss after bariatric surgery.

    Science.gov (United States)

    Sharples, Alistair J; Mahawar, Kamal; Cheruvu, Chandra V N

    2017-08-12

    Patients often have less than realistic expectations of the weight loss they are likely to achieve after bariatric surgery. It would be useful to have a well-validated prediction tool that could give patients a realistic estimate of their expected weight loss. To perform a systematic review of the literature to identify existing prediction models and attempt to validate these models. University hospital, United Kingdom. A systematic review was performed. All English language studies were included if they used data to create a prediction model for postoperative weight loss after bariatric surgery. These models were then tested on patients undergoing bariatric surgery between January 1, 2013 and December 31, 2014 within our unit. An initial literature search produced 446 results, of which only 4 were included in the final review. Our study population included 317 patients. Mean preoperative body mass index was 46.1 ± 7.1. For 257 (81.1%) patients, 12-month follow-up was available, and mean body mass index and percentage excess weight loss at 12 months was 33.0 ± 6.7 and 66.1% ± 23.7%, respectively. All 4 of the prediction models significantly overestimated the amount of weight loss achieved by patients. The best performing prediction model in our series produced a correlation coefficient (R(2)) of .61 and an area under the curve of .71 on receiver operating curve analysis. All prediction models overestimated weight loss after bariatric surgery in our cohort. There is a need to develop better procedures and patient-specific models for better patient counselling. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  6. Systematic review of diagnostic criteria for IBS demonstrates poor validity and utilization of Rome III.

    Science.gov (United States)

    Dang, J; Ardila-Hani, A; Amichai, M M; Chua, K; Pimentel, M

    2012-09-01

    In the absence of a clear biomarker for irritable bowel syndrome (IBS), clinical criteria are used. In this study, we conduct a systematic review to examine the validation and utilization of IBS criteria. A systematic review was performed in two stages. The first was a review of literature from 1978 validating IBS diagnostic criteria. The second stage of review was to select studies published in IBS between 1992 and 2011. This time period was divided into three segments (Rome I era from 1992 to 1999, Rome II era from 2000 to 2006, and Rome III era from 2007 to 2011). The number and type of study (RCT or other) and criteria used were evaluated for each era. The first stage of the systematic review identified only 14 published studies validating diagnostic tests for IBS (with three studies evaluating more than one criterion). There were eight validations for Manning, three validations for Kruis, four validations for Rome I, three validations for Rome II, and no validation for Rome III. In the second review of utilization of Rome criteria, only 25.7% of published IBS papers used Rome III criteria during the Rome III era (Rome II was used most in 64.8% of studies). This review identified that comparator groups varied widely between studies making comparison of criteria impossible. Manning criteria are the most valid and accurate criteria. More importantly, Rome III is not validated and is poorly adopted in clinical research trial enrollment. © 2012 Blackwell Publishing Ltd.

  7. External Validity and Model Validity: A Conceptual Approach for Systematic Review Methodology

    Directory of Open Access Journals (Sweden)

    Raheleh Khorsan

    2014-01-01

    Full Text Available Background. Evidence rankings do not consider equally internal (IV, external (EV, and model validity (MV for clinical studies including complementary and alternative medicine/integrative health care (CAM/IHC research. This paper describe this model and offers an EV assessment tool (EVAT© for weighing studies according to EV and MV in addition to IV. Methods. An abbreviated systematic review methodology was employed to search, assemble, and evaluate the literature that has been published on EV/MV criteria. Standard databases were searched for keywords relating to EV, MV, and bias-scoring from inception to Jan 2013. Tools identified and concepts described were pooled to assemble a robust tool for evaluating these quality criteria. Results. This study assembled a streamlined, objective tool to incorporate for the evaluation of quality of EV/MV research that is more sensitive to CAM/IHC research. Conclusion. Improved reporting on EV can help produce and provide information that will help guide policy makers, public health researchers, and other scientists in their selection, development, and improvement in their research-tested intervention. Overall, clinical studies with high EV have the potential to provide the most useful information about “real-world” consequences of health interventions. It is hoped that this novel tool which considers IV, EV, and MV on equal footing will better guide clinical decision making.

  8. Pediatric Observation Units in the US: A Systematic Review

    Science.gov (United States)

    Macy, Michelle L.; Kim, Christopher S.; Sasson, Comilla; Lozon, Marie M.; Davis, Matthew M.

    2009-01-01

    Background As the United States' (US) health system seeks more efficient and value-based care models, geographically distinct observation units (OUs) may become an integral part of hospital-based care for children. Purpose To systematically review the literature and evaluate the structure and function of pediatric OUs in the US. Data Sources Searches were conducted in Medline, Web of Science, CINAHL, HCAB, Lexis Nexis, National Guideline Clearinghouse and Cochrane Reviews through February 2009, with review of select bibliographies. Study Selection English language peer-reviewed publications on pediatric OU care in the US. Data Extraction Two authors independently determined study eligibility. Studies were graded using a 5-level quality assessment tool. Data were extracted using a standardized form. Data Synthesis 21 studies met inclusion criteria: 2 randomized trials, 2 prospective observational, 12 retrospective cohort, 2 before and after, and 3 descriptive studies. Studies present data on more than 22,000 children cared for in OUs, most at large academic centers. This systematic review provides a descriptive overview of the structure and function of pediatric OUs in the US. Despite seemingly straightforward outcomes for OU care, significant heterogeneity in the reporting of length of stay, admission rates, return visit rates, and costs precluded our ability to conduct meta-analyses. We propose standard outcome measures and future directions for pediatric OU research. Conclusions Future research using consistent outcome measures will be critical to determining whether OUs can improve the quality and cost of providing care to children requiring observation-length stays. PMID:20235288

  9. The Validity and Reliability of Global Positioning Systems in Team Sport: A Brief Review.

    Science.gov (United States)

    Scott, Macfarlane T U; Scott, Tannath J; Kelly, Vincent G

    2016-05-01

    The use of global positioning systems (GPS) has increased dramatically over the last decade. Using signals from orbiting satellites, the GPS receiver calculates the exact position of the device and the speed at which the device is moving. Within team sports GPS devices are used to quantify the external load experienced by an athlete, allowing coaches to better manage trainings loads and potentially identify athletes who are overreaching or overtraining. This review aims to collate all studies that have tested either (or both) the validity or reliability of GPS devices in a team sport setting, with a particular focus on (a) measurements of distance, speed, velocities, and accelerations across all sampling rates and (b) accelerometers, player/body load and impacts in accelerometer-integrated GPS devices. A comprehensive search of the online libraries identified 22 articles that fit search criteria. The literature suggests that all GPS units, regardless of sampling rate, are capable of tracking athlete's distance during team sport movements with adequate intraunit reliability. One Hertz and 5Hz GPS units have limitations in their reporting of distance during high-intensity running, velocity measures, and short linear running (particularly those involving changes of direction), although these limitations seem to be overcome during measures recorded during team sport movements. Ten Hertz GPS devices seem the most valid and reliable to date across linear and team sport simulated running, overcoming many limitations of earlier models, whereas the increase to 15Hz GPS devices have had no additional benefit.

  10. A Review of Validation Research on Psychological Variables Used in Hiring Police Officers.

    Science.gov (United States)

    Malouff, John M.; Schutte Nicola S.

    This paper reviews the methods and findings of published research on the validity of police selection procedures. As a preface to the review, the typical police officer selection process is briefly described. Several common methodological deficiencies of the validation research are identified and discussed in detail: (1) use of past-selection…

  11. A Concise Review on Validated Risk Assessment Tools For Sexually Abusive Youth

    Directory of Open Access Journals (Sweden)

    L. C. Miccio-Fonseca

    2014-11-01

    Full Text Available Reviewed are validated and cross-validated risk assessment tools for assessing sexual improprieties in youth: J-SOAP-II, ERASOR,2.0, and MEGA♪. Assessments are significantly more accurate when tools focused on specific populations of youth are employed. The review affirms a New Paradigm of ecologically based, developmentally and gender sensitive risk assessment tools.

  12. Modelling of pulverized coal boilers: review and validation of on-line simulation techniques

    Energy Technology Data Exchange (ETDEWEB)

    Diez, L.I.; Cortes, C.; Campo, A. [University of Zaragoza, Zaragoza (Spain). Centro de Investigacion de Recursos y Consumos Energeticos (CIRCE)

    2005-07-01

    Thermal modelling of large pulverized fuel utility boilers has reached a very remarkable development, through the application of CFD techniques and other advanced mathematical methods. However, due to the computational requirements, on-line monitoring and simulation tools still rely on lumped models and semiempirical approaches, which are often strongly simplified and not well connected with sound theoretical basis. This paper reviews on-line modelling techniques, aiming at the improvement of their capabilities, by means of the revision and modification of conventional lumped models and the integration of off-line CFD predictions. The paper illustrates the coherence of monitoring calculations as well as the validation of the on-line thermal simulator, starting from real operation data from a case-study unit. The outcome is that it is possible to significantly improve the accuracy of on-line calculations provided by conventional models, taking into account the singularities of large combustion systems and coupling offline CFD predictions for selected scenarios.

  13. Validity and reliability of Turkish version of family satisfaction in the intensive care unit.

    Science.gov (United States)

    Tastan, Sevinc; Iyigun, Emine; Ayhan, Hatice; Kılıckaya, Oguz; Yılmaz, Ali Abbas; Kurt, Ercan

    2014-06-01

    To evaluate the quality of care that is provided in intensive care units, needs and satisfaction of the patient relatives must also be considered. The aim of the study is to test the Turkish version of the Family Satisfaction in the Intensive Care Unit (FS-ICU-24) Survey, which was developed by Heyland et al. This study was planned and applied as a methodological study. Survey was conducted in the intensive care units of a military education and research hospital and a medical faculty hospital, department of anaesthesia and reanimation in the capital city Ankara of Turkey. Sample of the survey was composed of 120 participants. Cronbach's alpha value for the FS-ICU-24 general internal consistency in this study was calculated as 0.95 for total scale. In this study, the Turkish version of the FS-ICU-24 was found to be reliable and valid with Turkish population.

  14. Constructing a Validity Argument for the Objective Structured Assessment of Technical Skills (OSATS): A Systematic Review of Validity Evidence

    Science.gov (United States)

    Hatala, Rose; Cook, David A.; Brydges, Ryan; Hawkins, Richard

    2015-01-01

    In order to construct and evaluate the validity argument for the Objective Structured Assessment of Technical Skills (OSATS), based on Kane's framework, we conducted a systematic review. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Web of Science, Scopus, and selected reference lists through February 2013. Working in duplicate, we selected…

  15. Methodology for the validation of analytical methods involved in uniformity of dosage units tests.

    Science.gov (United States)

    Rozet, E; Ziemons, E; Marini, R D; Boulanger, B; Hubert, Ph

    2013-01-14

    Validation of analytical methods is required prior to their routine use. In addition, the current implementation of the Quality by Design (QbD) framework in the pharmaceutical industries aims at improving the quality of the end products starting from its early design stage. However, no regulatory guideline or none of the published methodologies to assess method validation propose decision methodologies that effectively take into account the final purpose of developed analytical methods. In this work a solution is proposed for the specific case of validating analytical methods involved in the assessment of the content uniformity or uniformity of dosage units of a batch of pharmaceutical drug products as proposed in the European or US pharmacopoeias. This methodology uses statistical tolerance intervals as decision tools. Moreover it adequately defines the Analytical Target Profile of analytical methods in order to obtain analytical methods that allow to make correct decisions about Content uniformity or uniformity of dosage units with high probability. The applicability of the proposed methodology is further illustrated using an HPLC-UV assay as well as a near infra-red spectrophotometric method.

  16. Motor unit changes in normal aging: a brief review.

    Science.gov (United States)

    Tudoraşcu, Iulia; Sfredel, Veronica; Riza, Anca Lelia; Dănciulescu Miulescu, Rucsandra; Ianoşi, Simona Laura; Dănoiu, Suzana

    2014-01-01

    Aging is explored by multiple lines of research, in a pursuit of understanding this natural process. The motor response is usually the main dependent variable in studies regarding physical or cognitive decline in aging. It is therefore critical to understand how the motor function changes with age. The present review, aims at presenting briefly some of the most recently published works in the field, focusing on the three key components of the motor unit. The changes that the skeletal muscle undergoes aging sarcopenia, alteration of fiber type distribution and also intimate metabolic transformations. The neuromuscular junction suffers at cellular and molecular level, with possible implications of various cell components, mediators and oxidative stress. Motoneuron loss and change in their physiological properties accompany remodeling in the motor units. The applicability of knowledge in this field lies in possible interventions intended to counteract these age-related losses.

  17. Occupational Therapy in the Intensive Care Unit: A Systematic Review.

    Science.gov (United States)

    Weinreich, Mark; Herman, Jennifer; Dickason, Stephanie; Mayo, Helen

    2017-07-01

    This paper is a synthesis of the available literature on occupational therapy interventions performed in the adult intensive care unit (ICU). The databases of Ovid MEDLINE, Embase, the Cochrane Library, ClinicalTrials.gov and CINAHL databases were systematically searched from inception through August 2016 for studies of adults who received occupational therapy interventions in the ICU. Of 1,938 citations reviewed, 10 studies met inclusion criteria. Only one study explicitly discussed occupational therapy interventions performed and only one study specifically tested the efficacy of occupational therapy. Future research is needed to clarify the specific interventions and role of occupational therapy in the ICU and the efficacy of these interventions.

  18. Energy policies of IEA countries: the United Kingdom 2006 review

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    The United Kingdom is facing a critical moment in its energy policy: North Sea oil and gas production is declining, dependence on imported energy is increasing, while rising energy prices and climate change considerations pose further challenges. The second thematic review of the UK addresses these challenges, focusing on energy investment, energy efficiency, and the return of nuclear power to the political agenda. Almost all coal-fired and nuclear power capacity in the United Kingdom will be retired within the next 15 years. The review encourages the government to maintain its trust in the market mechanism for the delivery of required investment and security of supply. However, it also identifies the need for the government to play a more active role in setting the framework. On the demand side, the IEA considers the government's 'Energy Efficiency Commitment' (EEC) an impressive success. The EEC was introduced in 2002 and is an energy-saving programme under which suppliers must achieve efficiency targets in households. Challenges, such as the requirement that 50 per cent of savings come from low-income households, remain, and the review invites the government to investigate ways in which fuel poverty could be reduced without distorting the EEC. The review also assesses the government's shifting direction on nuclear energy and backs this new path. It argues that the development of a positive investment framework in planning and licensing - without direct intervention in investment decisions favouring nuclear - will allow investors to judge the viability of new plants. 3 apps.

  19. Noise pollution in intensive care units: a systematic review article

    Directory of Open Access Journals (Sweden)

    Gholamreza Khademi

    2015-01-01

    Full Text Available Introduction: Noise pollution in hospital wards can arise from a wide range of sources including medical devices, air-conditioning systems and conversations among the staffs. Noise in intensive care units (ICUs can disrupt patients’ sleep pattern and may have a negative impact on cognitive performance. Material and methods: In this review article, we searched through PubMed and Google Scholar, using [noise and (ICU or “intensive care unit”] as keyword to find studies related to noise pollution in ICUs. In total, 250 studies were found among which 35 articles were included. Results: The majority of the reviewed studies showed that noise pollution levels were higher in ICUs than the level recommend by The United States Environmental Protection Agency and World Health Organization. Noise pollution was mostly caused by human activity and operating equipments in ICUs and other hospital wards.  Conclusion: As the results indicated, identifying, monitoring and controlling noise sources, as well as educating the hospital staffs about the negative effects of noise on patients’ health, can be highly effective in reducing noise pollution.

  20. Use of Physio-Hydrological Units for SMOS Validation at the Valencia Anchor Station Study Area

    Science.gov (United States)

    Millán-Scheiding, C.; Antolín, C.; Marco, J.; Soriano, M. P.; Torre, E.; Requena, F.; Carbó, E.; Cano, A.; Lopez-Baeza, E.

    2009-04-01

    The SMOS space mission will soil moisture over the continents and ocean surface salinity with the sufficient resolution to be used in global climate change studies. With the aim of validating SMOS land data and products at the Valencia Anchor Station site (VAS) in a Mediterranean Ecosystem area of Spain, we have designed a sample methodology using a subdivision of the landscape in environmental units related to the spatial variability of soil moisture (Millán-Scheiding, 2006; Lopez-Baeza, et al. 2008). These physio-hydrological units are heterogeneously structured entities which present a certain degree of internal uniformity of hydrological parameters. The units are delimited by integrating areas with the same physio-morphology, soil type, vegetation, geology and topography (Flugel, et al 2003; Millán-Scheiding et al, 2007). Each of these units presented over the same pedological characteristics, vegetation cover, and landscape position should have a certain degree of internal uniformity in its hydrological parameters and therefore similar soil moisture (SM). The main assumption for each unit is that the dynamical variation of the hydrological parameters within one unit should be minimum compared to the dynamics of another unit. This methodology will hopefully provide an effective sampling design consisting of a reduced number of measuring points, sparsely distributed over the area, or alternatively, using SM validation networks where each sampling point is located where it is representative of the mean soil moisture of a complete unit area. The Experimental Plan for the SMOS Validation Rehearsal Campaign at the VAS area of April-May 2008 used this environmental subdivision in the selection and sampling of over 21.000 soil moisture points in a control area of 10 x 10 km2. The ground measurements were carried out during 4 nights corresponding to a drying out period of the soil. The sampling consisted of 700 plots with 4 volumetric SM cylinders and 7 Delta-T Theta

  1. Validity and interunit reliability of 10 Hz and 15 Hz GPS units for assessing athlete movement demands.

    Science.gov (United States)

    Johnston, Richard J; Watsford, Mark L; Kelly, Stephen J; Pine, Matthew J; Spurrs, Robert W

    2014-06-01

    The purpose of this study was to assess the validity and interunit reliability of 10 Hz (Catapult) and 15 Hz (GPSports) Global Positioning System (GPS) units and investigate the differences between these units as measures of team sport athlete movement demands. A team sport simulation circuit was completed by 8 trained male participants. The movement demands examined included: total distance covered (TD), average peak speed, and the distance covered, time spent, and the number of efforts performed low-speed running (0.00-13.99 km · h(-1)), high-speed running (14.00-19.99 km · h(-1)), and very high-speed running (>20.00 km · h(-1)). The degree of difference between the 10 Hz and the 15 Hz GPS units and validity was assessed using a paired samples t-test. Pearson's correlations were also used for validity assessment. Interunit reliability was established using percentage typical error of measurement (%TEM) and intraclass correlations. The findings revealed that 10 Hz GPS units were a valid (p > 0.05) and reliable (%TEM = 1.3%) measure of TD. In contrast, the 15 Hz GPS units exhibited lower validity for TD and average peak speed. Further, as the speed of movement increased the level of error for the 10 Hz and 15 Hz GPS units increased (%TEM = 0.8-19.9). The findings from this study suggest that comparisons should not be undertaken between 10 Hz and 15 Hz GPS units. In general, the 10 Hz GPS units measured movement demands with greater validity and interunit reliability than the 15 Hz units, however, both 10 Hz and 15 Hz units provided the improved measures of movement demands in comparison to 1 Hz and 5 Hz GPS units.

  2. Energy policies of IEA countries: United States - 2007 review

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-02-15

    The United States is the largest economy and energy user in the world. Significant developments have taken place in its energy policy since the last IEA review in 2002. Most important is the Energy Policy Act 2005 - a comprehensive energy legislation which has set new directions, including opening the way for a nuclear renaissance. Two closely connected challenges shape all debates on the nation's energy policy path: how to increase security by reducing the dependence on imported supplies; and how to address growing emissions of greenhouse gases. The United States national strategy is to find solutions largely through technology. It is a world leader in R&D and is driving development of carbon capture and storage and second-generation biofuels. But thus far, no federal government policy is in place to establish as a target an absolute reduction of CO2 emissions. The resulting uncertainty risks holding back investments into new technologies and may delay projects that are urgently required. The transport sector will be a key to a sustainable success. In the short to medium term, reduced fuel demand through higher vehicle efficiency will increase security and reduce CO2 emissions. Yet the policy for the revision of CAFE (the corporate average fuel economy) standards will leave consumers with vehicles that fall short of the technological possibilities. This review takes an in-depth look at these issues and provides recommendations on how the United States can do more to answer the challenges of both improving its security of energy supply and lowering its emissions intensity, demonstrating the significant improvements that can already be realised through existing technologies.

  3. Using Confirmatory Factor Analysis for Construct Validation: An Empirical Review

    Science.gov (United States)

    DiStefano, Christine; Hess, Brian

    2005-01-01

    This study investigated the psychological assessment literature to determine what applied researchers are using and reporting from confirmatory factor analysis (CFA) studies for evidence of construct validation. One hundred and one articles published in four major psychological assessment journals between 1990 and 2002 were systematically…

  4. Script concordance testing: a review of published validity evidence.

    NARCIS (Netherlands)

    Lubarsky, S.; Charlin, B.; Cook, D.A.; Chalk, C.; Vleuten, C.P.M. van der

    2011-01-01

    CONTEXT: Script concordance test (SCT) scores are intended to reflect respondents' competence in interpreting clinical data under conditions of uncertainty. The validity of inferences based on SCT scores has not been rigorously established. OBJECTIVES: This study was conducted in order to develop a

  5. Validity, reliability, and feasibility of clinical staging scales in dementia: a systematic review

    NARCIS (Netherlands)

    Olde Rikkert, M.G.M.; Tona, K.D.; Janssen, L.; Burns, A.; Lobo, A.; Robert, P.; Sartorius, N.; Stoppe, G.; Waldemar, G.

    2011-01-01

    New staging systems of dementia require adaptation of disease management programs and adequate staging instruments. Therefore, we systematically reviewed the literature on validity and reliability of clinically applicable, multidomain, and dementia staging instruments. A total of 23 articles describ

  6. A Review of Models and Procedures for Synthetic Validation for Entry-Level Army Jobs

    Science.gov (United States)

    1988-12-01

    ARI Research Note 88-107 A Review of Models and Procedures for Co Synthetic Validation for Entry-LevelM -£.2 Army Jobs C i Jennifer L. Crafts, Philip...of Models and Procecures for Synthetic Validation for Entry-Level Army Jobs 12. PERSONAL AUTHOR(S) Crafts, Jennifer L., Szenas, Fhilip L., Chia, Wel...well as ability. ProJect A Validity Results Campbell (1986) and McHerry, Houigh. Thquam, Hanson, and Ashworth (1987) have conducted extensive

  7. Social Validity Assessment in Social Competence Interventions for Preschool Children: A Review

    Science.gov (United States)

    Hurley, Jennifer J.

    2012-01-01

    Social competence intervention studies published from 1970 to 2008 for preschoolers were reviewed for reports of social validity assessment. Analysis of 90 studies indicated that nearly 27% (n = 24) of studies reported at least one measure of social validity assessment for the goals (n = 7), procedures (n = 8), or effects (n = 19). The methods…

  8. The Validity of Individual Rorschach Variables: Systematic Reviews and Meta-Analyses of the Comprehensive System

    Science.gov (United States)

    Mihura, Joni L.; Meyer, Gregory J.; Dumitrascu, Nicolae; Bombel, George

    2013-01-01

    We systematically evaluated the peer-reviewed Rorschach validity literature for the 65 main variables in the popular Comprehensive System (CS). Across 53 meta-analyses examining variables against externally assessed criteria (e.g., observer ratings, psychiatric diagnosis), the mean validity was r = 0.27 (k = 770) as compared to r = 0.08 (k = 386)…

  9. A Review on Method Development and Validation using HPLC

    Directory of Open Access Journals (Sweden)

    Rashmi Adhikari

    2016-09-01

    Full Text Available High performance liquid chromatography (HPLC is an analytical technique which is used to separate, detect and quantify various drugs and its related degradants. It is employed to separate manufactured drugs from drug related impurities, to detect and quantify synthesized drug and to reduce other impurities at the time of separation. A number of chromatographic parameters were evaluated in order to optimize the method. An appropriate mobile phase, column, column temperature, wavelength and gradient must be found that affords suitable compatibility and stability of drug as well as degradants and impurities. Validation of HPLC as per ICH guidelines covers all the performance characteristics of validation, likeaccuracy, precision, specificity, linearity, range, limit of detection, limit of quantification, robustness and system suitability testing.

  10. Validity of the Kinect for Gait Assessment: A Focused Review.

    Science.gov (United States)

    Springer, Shmuel; Yogev Seligmann, Galit

    2016-02-04

    Gait analysis may enhance clinical practice. However, its use is limited due to the need for expensive equipment which is not always available in clinical settings. Recent evidence suggests that Microsoft Kinect may provide a low cost gait analysis method. The purpose of this report is to critically evaluate the literature describing the concurrent validity of using the Kinect as a gait analysis instrument. An online search of PubMed, CINAHL, and ProQuest databases was performed. Included were studies in which walking was assessed with the Kinect and another gold standard device, and consisted of at least one numerical finding of spatiotemporal or kinematic measures. Our search identified 366 papers, from which 12 relevant studies were retrieved. The results demonstrate that the Kinect is valid only for some spatiotemporal gait parameters. Although the kinematic parameters measured by the Kinect followed the trend of the joint trajectories, they showed poor validity and large errors. In conclusion, the Kinect may have the potential to be used as a tool for measuring spatiotemporal aspects of gait, yet standardized methods should be established, and future examinations with both healthy subjects and clinical participants are required in order to integrate the Kinect as a clinical gait analysis tool.

  11. The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients.

    Science.gov (United States)

    Sessler, Curtis N; Gosnell, Mark S; Grap, Mary Jo; Brophy, Gretchen M; O'Neal, Pam V; Keane, Kimberly A; Tesoro, Eljim P; Elswick, R K

    2002-11-15

    Sedative medications are widely used in intensive care unit (ICU) patients. Structured assessment of sedation and agitation is useful to titrate sedative medications and to evaluate agitated behavior, yet existing sedation scales have limitations. We measured inter-rater reliability and validity of a new 10-level (+4 "combative" to -5 "unarousable") scale, the Richmond Agitation-Sedation Scale (RASS), in two phases. In phase 1, we demonstrated excellent (r = 0.956, lower 90% confidence limit = 0.948; kappa = 0.73, 95% confidence interval = 0.71, 0.75) inter-rater reliability among five investigators (two physicians, two nurses, and one pharmacist) in adult ICU patient encounters (n = 192). Robust inter-rater reliability (r = 0.922-0.983) (kappa = 0.64-0.82) was demonstrated for patients from medical, surgical, cardiac surgery, coronary, and neuroscience ICUs, patients with and without mechanical ventilation, and patients with and without sedative medications. In validity testing, RASS correlated highly (r = 0.93) with a visual analog scale anchored by "combative" and "unresponsive," including all patient subgroups (r = 0.84-0.98). In the second phase, after implementation of RASS in our medical ICU, inter-rater reliability between a nurse educator and 27 RASS-trained bedside nurses in 101 patient encounters was high (r = 0.964, lower 90% confidence limit = 0.950; kappa = 0.80, 95% confidence interval = 0.69, 0.90) and very good for all subgroups (r = 0.773-0.970, kappa = 0.66-0.89). Correlations between RASS and the Ramsay sedation scale (r = -0.78) and the Sedation Agitation Scale (r = 0.78) confirmed validity. Our nurses described RASS as logical, easy to administer, and readily recalled. RASS has high reliability and validity in medical and surgical, ventilated and nonventilated, and sedated and nonsedated adult ICU patients.

  12. GENETIC ALGORITHM ON GENERAL PURPOSE GRAPHICS PROCESSING UNIT: PARALLELISM REVIEW

    Directory of Open Access Journals (Sweden)

    A.J. Umbarkar

    2013-01-01

    Full Text Available Genetic Algorithm (GA is effective and robust method for solving many optimization problems. However, it may take more runs (iterations and time to get optimal solution. The execution time to find the optimal solution also depends upon the niching-technique applied to evolving population. This paper provides the information about how various authors, researchers, scientists have implemented GA on GPGPU (General purpose Graphics Processing Units with and without parallelism. Many problems have been solved on GPGPU using GA. GA is easy to parallelize because of its SIMD nature and therefore can be implemented well on GPGPU. Thus, speedup can definitely be achieved if bottleneck in GAs are identified and implemented effectively on GPGPU. Paper gives review of various applications solved using GAs on GPGPU with the future scope in the area of optimization.

  13. Validation of the USGS Landsat Burned Area Essential Climate Variable (BAECV) across the conterminous United States

    Science.gov (United States)

    Vanderhoof, Melanie; Fairaux, Nicole; Beal, Yen-Ju G.; Hawbaker, Todd J.

    2017-01-01

    The Landsat Burned Area Essential Climate Variable (BAECV), developed by the U.S. Geological Survey (USGS), capitalizes on the long temporal availability of Landsat imagery to identify burned areas across the conterminous United States (CONUS) (1984–2015). Adequate validation of such products is critical for their proper usage and interpretation. Validation of coarse-resolution products often relies on independent data derived from moderate-resolution sensors (e.g., Landsat). Validation of Landsat products, in turn, is challenging because there is no corresponding source of high-resolution, multispectral imagery that has been systematically collected in space and time over the entire temporal extent of the Landsat archive. Because of this, comparison between high-resolution images and Landsat science products can help increase user's confidence in the Landsat science products, but may not, alone, be adequate. In this paper, we demonstrate an approach to systematically validate the Landsat-derived BAECV product. Burned area extent was mapped for Landsat image pairs using a manually trained semi-automated algorithm that was manually edited across 28 path/rows and five different years (1988, 1993, 1998, 2003, 2008). Three datasets were independently developed by three analysts and the datasets were integrated on a pixel by pixel basis in which at least one to all three analysts were required to agree a pixel was burned. We found that errors within our Landsat reference dataset could be minimized by using the rendition of the dataset in which pixels were mapped as burned if at least two of the three analysts agreed. BAECV errors of omission and commission for the detection of burned pixels averaged 42% and 33%, respectively for CONUS across all five validation years. Errors of omission and commission were lowest across the western CONUS, for example in the shrub and scrublands of the Arid West (31% and 24%, respectively), and highest in the grasslands and

  14. Operations research in intensive care unit management: a literature review.

    Science.gov (United States)

    Bai, Jie; Fügener, Andreas; Schoenfelder, Jan; Brunner, Jens O

    2016-08-12

    The intensive care unit (ICU) is a crucial and expensive resource largely affected by uncertainty and variability. Insufficient ICU capacity causes many negative effects not only in the ICU itself, but also in other connected departments along the patient care path. Operations research/management science (OR/MS) plays an important role in identifying ways to manage ICU capacities efficiently and in ensuring desired levels of service quality. As a consequence, numerous papers on the topic exist. The goal of this paper is to provide the first structured literature review on how OR/MS may support ICU management. We start our review by illustrating the important role the ICU plays in the hospital patient flow. Then we focus on the ICU management problem (single department management problem) and classify the literature from multiple angles, including decision horizons, problem settings, and modeling and solution techniques. Based on the classification logic, research gaps and opportunities are highlighted, e.g., combining bed capacity planning and personnel scheduling, modeling uncertainty with non-homogenous distribution functions, and exploring more efficient solution approaches.

  15. The validity of the DSM-IV PTSD criteria in children and adolescents: a review

    NARCIS (Netherlands)

    Blom, M.; Oberink, R.

    2012-01-01

    Objective: DSM-V is on its way and doubts have been raised regarding the validity of pediatric PTSD. It is the goal of the current review to critically review the empirical literature on PTSD in youth. Method: A search of PsycINFO, PubMed and reference lists was conducted. Empirical information cons

  16. Modification and Validation of an Automotive Data Processing Unit, Compessed Video System, and Communications Equipment

    Energy Technology Data Exchange (ETDEWEB)

    Carter, R.J.

    1997-04-01

    The primary purpose of the "modification and validation of an automotive data processing unit (DPU), compressed video system, and communications equipment" cooperative research and development agreement (CRADA) was to modify and validate both hardware and software, developed by Scientific Atlanta, Incorporated (S-A) for defense applications (e.g., rotary-wing airplanes), for the commercial sector surface transportation domain (i.e., automobiles and trucks). S-A also furnished a state-of-the-art compressed video digital storage and retrieval system (CVDSRS), and off-the-shelf data storage and transmission equipment to support the data acquisition system for crash avoidance research (DASCAR) project conducted by Oak Ridge National Laboratory (ORNL). In turn, S-A received access to hardware and technology related to DASCAR. DASCAR was subsequently removed completely and installation was repeated a number of times to gain an accurate idea of complete installation, operation, and removal of DASCAR. Upon satisfactory completion of the DASCAR construction and preliminary shakedown, ORNL provided NHTSA with an operational demonstration of DASCAR at their East Liberty, OH test facility. The demonstration included an on-the-road demonstration of the entire data acquisition system using NHTSA'S test track. In addition, the demonstration also consisted of a briefing, containing the following: ORNL generated a plan for validating the prototype data acquisition system with regard to: removal of DASCAR from an existing vehicle, and installation and calibration in other vehicles; reliability of the sensors and systems; data collection and transmission process (data integrity); impact on the drivability of the vehicle and obtrusiveness of the system to the driver; data analysis procedures; conspicuousness of the vehicle to other drivers; and DASCAR installation and removal training and documentation. In order to identify any operational problems not captured by the systems

  17. Evaluation of a validated food frequency questionnaire for self-defined vegans in the United States.

    Science.gov (United States)

    Dyett, Patricia; Rajaram, Sujatha; Haddad, Ella H; Sabate, Joan

    2014-07-08

    This study aimed to develop and validate a de novo food frequency questionnaire for self-defined vegans in the United States. Diet histories from pilot samples of vegans and a modified 'Block Method' using seven selected nutrients of concern in vegan diet patterns, were employed to generate the questionnaire food list. Food frequency responses of 100 vegans from 19 different U.S. states were obtained via completed mailed questionnaires and compared to multiple telephone-conducted diet recall interviews. Computerized diet analyses were performed. Correlation coefficients, t-tests, rank, cross-tabulations, and probability tests were used to validate and compare intake estimates and dietary reference intake (DRI) assessment trends between the two methods. A 369-item vegan-specific questionnaire was developed with 252 listed food frequency items. Calorie-adjusted correlation coefficients ranged from r = 0.374 to 0.600 (p vegans). This vegan-specific questionnaire can be a useful assessment tool for health screening initiatives in U.S. vegan communities.

  18. Evaluation of a Validated Food Frequency Questionnaire for Self-Defined Vegans in the United States

    Science.gov (United States)

    Dyett, Patricia; Rajaram, Sujatha; Haddad, Ella H.; Sabate, Joan

    2014-01-01

    This study aimed to develop and validate a de novo food frequency questionnaire for self-defined vegans in the United States. Diet histories from pilot samples of vegans and a modified ‘Block Method’ using seven selected nutrients of concern in vegan diet patterns, were employed to generate the questionnaire food list. Food frequency responses of 100 vegans from 19 different U.S. states were obtained via completed mailed questionnaires and compared to multiple telephone-conducted diet recall interviews. Computerized diet analyses were performed. Correlation coefficients, t-tests, rank, cross-tabulations, and probability tests were used to validate and compare intake estimates and dietary reference intake (DRI) assessment trends between the two methods. A 369-item vegan-specific questionnaire was developed with 252 listed food frequency items. Calorie-adjusted correlation coefficients ranged from r = 0.374 to 0.600 (p vegans). This vegan-specific questionnaire can be a useful assessment tool for health screening initiatives in U.S. vegan communities. PMID:25006856

  19. Evaluation of a Validated Food Frequency Questionnaire for Self-Defined Vegans in the United States

    Directory of Open Access Journals (Sweden)

    Patricia Dyett

    2014-07-01

    Full Text Available This study aimed to develop and validate a de novo food frequency questionnaire for self-defined vegans in the United States. Diet histories from pilot samples of vegans and a modified ‘Block Method’ using seven selected nutrients of concern in vegan diet patterns, were employed to generate the questionnaire food list. Food frequency responses of 100 vegans from 19 different U.S. states were obtained via completed mailed questionnaires and compared to multiple telephone-conducted diet recall interviews. Computerized diet analyses were performed. Correlation coefficients, t-tests, rank, cross-tabulations, and probability tests were used to validate and compare intake estimates and dietary reference intake (DRI assessment trends between the two methods. A 369-item vegan-specific questionnaire was developed with 252 listed food frequency items. Calorie-adjusted correlation coefficients ranged from r = 0.374 to 0.600 (p < 0.001 for all analyzed nutrients except calcium. Estimates, ranks, trends and higher-level participant percentile placements for Vitamin B12 were similar with both methods. Questionnaire intakes were higher than recalls for most other nutrients. Both methods demonstrated similar trends in DRI adequacy assessment (e.g., significantly inadequate vitamin D intake among vegans. This vegan-specific questionnaire can be a useful assessment tool for health screening initiatives in U.S. vegan communities.

  20. Validated Screening Tools for Common Mental Disorders in Low and Middle Income Countries: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Gemma-Claire Ali

    Full Text Available A wide range of screening tools are available to detect common mental disorders (CMDs, but few have been specifically developed for populations in low and middle income countries (LMIC. Cross-cultural application of a screening tool requires that its validity be assessed against a gold standard diagnostic interview. Validation studies of brief CMD screening tools have been conducted in several LMIC, but until now there has been no review of screening tools for all CMDs across all LMIC populations.A systematic review with broad inclusion criteria was conducted, producing a comprehensive summary of brief CMD screening tools validated for use in LMIC populations. For each validation, the diagnostic odds ratio (DOR was calculated as an easily comparable measure of screening tool validity. Average DOR results weighted by sample size were calculated for each screening tool, enabling us to make broad recommendations about best performing screening tools.153 studies fulfilled our inclusion criteria. Because many studies validated two or more screening tools, this corresponded to 273 separate validations against gold standard diagnostic criteria. We found that the validity of every screening tool tested in multiple settings and populations varied between studies, highlighting the importance of local validation. Many of the best performing tools were purposely developed for a specific population; however, as these tools have only been validated in one study, it is not possible to draw broader conclusions about their applicability in other contexts.Of the tools that have been validated in multiple settings, the authors broadly recommend using the SRQ-20 to screen for general CMDs, the GHQ-12 for CMDs in populations with physical illness, the HADS-D for depressive disorders, the PHQ-9 for depressive disorders in populations with good literacy levels, the EPDS for perinatal depressive disorders, and the HADS-A for anxiety disorders. We recommend that

  1. Validation of population-based disease simulation models: a review of concepts and methods

    Directory of Open Access Journals (Sweden)

    Sharif Behnam

    2010-11-01

    Full Text Available Abstract Background Computer simulation models are used increasingly to support public health research and policy, but questions about their quality persist. The purpose of this article is to review the principles and methods for validation of population-based disease simulation models. Methods We developed a comprehensive framework for validating population-based chronic disease simulation models and used this framework in a review of published model validation guidelines. Based on the review, we formulated a set of recommendations for gathering evidence of model credibility. Results Evidence of model credibility derives from examining: 1 the process of model development, 2 the performance of a model, and 3 the quality of decisions based on the model. Many important issues in model validation are insufficiently addressed by current guidelines. These issues include a detailed evaluation of different data sources, graphical representation of models, computer programming, model calibration, between-model comparisons, sensitivity analysis, and predictive validity. The role of external data in model validation depends on the purpose of the model (e.g., decision analysis versus prediction. More research is needed on the methods of comparing the quality of decisions based on different models. Conclusion As the role of simulation modeling in population health is increasing and models are becoming more complex, there is a need for further improvements in model validation methodology and common standards for evaluating model credibility.

  2. Emotional consequences of intensive care unit delirium and delusional memories after intensive care unit admission : A systematic review

    NARCIS (Netherlands)

    Nouwen, Marinus J.; Klijn, Francina A. M.; van den Broek, Brigitte T. A.; Slooter, Arjen J. C.

    2012-01-01

    Purpose: The aim of this study was to review literature exploring the emotional consequences of delirium and delusional memories in intensive care unit patients. Methods: A systematic review was performed using PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and PsychINFO.

  3. Validity, reliability, and feasibility of clinical staging scales in dementia: a systematic review

    DEFF Research Database (Denmark)

    Rikkert, Marcel G M Olde; Tona, Klodiana Daphne; Janssen, Lieneke;

    2011-01-01

    New staging systems of dementia require adaptation of disease management programs and adequate staging instruments. Therefore, we systematically reviewed the literature on validity and reliability of clinically applicable, multidomain, and dementia staging instruments. A total of 23 articles desc......, and is available in 14 languages. Taking into account the increasing differentiation of Alzheimer's disease in preclinical and predementia stages, there is an urgent need for global rating scales to be refined as well.......New staging systems of dementia require adaptation of disease management programs and adequate staging instruments. Therefore, we systematically reviewed the literature on validity and reliability of clinically applicable, multidomain, and dementia staging instruments. A total of 23 articles...... describing 12 staging instruments were identified (N = 6109 participants, age 65-87). Reliability was studied in most (91%) of the articles and was judged moderate to good. Approximately 78% of the articles evaluated concurrent validity, which was good to very good, while discriminant validity was assessed...

  4. Single-reviewer electronic phenotyping validation in operational settings: Comparison of strategies and recommendations.

    Science.gov (United States)

    Kukhareva, Polina; Staes, Catherine; Noonan, Kevin W; Mueller, Heather L; Warner, Phillip; Shields, David E; Weeks, Howard; Kawamoto, Kensaku

    2017-02-01

    Develop evidence-based recommendations for single-reviewer validation of electronic phenotyping results in operational settings. We conducted a randomized controlled study to evaluate whether electronic phenotyping results should be used to support manual chart review during single-reviewer electronic phenotyping validation (N=3104). We evaluated the accuracy, duration and cost of manual chart review with and without the availability of electronic phenotyping results, including relevant patient-specific details. The cost of identification of an erroneous electronic phenotyping result was calculated based on the personnel time required for the initial chart review and subsequent adjudication of discrepancies between manual chart review results and electronic phenotype determinations. Providing electronic phenotyping results (vs not providing those results) was associated with improved overall accuracy of manual chart review (98.90% vs 92.46%, pphenotyping result ($48.54 vs $63.56, p=0.16). The agreement between chart review and electronic phenotyping results was higher when the phenotyping results were provided (Cohen's kappa 0.98 vs 0.88, pphenotyping results were correct (99.74% vs 92.67%, N=3049, pphenotyping results were erroneous (56.67% vs 80.00%, N=55, p=0.07). Electronic phenotyping results provided the greatest benefit for the accurate identification of rare exclusion criteria. Single-reviewer chart review of electronic phenotyping can be conducted more accurately, quickly, and at lower cost when supported by electronic phenotyping results. However, human reviewers tend to agree with electronic phenotyping results even when those results are wrong. Thus, the value of providing electronic phenotyping results depends on the accuracy of the underlying electronic phenotyping algorithm. We recommend using a mix of phenotyping validation strategies, with the balance of strategies based on the anticipated electronic phenotyping error rate, the tolerance for missed

  5. Computer validation in toxicology: historical review for FDA and EPA good laboratory practice.

    Science.gov (United States)

    Brodish, D L

    1998-01-01

    The application of computer validation principles to Good Laboratory Practice is a fairly recent phenomenon. As automated data collection systems have become more common in toxicology facilities, the U.S. Food and Drug Administration and the U.S. Environmental Protection Agency have begun to focus inspections in this area. This historical review documents the development of regulatory guidance on computer validation in toxicology over the past several decades. An overview of the components of a computer life cycle is presented, including the development of systems descriptions, validation plans, validation testing, system maintenance, SOPs, change control, security considerations, and system retirement. Examples are provided for implementation of computer validation principles on laboratory computer systems in a toxicology facility.

  6. Validity of purchasing power parity for selected Latin American countries: Linear and non-linear unit root tests

    Directory of Open Access Journals (Sweden)

    Claudio Roberto Fóffano Vasconcelos

    2016-01-01

    Full Text Available The aim of this study is to examine empirically the validity of PPP in the context of unit root tests based on linear and non-linear models of the real effective exchange rate of Argentina, Brazil, Chile, Colombia, Mexico, Peru and Venezuela. For this purpose, we apply the Harvey et al. (2008 linearity test and the non-linear unit root test (Kruse, 2011. The results show that the series with linear characteristics are Argentina, Brazil, Chile, Colombia and Peru and those with non-linear characteristics are Mexico and Venezuela. The linear unit root tests indicate that the real effective exchange rate is stationary for Chile and Peru, and the non-linear unit root tests evidence that Mexico is stationary. In the period analyzed, the results show support for the validity of PPP in only three of the seven countries.

  7. Unit testing, model validation, and biological simulation [version 1; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    Gopal P. Sarma

    2016-08-01

    Full Text Available The growth of the software industry has gone hand in hand with the development of tools and cultural practices for ensuring the reliability of complex pieces of software. These tools and practices are now acknowledged to be essential to the management of modern software. As computational models and methods have become increasingly common in the biological sciences, it is important to examine how these practices can accelerate biological software development and improve research quality. In this article, we give a focused case study of our experience with the practices of unit testing and test-driven development in OpenWorm, an open-science project aimed at modeling Caenorhabditis elegans. We identify and discuss the challenges of incorporating test-driven development into a heterogeneous, data-driven project, as well as the role of model validation tests, a category of tests unique to software which expresses scientific models.

  8. Validity of Ski Skating Center-of-Mass Displacement Measured by a Single Inertial Measurement Unit.

    Science.gov (United States)

    Myklebust, Håvard; Gløersen, Øyvind; Hallén, Jostein

    2015-12-01

    In regard to simplifying motion analysis and estimating center of mass (COM) in ski skating, this study addressed 3 main questions concerning the use of inertial measurement units (IMU): (1) How accurately can a single IMU estimate displacement of os sacrum (S1) on a person during ski skating? (2) Does incorporating gyroscope and accelerometer data increase accuracy and precision? (3) Moreover, how accurately does S1 determine COM displacement? Six world-class skiers roller-ski skated on a treadmill using 2 different subtechniques. An IMU including accelerometers alone (IMU-A) or in combination with gyroscopes (IMU-G) were mounted on the S1. A reflective marker at S1, and COM calculated from 3D full-body optical analysis, were used to provide reference values. IMU-A provided an accurate and precise estimate of vertical S1 displacement, but IMU-G was required to attain accuracy and precision of < 8 mm (root-mean-squared error and range of displacement deviation) in all directions and with both subtechniques. Further, arm and torso movements affected COM, but not the S1. Hence, S1 displacement was valid for estimating sideways COM displacement, but the systematic amplitude and timing difference between S1 and COM displacement in the anteroposterior and vertical directions inhibits exact calculation of energy fluctuations.

  9. Families' experiences of intensive care unit quality of care : Development and validation of a European questionnaire (euroQ2)

    NARCIS (Netherlands)

    Jensen, Hanne Irene; Gerritsen, Rik T.; Koopmans, Matty; Zijlstra, Jan G.; Curtis, Jared Randall; Ording, Helle

    2015-01-01

    Purpose: The purpose of the study is to adapt and provide preliminary validation for questionnaires evaluating families' experiences of quality of care for critically ill patients in the intensive care unit (ICU). Materials and methods: This study took place in 2 European ICUs. Based on literature a

  10. Validation and Evaluation of Two Observational Pain Assessment Tools in a Trauma and Neurosurgical Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Jane Topolovec-Vranic

    2013-01-01

    Full Text Available BACKGROUND: Studies have demonstrated that patients in the intensive care unit experience high levels of pain. While many of these patients are nonverbal at some point during their stay, there are few valid tools available to assess pain in this group.

  11. Validation of distal limb mounted inertial-measurement-unit sensors for stride detection in Warmblood horses at walk and trot

    NARCIS (Netherlands)

    Bragança, F M; Bosch, S; Voskamp, J P; Marin-Perianu, M; Van der Zwaag, B J; Vernooij, J C M; van Weeren, P R; Back, W

    2016-01-01

    BACKGROUND: Inertial-measurement-unit (IMU)-sensor-based techniques are becoming more popular in horses as a tool for objective locomotor assessment. OBJECTIVES: To describe, evaluate and validate a method of stride detection and quantification at walk and trot using distal limb mounted IMU-sensors.

  12. Validation of distal limb mounted inertial measurement unit sensors for stride detection in Warmblood horses at walk and trot

    NARCIS (Netherlands)

    Braganca, F.M.; Bosch, Stephan; Voskamp, J.P.; Marin-Perianu, M.; Zwaag, van der B.J.; Vernooij, J.C.; Weeren, van P.R.; Back, W.

    2016-01-01

    Background: Inertial measurement unit (IMU) sensor-based techniques are becoming more popular in horses as a tool for objective locomotor assessment. Objectives: To describe, evaluate and validate a method of stride detection and quantification at walk and trot using distal limb mounted IMU sensors

  13. Validity of activity monitors in health and chronic disease : a systematic review

    NARCIS (Netherlands)

    Van Remoortel, Hans; Giavedoni, Santiago; Raste, Yogini; Burtin, Chris; Louvaris, Zafeiris; Gimeno-Santos, Elena; Langer, Daniel; Glendenning, Alastair; Hopkinson, Nicholas S; Vogiatzis, Ioannis; Peterson, Barry T; Wilson, Frederick; Mann, Bridget; Rabinovich, Roberto; Puhan, Milo A; Troosters, Thierry; de Jong, Corina

    2012-01-01

    The assessment of physical activity in healthy populations and in those with chronic diseases is challenging. The aim of this systematic review was to identify whether available activity monitors (AM) have been appropriately validated for use in assessing physical activity in these groups. Following

  14. Validity of activity monitors in health and chronic disease : a systematic review

    NARCIS (Netherlands)

    Van Remoortel, Hans; Giavedoni, Santiago; Raste, Yogini; Burtin, Chris; Louvaris, Zafeiris; Gimeno-Santos, Elena; Langer, Daniel; Glendenning, Alastair; Hopkinson, Nicholas S; Vogiatzis, Ioannis; Peterson, Barry T; Wilson, Frederick; Mann, Bridget; Rabinovich, Roberto; Puhan, Milo A; Troosters, Thierry; de Jong, Corina

    2012-01-01

    The assessment of physical activity in healthy populations and in those with chronic diseases is challenging. The aim of this systematic review was to identify whether available activity monitors (AM) have been appropriately validated for use in assessing physical activity in these groups. Following

  15. Diagnostic Validity of Criteria for Sacroiliac Joint Pain : A Systematic Review

    NARCIS (Netherlands)

    Szadek, Karolina M.; van der Wurff, Peter; van Tulder, Maurits W.; Zuurmond, Wouter W.; Perez, Roberto S. G. M.

    2009-01-01

    A systematic literature review was conducted to determine the diagnostic validity of the criteria for sacroiliac (SI) joint pain as proposed by the International Association for the Study of Pain (IASP). Databases were searched up to September 2007. Quality of the studies was assessed using a Qualit

  16. Development and validation of the Acculturative Stress Scale for Chinese College Students in the United States (ASSCS).

    Science.gov (United States)

    Bai, Jieru

    2016-04-01

    Chinese students are the biggest ethnic group of international students in the United States. This study aims to develop a reliable and valid scale to accurately measure their acculturative stress. A 72-item pool was sent online to Chinese students and a five-factor scale of 32 items was generated by exploratory factor analysis. The five factors included language insufficiency, social isolation, perceived discrimination, academic pressure, and guilt toward family. The Acculturative Stress Scale for Chinese Students demonstrated high reliability and initial validity by predicting depression and life satisfaction. It was the first Chinese scale of acculturative stress developed and validated among a Chinese student sample in the United States. In the future, the scale can be used as a diagnostic tool by mental health professionals and a self-assessment tool by Chinese students. (c) 2016 APA, all rights reserved.

  17. Validity and reliability of eating disorder assessments used with athletes:A review

    Institute of Scientific and Technical Information of China (English)

    Zachary Pope; Yong Gao; Nicole Bolter; Mary Pritchard

    2015-01-01

    Background:Prevalence of eating disorders (EDs) among college-aged athletes has risen in recent years. Although measures exist for assessing EDs, these measures have not been thoroughly reviewed in athletes. This study reviewed the validity and reliability evidence of the commonly used measures for assessing EDs in athlete populations aged 18-26 years. Methods:Databases were searched for studies of regarding ED on male and/or female athletes. Inclusion criteria stated the study (a) assessed EDs in an athlete population 18-26 years of age and (b) investigated EDs using a psychometric measure found valid and/or reliable in a non-athlete population and/or athlete population. Results:Fifty studies met the inclusion criteria. Seven and 22 articles, respectively, studied EDs behaviors in male and female athletes whereas 21 articles studied EDs in combined-gender samples. The five most commonly used measures were the Eating Attitudes Test (EAT), Eating Disorder Inventory (EDI), Bulimia Test-Revised (BULIT-R), Questionnaire for Eating Disorder Diagnosis (QEDD), and the Eating Disorder Examination Questionnaire (EDE-Q). Conclusion:Only seven studies calculated validity coefficients within the study whereas 47 cited the validity coefficient. Twenty-six calculated a reliability coefficient whereas 47 cited the reliability of the ED measures. Four studies found validity evidence for the EAT, EDI, BULIT-R, QEDD, and EDE-Q in an athlete population. Few studies reviewed calculated validity and reliability coefficients of ED measures. Cross-validation of these measures in athlete populations is clearly needed.

  18. Review of validation and reporting of non-targeted fingerprinting approaches for food authentication.

    Science.gov (United States)

    Riedl, Janet; Esslinger, Susanne; Fauhl-Hassek, Carsten

    2015-07-23

    Food fingerprinting approaches are expected to become a very potent tool in authentication processes aiming at a comprehensive characterization of complex food matrices. By non-targeted spectrometric or spectroscopic chemical analysis with a subsequent (multivariate) statistical evaluation of acquired data, food matrices can be investigated in terms of their geographical origin, species variety or possible adulterations. Although many successful research projects have already demonstrated the feasibility of non-targeted fingerprinting approaches, their uptake and implementation into routine analysis and food surveillance is still limited. In many proof-of-principle studies, the prediction ability of only one data set was explored, measured within a limited period of time using one instrument within one laboratory. Thorough validation strategies that guarantee reliability of the respective data basis and that allow conclusion on the applicability of the respective approaches for its fit-for-purpose have not yet been proposed. Within this review, critical steps of the fingerprinting workflow were explored to develop a generic scheme for multivariate model validation. As a result, a proposed scheme for "good practice" shall guide users through validation and reporting of non-targeted fingerprinting results. Furthermore, food fingerprinting studies were selected by a systematic search approach and reviewed with regard to (a) transparency of data processing and (b) validity of study results. Subsequently, the studies were inspected for measures of statistical model validation, analytical method validation and quality assurance measures. In this context, issues and recommendations were found that might be considered as an actual starting point for developing validation standards of non-targeted metabolomics approaches for food authentication in the future. Hence, this review intends to contribute to the harmonization and standardization of food fingerprinting, both

  19. The beliefs in the inheritance of risk factors for suicide scale (BIRFSS): cross-cultural validation in Estonia, Malaysia, Romania, the United Kingdom, and the United States.

    Science.gov (United States)

    Voracek, Martin; Loibl, Lisa Mariella; Swami, Viren; Vintilă, Mona; Kõlves, Kairi; Sinniah, Dhachayani; Pillai, Subash Kumar; Ponnusamy, Subramaniam; Sonneck, Gernot; Furnham, Adrian; Lester, David

    2008-12-01

    The genetics of suicide is increasingly recognized and relevant for mental health literacy, but actual beliefs may lag behind current knowledge. We examined such beliefs in student samples (total N = 686) from Estonia, Malaysia, Romania, the United Kingdom, and the United States with the Beliefs in the Inheritance of Risk Factors for Suicide Scale. Cultural effects were small, those of key demographics nil. Several facets of construct validity were demonstrated. Marked differences in perceived plausibility of evidence about the genetics of suicide according to research design, observed in all samples, may be of general interest for investigating lay theories of abnormal behavior and communicating behavioral and psychiatric genetic research findings.

  20. Validation of biomarkers for the study of environmental carcinogens: a review

    DEFF Research Database (Denmark)

    Gallo, Valentina; Khan, Aneire; Gonzales, Carlos

    2008-01-01

    There is a need for validation of biomarkers. Our aim is to review published work on the validation of selected biomarkers: bulky DNA adducts, N-nitroso compounds, 1-hydroxypyrene, and oxidative damage to DNA. A systematic literature search in PubMed was performed. Information on the variability...... and reliability of the laboratory tests used for biomarkers measurements was collected. For the evaluation of the evidence on validation we referred to the ACCE criteria. Little is known about intraindividual variation of DNA adduct measurements, but measurements have a good repeatability irrespective...... of the technique used for their identification; reproducibility improved after the correction for a laboratory factor. A high-sensitivity method is available for the measurement of 1-hydroxypyrene in urine. There is consensus on validation of biomarkers of oxidative damage DNA based on the comet assay...

  1. VALIDATION OF THE ASTER GLOBAL DIGITAL ELEVATION MODEL VERSION 3 OVER THE CONTERMINOUS UNITED STATES

    Directory of Open Access Journals (Sweden)

    D. Gesch

    2016-06-01

    Full Text Available The ASTER Global Digital Elevation Model Version 3 (GDEM v3 was evaluated over the conterminous United States in a manner similar to the validation conducted for the original GDEM Version 1 (v1 in 2009 and GDEM Version 2 (v2 in 2011. The absolute vertical accuracy of GDEM v3 was calculated by comparison with more than 23,000 independent reference geodetic ground control points from the U.S. National Geodetic Survey. The root mean square error (RMSE measured for GDEM v3 is 8.52 meters. This compares with the RMSE of 8.68 meters for GDEM v2. Another important descriptor of vertical accuracy is the mean error, or bias, which indicates if a DEM has an overall vertical offset from true ground level. The GDEM v3 mean error of −1.20 meters reflects an overall negative bias in GDEM v3. The absolute vertical accuracy assessment results, both mean error and RMSE, were segmented by land cover type to provide insight into how GDEM v3 performs in various land surface conditions. While the RMSE varies little across cover types (6.92 to 9.25 meters, the mean error (bias does appear to be affected by land cover type, ranging from −2.99 to +4.16 meters across 14 land cover classes. These results indicate that in areas where built or natural aboveground features are present, GDEM v3 is measuring elevations above the ground level, a condition noted in assessments of previous GDEM versions (v1 and v2 and an expected condition given the type of stereo-optical image data collected by ASTER. GDEM v3 was also evaluated by differencing with the Shuttle Radar Topography Mission (SRTM dataset. In many forested areas, GDEM v3 has elevations that are higher in the canopy than SRTM. The overall validation effort also included an evaluation of the GDEM v3 water mask. In general, the number of distinct water polygons in GDEM v3 is much lower than the number in a reference land cover dataset, but the total areas compare much more closely.

  2. Validation of the ASTER Global Digital Elevation Model version 3 over the conterminous United States

    Science.gov (United States)

    Gesch, Dean B.; Oimoen, Michael J.; Danielson, Jeffrey J.; Meyer, David

    2016-01-01

    The ASTER Global Digital Elevation Model Version 3 (GDEM v3) was evaluated over the conterminous United States in a manner similar to the validation conducted for the original GDEM Version 1 (v1) in 2009 and GDEM Version 2 (v2) in 2011. The absolute vertical accuracy of GDEM v3 was calculated by comparison with more than 23,000 independent reference geodetic ground control points from the U.S. National Geodetic Survey. The root mean square error (RMSE) measured for GDEM v3 is 8.52 meters. This compares with the RMSE of 8.68 meters for GDEM v2. Another important descriptor of vertical accuracy is the mean error, or bias, which indicates if a DEM has an overall vertical offset from true ground level. The GDEM v3 mean error of −1.20 meters reflects an overall negative bias in GDEM v3. The absolute vertical accuracy assessment results, both mean error and RMSE, were segmented by land cover type to provide insight into how GDEM v3 performs in various land surface conditions. While the RMSE varies little across cover types (6.92 to 9.25 meters), the mean error (bias) does appear to be affected by land cover type, ranging from −2.99 to +4.16 meters across 14 land cover classes. These results indicate that in areas where built or natural aboveground features are present, GDEM v3 is measuring elevations above the ground level, a condition noted in assessments of previous GDEM versions (v1 and v2) and an expected condition given the type of stereo-optical image data collected by ASTER. GDEM v3 was also evaluated by differencing with the Shuttle Radar Topography Mission (SRTM) dataset. In many forested areas, GDEM v3 has elevations that are higher in the canopy than SRTM. The overall validation effort also included an evaluation of the GDEM v3 water mask. In general, the number of distinct water polygons in GDEM v3 is much lower than the number in a reference land cover dataset, but the total areas compare much more closely.

  3. Validation of the Aster Global Digital Elevation Model Version 3 Over the Conterminous United States

    Science.gov (United States)

    Gesch, D.; Oimoen, M.; Danielson, J.; Meyer, D.

    2016-06-01

    The ASTER Global Digital Elevation Model Version 3 (GDEM v3) was evaluated over the conterminous United States in a manner similar to the validation conducted for the original GDEM Version 1 (v1) in 2009 and GDEM Version 2 (v2) in 2011. The absolute vertical accuracy of GDEM v3 was calculated by comparison with more than 23,000 independent reference geodetic ground control points from the U.S. National Geodetic Survey. The root mean square error (RMSE) measured for GDEM v3 is 8.52 meters. This compares with the RMSE of 8.68 meters for GDEM v2. Another important descriptor of vertical accuracy is the mean error, or bias, which indicates if a DEM has an overall vertical offset from true ground level. The GDEM v3 mean error of -1.20 meters reflects an overall negative bias in GDEM v3. The absolute vertical accuracy assessment results, both mean error and RMSE, were segmented by land cover type to provide insight into how GDEM v3 performs in various land surface conditions. While the RMSE varies little across cover types (6.92 to 9.25 meters), the mean error (bias) does appear to be affected by land cover type, ranging from -2.99 to +4.16 meters across 14 land cover classes. These results indicate that in areas where built or natural aboveground features are present, GDEM v3 is measuring elevations above the ground level, a condition noted in assessments of previous GDEM versions (v1 and v2) and an expected condition given the type of stereo-optical image data collected by ASTER. GDEM v3 was also evaluated by differencing with the Shuttle Radar Topography Mission (SRTM) dataset. In many forested areas, GDEM v3 has elevations that are higher in the canopy than SRTM. The overall validation effort also included an evaluation of the GDEM v3 water mask. In general, the number of distinct water polygons in GDEM v3 is much lower than the number in a reference land cover dataset, but the total areas compare much more closely.

  4. Validity of breast, lung and colorectal cancer diagnoses in administrative databases: a systematic review protocol.

    Science.gov (United States)

    Abraha, Iosief; Giovannini, Gianni; Serraino, Diego; Fusco, Mario; Montedori, Alessandro

    2016-03-18

    Breast, lung and colorectal cancers constitute the most common cancers worldwide and their epidemiology, related health outcomes and quality indicators can be studied using administrative healthcare databases. To constitute a reliable source for research, administrative healthcare databases need to be validated. The aim of this protocol is to perform the first systematic review of studies reporting the validation of International Classification of Diseases 9th and 10th revision codes to identify breast, lung and colorectal cancer diagnoses in administrative healthcare databases. This review protocol has been developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) 2015 statement. We will search the following databases: MEDLINE, EMBASE, Web of Science and the Cochrane Library, using appropriate search strategies. We will include validation studies that used administrative data to identify breast, lung and colorectal cancer diagnoses or studies that evaluated the validity of breast, lung and colorectal cancer codes in administrative data. The following inclusion criteria will be used: (1) the presence of a reference standard case definition for the disease of interest; (2) the presence of at least one test measure (eg, sensitivity, positive predictive values, etc) and (3) the use of data source from an administrative database. Pairs of reviewers will independently abstract data using standardised forms and will assess quality using a checklist based on the Standards for Reporting of Diagnostic accuracy (STARD) criteria. Ethics approval is not required. We will submit results of this study to a peer-reviewed journal for publication. The results will serve as a guide to identify appropriate case definitions and algorithms of breast, lung and colorectal cancers for researchers involved in validating administrative healthcare databases as well as for outcome research on these conditions that used administrative

  5. VALIDATION OF THE ASTER GLOBAL DIGITAL ELEVATION MODEL VERSION 2 OVER THE CONTERMINOUS UNITED STATES

    Directory of Open Access Journals (Sweden)

    D. Gesch

    2012-07-01

    Full Text Available The ASTER Global Digital Elevation Model Version 2 (GDEM v2 was evaluated over the conterminous United States in a manner similar to the validation conducted for the original GDEM Version 1 (v1 in 2009. The absolute vertical accuracy of GDEM v2 was calculated by comparison with more than 18,000 independent reference geodetic ground control points from the National Geodetic Survey. The root mean square error (RMSE measured for GDEM v2 is 8.68 meters. This compares with the RMSE of 9.34 meters for GDEM v1. Another important descriptor of vertical accuracy is the mean error, or bias, which indicates if a DEM has an overall vertical offset from true ground level. The GDEM v2 mean error of –0.20 meters is a significant improvement over the GDEM v1 mean error of –3.69 meters. The absolute vertical accuracy assessment results, both mean error and RMSE, were segmented by land cover to examine the effects of cover types on measured errors. The GDEM v2 mean errors by land cover class verify that the presence of aboveground features (tree canopies and built structures cause a positive elevation bias, as would be expected for an imaging system like ASTER. In open ground classes (little or no vegetation with significant aboveground height, GDEM v2 exhibits a negative bias on the order of 1 meter. GDEM v2 was also evaluated by differencing with the Shuttle Radar Topography Mission (SRTM dataset. In many forested areas, GDEM v2 has elevations that are higher in the canopy than SRTM.

  6. Validating the Concept of COPD Control: A Real-world Cohort Study from the United Kingdom.

    Science.gov (United States)

    Nibber, Anjan; Chisholm, Alison; Soler-Cataluña, Juan José; Alcazar, Bernardino; Price, David; Miravitlles, Marc

    2017-10-01

    The concept of Chronic Obstructive Pulmonary Disease (COPD) control has been developed to inform therapeutic decision-making. We explored the validity of a definition of COPD control in a representative population of patients with COPD in the United Kingdom. Electronic medical records and linked COPD questionnaire data from the Optimum Patient Care Research Database were used to characterize control status. Patients were aged ≥40 years, with spirometry-confirmed COPD, current or ex-smokers, and continuous records throughout the study period. Control was evaluated based on COPD stability and patients' (i) clinical features or (ii) COPD Assessment Test (CAT) score over a three-month baseline period and linked to time to first exacerbation. Of 2788 eligible patients, 2511 (90%) had mild/moderate COPD and 277 (10%) had severe/very severe COPD based on Body Mass Index, Obstruction, Dyspnoea, Exacerbations (BODEx) cut-off of 4. Within the mild/moderate cohort, 4.5% of patients were controlled at baseline according to clinical features and 21.5% according to CAT threshold of 10. Within the severe/very severe cohort, no patients were controlled at baseline according to the proposed clinical features and 8.3% were controlled according to CAT threshold of 20. Compared with uncontrolled patients, time to first exacerbation was longer for controlled patients with mild/moderate COPD but not for those with severe/very severe COPD. Lowering the BODEx threshold for severity classification to 2 increased the number of patients achieving control. CAT scores were not good predictors of the risk of future exacerbation. With the proposed definition, very few patients were defined as controlled.

  7. Validated Smartphone-Based Apps for Ear and Hearing Assessments: A Review.

    Science.gov (United States)

    Bright, Tess; Pallawela, Danuk

    2016-12-23

    An estimated 360 million people have a disabling hearing impairment globally, the vast majority of whom live in low- and middle-income countries (LMICs). Early identification through screening is important to negate the negative effects of untreated hearing impairment. Substantial barriers exist in screening for hearing impairment in LMICs, such as the requirement for skilled hearing health care professionals and prohibitively expensive specialist equipment to measure hearing. These challenges may be overcome through utilization of increasingly available smartphone app technologies for ear and hearing assessments that are easy to use by unskilled professionals. Our objective was to identify and compare available apps for ear and hearing assessments and consider the incorporation of such apps into hearing screening programs. In July 2015, the commercial app stores Google Play and Apple App Store were searched to identify apps for ear and hearing assessments. Thereafter, six databases (EMBASE, MEDLINE, Global Health, Web of Science, CINAHL, and mHealth Evidence) were searched to assess which of the apps identified in the commercial review had been validated against gold standard measures. A comparison was made between validated apps. App store search queries returned 30 apps that could be used for ear and hearing assessments, the majority of which are for performing audiometry. The literature search identified 11 eligible validity studies that examined 6 different apps. uHear, an app for self-administered audiometry, was validated in the highest number of peer reviewed studies against gold standard pure tone audiometry (n=5). However, the accuracy of uHear varied across these studies. Very few of the available apps have been validated in peer-reviewed studies. Of the apps that have been validated, further independent research is required to fully understand their accuracy at detecting ear and hearing conditions.

  8. Inter-rater reliability and convergent validity of F1000Prime peer review

    CERN Document Server

    Bornmann, Lutz

    2014-01-01

    Peer review is the backbone of modern science. F1000Prime is a post-publication peer review system of the biomedical literature (papers from medical and biological journals). This study is concerned with the inter-rater reliability and convergent validity of the peer recommendations formulated in the F1000Prime peer review system. The study is based on around 100,000 papers with recommendations from Faculty members. Even if intersubjectivity plays a fundamental role in science, the analyses of the reliability of the F1000Prime peer review system show a rather low level of agreement between Faculty members. This result is in agreement with most other studies which have been published on the journal peer review system. Logistic regression models are used to investigate the convergent validity of the F1000Prime peer review system. As the results show, the proportion of highly cited papers among those selected by the Faculty members is significantly higher than expected. In addition, better recommendation scores ...

  9. Measuring Resource Utilization: A Systematic Review of Validated Self-Reported Questionnaires.

    Science.gov (United States)

    Leggett, Laura E; Khadaroo, Rachel G; Holroyd-Leduc, Jayna; Lorenzetti, Diane L; Hanson, Heather; Wagg, Adrian; Padwal, Raj; Clement, Fiona

    2016-03-01

    A variety of methods may be used to obtain costing data. Although administrative data are most commonly used, the data available in these datasets are often limited. An alternative method of obtaining costing is through self-reported questionnaires. Currently, there are no systematic reviews that summarize self-reported resource utilization instruments from the published literature.The aim of the study was to identify validated self-report healthcare resource use instruments and to map their attributes.A systematic review was conducted. The search identified articles using terms like "healthcare utilization" and "questionnaire." All abstracts and full texts were considered in duplicate. For inclusion, studies had to assess the validity of a self-reported resource use questionnaire, to report original data, include adult populations, and the questionnaire had to be publically available. Data such as type of resource utilization assessed by each questionnaire, and validation findings were extracted from each study.In all, 2343 unique citations were retrieved; 2297 were excluded during abstract review. Forty-six studies were reviewed in full text, and 15 studies were included in this systematic review. Six assessed resource utilization of patients with chronic conditions; 5 assessed mental health service utilization; 3 assessed resource utilization by a general population; and 1 assessed utilization in older populations. The most frequently measured resources included visits to general practitioners and inpatient stays; nonmedical resources were least frequently measured. Self-reported questionnaires on resource utilization had good agreement with administrative data, although, visits to general practitioners, outpatient days, and nurse visits had poorer agreement.Self-reported questionnaires are a valid method of collecting data on healthcare resource utilization.

  10. [Validated Instruments for the Psychological Assessment of Unaccompanied Refugee Minors - a Systematic Review].

    Science.gov (United States)

    Rassenhofer, Miriam; Fegert, Jörg Michael; Plener, Paul L; Witt, Andreas

    2016-01-01

    The German care system faces a growing number of unaccompanied refugee minors (URM). URM show high levels of traumatization, a variety of psychological symptoms and lack important resilience factors. Therefore an early and valid psychological assessment is important for intervention and service planning. Yet, no systematic review on validated instruments for the assessment of this group exists. Literature search revealed one study about translators in the assessment of URM and five validated instruments for proxy and self-report. These instruments are available in several languages and showed good psychometric properties. It has to be critically stated that all instruments have been validated by a single work group within a single population. Especially with regards to changing definitions of Posttraumatic Stress Disorder within the new (and upcoming) classification systems ICD-11 and DSM-5, increased awareness for diagnostic procedures is necessary. Additionally, more validated instruments for specific psychological disorders in multiple languages are needed. Under an economic perspective the use of open access questionnaires that are available in different languages seems useful, even if they are not especially validated for URM.

  11. Gynecologic and dermatologic electrosurgical units: a comparative review.

    Science.gov (United States)

    Ferris, D G; Saxena, S; Hainer, B L; Searle, J R; Powell, J L; Gay, J N

    1994-08-01

    Electrosurgery is a popular surgical technique in which high-frequency, low-voltage electrical energy produced by an electrosurgical unit is used to excise abnormal tissue with hemostasis. In this study, electrosurgical units were critically evaluated for safety, electrical specifications, design, and performance characteristics. Quantitative electrical specification and histologic thermal artifact measurements and qualitative observations were recorded for 13 electrosurgical units representing 11 manufacturers. The Aspen Sabre 180 and Laerscope e10 were considered exemplary units based on safety criteria alone. Cut-mode thermal artifact was less than 10 microns for the Cooper Leep 6000, Laserscope e10, and Utah Finesse. A maximum fulguration distance of greater than 0.5 mm was demonstrated by the Gyne-Tech Autolepe 2000 and 4000, Laserscope e10, and the Elmed ESU 30. For gynecologic electrosurgery, the Aspen Sabre 180 and Laserscope e10 were rated best, followed closely by the Utah Finesse and Finesse II and the Gyne-Tech Autolepe 4000. Dermatologic electrosurgery may be well accomplished with many of the electrosurgical units, except as noted.

  12. Institutional Review Boards: Perspectives from the United States

    Directory of Open Access Journals (Sweden)

    Alvita Nathaniel, Ph.D., FNP-BC, FAANP

    2010-12-01

    Full Text Available In the U.S., all research must be approved by an Institutional Review Board (IRB that evaluates research protocols for the purpose of protecting human subjects. This paper includes a brief history of the development of public policy that guides institutional review boards in the U.S. and commentary on the responsibilities of a grounded theory researcher interested in applying for approval for a research study.An institutional review board (IRB is a formally constituted committee that approves and monitors biomedical and behavioural research with the purpose of protecting the rights and welfare of research participants. An IRB performs scientific, ethical, and regulatory oversight functions. In the U.S., it is common for grounded theorists to experience frustration with the IRB protocol submission process. Facets of the application process may seem rigid, redundant, and non-applicable. Review board members may not seem to understand or appreciate qualitative methods and delays are common. In addition, a conglomeration of disparate policies and procedures coupled with a variety of types of review boards creates a system that defies description. Nevertheless, a researcher who understands public policy and the responsibilities of institutional review boards can learn to develop research applications that are quickly approved.

  13. The validation of peer review through research impact measures and the implications for funding strategies.

    Directory of Open Access Journals (Sweden)

    Stephen A Gallo

    Full Text Available There is a paucity of data in the literature concerning the validation of the grant application peer review process, which is used to help direct billions of dollars in research funds. Ultimately, this validation will hinge upon empirical data relating the output of funded projects to the predictions implicit in the overall scientific merit scores from the peer review of submitted applications. In an effort to address this need, the American Institute of Biological Sciences (AIBS conducted a retrospective analysis of peer review data of 2,063 applications submitted to a particular research program and the bibliometric output of the resultant 227 funded projects over an 8-year period. Peer review scores associated with applications were found to be moderately correlated with the total time-adjusted citation output of funded projects, although a high degree of variability existed in the data. Analysis over time revealed that as average annual scores of all applications (both funded and unfunded submitted to this program improved with time, the average annual citation output per application increased. Citation impact did not correlate with the amount of funds awarded per application or with the total annual programmatic budget. However, the number of funded applications per year was found to correlate well with total annual citation impact, suggesting that improving funding success rates by reducing the size of awards may be an efficient strategy to optimize the scientific impact of research program portfolios. This strategy must be weighed against the need for a balanced research portfolio and the inherent high costs of some areas of research. The relationship observed between peer review scores and bibliometric output lays the groundwork for establishing a model system for future prospective testing of the validity of peer review formats and procedures.

  14. The validation of peer review through research impact measures and the implications for funding strategies.

    Science.gov (United States)

    Gallo, Stephen A; Carpenter, Afton S; Irwin, David; McPartland, Caitlin D; Travis, Joseph; Reynders, Sofie; Thompson, Lisa A; Glisson, Scott R

    2014-01-01

    There is a paucity of data in the literature concerning the validation of the grant application peer review process, which is used to help direct billions of dollars in research funds. Ultimately, this validation will hinge upon empirical data relating the output of funded projects to the predictions implicit in the overall scientific merit scores from the peer review of submitted applications. In an effort to address this need, the American Institute of Biological Sciences (AIBS) conducted a retrospective analysis of peer review data of 2,063 applications submitted to a particular research program and the bibliometric output of the resultant 227 funded projects over an 8-year period. Peer review scores associated with applications were found to be moderately correlated with the total time-adjusted citation output of funded projects, although a high degree of variability existed in the data. Analysis over time revealed that as average annual scores of all applications (both funded and unfunded) submitted to this program improved with time, the average annual citation output per application increased. Citation impact did not correlate with the amount of funds awarded per application or with the total annual programmatic budget. However, the number of funded applications per year was found to correlate well with total annual citation impact, suggesting that improving funding success rates by reducing the size of awards may be an efficient strategy to optimize the scientific impact of research program portfolios. This strategy must be weighed against the need for a balanced research portfolio and the inherent high costs of some areas of research. The relationship observed between peer review scores and bibliometric output lays the groundwork for establishing a model system for future prospective testing of the validity of peer review formats and procedures.

  15. Validity, reliability, and feasibility of clinical staging scales in dementia: a systematic review

    DEFF Research Database (Denmark)

    Rikkert, Marcel G M Olde; Tona, Klodiana Daphne; Janssen, Lieneke

    2011-01-01

    New staging systems of dementia require adaptation of disease management programs and adequate staging instruments. Therefore, we systematically reviewed the literature on validity and reliability of clinically applicable, multidomain, and dementia staging instruments. A total of 23 articles...... describing 12 staging instruments were identified (N = 6109 participants, age 65-87). Reliability was studied in most (91%) of the articles and was judged moderate to good. Approximately 78% of the articles evaluated concurrent validity, which was good to very good, while discriminant validity was assessed......, and is available in 14 languages. Taking into account the increasing differentiation of Alzheimer's disease in preclinical and predementia stages, there is an urgent need for global rating scales to be refined as well....

  16. Validating Vegetable Production Unit (VPU) Plants, Protocols, Procedures and Requirements (P3R) using Currently Existing Flight Resources

    Science.gov (United States)

    Bingham, Gail; Bates, Scott; Bugbee, Bruce; Garland, Jay; Podolski, Igor; Levinskikh, Rita; Sychev, Vladimir; Gushin, Vadim

    2009-01-01

    Validating Vegetable Production Unit (VPU) Plants, Protocols, Procedures and Requirements (P3R) Using Currently Existing Flight Resources (Lada-VPU-P3R) is a study to advance the technology required for plant growth in microgravity and to research related food safety issues. Lada-VPU-P3R also investigates the non-nutritional value to the flight crew of developing plants on-orbit. The Lada-VPU-P3R uses the Lada hardware on the ISS and falls under a cooperative agreement between National Aeronautics and Space Administration (NASA) and the Russian Federal Space Association (FSA). Research Summary: Validating Vegetable Production Unit (VPU) Plants, Protocols, Procedures and Requirements (P3R) Using Currently Existing Flight Resources (Lada-VPU-P3R) will optimize hardware and

  17. Investigating the reliability and validity of the waterlow risk assessment scale: a literature review.

    LENUS (Irish Health Repository)

    Walsh, Breda

    2011-05-01

    The aim of this review was to examine health literature on the reliability and validity of the Waterlow pressure sore assessment scale. A systematic review of published studies relating to the topic was conducted and literature was examined for its relevancy to the topic under investigation. Findings suggest that despite the availability of over 40 assessment tools, the Waterlow assessment scale is the most frequently used by health care staff. Research suggests that the Waterlow Scale is an unreliable method of assessing individuals at risk of pressure sore development with all studies indicating a poor interrater reliability status. Its validity has also been criticized because of its high-sensitivity but low-specificity levels.

  18. Investigating the reliability and validity of the waterlow risk assessment scale: a literature review.

    LENUS (Irish Health Repository)

    Walsh, Breda

    2012-02-01

    The aim of this review was to examine health literature on the reliability and validity of the Waterlow pressure sore assessment scale. A systematic review of published studies relating to the topic was conducted and literature was examined for its relevancy to the topic under investigation. Findings suggest that despite the availability of over 40 assessment tools, the Waterlow assessment scale is the most frequently used by health care staff. Research suggests that the Waterlow Scale is an unreliable method of assessing individuals at risk of pressure sore development with all studies indicating a poor interrater reliability status. Its validity has also been criticized because of its high-sensitivity but low-specificity levels.

  19. Initial approach to hypertension in the hemodynamics unit: review article

    Directory of Open Access Journals (Sweden)

    Gustavo Teixeira Fulton Schimit

    2013-06-01

    Full Text Available Correct identification and early management of hypertensive disorders should be a part of the therapeutic repertoire of every professional working in hemodynamics units. Based on recent publications, this study aims to propose a practical approach to the identification and early management of these disorders in this type of service.

  20. Teamwork assessment in internal medicine: a systematic review of validity evidence and outcomes.

    Science.gov (United States)

    Havyer, Rachel D A; Wingo, Majken T; Comfere, Nneka I; Nelson, Darlene R; Halvorsen, Andrew J; McDonald, Furman S; Reed, Darcy A

    2014-06-01

    Valid teamwork assessment is imperative to determine physician competency and optimize patient outcomes. We systematically reviewed published instruments assessing teamwork in undergraduate, graduate, and continuing medical education in general internal medicine and all medical subspecialties. We searched MEDLINE, MEDLINE In-process, CINAHL and PsycINFO from January 1979 through October 2012, references of included articles, and abstracts from four professional meetings. Two content experts were queried for additional studies. Included studies described quantitative tools measuring teamwork among medical students, residents, fellows, and practicing physicians on single or multi-professional (interprofessional) teams. Instrument validity and study quality were extracted using established frameworks with existing validity evidence. Two authors independently abstracted 30 % of articles and agreement was calculated. Of 12,922 citations, 178 articles describing 73 unique teamwork assessment tools met inclusion criteria. Interrater agreement was intraclass correlation coefficient 0.73 (95 % CI 0.63-0.81). Studies involved practicing physicians (142, 80 %), residents/fellows (70, 39 %), and medical students (11, 6 %). The majority (152, 85 %) assessed interprofessional teams. Studies were conducted in inpatient (77, 43 %), outpatient (42, 24 %), simulation (37, 21 %), and classroom (13, 7 %) settings. Validity evidence for the 73 tools included content (54, 74 %), internal structure (51, 70 %), relationships to other variables (25, 34 %), and response process (12, 16 %). Attitudes and opinions were the most frequently assessed outcomes. Relationships between teamwork scores and patient outcomes were directly examined for 13 (18 %) of tools. Scores from the Safety Attitudes Questionnaire and Team Climate Inventory have substantial validity evidence and have been associated with improved patient outcomes. Review is limited to quantitative assessments of teamwork in internal

  1. External validation of a measurement tool to assess systematic reviews (AMSTAR.

    Directory of Open Access Journals (Sweden)

    Beverley J Shea

    Full Text Available BACKGROUND: Thousands of systematic reviews have been conducted in all areas of health care. However, the methodological quality of these reviews is variable and should routinely be appraised. AMSTAR is a measurement tool to assess systematic reviews. METHODOLOGY: AMSTAR was used to appraise 42 reviews focusing on therapies to treat gastro-esophageal reflux disease, peptic ulcer disease, and other acid-related diseases. Two assessors applied the AMSTAR to each review. Two other assessors, plus a clinician and/or methodologist applied a global assessment to each review independently. CONCLUSIONS: The sample of 42 reviews covered a wide range of methodological quality. The overall scores on AMSTAR ranged from 0 to 10 (out of a maximum of 11 with a mean of 4.6 (95% CI: 3.7 to 5.6 and median 4.0 (range 2.0 to 6.0. The inter-observer agreement of the individual items ranged from moderate to almost perfect agreement. Nine items scored a kappa of >0.75 (95% CI: 0.55 to 0.96. The reliability of the total AMSTAR score was excellent: kappa 0.84 (95% CI: 0.67 to 1.00 and Pearson's R 0.96 (95% CI: 0.92 to 0.98. The overall scores for the global assessment ranged from 2 to 7 (out of a maximum score of 7 with a mean of 4.43 (95% CI: 3.6 to 5.3 and median 4.0 (range 2.25 to 5.75. The agreement was lower with a kappa of 0.63 (95% CI: 0.40 to 0.88. Construct validity was shown by AMSTAR convergence with the results of the global assessment: Pearson's R 0.72 (95% CI: 0.53 to 0.84. For the AMSTAR total score, the limits of agreement were -0.19+/-1.38. This translates to a minimum detectable difference between reviews of 0.64 'AMSTAR points'. Further validation of AMSTAR is needed to assess its validity, reliability and perceived utility by appraisers and end users of reviews across a broader range of systematic reviews.

  2. Failure to Validate a Multivariable Clinical Prediction Model to Identify Pediatric Intensive Care Unit Patients at High Risk for Candidemia.

    Science.gov (United States)

    Fisher, Brian T; Ross, Rachael K; Roilides, Emmanuel; Palazzi, Debra L; Abzug, Mark J; Hoffman, Jill A; Berman, David M; Prasad, Priya A; Localio, A Russell; Steinbach, William J; Vogiatzi, Lambrini; Dutta, Ankhi; Zaoutis, Theoklis E

    2016-12-01

    We attempted to validate a previously derived clinical prediction rule for candidemia in the pediatric intensive care unit. This multicenter case control study did not identify significant association of candidemia with most of the previously identified predictors. Additional study in larger cohorts with other predictor variables is needed. © The Author 2015. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  3. Measurement of predictive validity in violence risk assessment studies: a second-order systematic review.

    Science.gov (United States)

    Singh, Jay P; Desmarais, Sarah L; Van Dorn, Richard A

    2013-01-01

    The objective of the present review was to examine how predictive validity is analyzed and reported in studies of instruments used to assess violence risk. We reviewed 47 predictive validity studies published between 1990 and 2011 of 25 instruments that were included in two recent systematic reviews. Although all studies reported receiver operating characteristic curve analyses and the area under the curve (AUC) performance indicator, this methodology was defined inconsistently and findings often were misinterpreted. In addition, there was between-study variation in benchmarks used to determine whether AUCs were small, moderate, or large in magnitude. Though virtually all of the included instruments were designed to produce categorical estimates of risk - through the use of either actuarial risk bins or structured professional judgments - only a minority of studies calculated performance indicators for these categorical estimates. In addition to AUCs, other performance indicators, such as correlation coefficients, were reported in 60% of studies, but were infrequently defined or interpreted. An investigation of sources of heterogeneity did not reveal significant variation in reporting practices as a function of risk assessment approach (actuarial vs. structured professional judgment), study authorship, geographic location, type of journal (general vs. specialized audience), sample size, or year of publication. Findings suggest a need for standardization of predictive validity reporting to improve comparison across studies and instruments.

  4. Nutrition knowledge and Mediterranean diet adherence in the southeast United States: Validation of a field-based survey instrument.

    Science.gov (United States)

    Bottcher, Mary Rose; Marincic, Patricia Z; Nahay, Katie L; Baerlocher, Brittany E; Willis, Amy W; Park, Jieun; Gaillard, Philippe; Greene, Michael W

    2017-04-01

    The Mediterranean diet (MD) can reduce chronic disease risk and is a recommended diet for prevention and management of diabetes. Adherence to the MD in the southeast United States where obesity and diabetes are highly prevalent is unknown. The purpose of the present study was to: 1) construct a survey instrument relevant to the general population integrating both MD related nutrition knowledge and adherence questions from previously validated instruments, and 2) assess MD related nutrition knowledge and adherence in a sample population in the southest United States. Adherance was assessed using the validated short MD Adherence Screener (MEDAS). A MD nutrition knowledge (MDNK) questionnaire was developed from previously validated general nutrition knowledge questionnaires and was validated using 127 university students enrolled in three courses with varying levels of nutrition education. Cronbach's α for internal validity of MDNK was acceptable for a short questionnaire (0.653). Test-retest reliability was established (r = 0.853). Field validation of the three-part survey instrument (MEDAS, MDNK and demographic questions) was subsequently performed in 230 adults shopping at supermarkets and farmers markets in eastern Alabama. Total MDNK and MEDAS scores were significantly higher in students with formal nutrition education and in patrons of farmers markets. Greater MD adherence, assessed by dividing MEDAS scores into thirds, was found with increasing formal nutrition education in university students (p = 0.002) and in farmers market participants (p < 0.001). There was a weak but significant association between MDNK and MEDAS scores within university students and participants in the field. Together, the MDNK-MEDAS survey instrument is an effective tool for assessing baseline knowledge and adherence and can be used to target nutritional interventions to improve MD adherence for prevention and management of diabetes and other chronic disease.

  5. Transcultural Adaptation and Validation of the Family Satisfaction in the Intensive Care Unit Questionnaire in a Korean Sample

    Directory of Open Access Journals (Sweden)

    Youlim Kim

    2017-02-01

    Full Text Available Background A number of questionnaires designed for analyzing family members’ inconvenience and demands in intensive care unit (ICU care have been developed and validated in North America. The family satisfaction in the intensive care Unit-24 (FS-ICU-24 questionnaire is one of the most widely used of these instruments. This study aimed to translate the FS-ICU-24 questionnaire into Korean and validate the Korean version of the questionnaire. Methods The study was conducted in the medical, surgical, and emergency ICUs at three tertiary hospitals. Relatives of all patients hospitalized for at least 48 hours were enrolled for this study participants. The validation process included the measurement of construct validity, internal consistency, and interrater reliability. The questionnaire consists of 24 items divided between two subscales: satisfaction with care (14 items and satisfaction with decision making (10 items. Results In total, 200 family members of 176 patients from three hospitals completed the FS-ICU-24 questionnaire. Construct validity for the questionnaire was superior to that observed for a visual analog scale (Spearman’s r = 0.84, p < 0.001. Cronbach’s αs were 0.83 and 0.80 for the satisfaction with care and satisfaction with decision making subscales, respectively. The mean (± standard deviation total FS-ICU-24 score was 75.44 ± 17.70, and participants were most satisfied with consideration of their needs (82.13 ± 21.03 and least satisfied with the atmosphere in the ICU waiting room (35.38 ± 34.84. Conclusions The Korean version of the FS-ICU-24 questionnaire demonstrated good validity and could be a useful instrument with which to measure family members’ satisfaction about ICU care.

  6. Waterpipe Smoking and Regulation in the United States: A Comprehensive Review of the Literature

    OpenAIRE

    Linda Haddad; Omar El-Shahawy; Roula Ghadban; Barnett, Tracey E.; Emily Johnson

    2015-01-01

    Background: Researchers in tobacco control are concerned about the increasing prevalence of waterpipe smoking in the United States, which may pose similar risks as cigarette smoking. This review explores the prevalence of waterpipe smoking in the United States as well as the shortcomings of current U.S. policy for waterpipe control and regulation. Methods: Researchers conducted a literature review for waterpipe articles dated between 2004 and 2015 using five online databases: MEDLINE, CINHAHL...

  7. How to assess the external validity and model validity of therapeutic trials: a conceptual approach to systematic review methodology.

    Science.gov (United States)

    Khorsan, Raheleh; Crawford, Cindy

    2014-01-01

    Background. Evidence rankings do not consider equally internal (IV), external (EV), and model validity (MV) for clinical studies including complementary and alternative medicine/integrative medicine (CAM/IM) research. This paper describe this model and offers an EV assessment tool (EVAT©) for weighing studies according to EV and MV in addition to IV. Methods. An abbreviated systematic review methodology was employed to search, assemble, and evaluate the literature that has been published on EV/MV criteria. Standard databases were searched for keywords relating to EV, MV, and bias-scoring from inception to Jan 2013. Tools identified and concepts described were pooled to assemble a robust tool for evaluating these quality criteria. Results. This study assembled a streamlined, objective tool to incorporate for the evaluation of quality of EV/MV research that is more sensitive to CAM/IM research. Conclusion. Improved reporting on EV can help produce and provide information that will help guide policy makers, public health researchers, and other scientists in their selection, development, and improvement in their research-tested intervention. Overall, clinical studies with high EV have the potential to provide the most useful information about "real-world" consequences of health interventions. It is hoped that this novel tool which considers IV, EV, and MV on equal footing will better guide clinical decision making.

  8. Validating the Remotely Sensed Geography of Crime: A Review of Emerging Issues

    Directory of Open Access Journals (Sweden)

    Alice B. Kelly

    2014-12-01

    Full Text Available This paper explores the existing literature on the active detection of crimes using remote sensing technologies. The paper reviews sixty-one studies that use remote sensing to actively detect crime. Considering the serious consequences of misidentifying crimes or sites of crimes (e.g., opening that place and its residents up to potentially needless intrusion, intimidation, surveillance or violence, the authors were surprised to find a lack of rigorous validation of the remote sensing methods utilized in these studies. In some cases, validation was not mentioned, while in others, validation was severely hampered by security issues, rough terrain and weather conditions. The paper also considers the potential hazards of the use of Google Earth to identify crimes and criminals. The paper concludes by considering alternate, “second order” validation techniques that could add vital context and understanding to remotely sensed images in a law enforcement context. With this discussion, the authors seek to initiate a discussion on other potential “second order” validation techniques, as well as on the exponential growth of surveillance in our everyday lives.

  9. A systematic review of reliability and objective criterion-related validity of physical activity questionnaires

    Directory of Open Access Journals (Sweden)

    Helmerhorst Hendrik JF

    2012-08-01

    Full Text Available Abstract Physical inactivity is one of the four leading risk factors for global mortality. Accurate measurement of physical activity (PA and in particular by physical activity questionnaires (PAQs remains a challenge. The aim of this paper is to provide an updated systematic review of the reliability and validity characteristics of existing and more recently developed PAQs and to quantitatively compare the performance between existing and newly developed PAQs. A literature search of electronic databases was performed for studies assessing reliability and validity data of PAQs using an objective criterion measurement of PA between January 1997 and December 2011. Articles meeting the inclusion criteria were screened and data were extracted to provide a systematic overview of measurement properties. Due to differences in reported outcomes and criterion methods a quantitative meta-analysis was not possible. In total, 31 studies testing 34 newly developed PAQs, and 65 studies examining 96 existing PAQs were included. Very few PAQs showed good results on both reliability and validity. Median reliability correlation coefficients were 0.62–0.71 for existing, and 0.74–0.76 for new PAQs. Median validity coefficients ranged from 0.30–0.39 for existing, and from 0.25–0.41 for new PAQs. Although the majority of PAQs appear to have acceptable reliability, the validity is moderate at best. Newly developed PAQs do not appear to perform substantially better than existing PAQs in terms of reliability and validity. Future PAQ studies should include measures of absolute validity and the error structure of the instrument.

  10. Review of noise in neonatal intensive care units - regional analysis

    Energy Technology Data Exchange (ETDEWEB)

    Alvarez Abril, A [National Technological University, Regional Bioengineering Institute, Mendoza (Argentina); Terron, A; Boschi, C [National Technological University, Regional Bioengineering Institute, Mendoza (Argentina); Gomez, M [National Technological University, La Rioja (Argentina)

    2007-11-15

    This work is about the problem of noise in neonatal incubators and in the environment in the neonatal intensive care units. Its main objective is to analyse the impact of noise in hospitals of Mendoza and La Rioja. Methodology: The measures were taken in different moments in front of higher or lower severity level in the working environment. It is shown that noise produces severe damages and changes in the behaviour and the psychological status of the new born babies. Results: The noise recorded inside the incubators and the neonatal intensive care units together have many components but the noise of motors, opening and closing of access gates have been considered the most important ones. Values above 60 db and and up to 120 db in some cases were recorded, so the need to train the health staff in order to manage the new born babies, the equipment and the instruments associated with them very carefully is revealed.

  11. Treatment of hypophosphatemia in the intensive care unit: a review

    NARCIS (Netherlands)

    Geerse, D.A.; Bindels, A.J.; Kuiper, M.A.; Roos, A.N.; Spronk, P.E.; Schultz, M.J.

    2010-01-01

    Introduction: Currently no evidence-based guideline exists for the approach to hypophosphatemia in critically ill patients. Methods: We performed a narrative review of the medical literature to identify the incidence, symptoms, and treatment of hypophosphatemia in critically ill patients. Specifical

  12. Depression screening tools in persons with epilepsy: A systematic review of validated tools.

    Science.gov (United States)

    Gill, Stephanie J; Lukmanji, Sara; Fiest, Kirsten M; Patten, Scott B; Wiebe, Samuel; Jetté, Nathalie

    2017-05-01

    Depression affects approximately 25% of epilepsy patients. However, the optimal tool to screen for depression in epilepsy has not been definitively established. The purpose of this study was to systematically review the literature on the validity of depression-screening tools in epilepsy. MEDLINE, EMBASE, and PsycINFO were searched until April 4, 2016 with no restriction on dates. Abstract, full-text review and data abstraction were conducted in duplicate. We included studies that evaluated the validity of depression-screening tools and reported measures of diagnostic accuracy (e.g., sensitivity, specificity, and negative and positive predictive values) in epilepsy. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies Version 2. Medians and ranges for estimates of diagnostic accuracy were calculated when appropriate. A total of 16,070 abstracts were screened, and 38 articles met eligibility criteria. Sixteen screening tools were validated in 13 languages. The most commonly validated screening tool was the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) (n = 26). The Mini International Neuropsychiatric Interview (MINI) (n = 19) was the most common reference standard used. At the most common cutpoint of >15 (n = 12 studies), the NDDI-E had a median sensitivity of 80.5% (range 64.0-100.0) and specificity of 86.2 (range 81.0-95.6). Meta-analyses were not possible due to variability in cutpoints assessed, reference standards used, and lack of confidence intervals reported. A number of studies validated depression screening tools; however, estimates of diagnostic accuracy were inconsistently reported. The validity of scales in practice may have been overestimated, as cutpoints were often selected post hoc based on the study sample. The NDDI-E, which performed well, was the most commonly validated screening tool, is free to the public, and is validated in multiple languages and is easy to administer, although

  13. Validity of the international physical activity questionnaire short form (IPAQ-SF: A systematic review

    Directory of Open Access Journals (Sweden)

    Stewart Sunita M

    2011-10-01

    Full Text Available Abstract Background The International Physical Activity Questionnaire - Short Form (IPAQ-SF has been recommended as a cost-effective method to assess physical activity. Several studies validating the IPAQ-SF have been conducted with differing results, but no systematic review of these studies has been reported. Methods The keywords "IPAQ", "validation", and "validity" were searched in PubMed and Scopus. Studies published in English that validated the IPAQ-SF against an objective physical activity measuring device, doubly labeled water, or an objective fitness measure were included. Results Twenty-three validation studies were included in this review. There was a great deal of variability in the methods used across studies, but the results were largely similar. Correlations between the total physical activity level measured by the IPAQ-SF and objective standards ranged from 0.09 to 0.39; none reached the minimal acceptable standard in the literature (0.50 for objective activity measuring devices, 0.40 for fitness measures. Correlations between sections of the IPAQ-SF for vigorous activity or moderate activity level/walking and an objective standard showed even greater variability (-0.18 to 0.76, yet several reached the minimal acceptable standard. Only six studies provided comparisons between physical activity levels derived from the IPAQ-SF and those obtained from objective criterion. In most studies the IPAQ-SF overestimated physical activity level by 36 to 173 percent; one study underestimated by 28 percent. Conclusions The correlation between the IPAQ-SF and objective measures of activity or fitness in the large majority of studies was lower than the acceptable standard. Furthermore, the IPAQ-SF typically overestimated physical activity as measured by objective criterion by an average of 84 percent. Hence, the evidence to support the use of the IPAQ-SF as an indicator of relative or absolute physical activity is weak.

  14. What are validated self-report adherence scales really measuring?: a systematic review

    Science.gov (United States)

    Nguyen, Thi-My-Uyen; Caze, Adam La; Cottrell, Neil

    2014-01-01

    Aims Medication non-adherence is a significant health problem. There are numerous methods for measuring adherence, but no single method performs well on all criteria. The purpose of this systematic review is to (i) identify self-report medication adherence scales that have been correlated with comparison measures of medication-taking behaviour, (ii) assess how these scales measure adherence and (iii) explore how these adherence scales have been validated. Methods Cinahl and PubMed databases were used to search articles written in English on the development or validation of medication adherence scales dating to August 2012. The search terms used were medication adherence, medication non-adherence, medication compliance and names of each scale. Data such as barriers identified and validation comparison measures were extracted and compared. Results Sixty articles were included in the review, which consisted of 43 adherence scales. Adherence scales include items that either elicit information regarding the patient's medication-taking behaviour and/or attempts to identify barriers to good medication-taking behaviour or beliefs associated with adherence. The validation strategies employed depended on whether the focus of the scale was to measure medication-taking behaviour or identify barriers or beliefs. Conclusions Supporting patients to be adherent requires information on their medication-taking behaviour, barriers to adherence and beliefs about medicines. Adherence scales have the potential to explore these aspects of adherence, but currently there has been a greater focus on measuring medication-taking behaviour. Selecting the ‘right’ adherence scale(s) requires consideration of what needs to be measured and how (and in whom) the scale has been validated. PMID:23803249

  15. Factor Analysis Methods and Validity Evidence: A Systematic Review of Instrument Development across the Continuum of Medical Education

    Science.gov (United States)

    Wetzel, Angela Payne

    2011-01-01

    Previous systematic reviews indicate a lack of reporting of reliability and validity evidence in subsets of the medical education literature. Psychology and general education reviews of factor analysis also indicate gaps between current and best practices; yet, a comprehensive review of exploratory factor analysis in instrument development across…

  16. Energy Policies of IEA Countries: The United Kingdom 2012 Review

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

    The United Kingdom is preparing for a deep decarbonisation of its energy system. The country has decided to halve its greenhouse gas emissions from 1990 to 2027 and to cut them by a total of 80% by 2050. For this to happen, significant private-sector investment in new energy infrastructure is needed. As it seeks concrete solutions to the low-carbon investment challenge, the United Kingdom is leading by example. The UK's proposed Electricity Market Reform is a pioneering effort that will be closely observed by other countries. Ideally, this complex and ambitious reform would in the long run lead to a more liberalised marketplace in which low-carbon power generation technologies compete to deliver innovative and least-cost outcomes. Security of supply remains a key focus of energy policy. Fossil fuel production in the United Kingdom has peaked, and a fifth of the country's ageing power generating capacity will have to be closed this decade. However, oil and gas imports are well diversified, and the government intends to promote various technologies to generate low-carbon electricity -- renewable and nuclear energy and carbon capture and storage. More efficient energy use is essential to both decarbonisation and energy security. The Green Deal programme, which the UK plans to launch later this year, aims to improve energy efficiency in buildings and public spaces. The programme has the potential to help energy consumers overcome economic challenges, but for it to succeed, the general public must be sufficiently aware of its benefits.

  17. Energy Policies of IEA Countries: United Kingdom 2012 Review

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

    The United Kingdom is preparing for a deep decarbonisation of its energy system. The country has decided to halve its greenhouse gas emissions from 1990 to 2027 and to cut them by a total of 80% by 2050. For this to happen, significant private-sector investment in new energy infrastructure is needed. As it seeks concrete solutions to the low-carbon investment challenge, the United Kingdom is leading by example. The UK's proposed Electricity Market Reform is a pioneering effort that will be closely observed by other countries. Ideally, this complex and ambitious reform would in the long run lead to a more liberalised marketplace in which low-carbon power generation technologies compete to deliver innovative and least-cost outcomes. Security of supply remains a key focus of energy policy. Fossil fuel production in the United Kingdom has peaked, and a fifth of the country's ageing power generating capacity will have to be closed this decade. However, oil and gas imports are well diversified, and the government intends to promote various technologies to generate low-carbon electricity -- renewable and nuclear energy and carbon capture and storage. More efficient energy use is essential to both decarbonisation and energy security. The Green Deal programme, which the UK plans to launch later this year, aims to improve energy efficiency in buildings and public spaces. The programme has the potential to help energy consumers overcome economic challenges, but for it to succeed, the general public must be sufficiently aware of its benefits.

  18. Cooperative Fish and Wildlife Research Units Program—2016 year in review postcard

    Science.gov (United States)

    Organ, John F.; Thompson, John D.; Dennerline, Don E.; Childs, Dawn E.

    2017-02-22

    Cooperative Fish and Wildlife Research Units Program—2016 Year in Review postcardThis postcard provides details about the Cooperative Fish and Wildlife Research Units (CRU) Program—2016 Year in Review, Circular 1424. This Circular provides information relating to fish and wildlife science, students, staffing, vacancies, research funding, outreach and training, science themes, background on the CRU program, accolades, and professional services. Snapshots of Unit projects with information on how results have been or are being applied by cooperators are included. This is the essence of what we do: science that matters.Throughout the year, keep up with our research projects at www.coopunits.org.

  19. Current status of validation for robotic surgery simulators - a systematic review.

    Science.gov (United States)

    Abboudi, Hamid; Khan, Mohammed S; Aboumarzouk, Omar; Guru, Khurshid A; Challacombe, Ben; Dasgupta, Prokar; Ahmed, Kamran

    2013-02-01

    To analyse studies validating the effectiveness of robotic surgery simulators. The MEDLINE(®), EMBASE(®) and PsycINFO(®) databases were systematically searched until September 2011. References from retrieved articles were reviewed to broaden the search. The simulator name, training tasks, participant level, training duration and evaluation scoring were extracted from each study. We also extracted data on feasibility, validity, cost-effectiveness, reliability and educational impact. We identified 19 studies investigating simulation options in robotic surgery. There are five different robotic surgery simulation platforms available on the market. In all, 11 studies sought opinion and compared performance between two different groups; 'expert' and 'novice'. Experts ranged in experience from 21-2200 robotic cases. The novice groups consisted of participants with no prior experience on a robotic platform and were often medical students or junior doctors. The Mimic dV-Trainer(®), ProMIS(®), SimSurgery Educational Platform(®) (SEP) and Intuitive systems have shown face, content and construct validity. The Robotic Surgical SimulatorTM system has only been face and content validated. All of the simulators except SEP have shown educational impact. Feasibility and cost-effectiveness of simulation systems was not evaluated in any trial. Virtual reality simulators were shown to be effective training tools for junior trainees. Simulation training holds the greatest potential to be used as an adjunct to traditional training methods to equip the next generation of robotic surgeons with the skills required to operate safely. However, current simulation models have only been validated in small studies. There is no evidence to suggest one type of simulator provides more effective training than any other. More research is needed to validate simulated environments further and investigate the effectiveness of animal and cadaveric training in robotic surgery.

  20. [Reliability and validity of the modified Allen test: a systematic review and metanalysis].

    Science.gov (United States)

    Romeu-Bordas, Óscar; Ballesteros-Peña, Sendoa

    2017-01-01

    The objective was to evaluate the reliability and validity of the modified Allen test in screening for collateral circulation deficits in the palm and for predicting distal hand ischemia. We performed a systematic review of the literature indexed in 6 databases. We developed a search strategy to locate studies comparing the Allen test to Doppler ultrasound to detect circulation deficits in the hand, studies assessing the incidence of ischemic events on arterial puncture after an abnormal Allen test result, and studies of Allen test interobserver agreement. Fourteen articles met the inclusion criteria. Nine assessed the validity of the test as a screening tool for detecting collateral circulation deficits. From data published in 3 studies that had followed comparable designs we calculated a sensitivity of 77% and specificity of 93% for the Allen test. Four studies that assessed the ability of the test to predict ischemia did not predict any ischemic hand events following arterial puncture in patients with abnormal Allen test results. A single study assessing the test's reliability reported an interobserver agreement rate of 71.5%. This systematic review and metanalysis allows to conclude that the Allen test does not have sufficient diagnostic validity to serve as a screening tool for collateral circulation deficits in the hand. Nor is it a good predictor of hand ischemia after arterial puncture. Moreover, its reliability is limited. There is insufficient evidence to support its systematic use before arterial puncture.

  1. A review of recent activity in the United States.

    Science.gov (United States)

    Cannon, H.L.; Petrie, W.L.

    1979-01-01

    Either an overabundance or a deficiency of trace metals in the food chain can ultimately affect adversely the health of livestock and man. Increasing interest in the United States in the distribution of metals in the environment and in metal pollutants has led to widespread interdisciplinary research sponsored by governmental, private and academic groups concerning the availability of trace elements for absorption by plants and animals, and the effects of trace elements throughout the food chain. Effects on the environment of coal-fired power plants, the mining and processing of metals, asbestos, and phosphate, and the disposal of industrial and nuclear wastes have also received much attention in the past few years.-Authors

  2. Quadrennial review of a paediatric emergency assessment unit.

    Science.gov (United States)

    Aitken, Penny; Birch, Simon; Cogman, Genevieve; Glasper, Edward A; Wiltshire, Maureen

    The primary aim of this article is to report on one aspect of a quadrennial study designed to explore the appropriateness and impact of the development of a paediatric emergency assessment unit (PEAU) as a response to increases in paediatric emergencies presenting to a south-western regional child health unit. In particular, this article will present the findings of a prospective audit of admissions to the PEAU over a 1-month period during the latter part of 2002. The primary method of data collection utilized a structured survey instrument developed using a design and automatic data computer software package, completed by the nursing staff. Anonymized descriptive data were obtained from 223 children admitted to the PEAU during one calendar moth and authorized by the appropriate clinical directorate audit committee as part of its ongoing commitment to the full implementation of clinical governance. The data presented primarily relate to children admitted during the official opening times of the PEAU, and those presenting out of hours. The data analysis demonstrates a reduction in the number of children staying overnight in hospital since the opening of the PEAU, with the majority of children being referred by their own family doctor. Only one child in the sample was readmitted to the PEAU within 24 hours, and two within 24 hours of discharge as inpatients. Although thought to be pertinent, only one child admitted after official closing of the PEAU and out of hours was described as being admitted for social reasons. The International Classification of Diagnosis (ICD) 10 (World Health Organization (WHO), 1994) classifications of the children admitted to the PEAU reflect those found in other similar studies. Overall, the results of this investigation demonstrate that a PEAU can offer an efficient service to GPs, families and others as a route of referral, thus mitigating unnecessary overnight stays for individual children.

  3. Validation of genotype cluster investigations for Mycobacterium tuberculosis: application results for 44 clusters from four heterogeneous United States jurisdictions.

    Science.gov (United States)

    Teeter, Larry D; Vempaty, Padmaja; Nguyen, Duc T M; Tapia, Jane; Sharnprapai, Sharon; Ghosh, Smita; Kammerer, J Steven; Miramontes, Roque; Cronin, Wendy A; Graviss, Edward A

    2016-10-21

    Tracking the dissemination of specific Mycobacterium tuberculosis (Mtb) strains using genotyped Mtb isolates from tuberculosis patients is a routine public health practice in the United States. The present study proposes a standardized cluster investigation method to identify epidemiologic-linked patients in Mtb genotype clusters. The study also attempts to determine the proportion of epidemiologic-linked patients the proposed method would identify beyond the outcome of the conventional contact investigation. The study population included Mtb culture positive patients from Georgia, Maryland, Massachusetts and Houston, Texas. Mtb isolates were genotyped by CDC's National TB Genotyping Service (NTGS) from January 2006 to October 2010. Mtb cluster investigations (CLIs) were conducted for patients whose isolates matched exactly by spoligotyping and 12-locus MIRU-VNTR. CLIs were carried out in four sequential steps: (1) Public Health Worker (PHW) Interview, (2) Contact Investigation (CI) Evaluation, (3) Public Health Records Review, and (4) CLI TB Patient Interviews. Comparison between patients whose links were identified through the study's CLI interviews (Step 4) and patients whose links were identified earlier in CLI (Steps 1-3) was conducted using logistic regression. Forty-four clusters were randomly selected from the four study sites (401 patients in total). Epidemiologic links were identified for 189/401 (47 %) study patients in a total of 201 linked patient-pairs. The numbers of linked patients identified in each CLI steps were: Step 1 - 105/401 (26.2 %), Step 2 - 15/388 (3.9 %), Step 3 - 41/281 (14.6 %), and Step 4 - 28/119 (30 %). Among the 189 linked patients, 28 (14.8 %) were not identified in previous CI. No epidemiologic links were identified in 13/44 (30 %) clusters. We validated a standardized and practical method to systematically identify epidemiologic links among patients in Mtb genotype clusters, which can be integrated into the TB control and

  4. Report of the DOE Review Committee on the baseline validation of the Superconducting Super Collider

    Energy Technology Data Exchange (ETDEWEB)

    1993-08-01

    The Secretary of Energy directed that an independent review of the current cost and schedule baseline for the SSC be conducted. The purpose of this independent review was to validate the current cost and schedule baseline and to ensure that the project status is accurate as currently reported. Through May 1993, approximately $1.5 billion of the baseline cost of $8.249 billion had been expended, with project completion forecasted on the baseline schedule as of September 1999. This report documents the findings of the SSC Baseline Validation Review Committee (the Committee). The report is organized into five parts. The first section is the Executive Summary. This introduction is followed by a discussion of the project progress/status as determined by the Committee. The next section describes the Committee`s estimate of the cost at completion for the SSC project, followed by an assessment of the adequacy of the business management systems currently being used to manage the project. The final section presents the Committee`s conclusions and recommendations. The main body of the report is followed by the subcommittee reports and appendices.

  5. The validity and reliability of 5-Hz global positioning system units to measure team sport movement demands.

    Science.gov (United States)

    Johnston, Richard J; Watsford, Mark L; Pine, Matthew J; Spurrs, Robert W; Murphy, Aron J; Pruyn, Elizabeth C

    2012-03-01

    The purpose of this research was to investigate the validity and the reliability of 5-Hz MinimaxX global positioning system (GPS) units measuring athlete movement demands. A team sport simulation circuit (files collected from each unit = 12) and flying 50-m sprints (files collected from each unit = 34) were undertaken, during which the total distance covered; peak speed; player load; the distance covered; time spent and number of efforts performed walking, jogging, running, high-speed running, and sprinting were examined. Movement demands were also separately categorized into low-intensity activity, high-intensity running, and very high-intensity running. The results revealed that GPS was a valid and reliable measure of total distance covered (p > 0.05, percentage typical error of measurement [%TEM] 0.05, %TEM 5-10%). Further, GPS was found to be a reliable measure of player load (%TEM 4.9%) and the distance covered, time spent, and number of efforts performed at certain velocity zones (%TEM 10%). The level of GPS error was found to increase along with the velocity of exercise. The findings demonstrated that GPS is capable of measuring movement demands performed at velocities 20 km·h(-1).

  6. Surveillance length and validity of benchmarks for central line-associated bloodstream infection incidence rates in intensive care units.

    Directory of Open Access Journals (Sweden)

    Patricia S Fontela

    Full Text Available INTRODUCTION: Several national and regional central line-associated bloodstream infections (CLABSI surveillance programs do not require continuous hospital participation. We evaluated the effect of different hospital participation requirements on the validity of annual CLABSI incidence rate benchmarks for intensive care units (ICUs. METHODS: We estimated the annual pooled CLABSI incidence rates for both a real regional (<100 ICUs and a simulated national (600 ICUs surveillance program, which were used as a reference for the simulations. We simulated scenarios where the annual surveillance participation was randomly or non-randomly reduced. Each scenario's annual pooled CLABSI incidence rate was estimated and compared to the reference rates in terms of validity, bias, and proportion of simulation iterations that presented valid estimates (ideal if ≥ 90%. RESULTS: All random scenarios generated valid CLABSI incidence rates estimates (bias -0.37 to 0.07 CLABSI/1000 CVC-days, while non-random scenarios presented a wide range of valid estimates (0 to 100% and higher bias (-2.18 to 1.27 CLABSI/1000 CVC-days. In random scenarios, the higher the number of participating ICUs, the shorter the participation required to generate ≥ 90% valid replicates. While participation requirements in a countrywide program ranged from 3 to 13 surveillance blocks (1 block = 28 days, requirements for a regional program ranged from 9 to 13 blocks. CONCLUSIONS: Based on the results of our model of national CLABSI reporting, the shortening of participation requirements may be suitable for nationwide ICU CLABSI surveillance programs if participation months are randomly chosen. However, our regional models showed that regional programs should opt for continuous participation to avoid biased benchmarks.

  7. Validity and reliability of the Thai version of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU

    Directory of Open Access Journals (Sweden)

    Pipanmekaporn T

    2014-05-01

    Full Text Available Tanyong Pipanmekaporn,1 Nahathai Wongpakaran,2 Sirirat Mueankwan,3 Piyawat Dendumrongkul,2 Kaweesak Chittawatanarat,3 Nantiya Khongpheng,3 Nongnut Duangsoy31Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 3Division of Surgical Critical Care and Trauma, Department of Surgery, Chiang Mai University Hospital, Chiang Mai, ThailandPurpose: The purpose of this study was to determine the validity and reliability of the Thai version of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU, when compared to the diagnoses made by delirium experts.Patients and methods: This was a cross-sectional study conducted in both surgical intensive care and subintensive care units in Thailand between February–June 2011. Seventy patients aged 60 years or older who had been admitted to the units were enrolled into the study within the first 48 hours of admission. Each patient was randomly assessed as to whether they had delirium by a nurse using the Thai version of the CAM-ICU algorithm (Thai CAM-ICU or by a delirium expert using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision.Results: The prevalence of delirium was found to be 18.6% (n=13 by the delirium experts. The sensitivity of the Thai CAM-ICU’s algorithms was found to be 92.3% (95% confidence interval [CI] =64.0%-99.8%, while the specificity was 94.7% (95% CI =85.4%-98.9%. The instrument displayed good interrater reliability (Cohen’s κ=0.81; 95% CI =0.64-0.99. The time taken to complete the Thai CAM-ICU was 1 minute (interquatile range, 1-2 minutes.Conclusion: The Thai CAM-ICU demonstrated good validity, reliability, and ease of use when diagnosing delirium in a surgical intensive care unit setting. The use of this diagnostic tool should be encouraged for daily, routine use, so as to promote the early detection

  8. A review on recent developments in solar distillation units

    Indian Academy of Sciences (India)

    Pankaj Kalita; Anupam Dewan; Sangeeta Borah

    2016-02-01

    The solar still is gaining popularity among the scientific community for the production of distillate and fluoride free water due to its low cost and simple working principle. Continuous efforts have been made by various researchers to increase its productivity. Various techniques and configurations have been attempted in the literature to enhance the efficiency of the solar still. Many researchers have also studied different parameters influencing the performance of solar stills. Thermodynamic analysis, such as, energy balance and losses by using the second law of thermodynamics have also been reported in the literature. However, optimum combinations of the operating parameters in addition to thermodynamic optimization for high distillate yield as well as the efficiency have not been thoroughly studied in the literature. In the present work, an emphasis has been given to review the effects of various operating and geometric parameters, and thermodynamic optimization on the performance of a solar still.

  9. Dry coolers and air-condensing units (Review)

    Science.gov (United States)

    Milman, O. O.; Anan'ev, P. A.

    2016-03-01

    The analysis of factors affecting the growth of shortage of freshwater is performed. The state and dynamics of the global market of dry coolers used at electric power plants are investigated. Substantial increase in number and maximum capacity of air-cooled condensers, which have been put into operation in the world in recent years, are noted. The key reasons facilitating the choice of developers of the dry coolers, in particular the independence of the location of thermal power plant from water sources, are enumerated. The main steam turbine heat removal schemes using air cooling are considered, their comparison of thermal efficiency is assessed, and the change of three important parameters, such as surface area of heat transfer, condensate pump flow, and pressure losses in the steam exhaust system, are estimated. It is shown that the most effective is the scheme of direct steam condensation in the heat-exchange tubes, but other schemes also have certain advantages. The air-cooling efficiency may be enhanced much more by using an air-cooling hybrid system: a combination of dry and wet cooling. The basic applied constructive solutions are shown: the arrangement of heat-exchange modules and the types of fans. The optimal mounting design of a fully shopassembled cooling system for heat-exchange modules is represented. Different types of heat-exchange tubes ribbing that take into account the operational features of cooling systems are shown. Heat transfer coefficients of the plants from different manufacturers are compared, and the main reasons for its decline are named. When using evaporative air cooling, it is possible to improve the efficiency of air-cooling units. The factors affecting the faultless performance of dry coolers (DC) and air-condensing units (ACU) and the ways of their elimination are described. A high velocity wind forcing reduces the efficiency of cooling systems and creates preconditions for the development of wind-driven devices. It is noted that

  10. Adaptation and Validation of the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) for Use in Spain.

    Science.gov (United States)

    Aguirre-Camacho, Aldo; Stepanous, Jessica; Blanco-Donoso, Luis M; Moreno-Jiménez, Bernardo; Wilburn, Jeanette; González-Saiz, Laura; McKenna, Stephen P

    2017-06-01

    The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) is a patient-reported outcome measure of health-related quality of life and quality of life specific to individuals with pulmonary hypertension (PH). This questionnaire has demonstrated superiority over other instruments assessing similar domains. The objective of the present study was to adapt and validate the Spanish version of the questionnaire. The adaptation consisted of 3 stages: translation from English to Spanish using bilingual and lay panels, cognitive debriefing interviews with patients, and assessment of psychometric properties by means of a postal validation survey. The translation panels produced a version of the CAMPHOR that was considered suitable for use by Spanish PH patients. The relevance, comprehensiveness, and acceptability of this version were confirmed in interviews with PH patients. Finally, the validation survey (n = 70) revealed that the 3 CAMPHOR scales (Symptoms, Activities, and Quality of life) showed strong psychometric properties. The internal consistency (Cronbach α) coefficients of the scales were above 0.89, and the test-retest reliability was above 0.87. The convergent and known group validity of the CAMPHOR scales was also demonstrated. The Spanish version of the CAMPHOR is a valid and reliable instrument for the assessment of health-related quality of life and quality of life in Spanish PH patients. Therefore, it is recommended for use in future research and clinical practice in the Spanish population of PH patients. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  11. Groundwater Model Validation for the Project Shoal Area, Corrective Action Unit 447

    Energy Technology Data Exchange (ETDEWEB)

    None

    2008-05-19

    Stoller has examined newly collected water level data in multiple wells at the Shoal site. On the basis of these data and information presented in the report, we are currently unable to confirm that the model is successfully validated. Most of our concerns regarding the model stem from two findings: (1) measured water level data do not provide clear evidence of a prevailing lateral flow direction; and (2) the groundwater flow system has been and continues to be in a transient state, which contrasts with assumed steady-state conditions in the model. The results of DRI's model validation efforts and observations made regarding water level behavior are discussed in the following sections. A summary of our conclusions and recommendations for a path forward are also provided in this letter report.

  12. Threats to internal validity in exercise science: a review of overlooked confounding variables.

    Science.gov (United States)

    Halperin, Israel; Pyne, David B; Martin, David T

    2015-10-01

    Internal validity refers to the degree of control exerted over potential confounding variables to reduce alternative explanations for the effects of various treatments. In exercise and sports-science research and routine testing, internal validity is commonly achieved by controlling variables such as exercise and warm-up protocols, prior training, nutritional intake before testing, ambient temperature, time of testing, hours of sleep, age, and gender. However, a number of other potential confounding variables often do not receive adequate attention in sports physiology and performance research. These confounding variables include instructions on how to perform the test, volume and frequency of verbal encouragement, knowledge of exercise endpoint, number and gender of observers in the room, influence of music played before and during testing, and the effects of mental fatigue on performance. In this review the authors discuss these variables in relation to common testing environments in exercise and sports science and present some recommendations with the goal of reducing possible threats to internal validity.

  13. A review of the neural and behavioral consequences for unitizing emotional and neutral information

    Directory of Open Access Journals (Sweden)

    Brendan eMurray

    2013-05-01

    Full Text Available A special type of association, called a unitization, is formed when pieces of information are encoded as a single representation in memory (e.g., shirt and blue are encoded as a blue shirt; Graf & Schacter, 1989 and typically are later reactivated in memory as a single unit, allowing access to the features of multiple related stimuli at once (Bader et al., 2010; Diana et al., 2011. This review examines the neural processes supporting memory for unitizations and how the emotional content of the material may influence unitization. Although associative binding is typically reliant on hippocampal processes and supported by recollection, the first part of this review will present evidence to suggest that when two items are unitized into a single representation, memory for those bound items may be accomplished on the basis of familiarity and without reliance on the hippocampus. The second part of this review discusses how emotion may affect the processes that give rise to unitizations. Emotional information typically receives a mnemonic benefit over neutral information, but the literature is mixed on whether the presence of emotional information impedes or enhances the associative binding of neutral information (reviewed by Mather, 2007. It has been suggested that the way the emotional and neutral details are related together may be critical to whether the neutral details are enhanced or impeded (Mather, 2007; Mather & Sutherland, 2011. We focus on whether emotional arousal aides or inhibits the creation of a unitized representation, presenting preliminary data and future directions to test empirically the effects of forming and retrieving emotional and neutral unitizations.

  14. Validation of in-house treatment planning system software for cobalt-60 teletherapy unit at two radiotherapy installations

    Science.gov (United States)

    Mu'minah, I. A. S.; Toresano, L. O. H. Z.; Wibowo, W. E.; Sugiyantari; Pawiro, S. A.

    2016-03-01

    DSSuperDose v.1.0 is an in-house treatment planning system (TPS) developed by Medical Physics and Biophysics Laboratory (LFMB) Universitas Indonesia as a treatment planning software for Cobalt-60 teletherapy unit. The main objective of this study was the validation of in-house TPS calculation as an essential part in quality assurance (QA) of radiotherapy. Validation of an in-house TPS was performed with two Cobalt-60 teletherapy units by comparison between in-house TPS and ISIS TPS and by measurements of absorbed dose. Mean dose deviations between in-house TPS and measurement were (1.97 ± 2.42)% for open field, (1.32 ± 1.30)% for tray field, and (2.91 ± 2.36)% for wedge field treatments. In-house TPS provide optimal planning for open and tray beam conditions with depth fewer than 10 cm (≤ 10 cm) and field sizes up to 20×20 cm2, while for wedge beam conditions with field sizes fewer than the physical size of the wedge. Comparison of in-house TPS and ISIS TPS demonstrated a good match of 96%. From the results, it is concluded that DSSuperDose v.1.0 is adequately accurate for treatment planning of radiotherapy.

  15. Development and Validation of an Instrument to Assess the Implementation of Family-Centred Care in Traditional Open Bay Neonatal Intensive Care Units

    Science.gov (United States)

    Al-Motlaq, Mohammad A.; Abuidhail, Jamila; Salameh, Taghreed; Awwad, Wesam

    2017-01-01

    Objective: To develop an instrument to study family-centred care (FCC) in traditional open bay Neonatal Intensive Care Units (NICUs). Methods: The development process involved constructing instrument's items, establishing content validity by an expert panel and testing the instrument for validity and reliability with a convenience sample of 25…

  16. Quantifying the foodscape: A systematic review and meta-analysis of the validity of commercially available business data.

    Science.gov (United States)

    Lebel, Alexandre; Daepp, Madeleine I G; Block, Jason P; Walker, Renée; Lalonde, Benoît; Kestens, Yan; Subramanian, S V

    2017-01-01

    This paper reviews studies of the validity of commercially available business (CAB) data on food establishments ("the foodscape"), offering a meta-analysis of characteristics associated with CAB quality and a case study evaluating the performance of commonly-used validity indicators describing the foodscape. Existing validation studies report a broad range in CAB data quality, although most studies conclude that CAB quality is "moderate" to "substantial". We conclude that current studies may underestimate the quality of CAB data. We recommend that future validation studies use density-adjusted and exposure measures to offer a more meaningful characterization of the relationship of data error with spatial exposure.

  17. Validity of activity monitors in health and chronic disease: a systematic review

    Directory of Open Access Journals (Sweden)

    Van Remoortel Hans

    2012-07-01

    Full Text Available Abstract The assessment of physical activity in healthy populations and in those with chronic diseases is challenging. The aim of this systematic review was to identify whether available activity monitors (AM have been appropriately validated for use in assessing physical activity in these groups. Following a systematic literature search we found 134 papers meeting the inclusion criteria; 40 conducted in a field setting (validation against doubly labelled water, 86 in a laboratory setting (validation against a metabolic cart, metabolic chamber and 8 in a field and laboratory setting. Correlation coefficients between AM outcomes and energy expenditure (EE by the criterion method (doubly labelled water and metabolic cart/chamber and percentage mean differences between EE estimation from the monitor and EE measurement by the criterion method were extracted. Random-effects meta-analyses were performed to pool the results across studies where possible. Types of devices were compared using meta-regression analyses. Most validation studies had been performed in healthy adults (n = 118, with few carried out in patients with chronic diseases (n = 16. For total EE, correlation coefficients were statistically significantly lower in uniaxial compared to multisensor devices. For active EE, correlations were slightly but not significantly lower in uniaxial compared to triaxial and multisensor devices. Uniaxial devices tended to underestimate TEE (−12.07 (95%CI; -18.28 to −5.85 % compared to triaxial (−6.85 (95%CI; -18.20 to 4.49 %, p = 0.37 and were statistically significantly less accurate than multisensor devices (−3.64 (95%CI; -8.97 to 1.70 %, p

  18. Validity, Reliability And Responsiveness Of Patient-Reported Outcome Questionnaires When Assessing Hip And Groin Disability: A Systematic Review

    DEFF Research Database (Denmark)

    Thorborg, Kristian; Roos, Ewa; Bartels, Else Marie;

    2010-01-01

    disability based on a systematic review of evidence of validity, reliability and responsiveness of these instruments. Methods MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, PsycINFO, SportsDiscus and Web of Science were all searched up to January 2009. Two reviewers independently...

  19. Predictive validity and reliability of the Braden scale for risk assessment of pressure ulcers in an intensive care unit.

    Science.gov (United States)

    Lima-Serrano, M; González-Méndez, M I; Martín-Castaño, C; Alonso-Araujo, I; Lima-Rodríguez, J S

    2017-02-15

    Contribution to validation of the Braden scale in patients admitted to the ICU, based on an analysis of its reliability and predictive validity. An analytical, observational, longitudinal prospective study was carried out. Intensive Care Unit, Hospital Virgen del Rocío, Seville (Spain). Patients aged 18years or older and admitted for over 24hours to the ICU were included. Patients with pressure ulcers upon admission were excluded. A total of 335 patients were enrolled in two study periods of one month each. None. The presence of gradei-iv pressure ulcers was regarded as the main or dependent variable. Three categories were considered (demographic, clinical and prognostic) for the remaining variables. The incidence of patients who developed pressure ulcers was 8.1%. The proportion of gradei andii pressure ulcer was 40.6% and 59.4% respectively, highlighting the sacrum as the most frequently affected location. Cronbach's alpha coefficient in the assessments considered indicated good to moderate reliability. In the three evaluations made, a cutoff point of 12 was presented as optimal in the assessment of the first and second days of admission. In relation to the assessment of the day with minimum score, the optimal cutoff point was 10. The Braden scale shows insufficient predictive validity and poor precision for cutoff points of both 18 and 16, which are those accepted in the different clinical scenarios. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  20. Development and Validation of a Prototype Vacuum Sensing Unit for the DD2011 Chairside Amalgam Separators

    Science.gov (United States)

    2015-10-30

    pressure values onto the SD card. The addition of free and open-source Arduino libraries allowed for the seamless integration of the shield into the...permanent or adult posterior teeth,” in Cochrane Database of Systematic Reviews, The Cochrane Collaboration, Ed. Chichester, UK: John Wiley & Sons, Ltd...Feb-2015. [ Online ]. Available: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DentalProducts/Denta lAmalgam/ucm171094.htm

  1. Are Visceral Proteins Valid Markers for Nutritional Status in the Burn Intensive Care Unit?

    Science.gov (United States)

    2015-05-01

    B. A., Pidcoke H. F., Chung K. K., Wade C. E., Martini W. Z., Renz E. M., Wolf S. E., 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7...unable to perform indirect calorimetry . Indirect calo- rimetry was performed to measure the REE when clinically available. An activity factor of 1.2...and 1.4 was used clinically with the Carlson or Milner equa- tions and with indirect calorimetry because these lev- els have been found to increase

  2. Clinical peer review in the United States: history, legal development and subsequent abuse.

    Science.gov (United States)

    Vyas, Dinesh; Hozain, Ahmed E

    2014-06-07

    The Joint Commission on Accreditation requires hospitals to conduct peer review to retain accreditation. Despite the intended purpose of improving quality medical care, the peer review process has suffered several setbacks throughout its tenure. In the 1980s, abuse of peer review for personal economic interest led to a highly publicized multimillion-dollar verdict by the United States Supreme Court against the perpetrating physicians and hospital. The verdict led to decreased physician participation for fear of possible litigation. Believing that peer review was critical to quality medical care, Congress subsequently enacted the Health Care Quality Improvement Act (HCQIA) granting comprehensive legal immunity for peer reviewers to increase participation. While serving its intended goal, HCQIA has also granted peer reviewers significant immunity likely emboldening abuses resulting in Sham Peer Reviews. While legal reform of HCQIA is necessary to reduce sham peer reviews, further measures including the need for standardization of the peer review process alongside external organizational monitoring are critical to improving peer review and reducing the prevalence of sham peer reviews.

  3. Construct validity test of evaluation tool for professional behaviors of entry-level occupational therapy students in the United States

    Directory of Open Access Journals (Sweden)

    Hon K. Yuen

    2016-06-01

    Full Text Available Purpose: This study aimed to test the construct validity of an instrument to measure student professional behaviors in entry-level occupational therapy (OT students in the academic setting. Methods: A total of 718 students from 37 OT programs across the United States answered a self-assessment survey of professional behavior that we developed. The survey consisted of ranking 28 attributes, each on a 5-point Likert scale. A split-sample approach was used for exploratory and then confirmatory factor analysis. Results: A three-factor solution with nine items was extracted using exploratory factor analysis [EFA] (n=430, 60%. The factors were ‘Commitment to Learning’ (2 items, ‘Skills for Learning’ (4 items, and ‘Cultural Competence’ (3 items. Confirmatory factor analysis (CFA on the validation split (n=288, 40% indicated fair fit for this three-factor model (fit indices: CFI=0.96, RMSEA=0.06, and SRMR=0.05. Internal consistency reliability estimates of each factor and the instrument ranged from 0.63 to 0.79. Conclusion: Results of the CFA in a separate validation dataset provided robust measures of goodness-of-fit for the three-factor solution developed in the EFA, and indicated that the three-factor model fitted the data well enough. Therefore, we can conclude that this student professional behavior evaluation instrument is a structurally validated tool to measure professional behaviors reported by entry-level OT students. The internal consistency reliability of each individual factor and the whole instrument was considered to be adequate to good.

  4. Validity of peer grading using Calibrated Peer Review in a guided-inquiry, conceptual physics course

    Science.gov (United States)

    Price, Edward; Goldberg, Fred; Robinson, Steve; McKean, Michael

    2016-12-01

    Constructing and evaluating explanations are important science practices, but in large classes it can be difficult to effectively engage students in these practices and provide feedback. Peer review and grading are scalable instructional approaches that address these concerns, but which raise questions about the validity of the peer grading process. Calibrated Peer Review (CPR) is a web-based system that scaffolds peer evaluation through a "calibration" process where students evaluate sample responses and receive feedback on their evaluations before evaluating their peers. Guided by an activity theory framework, we developed, implemented, and evaluated CPR-based tasks in guided-inquiry, conceptual physics courses for future teachers and general education students. The tasks were developed through iterative testing and revision. Effective tasks had specific and directed prompts and evaluation instructions. Using these tasks, over 350 students at three universities constructed explanations or analyzed physical phenomena, and evaluated their peers' work. By independently assessing students' responses, we evaluated the CPR calibration process and compared students' peer reviews with expert evaluations. On the tasks analyzed, peer scores were equivalent to our independent evaluations. On a written explanation item included on the final exam, students in the courses using CPR outperformed students in similar courses using traditional writing assignments without a peer evaluation element. Our research demonstrates that CPR can be an effective way to explicitly include the science practices of constructing and evaluating explanations into large classes without placing a significant burden on the instructor.

  5. "Bed Side" Human Milk Analysis in the Neonatal Intensive Care Unit: A Systematic Review.

    Science.gov (United States)

    Fusch, Gerhard; Kwan, Celia; Kotrri, Gynter; Fusch, Christoph

    2017-03-01

    Human milk analyzers can measure macronutrient content in native breast milk to tailor adequate supplementation with fortifiers. This article reviews all studies using milk analyzers, including (i) evaluation of devices, (ii) the impact of different conditions on the macronutrient analysis of human milk, and (iii) clinical trials to improve growth. Results lack consistency, potentially due to systematic errors in the validation of the device, or pre-analytical sample preparation errors like homogenization. It is crucial to introduce good laboratory and clinical practice when using these devices; otherwise a non-validated clinical usage can severely affect growth outcomes of infants.

  6. Validated instruments used to measure attitudes of healthcare students and professionals towards patients with physical disability: a systematic review

    Directory of Open Access Journals (Sweden)

    Symons Andrew B

    2010-11-01

    Full Text Available Abstract Background Instruments to detect changes in attitudes towards people with disabilities are important for evaluation of training programs and for research. While we were interested in instruments specific for medical students, we aimed to systematically review the medical literature for validated survey instruments used to measure attitudes of healthcare students and professionals towards patients with physical disability. Methods We electronically searched Medline, EMBASE, PsycINFO, Health and Psychosocial Instruments. We included papers reporting on the development and/or validation of survey instruments to measure attitudes of healthcare students and professionals towards patients with physical disability. We excluded papers in which the attitudes were not measured in a provider-patient context. Two reviewers carried out titles and abstracts screening, full texts screening, and data abstraction in a duplicate and independent manner using standardized and pilot tested forms. Results We identified seven validated survey instruments used for healthcare students and professionals. These instruments were originally developed for the following target populations: general population (n = 4; dental students (n = 1; nursing students (n = 1; and rehabilitation professionals (n = 1. The types of validity reported for these instruments were content validity (n = 3, criterion-related validity (n = 1, construct validity (n = 2, face validity (n = 1, discriminant validity (n = 1, and responsiveness (n = 1. The most widely validated and used tool (ATDP was developed in the late 1960s while the most recent instrument was developed in the early 1990s. Conclusion Of the seven identified validated instruments, less than half were specifically designed for healthcare students and professionals and none for medical students. There is a need to develop and validate a contemporary instrument specifically for medical students.

  7. The Evolving Practice of Developmental Care in the Neonatal Unit: A Systematic Review

    Science.gov (United States)

    Legendre, Valerie; Burtner, Patricia A.; Martinez, Katrina L.; Crowe, Terry K.

    2011-01-01

    Many neonatal intensive care units (NICUs) are experiencing changes in their approaches to preterm infant care as they consider and incorporate the philosophy of individualized developmental care. The aim of this systematic review is to research current literature documenting the short-term effects of developmental care and the Newborn…

  8. Depression among Latinos in the United States: A Meta-Analytic Review

    Science.gov (United States)

    Menselson, Tamar; Rehkopf, David H.; Kubzansky, Laura D.

    2008-01-01

    The authors conducted a meta-analytic review to assess the prevalence of major depressive disorder and depressive symptoms among Latinos compared with non-Latino Whites in the United States using community-based data. Random-effects estimates were calculated for 8 studies meeting inclusion criteria that reported lifetime prevalence of major…

  9. School Hopscotch: A Comprehensive Review of K-12 Student Mobility in the United States

    Science.gov (United States)

    Welsh, Richard O.

    2017-01-01

    This article provides an integrative review of the extant literature on K-12 student mobility in the United States. Student mobility is a widespread phenomenon with significant policy implications. Changing schools is most prevalent among minority and low-income students in urban school districts. There is an ongoing debate about whether student…

  10. Mentoring and New Teacher Induction in the United States: A Review and Analysis of Current Practices

    Science.gov (United States)

    Bullough, Robert V., Jr.

    2012-01-01

    In this article, current practices were reviewed in mentoring and induction across three large states--New York, Texas, and California--and one small state, Utah. Patterns and trends are described in the United States, program results and evolving views of mentoring are discussed, gaps in the research literature are identified, and the future of…

  11. 15 review article biofilm, dental unit water line and its control

    African Journals Online (AJOL)

    Dr Oboro VO

    Dental unit waterlines (DUWL) are an integral part of dental surgery equipment, supplying water as a ... At present, the goal of this review is to discuss various aspects of biofilm formation and .... in adhesion for both cell-surface and cell-cell.

  12. The Impact of Structural Break(s on the Validity of Purchasing Power Parity in Turkey: Evidence from Zivot-Andrews and Lagrange Multiplier Unit Root Tests

    Directory of Open Access Journals (Sweden)

    Hakan Kum

    2012-01-01

    Full Text Available This study examines the validity of the purchasing power parity (PPP in Turkey for annual data from 1953 to 2009. While results from both the ADF unit root and the DF-GLS unit root test indicate mixed results, PPP holds for Turkey with the presence of structural breaks which are obtained by Zivot and Andrews and Lagrange Multiplier unit root tests.

  13. Malignancy validation in a United States registry of rheumatoid arthritis patients

    Directory of Open Access Journals (Sweden)

    Fisher Mark C

    2012-05-01

    Full Text Available Abstract Background Physician reporting is commonly used to ascertain adverse events or outcomes measured in epidemiologic studies. However, little is known on the accuracy of physician reported malignancies compared to pertinent medical record review in large cohort studies. Methods The Consortium of Rheumatology Researchers of North America (CORRONA registry gathers physician-completed questionnaires for rheumatoid arthritis (RA patients, including request for information on incident malignancies, approximately every three months. For incident malignancies reported from October 1st, 2001, through December 31st, 2007, we retrospectively requested completion of a Targeted Adverse Event (TAE form for additional information as well as primary source documents to adjudicate the malignancy reports. CORRONA has employed a prospective request for source documentation for these events since 2008. We classified each malignancy as definite, probable, possible, or not a malignancy. Results From 20,837 RA patients enrolled in CORRONA, 461 incident malignancies were initially reported on physician questionnaires. After review of returned source documents with adjudication, 234 were deemed definite, 69 probable, 101 possible, and 57 not an incident malignancy. The positive predictive value (PPV of initial physician report of a malignancy versus “definite or probable” malignancy based on adjudication was 0.66 (95% CI 0.61 - 0.70. The PPV was 0.68 (95% CI 0.63 – 0.72 when the subsequent TAE form also confirmed the presence of malignancy. When possible malignancies were included, the PPV of physician-reported malignancies without a subsequent TAE form increased to 0.86 (0.83 – 0.89, and with a subsequent TAE form, 0.89 (0.85-0.91. Conclusion Twelve percent of initial physician reports of incident malignancy could not be confirmed with review of source documents. The most common reason for lack of confirmation was inability to obtain documents or

  14. Serum calprotectin: review of its usefulness and validity in paediatric rheumatic diseases.

    Science.gov (United States)

    Mariani, Anthea; Marsili, Manuela; Nozzi, Manuela; Faricelli, Raffaella; Chiarelli, Francesco; Breda, Luciana

    2015-01-01

    In most childhood rheumatic diseases, specific diagnostic markers are not yet available. Therefore, a major emphasis in medical research today is directed to the discovery of new inflammation molecules, like calprotectin. Calprotectin (MRP8/MRP14) is a complex of calcium- and zinc-binding proteins that belong to the S100 protein family. This protein is directly released by leukocytes during the interaction with inflammatory activated endothelium at the site of inflammation. Increased plasma calprotectin levels have been found in inflammatory chronic diseases such as rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), inflammatory bowel diseases (IBD), multiple sclerosis, cystic fibrosis and systemic lupus erythematosus (SLE). In these diseases, serum calprotectin has been shown to correlate with disease activity and laboratory variables of inflammation such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). This review outlines the validity and the possible applications of calprotectin as a new inflammation marker in paediatric rheumatic diseases.

  15. Estimating Rooftop Suitability for PV: A Review of Methods, Patents, and Validation Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Melius, J.; Margolis, R.; Ong, S.

    2013-12-01

    A number of methods have been developed using remote sensing data to estimate rooftop area suitable for the installation of photovoltaics (PV) at various geospatial resolutions. This report reviews the literature and patents on methods for estimating rooftop-area appropriate for PV, including constant-value methods, manual selection methods, and GIS-based methods. This report also presents NREL's proposed method for estimating suitable rooftop area for PV using Light Detection and Ranging (LiDAR) data in conjunction with a GIS model to predict areas with appropriate slope, orientation, and sunlight. NREL's method is validated against solar installation data from New Jersey, Colorado, and California to compare modeled results to actual on-the-ground measurements.

  16. Second periodic safety review of Angra Nuclear Power Station, unit 1

    Energy Technology Data Exchange (ETDEWEB)

    Martins, Carlos F.O.; Crepaldi, Roberto; Freire, Enio M., E-mail: ottoncf@tecnatom.com.br, E-mail: emfreire46@gmail.com, E-mail: robcrepaldi@hotmail.com [Tecnatom do Brasil Engenharia e Servicos Ltda, Rio de Janeiro, RJ (Brazil); Campello, Sergio A., E-mail: sacampe@eletronuclear.gov.br [Eletrobras Termonuclear S.A. (ELETRONUCLEAR), Rio de Janeiro, RJ (Brazil)

    2015-07-01

    This paper describes the second Periodic Safety Review (PSR2-A1) of Angra Nuclear Power Station, Unit 1, prepared by Eletrobras Eletronuclear S.A. and Tecnatom do Brasil Engenharia e Servicos Ltda., during Jul.2013-Aug.2014, covering the period of 2004-2013. The site, in Angra dos Reis-RJ, Brazil, comprises: Unit 1, (640 MWe, Westinghouse PWR, operating), Unit 2 (1300 MWe, KWU/Areva, operating) and Unit 3 (1405 MWe, KWU/Areva, construction). The PSR2-A1 attends the Standards 1.26-Safety in Operation of Nuclear Power Plants, Brazilian Nuclear Regulatory Commission (CNEN), and IAEA.SSG.25-Periodic Safety Review of Nuclear Power Plants. Within 18 months after each 10 years operation, the operating organization shall perform a plant safety review, to investigate the evolution consequences of safety code and standards, regarding: Plant design; structure, systems and components behavior; equipment qualification; plant ageing management; deterministic and probabilistic safety analysis; risk analysis; safety performance; operating experience; organization and administration; procedures; human factors; emergency planning; radiation protection and environmental radiological impacts. The Review included 6 Areas and 14 Safety Parameters, covered by 33 Evaluations.After document evaluations and discussions with plant staff, it was generated one General and 33 Specific Guide Procedures, 33 Specific and one Final Report, including: Description, Strengths, Deficiencies, Areas for Improvement and Conclusions. An Action Plan was prepared by Electronuclear for the recommendations. It was concluded that the Unit was operated within safety standards and will attend its designed operational lifetime, including possible life extensions. The Final Report was submitted to CNEN, as one requisite for renewal of the Unit Permanent Operation License. (author)

  17. Validation of beverage intake methods vs. hydration biomarker: a short review

    Directory of Open Access Journals (Sweden)

    Mariela Nissensohn

    2013-12-01

    Full Text Available Introduction: Fluid intake is difficult to monitor. Biomarkers of beverage intake are able to assess dietary intake / hydration status without the bias of self-reported dietary intake errors and also the intra-individual variability. Various markers have been proposed to assess hydration, however, to date; there is a lack of universally accepted biomarker that reflects changes of hydration status in response to changes in beverage intake. Aim: We conduct a review to find out the questionnaires of beverage intake available in the scientific literature to assess beverage intake and hydration status and their validation against hydration biomarkers. Methods: A scientific literature search was conducted. Only two articles were selected, in which, two different beverage intake questionnaires designed to capture the usual beverage intake were validated against Urine Specific Gravidity biomarker (Usg. Results: Water balance questionnaire (WBQ reported no correlations in the first study and the Beverage Intake Questionnaire (BEVQ, a quantitative Food frequency questionnaire (FFQ in the second study, also found a negative correlation. FFQ appears to measure better beverage intake than WBQ when compared with biomarkers. However, the WBQ seems to be a more complete method to evaluate the hydration balance of a given population. Conclusions: Further research is needed to understand the meaning of the different correlations between intake estimates and biomarkers of hydration in distinct population groups and environments.

  18. Predictive validity of health-related fitness in youth: a systematic review.

    Science.gov (United States)

    Ruiz, J R; Castro-Piñero, J; Artero, E G; Ortega, F B; Sjöström, M; Suni, J; Castillo, M J

    2009-12-01

    The objective of the present systematic review was to investigate whether physical fitness in childhood and adolescence is a predictor of cardiovascular disease (CVD) risk factors, events and syndromes, quality of life and low back pain later in life. Physical fitness-related components were: cardiorespiratory fitness, musculoskeletal fitness, motor fitness and body composition. Adiposity was considered as both exposure and outcome. The results of 42 studies reporting the predictive validity of health-related physical fitness for CVD risk factors, events and syndromes as well as the results of five studies reporting the predictive validity of physical fitness for low back pain in children and adolescents were summarised. Strong evidence was found indicating that higher levels of cardiorespiratory fitness in childhood and adolescence are associated with a healthier cardiovascular profile later in life. Muscular strength improvements from childhood to adolescence are negatively associated with changes in overall adiposity. A healthier body composition in childhood and adolescence is associated with a healthier cardiovascular profile later in life and with a lower risk of death. The evidence was moderate for the association between changes in cardiorespiratory fitness and CVD risk factors, and between cardiorespiratory fitness and the risk of developing the metabolic syndrome and arterial stiffness. Moderate evidence on the lack of a relationship between body composition and low back pain was found. Due to a limited number of studies, inconclusive evidence emerged for a relationship between muscular strength or motor fitness and CVD risk factors, and between flexibility and low back pain.

  19. Criticality safety validation: Simple geometry, single unit {sup 233}U systems

    Energy Technology Data Exchange (ETDEWEB)

    Putman, V.L.

    1997-06-01

    Typically used LMITCO criticality safety computational methods are evaluated for suitability when applied to INEEL {sup 233}U systems which reasonably can be modeled as simple-geometry, single-unit systems. Sixty-seven critical experiments of uranium highly enriched in {sup 233}U, including 57 aqueous solution, thermal-energy systems and 10 metal, fast-energy systems, were modeled. These experiments include 41 cylindrical and 26 spherical cores, and 41 reflected and 26 unreflected systems. No experiments were found for intermediate-neutron-energy ranges, or with interstitial non-hydrogenous materials typical of waste systems, mixed {sup 233}U and plutonium, or reflectors such as steel, lead, or concrete. No simple geometry experiments were found with cubic or annular cores, or approximating infinite sea systems. Calculations were performed with various tools and methodologies. Nine cross-section libraries, based on ENDF/B-IV, -V, or -VI.2, or on Hansen-Roach source data, were used with cross-section processing methods of MCNP or SCALE. The k{sub eff} calculations were performed with neutral-particle transport and Monte Carlo methods of criticality codes DANT, MCNP 4A, and KENO Va.

  20. Validity of Drought Indices as Drought Predictors in the South-Central United States

    Science.gov (United States)

    Rohli, R. V.; Bushra, N.; Lam, N.; Zou, L.; Mihunov, V.; Reams, M.; Argote, J.

    2015-12-01

    Drought is among the most insidious types of natural disasters and can have tremendous economic and human health impacts. This research analyzes the relationship between two readily-accessible drought indices - the Palmer Drought Severity Index (PDSI) and Palmer Hydrologic Drought Index (PHDI) - and the damage incurred by such droughts in terms of monetary loss, over the 1975-2010 time period on monthly basis, for five states in the south-central U.S.A. Because drought damage in the Spatial Hazards Events and Losses Database for the United States (SHELDUSTM) is reported at the county level, statistical downscaling techniques were used to estimate the county-level PDSI and PHDI. Correlation analysis using the downscaled indices suggests that although relatively few months contain drought damage reports, in general drought indices can be useful predictors of drought damage at the monthly temporal scale extended to 12 months and at the county-wide spatial scale. The varying time lags between occurrence of drought and reporting of damage, perhaps due to varying resilience to drought intensity and duration by crop types across space, irrigation methods, and adaptation measures of the community to drought varies over space and time, are thought to contribute to weakened correlations. These results present a reminder of the complexities of anticipating the effects of drought but they contribute to the effort to improve our ability to mitigate the effects of incipient drought.

  1. Validation of Pinnacle treatment planning system for use with Novalis delivery unit.

    Science.gov (United States)

    Faygelman, Vladimir; Hunt, Dylan; Walker, Luke; Mueller, Richard; Demarco, Mary Lou; Dilling, Thomas; Stevens, Craig; Zhang, Geoffrey

    2010-06-15

    For an institution that already owns the licenses, it is economically advantageous and technically feasible to use Pinnacle TPS (Philips Radiation Oncology Systems, Fitchburg, WI) with the BrainLab Novalis delivery system (BrainLAB A.G., Heimstetten, Germany). This takes advantage of the improved accuracy of the convolution algorithm in the presence of heterogeneities compared with the pencil beam calculation, which is particularly significant for lung SBRT treatments. The reference patient positioning DRRs still have to be generated by the BrainLab software from the CT images and isocenter coordinates transferred from Pinnacle. We validated this process with the end-to-end hidden target test, which showed an isocenter positioning error within one standard deviation from the previously established mean value. The Novalis treatment table attenuation is substantial (up to 6.2% for a beam directed straight up and up to 8.4% for oblique incidence) and has to be accounted for in calculations. A simple single-contour treatment table model was developed, resulting in mean differences between the measured and calculated attenuation factors of 0.0%-0.2%, depending on the field size. The maximum difference for a single incidence angle is 1.1%. The BrainLab micro-MLC (mMLC) leaf tip, although not geometrically round, can be represented in Pinnacle by an arch with satisfactory dosimetric accuracy. Subsequently, step-and-shoot (direct machine parameter optimization) IMRT dosimetric agreement is excellent. VMAT (called "SmartArc" in Pinnacle) treatments with constant gantry speed and dose rate are feasible without any modifications to the accelerator. Due to the 3 mm-wide mMLC leaves, the use of a 2 mm calculation grid is recommended. When dual arcs are used for the more complex cases, the overall dosimetric agreement for the SmartArc plans compares favorably with the previously reported results for other implementations of VMAT: gamma(3%,3mm) for absolute dose obtained with the

  2. Validated methods for identifying tuberculosis patients in health administrative databases: systematic review.

    Science.gov (United States)

    Ronald, L A; Ling, D I; FitzGerald, J M; Schwartzman, K; Bartlett-Esquilant, G; Boivin, J-F; Benedetti, A; Menzies, D

    2017-05-01

    An increasing number of studies are using health administrative databases for tuberculosis (TB) research. However, there are limitations to using such databases for identifying patients with TB. To summarise validated methods for identifying TB in health administrative databases. We conducted a systematic literature search in two databases (Ovid Medline and Embase, January 1980-January 2016). We limited the search to diagnostic accuracy studies assessing algorithms derived from drug prescription, International Classification of Diseases (ICD) diagnostic code and/or laboratory data for identifying patients with TB in health administrative databases. The search identified 2413 unique citations. Of the 40 full-text articles reviewed, we included 14 in our review. Algorithms and diagnostic accuracy outcomes to identify TB varied widely across studies, with positive predictive value ranging from 1.3% to 100% and sensitivity ranging from 20% to 100%. Diagnostic accuracy measures of algorithms using out-patient, in-patient and/or laboratory data to identify patients with TB in health administrative databases vary widely across studies. Use solely of ICD diagnostic codes to identify TB, particularly when using out-patient records, is likely to lead to incorrect estimates of case numbers, given the current limitations of ICD systems in coding TB.

  3. Diagnostic validity of physical examination tests for common knee disorders: An overview of systematic reviews and meta-analysis.

    Science.gov (United States)

    Décary, Simon; Ouellet, Philippe; Vendittoli, Pascal-André; Roy, Jean-Sébastien; Desmeules, François

    2017-01-01

    More evidence on diagnostic validity of physical examination tests for knee disorders is needed to lower frequently used and costly imaging tests. To conduct a systematic review of systematic reviews (SR) and meta-analyses (MA) evaluating the diagnostic validity of physical examination tests for knee disorders. A structured literature search was conducted in five databases until January 2016. Methodological quality was assessed using the AMSTAR. Seventeen reviews were included with mean AMSTAR score of 5.5 ± 2.3. Based on six SR, only the Lachman test for ACL injuries is diagnostically valid when individually performed (Likelihood ratio (LR+):10.2, LR-:0.2). Based on two SR, the Ottawa Knee Rule is a valid screening tool for knee fractures (LR-:0.05). Based on one SR, the EULAR criteria had a post-test probability of 99% for the diagnosis of knee osteoarthritis. Based on two SR, a complete physical examination performed by a trained health provider was found to be diagnostically valid for ACL, PCL and meniscal injuries as well as for cartilage lesions. When individually performed, common physical tests are rarely able to rule in or rule out a specific knee disorder, except the Lachman for ACL injuries. There is low-quality evidence concerning the validity of combining history elements and physical tests. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Scientific Literature on the Reliability and Validity of the Manchester Triage System (MTS Protocol: A Integrative Literature Review

    Directory of Open Access Journals (Sweden)

    Cristiane Chaves de Souza

    2015-02-01

    Full Text Available OBJECTIVE To analyze the scientific production about the validity and reliability of the Manchester Triage System (MTS protocol. METHOD A descriptive study of an integrative literature review. Articles on the validity and reliability of the MTS developed with children and adults published between 1999 and 2013 were included. RESULTS 14 articles were selected from a total of 8438, nine of validity and five of reliability. The reliability of the MTS ranged from moderate to almost perfect, with higher intra-evaluation. Regarding validity, the results seem to point to equivalent and satisfactory sensibility and specificity levels of the MTS. The instrument proved to be a good predictor of the need for hospitalization and of hospital mortality. CONCLUSION The reliability and validity of the MTS obtained in the studies is varied. It is recommended that new studies indicate necessary modifications to the MTS so that it is more safely used by nurses.

  5. The Leapfrog initiative for intensive care unit physician staffing and its impact on intensive care unit performance: a narrative review.

    Science.gov (United States)

    Gasperino, James

    2011-10-01

    The field of critical care has changed markedly in recent years to accommodate a growing population of chronically critically ill patients. New administrative structures have evolved to include divisions, departments, and sections devoted exclusively to the practice of critical care medicine. On an individual level, the ability to manage complex multisystem critical illnesses and to introduce invasive monitoring devices defines the intensivist. On a systems level, critical care services managed by an intensivist-led multidisciplinary team are now recognized by their ability to efficiently utilize hospital resources and improve patient outcomes. Due to the numerous cost and quality issues related to the delivery of critical care medicine, intensive care unit physician staffing (IPS) has become a charged subject in recent years. Although the federal government has played a large role in regulating best practices by physicians, other third parties have entered the arena. Perhaps the most influential of these has been The Leapfrog Group, a consortium representing 130 employers and 65 Fortune 500 companies that purchase health care for their employees. This group has proposed specific regulatory guidelines for IPS that are purported to result in substantial cost containment and improved quality of care. This narrative review examines the impact of The Leapfrog Group's recommendations on critical care delivery in the United States.

  6. Validity of 2D lateral cephalometry in orthodontics: a systematic review

    Science.gov (United States)

    2013-01-01

    Lateral cephalometric radiography is commonly used as a standard tool in orthodontic assessment and treatment planning. The aim of this study was to evaluate the available scientific literature and existing evidence for the validation of using lateral cephalometric imaging for orthodontic treatment planning. The secondary objective was to determine the accuracy and reliability of this technique. We did not attempt to evaluate the value of this radiographic technique for other purposes. A literature search was performed using specific keywords on electronic databases: Ovid MEDLINE, Scopus and Web of Science. Two reviewers selected relevant articles, corresponding to predetermined inclusion criteria. The electronic search was followed by a hand search of the reference lists of relevant papers. Two reviewers assessed the level of evidence of relevant publications as high, moderate or low. Based on this, the evidence grade for diagnostic efficacy was rated as strong, moderately strong, limited or insufficient. The initial search revealed 784 articles listed in MEDLINE (Ovid), 1,034 in Scopus and 264 articles in the Web of Science. Only 17 articles met the inclusion criteria and were selected for qualitative synthesis. Results showed seven studies on the role of cephalometry in orthodontic treatment planning, eight concerning cephalometric measurements and landmark identification and two on cephalometric analysis. It is surprising that, notwithstanding the 968 articles published in peer-reviewed journals, scientific evidence on the usefulness of this radiographic technique in orthodontics is still lacking, with contradictory results. More rigorous research on a larger study population should be performed to achieve full evidence on this topic. PMID:24325757

  7. Validity of 2D lateral cephalometry in orthodontics: a systematic review.

    Science.gov (United States)

    Durão, Ana R; Pittayapat, Pisha; Rockenbach, Maria Ivete B; Olszewski, Raphael; Ng, Suk; Ferreira, Afonso P; Jacobs, Reinhilde

    2013-09-20

    Lateral cephalometric radiography is commonly used as a standard tool in orthodontic assessment and treatment planning. The aim of this study was to evaluate the available scientific literature and existing evidence for the validation of using lateral cephalometric imaging for orthodontic treatment planning. The secondary objective was to determine the accuracy and reliability of this technique. We did not attempt to evaluate the value of this radiographic technique for other purposes. A literature search was performed using specific keywords on electronic databases: Ovid MEDLINE, Scopus and Web of Science. Two reviewers selected relevant articles, corresponding to predetermined inclusion criteria. The electronic search was followed by a hand search of the reference lists of relevant papers. Two reviewers assessed the level of evidence of relevant publications as high, moderate or low. Based on this, the evidence grade for diagnostic efficacy was rated as strong, moderately strong, limited or insufficient. The initial search revealed 784 articles listed in MEDLINE (Ovid), 1,034 in Scopus and 264 articles in the Web of Science. Only 17 articles met the inclusion criteria and were selected for qualitative synthesis. Results showed seven studies on the role of cephalometry in orthodontic treatment planning, eight concerning cephalometric measurements and landmark identification and two on cephalometric analysis. It is surprising that, notwithstanding the 968 articles published in peer-reviewed journals, scientific evidence on the usefulness of this radiographic technique in orthodontics is still lacking, with contradictory results. More rigorous research on a larger study population should be performed to achieve full evidence on this topic.

  8. Factor analysis methods and validity evidence: A systematic review of instrument development across the continuum of medical education

    Science.gov (United States)

    Wetzel, Angela Payne

    Previous systematic reviews indicate a lack of reporting of reliability and validity evidence in subsets of the medical education literature. Psychology and general education reviews of factor analysis also indicate gaps between current and best practices; yet, a comprehensive review of exploratory factor analysis in instrument development across the continuum of medical education had not been previously identified. Therefore, the purpose for this study was critical review of instrument development articles employing exploratory factor or principal component analysis published in medical education (2006--2010) to describe and assess the reporting of methods and validity evidence based on the Standards for Educational and Psychological Testing and factor analysis best practices. Data extraction of 64 articles measuring a variety of constructs that have been published throughout the peer-reviewed medical education literature indicate significant errors in the translation of exploratory factor analysis best practices to current practice. Further, techniques for establishing validity evidence tend to derive from a limited scope of methods including reliability statistics to support internal structure and support for test content. Instruments reviewed for this study lacked supporting evidence based on relationships with other variables and response process, and evidence based on consequences of testing was not evident. Findings suggest a need for further professional development within the medical education researcher community related to (1) appropriate factor analysis methodology and reporting and (2) the importance of pursuing multiple sources of reliability and validity evidence to construct a well-supported argument for the inferences made from the instrument. Medical education researchers and educators should be cautious in adopting instruments from the literature and carefully review available evidence. Finally, editors and reviewers are encouraged to recognize

  9. A Validity Review of the Color Company Competition at the United States Naval Academy

    Science.gov (United States)

    2006-06-01

    from one company is broken up such that individuals move to different companies throughout the brigade (i.e. one or two plebes from 15th company...shuffling’ and ‘shot gunning’ break up the team cohesion that develops over the course of a year, especially during plebe (freshman) year. After...J. S. (2002). A Qualitative Analysis Of The Performance Measurement and Outcome Management Procedures Applied To The Plebe Summer Program At The

  10. Validation of WIMS-AECL/(MULTICELL)/RFSP code system using wolsong units 3, 4 phase-B measurement data

    Energy Technology Data Exchange (ETDEWEB)

    Lyou, Seok Jean; Hong, In Seob; Min, Byung Joo; Suk, Ho Chun

    2000-07-01

    The objects of this study is to evaluate and validate and the WIMS-AECL/(MULTICELL)/RFSP code system for nuclear design and analysis of advanced CANDU fuel core. Wolsong units 3 and 4 phase-B physics test data were used for the assessment of code system. The code system used in this study is the same as one used in the previous post-simulation of wolsong unit 2. As a result, the predicted boron worth was consistent with measured data within 1%(0.08mk/ppm). And the predicted total worth of reactivity control device was generally agreed with the measured data, but individual worths were a tendency to have a difference between the predicted and measured values. Also moderator temperature coefficient was calculated to be lower than that of measurement by about 0.13-0.23mk. As synthesizing the results of wolsong units 2,3 and 4 post-simulations, the difference between the predicted and measured critical boron concentrations was caused by the worth of reactivity devices and structural materials and the difference between the predicted and measured individual worth of the strong absorber such as shutoff rod and mechanical control absorber was estimated to need the detail simulation of the core structure. Also the difference between the predicted and measured moderator temperature coefficient would be brought about measured data rather than calculation error. In order to improve the accuracy of the predicted values by WIMS-AECL/(MULTICELL)/RFSP code system, a sensitivity test shall be performed about the mesh structure surrounding the strong absorber, and also more accurate condition in the operation of the moderator temperature coefficient measurement shall be recorded.

  11. The undergraduate premedical experience in the United States: a critical review.

    Science.gov (United States)

    Lin, Katherine Y; Parnami, Sonali; Fuhrel-Forbis, Andrea; Anspach, Renee R; Crawford, Brett; De Vries, Raymond G

    2013-01-01

    To better understand the consequences of the premedical years for the character of (future) physicians by critically reviewing the empirical research done on the undergraduate premedical experience in the United States. We searched ERIC, JSTOR, PubMed, Scopus, ISI Web of Science, and PsycINFO from the earliest available date for empirical, peer-reviewed studies of premedical students in the United States. We then used qualitative methods to uncover overall themes present in this literature. The initial literature search identified 1,168 articles, 19 of which were included for review. Reviewed articles were published between 1976 and 2010 with the majority published prior to 1990. Articles covered two broad topics: explaining attrition from the premedical track, and investigating the personality traits and stereotypes of premedical students. Self-selection bias and high attrition rates were among the limitations of the reviewed articles. There is very little current research on the premedical experience. Given the importance of the premedical years on the process of becoming a medical professional, it is imperative that we do more and better research on how the premedical experience shapes future physicians.

  12. Retiree health benefits in the United States: a strategic critical management review.

    Science.gov (United States)

    Asubonteng, P; Bumpus, M; Munchus, G

    1997-01-01

    This article provides a critical review of studies associated with retiree health benefits in the United States. An attempt is made to determine if logical conclusions or trends could be identified regarding this issue of health care policy debate. The forms of retiree health benefits are covered, as is a discussion of Medigap policies and insurance coverage for the elderly. Employer-sponsored retiree benefits and the effects of supplemental coverage on the use of services are also reviewed. Lastly, a discussion and conclusion regarding this research agenda is presented with a critical analysis of the health care policy management debate for the future.

  13. Human factors review of CFMS displays for Ulchin Nuclear Power Unit 3 and 4

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yong Hee; Baek, Seung Min; Kim, Jung Taek; Park, Jae Chang; Lee, Jung Woon; Oh, In Suk; Lee, Joon Whan; Jung, Kwang Tae; Cha, Hye Young [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1996-11-01

    This report describes the human factors review of CFMS displays for Ulchin 3 and 4 by the following four subjects; At first, by reviewing issues regarding the design process of present CFMS, human factors engineering program plan (HFEPP) and human factors verification and validation plan Were proposed to accomplish the completeness of design word; Secondly, researches and developments were integrated into the review results at the point of suitability of CFMS design concept and basic function; For the third, availability and suitability were assessed according to human factors evaluation criteria on the CFMS display design, and overall effectiveness was also evaluated in parts; For the fourth, recommendations were made to human factors problems in accordance with their importance and an implementation plan was suggested for the resolution of problems. 54 refs., 34 tabs., 42 figs. (author)

  14. The applicability of a validated team-based learning student assessment instrument to assess United Kingdom pharmacy students’ attitude toward team-based learning

    OpenAIRE

    Nation, Leanne Marie; Tweddell, Simon; Rutter, Paul

    2016-01-01

    Purpose: It aimed at testing the validity and reliability of a validated team-based learning student assessment instrument (TBL-SAI) to assess United Kingdom pharmacy students’ attitude toward TBL. Methods: TBL-SAI, consisting of 33 items, was administered to undergraduate pharmacy students from two schools of pharmacy each at University of Wolverhampton and University of Bradford were conducted on the data, along with comparison between the two schools. Results: Students’ response rate was 8...

  15. Information systems for urban and regional planning in the United Kingdom: a review

    OpenAIRE

    Worrall, L.

    1990-01-01

    Design criteria for urban and regional information systems are outlined. An attempt is made to evaluate the nationally available statistical series in the United Kingdom in the context of those design criteria and some of the systems developed in British local government to counter the deficiencies of an inadequate national data system are reviewed. Various systems for collecting local data have been instituted by particular local authorities, although the problems of using such data are ofte...

  16. Professional competences of nurse to work in Intensive Care Units: an integrative review.

    Science.gov (United States)

    Camelo, Silvia Helena Henriques

    2012-01-01

    This study aimed to identify and analyze nurses' competences to work at Intensive Care Units-ICU. An integrative review method was used, and data were collected in LILACS, SciELO and BDENF, from August to October 2010. Ten articles were identified, published in the last 12 years. Data grouping permitted the construction of thematic units related to nurses' competences: nursing care management, high-complexity nursing care delivery, decision making, leadership, communication, continuing/permanent education, human resource management, material resource management. The professional competences identified can support the outline of guidelines to constitute the profile of nursing working in intensive care units and drive/mobilize the improvement of nursing care practices.

  17. Construction and validation of a tool to Assess the Use of Light Technologies at Intensive Care Units.

    Science.gov (United States)

    Marinho, Pabliane Matias Lordelo; Campos, Maria Pontes de Aguiar; Rodrigues, Eliana Ofélia Llapa; Gois, Cristiane Franca Lisboa; Barreto, Ikaro Daniel de Carvalho

    2016-12-19

    to construct and validate a tool to assess the use of light technologies by the nursing team at Intensive Care Units. methodological study in which the tool was elaborated by means of the psychometric method for construction based on the categorization of health technologies by Merhy and Franco, from the National Humanization Policy, using the Nursing Intervention Classification taxonomy to categorize the domains of the tool. Agreement Percentages and Content Validity Indices were used for the purpose of validation. The result of the application of the Interrater Agreement Percentage exceeded the recommended level of 80%, highlighting the relevance for the proposed theme in the assessment, with an agreement rate of 99%. the tool was validated with four domains (Bond, Autonomy, Welcoming and Management) and nineteen items that assess the use of light technologies at Intensive Care Units. construir e validar um instrumento para avaliação do uso de tecnologias leves, pela equipe de enfermagem, em Unidades de Terapia Intensiva. estudo metodológico no qual o instrumento foi elaborado utilizando o método psicométrico para construção com base na categorização das tecnologias em saúde de Merhy e Franco, da Política Nacional de Humanização, utilizando-se a taxonomia Nursing Intervention Classification para categorizar os domínios do instrumento. Utilizou-se o Percentual de Concordância e o Índice de Validade de Conteúdo (IVC) para validação. o resultado da aplicação do Percentual de Concordância entre os juízes foi superior ao recomendado de 80%, havendo destaque na avaliação da pertinência ao tema proposto, apresentando um percentual de concordância de 99%. o instrumento foi validado com quatro domínios (Vínculo, Autonomia, Acolhimento e Gestão) e dezenove itens que avaliam o uso das tecnologias leves em Unidade de Terapia Intensiva. construir y validar un instrumento para evaluación del uso de tecnologías leves, por el equipo de enfermer

  18. Patterns of Colorectal Cancer Care in the United States and Canada: A Systematic Review

    Science.gov (United States)

    2013-01-01

    Colorectal cancer is the third most common cancer in the United States and Canada. Given the high incidence and increased survival of colorectal cancer patients, prevalence is increasing over time in both countries. Using MEDLINE, we conducted a systematic review of the literature published between 2000 and 2010 to describe patterns of colorectal cancer care. Specifically we examined data sources used to obtain treatment information and compared patterns of cancer-directed initial care, post-diagnostic surveillance care, and end-of-life care among colorectal cancer patients diagnosed in the United States and Canada. Receipt of initial treatment for colorectal cancer was associated with the anatomical position of the tumor and extent of disease at diagnosis, in accordance with consensus-based guidelines. Overall, care trends were similar between the United States and Canada; however, we observed differences with respect to data sources used to measure treatment receipt. Differences were also present between study populations within country, further limiting direct comparisons. Findings from this review will allow researchers, clinicians, and policy makers to evaluate treatment receipt by patient, clinical, or system characteristics and identify emerging trends over time. Furthermore, comparisons between health-care systems in the United States and Canada can identify disparities in care, allow the evaluation of different models of care, and highlight issues regarding the utility of existing data sources to estimate national patterns of care. PMID:23962508

  19. Developing a framework for implementing intensive care unit diaries: a focused review of the literature.

    Science.gov (United States)

    Beg, Muna; Scruth, Elizabeth; Liu, Vincent

    2016-11-01

    Intensive care unit diaries have been shown to improve post-critical illness recovery, however, prior reports of diary implementation are heterogeneous. We sought to construct a common framework for designing and implementing Intensive Care Unit diaries based on prior studies. We conducted a focused review of the literature regarding intensive care diaries based on a systematic search of several databases. Two reviewers assessed 56 studies and data were abstracted from a total of 25 eligible studies conducted between 1990 and 2014. We identified key information regarding the development, design, and implementation of the journals. We then grouped elements that appeared consistently across these studies within three main categories: (1) diary target populations; (2) diary format and content; and (3) the manner of diary return and follow-up. Most studies were conducted in European countries in adult intensive care units and targeted patients in both medical and surgical units. The timing of diary initiation was based on the elapsed length of stay or duration of mechanical ventilation. We categorised diary format and content as: entry content, authors, use of standardised headings, type of language, initiation, frequency of entries, and physical location of diaries. Diaries were hand written and many studies found that photographs were an essential element in ICU diaries. We categorised the manner of diary return and follow-up. The context in which intensive care unit diaries were returned were felt to be important factors in improving the use of diaries in recovery. In conclusion, we describe a common framework for the future development of intensive care unit diaries that revolves around the target population for the diaries, their format and content, and the timing of their use. Future studies should address how these elements impact the mechanisms by which intensive are diaries exert beneficial effects. Copyright © 2016 Australian College of Critical Care Nurses

  20. A Systematic Review of Validated Methods for Identifying Cerebrovascular Accident or Transient Ischemic Attack Using Administrative Data

    Science.gov (United States)

    Andrade, Susan E.; Harrold, Leslie R.; Tjia, Jennifer; Cutrona, Sarah L.; Saczynski, Jane S.; Dodd, Katherine S.; Goldberg, Robert J.; Gurwitz, Jerry H.

    2012-01-01

    Purpose To perform a systematic review of the validity of algorithms for identifying cerebrovascular accidents (CVAs) or transient ischemic attacks (TIAs) using administrative and claims data. Methods PubMed and Iowa Drug Information Service (IDIS) searches of the English language literature were performed to identify studies published between 1990 and 2010 that evaluated the validity of algorithms for identifying CVAs (ischemic and hemorrhagic strokes, intracranial hemorrhage and subarachnoid hemorrhage) and/or TIAs in administrative data. Two study investigators independently reviewed the abstracts and articles to determine relevant studies according to pre-specified criteria. Results A total of 35 articles met the criteria for evaluation. Of these, 26 articles provided data to evaluate the validity of stroke, 7 reported the validity of TIA, 5 reported the validity of intracranial bleeds (intracerebral hemorrhage and subarachnoid hemorrhage), and 10 studies reported the validity of algorithms to identify the composite endpoints of stroke/TIA or cerebrovascular disease. Positive predictive values (PPVs) varied depending on the specific outcomes and algorithms evaluated. Specific algorithms to evaluate the presence of stroke and intracranial bleeds were found to have high PPVs (80% or greater). Algorithms to evaluate TIAs in adult populations were generally found to have PPVs of 70% or greater. Conclusions The algorithms and definitions to identify CVAs and TIAs using administrative and claims data differ greatly in the published literature. The choice of the algorithm employed should be determined by the stroke subtype of interest. PMID:22262598

  1. A systematic review of validated methods for identifying Kawasaki disease using administrative or claims data.

    Science.gov (United States)

    Williams, Candice L; Sathe, Nila A; Krishnaswami, Shanthi; McPheeters, Melissa L

    2013-12-30

    To identify and assess algorithms used to identify Kawasaki syndrome/Kawasaki disease in administrative and claims databases. We searched the MEDLINE database from 1991 to September 2012 using controlled vocabulary and key terms related to Kawasaki disease. We also searched the reference lists of included studies. Two investigators independently assessed the full text of studies against pre-determined inclusion criteria. Two reviewers independently extracted data regarding participant and algorithm characteristics. Our searches identified 177 citations of which 22 met our inclusion criteria. All studies used algorithms including International Classification of Diseases, Ninth Revision (ICD-9) code 446.1 either alone, or with evidence of intravenous immunoglobulin (IVIG) administration, or with ICD-10 code M30.3. Six studies confirmed diagnoses by medical chart review. Three of these six studies reported validation statistics, with positive predictive values of 74%, 84%, and 86%, respectively. All studies that reported algorithms used either the ICD-9 code 446.1 either alone, with evidence of IVIG administration or with ICD-10 code M30.3. The ICD-9 code 446.1 alone produced positive predictive values of 74%, 84%, and 86% in separate studies in Georgia and California. The sensitivity of these codes to detect Kawasaki disease is unknown, as no sampling of medical records for missed true cases of Kawasaki disease was done. Further research would be helpful to determine whether the relatively high positive predictive values found in southern California are seen elsewhere and also to evaluate the performance of other codes to identify cases of Kawasaki disease and the sensitivity of the narrow algorithms that have been used to date. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. External validity of randomized controlled trials in older adults, a systematic review

    Science.gov (United States)

    van Deudekom, Floor J.; Postmus, Iris; van der Ham, Danielle J.; Pothof, Alexander B.; Broekhuizen, Karen; Blauw, Gerard J.; Mooijaart, Simon P.

    2017-01-01

    Background To critically assess the external validity of randomized controlled trials (RCTs) it is important to know what older adults have been enrolled in the trials. The aim of this systematic review is to study what proportion of trials specifically designed for older patients report on somatic status, physical and mental functioning, social environment and frailty in the patient characteristics. Methods PubMed was searched for articles published in 2012 and only RCTs were included. Articles were further excluded if not conducted with humans or only secondary analyses were reported. A random sample of 10% was drawn. The current review analyzed this random sample and further selected trials when the reported mean age was ≥ 60 years. We extracted geriatric assessments from the population descriptives or the in- and exclusion criteria. Results In total 1396 trials were analyzed and 300 trials included. The median of the reported mean age was 66 (IQR 63–70) and the median percentage of men in the trials was 60 (IQR 45–72). In 34% of the RCTs specifically designed for older patients somatic status, physical and mental functioning, social environment or frailty were reported in the population descriptives or the in- and exclusion criteria. Physical and mental functioning was reported most frequently (22% and 14%). When selecting RCTs on a mean age of 70 or 80 years the report of geriatric assessments in the patient characteristics was 46% and 85% respectively but represent only 5% and 1% of the trials. Conclusion Somatic status, physical and mental functioning, social environment and frailty are underreported even in RCTs specifically designed for older patients published in 2012. Therefore, it is unclear for clinicians to which older patients the results can be applied. We recommend systematic to transparently report these relevant characteristics of older participants included in RCTs. PMID:28346503

  3. The Safety Organizing Scale: development and validation of a behavioral measure of safety culture in hospital nursing units.

    Science.gov (United States)

    Vogus, Timothy J; Sutcliffe, Kathleen M

    2007-01-01

    Evidence that medical error is a systemic problem requiring systemic solutions continues to expand. Developing a "safety culture" is one potential strategy toward improving patient safety. A reliable and valid self-report measure of safety culture is needed that is both grounded in concrete behaviors and is positively related to patient safety. We sought to develop and test a self-report measure of safety organizing that captures the behaviors theorized to underlie a safety culture and demonstrates use for potentially improving patient safety as evidenced by fewer reported medication errors and patient falls. A total of 1685 registered nurses from 125 nursing units in 13 hospitals in California, Indiana, Iowa, Maryland, Michigan, and Ohio completed questionnaires between December 2003 and June 2004. The authors conducted a cross-sectional assessment of factor structure, dimensionality, and construct validity. The Safety Organizing Scale (SOS), a 9-item unidimensional measure of self-reported behaviors enabling a safety culture, was found to have high internal reliability and reflect theoretically derived and empirically observed content domains. The measure was shown to discriminate between related concepts like organizational commitment and trust, vary significantly within hospitals, and was negatively associated with reported medication errors and patient falls in the subsequent 6-month period. The SOS not only provides meaningful, behavioral insight into the enactment of a safety culture, but because of the association between SOS scores and reported medication errors and patient falls, it also provides information that may be useful to registered nurses, nurse managers, hospital administrators, and governmental agencies.

  4. Validity of biomarkers predicting onset or progression of nephropathy in patients with Type 2 diabetes : a systematic review

    NARCIS (Netherlands)

    Hellemons, M. E.; Kerschbaum, J.; Bakker, S. J. L.; Neuwirt, H.; Mayer, B.; Mayer, G.; de Zeeuw, D.; Lambers Heerspink, H. J.; Rudnicki, M.

    2012-01-01

    Novel biomarkers predicting onset or progression of nephropathy in patients with Type 2 diabetes have been recently identified. We performed a systematic review to assess the validity of biomarkers predicting onset or progression of nephropathy in patients with Type 2 diabetes in longitudinal studie

  5. Are chiropractic tests for the lumbo-pelvic spine reliable and valid? A systematic critical literature review

    DEFF Research Database (Denmark)

    Hestbaek, L; Leboeuf-Yde, C

    2000-01-01

    was searched for the years 1976 to 1995 with the following index terms: "chiropractic tests," "chiropractic adjusting technique," "motion palpation," "movement palpation," "leg length," "applied kinesiology," and "sacrooccipital technique." In addition, a manual search was performed at the libraries....... Documentation of applied kinesiology was not available. Palpation for muscle tension, palpation for misalignment, and visual inspection were either undocumented, unreliable, or not valid. CONCLUSION: The detection of the manipulative lesion in the lumbo-pelvic spine depends on valid and reliable tests. Because......OBJECTIVE: To systematically review the peer-reviewed literature about the reliability and validity of chiropractic tests used to determine the need for spinal manipulative therapy of the lumbo-pelvic spine, taking into account the quality of the studies. DATA SOURCES: The CHIROLARS database...

  6. Validation of online psychometric instruments for common mental health disorders: a systematic review.

    Science.gov (United States)

    van Ballegooijen, Wouter; Riper, Heleen; Cuijpers, Pim; van Oppen, Patricia; Smit, Johannes H

    2016-02-25

    Online questionnaires for measuring common mental health disorders such as depression and anxiety disorders are increasingly used. The psychometrics of several pen-and-paper questionnaires have been re-examined for online use and new online instruments have been developed and tested for validity as well. This study aims to review and synthesise the literature on this subject and provide a framework for future research. We searched Medline and PsycINFO for psychometric studies on online instruments for common mental health disorders and extracted the psychometric data. Studies were coded and assessed for quality by independent raters. We included 56 studies on 62 online instruments. For common instruments such as the CES-D, MADRS-S and HADS there is mounting evidence for adequate psychometric properties. Further results are scattered over different instruments and different psychometric characteristics. Few studies included patient populations. We found at least one online measure for each of the included mental health disorders and symptoms. A small number of online questionnaires have been studied thoroughly. This study provides an overview of online instruments to refer to when choosing an instrument for assessing common mental health disorders online, and can structure future psychometric research.

  7. Validity and reliability of swallowing screening tools used by nurses for dysphagia: A systematic review.

    Science.gov (United States)

    Jiang, Jiin-Ling; Fu, Shu-Ying; Wang, Wan-Hsiang; Ma, Yu-Chin

    2016-01-01

    Dysphagia following neurological impairment increases the risk of dehydration, malnutrition, aspiration pneumonia, and even death. Screening for dysphagia has been reported to change negative outcomes. This review evaluated the validity and reliability of measurement tools for screening dysphagia in patients with neurological disorders to identify a feasible tool that can be used by nurses. Electronic databases were searched for studies from 1992 to 2015 related to dysphagia screening measurements. The search was applied to the Pubmed, CINAHL, Cochrane, Medline, EBSCO host, and CEPS + CETD databases. A checklist was used to evaluate the psychometric quality. The tools were evaluated for their feasibility for incorporation into routine care by nurses in hospitals. A total of 104 papers were retrieved, and eight articles finally met the inclusion criteria. The sensitivity and specificity of the screening tools ranged from 29% to 100% and from 65% to 100%, respectively. The interrater reliability ranged from good to excellent agreement. On the basis of quality evaluations, all the included studies had a risk of bias because of inadequate methodological characteristics. The Standardized Swallowing Assessment is the most suitable tool for detecting dysphagia because its psychometric properties and feasibility are higher than those of other screening tools that can be administered by nurses.

  8. 78 FR 65711 - Uncovered Innerspring Units From China, South Africa, and Vietnam Institution of Five-Year Reviews

    Science.gov (United States)

    2013-11-01

    ... COMMISSION Uncovered Innerspring Units From China, South Africa, and Vietnam Institution of Five-Year Reviews... the scope of the five-year reviews, as defined by the Department of Commerce. (2) The Subject.... Former Commission employees who are seeking to appear in Commission five-year reviews are advised that...

  9. Prediction models for the mortality risk in chronic dialysis patients: a systematic review and independent external validation study.

    Science.gov (United States)

    Ramspek, Chava L; Voskamp, Pauline Wm; van Ittersum, Frans J; Krediet, Raymond T; Dekker, Friedo W; van Diepen, Merel

    2017-01-01

    In medicine, many more prediction models have been developed than are implemented or used in clinical practice. These models cannot be recommended for clinical use before external validity is established. Though various models to predict mortality in dialysis patients have been published, very few have been validated and none are used in routine clinical practice. The aim of the current study was to identify existing models for predicting mortality in dialysis patients through a review and subsequently to externally validate these models in the same large independent patient cohort, in order to assess and compare their predictive capacities. A systematic review was performed following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. To account for missing data, multiple imputation was performed. The original prediction formulae were extracted from selected studies. The probability of death per model was calculated for each individual within the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD). The predictive performance of the models was assessed based on their discrimination and calibration. In total, 16 articles were included in the systematic review. External validation was performed in 1,943 dialysis patients from NECOSAD for a total of seven models. The models performed moderately to well in terms of discrimination, with C-statistics ranging from 0.710 (interquartile range 0.708-0.711) to 0.752 (interquartile range 0.750-0.753) for a time frame of 1 year. According to the calibration, most models overestimated the probability of death. Overall, the performance of the models was poorer in the external validation than in the original population, affirming the importance of external validation. Floege et al's models showed the highest predictive performance. The present study is a step forward in the use of a prediction model as a useful tool for nephrologists, using evidence-based medicine that

  10. Pharmacist Remote Review of Medication Prescriptions for Appropriateness in Pediatric Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Moran Lazaryan

    2016-08-01

    Full Text Available Background: One aspect of ordering and prescribing medication is the requirement for a trained professional to review medication orders or prescriptions for appropriateness. In practice, this review process is usually performed by a clinical pharmacist. However, in many medical centers there is a shortage of staff and a pharmacist is not always available.Objective: To determine whether remote review of medication orders by a pharmacist is a plausible method in a pediatric intensive care unit (PICU. Methods: A pharmacist from the pharmacy department reviewed medication orders of patients admitted to our PICU over a 7-month period for appropriateness. A special form for medical orders was filled in and sent to the physician in the PICU, who replied informing whether the recommendation had been accepted. The time spent by the pharmacist for this activity was recorded.Results: The review time for one medical record was 8.9 (95% CI, 6.9-10.9 minutes. Every additional drug prescribed increased the total review time by 0.8 (95% CI, 0.45-1.11 minutes. The pharmacist filled in 186 forms on 117 admissions for 109 children. The median review time was 15 (12.8-18.8 and 12 (9-15 minutes, respectively, for patients with psychiatric-neurologic disorders compared to those without (p=0.032. Usually, a daily workload of 240 minutes was needed for the pharmacist accompanying the round in contrast to 108 minutes per day needed to review all the medical records in 95% of the cases. The physician accepted 51.2%, rejected 11.9% and made no comment on 36.9% of the recommendations. Conclusion: Hospitals facing budget shortages can carry out focused remote reviews of prescriptions by the pharmacist.

  11. Quantifying the foodscape: A systematic review and meta-analysis of the validity of commercially available business data

    Science.gov (United States)

    Lebel, Alexandre; Daepp, Madeleine I. G.; Block, Jason P.; Walker, Renée; Lalonde, Benoît; Kestens, Yan; Subramanian, S. V.

    2017-01-01

    This paper reviews studies of the validity of commercially available business (CAB) data on food establishments (“the foodscape”), offering a meta-analysis of characteristics associated with CAB quality and a case study evaluating the performance of commonly-used validity indicators describing the foodscape. Existing validation studies report a broad range in CAB data quality, although most studies conclude that CAB quality is “moderate” to “substantial”. We conclude that current studies may underestimate the quality of CAB data. We recommend that future validation studies use density-adjusted and exposure measures to offer a more meaningful characterization of the relationship of data error with spatial exposure. PMID:28358819

  12. Palliative care and prognosis in COPD: a systematic review with a validation cohort

    Directory of Open Access Journals (Sweden)

    Almagro P

    2017-06-01

    Full Text Available Pere Almagro,1 Sergi Yun,1 Ana Sangil,1 Mónica Rodríguez-Carballeira,1 Meritxell Marine,1 Pedro Landete,2 Juan José Soler-Cataluña,3 Juan B Soriano,4 Marc Miravitlles5 1Multimorbidity Patients Unit, Internal Medicine Department, Hospital Universitario Mutua de Terrassa, Universidad de Barcelona, Terrassa, Barcelona, 2Department of Pneumology, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, 3Department of Pneumology, Hospital Arnau de Vilanova-Lliria, Valencia, 4Instituto de Investigación Hospital Universitario de la Princesa (IISP, Universidad Autónoma de Madrid, Madrid, 5Department of Pneumology, Vall d’Hebron University Hospital, CIBER de Enfermedades Respiratorias (CIBERES, Barcelona, Spain Abstract: Current recommendations to consider initiation of palliative care (PC in COPD patients are often based on an expected poor prognosis. However, this approach is not evidence-based, and which and when COPD patients should start PC is controversial. We aimed to assess whether current suggested recommendations for initiating PC were sufficiently reliable. We identified prognostic variables proposed in the literature for initiating PC; then, we ascertained their relationship with 1-year mortality, and finally, we validated their utility in our cohort of 697 patients hospitalized for COPD exacerbation. From 24 articles of 499 screened, we selected 20 variables and retrieved 48 original articles in which we were able to calculate the relationship between each of them and 1-year mortality. The number of studies where 1-year mortality was detailed for these variables ranged from 9 for previous hospitalizations or FEV1 ≤30% to none for albumin ≤25 mg/dL. The percentage of 1-year mortality in the literature for these variables ranged from 5% to 60%. In the validation cohort study, the prevalence of these proposed variables ranged from 8% to 64%; only 10 of the 18 variables analyzed in our cohort reached

  13. The units of measurement of the ventricular stroke work: a review study.

    Science.gov (United States)

    Schramm, Wolfgang

    2010-06-01

    The ventricular stroke work refers to the work done by the left or right ventricle to eject the volume of blood during one cardiac cycle, called stroke volume. Sarnoff and Berglund were one of the first to calculate the stroke work from the pressure volume diagram in 1954. However, they published a wrong unit of measurement for the stroke work, namely gram meter. The present work reviewed 779 scientific publications between May 1954 and January 2010 which used the left or right ventricular stroke work as a variable. Interestingly, the majority (87.2%) of scientific papers since 1954 have either copied this (or a similar) wrong unit of measurement or have invented another one. Only 12.8% of the publications gave a correct unit. The present search in scientific literature demonstrates that the haemodynamic variable ventricular stroke work, which is used daily by thousands of medical doctors and scientists, was specified in an incorrect manner for 56 years in the majority of scientific papers. A correct unit of measurement, of course, is an imperative condition when comparing scientific papers. The aim of this publication is the elimination of incorrect units of measurement of the ventricular stroke work variable in all future scientific papers. Moreover, the present work facilitates the interpretation of at least some of the studies containing the ventricular stroke work variable published up to now.

  14. Prediction Models and Their External Validation Studies for Mortality of Patients with Acute Kidney Injury: A Systematic Review

    Science.gov (United States)

    Ohnuma, Tetsu; Uchino, Shigehiko

    2017-01-01

    Objectives To systematically review AKI outcome prediction models and their external validation studies, to describe the discrepancy of reported accuracy between the results of internal and external validations, and to identify variables frequently included in the prediction models. Methods We searched the MEDLINE and Web of Science electronic databases (until January 2016). Studies were eligible if they derived a model to predict mortality of AKI patients or externally validated at least one of the prediction models, and presented area under the receiver-operator characteristic curves (AUROC) to assess model discrimination. Studies were excluded if they described only results of logistic regression without reporting a scoring system, or if a prediction model was generated from a specific cohort. Results A total of 2204 potentially relevant articles were found and screened, of which 12 articles reporting original prediction models for hospital mortality in AKI patients and nine articles assessing external validation were selected. Among the 21 studies for AKI prediction models and their external validation, 12 were single-center (57%), and only three included more than 1,000 patients (14%). The definition of AKI was not uniform and none used recently published consensus criteria for AKI. Although good performance was reported in their internal validation, most of the prediction models had poor discrimination with an AUROC below 0.7 in the external validation studies. There were 10 common non-renal variables that were reported in more than three prediction models: mechanical ventilation, age, gender, hypotension, liver failure, oliguria, sepsis/septic shock, low albumin, consciousness and low platelet count. Conclusions Information in this systematic review should be useful for future prediction model derivation by providing potential candidate predictors, and for future external validation by listing up the published prediction models. PMID:28056039

  15. A systematic review of the reliability and validity of discrete choice experiments in valuing non-market environmental goods.

    Science.gov (United States)

    Rakotonarivo, O Sarobidy; Schaafsma, Marije; Hockley, Neal

    2016-12-01

    While discrete choice experiments (DCEs) are increasingly used in the field of environmental valuation, they remain controversial because of their hypothetical nature and the contested reliability and validity of their results. We systematically reviewed evidence on the validity and reliability of environmental DCEs from the past thirteen years (Jan 2003-February 2016). 107 articles met our inclusion criteria. These studies provide limited and mixed evidence of the reliability and validity of DCE. Valuation results were susceptible to small changes in survey design in 45% of outcomes reporting reliability measures. DCE results were generally consistent with those of other stated preference techniques (convergent validity), but hypothetical bias was common. Evidence supporting theoretical validity (consistency with assumptions of rational choice theory) was limited. In content validity tests, 2-90% of respondents protested against a feature of the survey, and a considerable proportion found DCEs to be incomprehensible or inconsequential (17-40% and 10-62% respectively). DCE remains useful for non-market valuation, but its results should be used with caution. Given the sparse and inconclusive evidence base, we recommend that tests of reliability and validity are more routinely integrated into DCE studies and suggest how this might be achieved. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Further Validation of the Psychosocial Costs of Racism to Whites Scale on a Sample of University Students in the Southeastern United States

    Science.gov (United States)

    Sifford, Amy; Ng, Kok-Mun; Wang, Chuang

    2009-01-01

    We examined the factor structure of the Psychosocial Costs of Racism to Whites Scale (PCRW; Spanierman & Heppner, 2004) on 766 White American university students from the southeastern United States. Results from confirmatory factor analyses supported the 3-factor model proposed by Spanierman and Heppner (2004). The construct validity of the…

  17. Reliability and validity of OSCE checklists used to assess the communication skills of undergraduate medical students: A systematic review.

    Science.gov (United States)

    Setyonugroho, Winny; Kennedy, Kieran M; Kropmans, Thomas J B

    2015-06-27

    To explore inter-rater agreement between reviewers comparing reliability and validity of checklist forms that claim to assess the communication skills of undergraduate medical students in Objective Structured Clinical Examinations (OSCEs). Papers explaining rubrics of OSCE checklist forms were identified from Pubmed, Embase, PsycINFO, and the ProQuest Education Databases up to 2013. Included were those studies that report empirical validity or reliability values for the communication skills assessment checklists used. Excluded were those papers that did not report reliability or validity. Papers focusing on generic communication skills, history taking, physician-patient communication, interviewing, negotiating treatment, information giving, empathy and 18 other domains (ICC -0.12-1) were identified. Regarding the validity and reliability of the communication skills checklists, agreement between reviewers was 0.45. Heterogeneity in the rubrics used in the assessment of communication skills and a lack of agreement between reviewers makes comparison of student competences within and across institutions difficult. Consideration should be afforded to the adoption of a standardized measurement instrument to assess communication skills in undergraduate medical education. Future research will focus upon evaluating the potential impact of adoption of a standardized measurement instrument. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. A systematic review and appraisal of methods of developing and validating lifestyle cardiovascular disease risk factors questionnaires.

    Science.gov (United States)

    Nse, Odunaiya; Quinette, Louw; Okechukwu, Ogah

    2015-09-01

    Well developed and validated lifestyle cardiovascular disease (CVD) risk factors questionnaires is the key to obtaining accurate information to enable planning of CVD prevention program which is a necessity in developing countries. We conducted this review to assess methods and processes used for development and content validation of lifestyle CVD risk factors questionnaires and possibly develop an evidence based guideline for development and content validation of lifestyle CVD risk factors questionnaires. Relevant databases at the Stellenbosch University library were searched for studies conducted between 2008 and 2012, in English language and among humans. Using the following databases; pubmed, cinahl, psyc info and proquest. Search terms used were CVD risk factors, questionnaires, smoking, alcohol, physical activity and diet. Methods identified for development of lifestyle CVD risk factors were; review of literature either systematic or traditional, involvement of expert and /or target population using focus group discussion/interview, clinical experience of authors and deductive reasoning of authors. For validation, methods used were; the involvement of expert panel, the use of target population and factor analysis. Combination of methods produces questionnaires with good content validity and other psychometric properties which we consider good.

  19. Waterpipe Smoking and Regulation in the United States: A Comprehensive Review of the Literature

    Directory of Open Access Journals (Sweden)

    Linda Haddad

    2015-05-01

    Full Text Available Background: Researchers in tobacco control are concerned about the increasing prevalence of waterpipe smoking in the United States, which may pose similar risks as cigarette smoking. This review explores the prevalence of waterpipe smoking in the United States as well as the shortcomings of current U.S. policy for waterpipe control and regulation. Methods: Researchers conducted a literature review for waterpipe articles dated between 2004 and 2015 using five online databases: MEDLINE, CINHAHL, ScienceDirect, PMC, and Cochrane Library. Results: To date, few studies have explored the marketing and regulation of waterpipe smoking in the U.S., which has increased in the last ten years, especially among women, adolescents, and young adults. Data indicate that the majority of waterpipe smokers are unaware of the potential risks of use. In addition, current tobacco control policies do not address waterpipe smoking, enabling tobacco companies to readily market and sell waterpipe products to young adults, who are at risk for becoming lifelong smokers. Conclusion: Policy makers in the area of public health need to update existing tobacco regulations to include waterpipe smoking. Similarly, public health researchers should develop public health campaigns and interventions to address the increasing rates of waterpipe smoking in the United States.

  20. Waterpipe Smoking and Regulation in the United States: A Comprehensive Review of the Literature.

    Science.gov (United States)

    Haddad, Linda; El-Shahawy, Omar; Ghadban, Roula; Barnett, Tracey E; Johnson, Emily

    2015-05-29

    Researchers in tobacco control are concerned about the increasing prevalence of waterpipe smoking in the United States, which may pose similar risks as cigarette smoking. This review explores the prevalence of waterpipe smoking in the United States as well as the shortcomings of current U.S. policy for waterpipe control and regulation. Researchers conducted a literature review for waterpipe articles dated between 2004 and 2015 using five online databases: MEDLINE, CINHAHL, ScienceDirect, PMC, and Cochrane Library. To date, few studies have explored the marketing and regulation of waterpipe smoking in the U.S., which has increased in the last ten years, especially among women, adolescents, and young adults. Data indicate that the majority of waterpipe smokers are unaware of the potential risks of use. In addition, current tobacco control policies do not address waterpipe smoking, enabling tobacco companies to readily market and sell waterpipe products to young adults, who are at risk for becoming lifelong smokers. Policy makers in the area of public health need to update existing tobacco regulations to include waterpipe smoking. Similarly, public health researchers should develop public health campaigns and interventions to address the increasing rates of waterpipe smoking in the United States.

  1. Understanding how organized youth sport maybe harming individual players within the family unit: a literature review.

    Science.gov (United States)

    Bean, Corliss N; Fortier, Michelle; Post, Courtney; Chima, Karam

    2014-10-01

    Within the United States, close to 45 million youths between the ages of 6 and 18 participate in some form of organized sports. While recent reviews have shown the positive effects of youth sport participation on youth health, there are also several negative factors surrounding the youth sport environment. To date, a comprehensive review of the negative physical and psychological effects of organized sport on youth has not been done and little to date has documented the effect organized sport has on other players within a family, particularly on parents and siblings. Therefore the purpose of this paper is to conduct a review of papers on the negative effects of organized sport on the youth athlete and their parents and siblings. Articles were found by searching multiple databases (Physical Education Index and Sociology, Psychology databases (Proquest), SPORTDiscus and Health, History, Management databases (EBSCOhost), Science, Social Science, Arts and Humanities on Web of Science (ISI), SCOPUS and Scirus (Elsevier). Results show the darker side of organized sport for actors within the family unit. Ideas for future research are drawn and recommendations are made to optimize the youth sport experience and family health.

  2. Validity and Reliability of Published Comprehensive Theory of Mind Tests for Normal Preschool Children: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Seyyede Zohreh Ziatabar Ahmadi

    2015-12-01

    Full Text Available Objective: Theory of mind (ToM or mindreading is an aspect of social cognition that evaluates mental states and beliefs of oneself and others. Validity and reliability are very important criteria when evaluating standard tests; and without them, these tests are not usable. The aim of this study was to systematically review the validity and reliability of published English comprehensive ToM tests developed for normal preschool children.Method: We searched MEDLINE (PubMed interface, Web of Science, Science direct, PsycINFO, and also evidence base Medicine (The Cochrane Library databases from 1990 to June 2015. Search strategy was Latin transcription of ‘Theory of Mind’ AND test AND children. Also, we manually studied the reference lists of all final searched articles and carried out a search of their references. Inclusion criteria were as follows: Valid and reliable diagnostic ToM tests published from 1990 to June 2015 for normal preschool children; and exclusion criteria were as follows: the studies that only used ToM tests and single tasks (false belief tasks for ToM assessment and/or had no description about structure, validity or reliability of their tests. Methodological quality of the selected articles was assessed using the Critical Appraisal Skills Programme (CASP.Result: In primary searching, we found 1237 articles in total databases. After removing duplicates and applying all inclusion and exclusion criteria, we selected 11 tests for this systematic review. Conclusion: There were a few valid, reliable and comprehensive ToM tests for normal preschool children. However, we had limitations concerning the included articles. The defined ToM tests were different in populations, tasks, mode of presentations, scoring, mode of responses, times and other variables. Also, they had various validities and reliabilities. Therefore, it is recommended that the researchers and clinicians select the ToM tests according to their psychometric

  3. The reliability and validity of radiological assessment for patellar instability. A systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Toby O. [University of East Anglia, Faculty of Health, Norwich (United Kingdom); Davies, Leigh [Norfolk and Norwich University Hospital, Norwich (United Kingdom); Toms, Andoni P.; Donell, Simon T. [University of East Anglia, Faculty of Health, Norwich (United Kingdom); Norfolk and Norwich University Hospital, Norwich (United Kingdom); Hing, Caroline B. [St George' s Hospital, London (United Kingdom)

    2011-04-15

    To determine the discriminative validity and reliability of the evidence base using meta-analysis. A review of published sources using the databases AMED, CINHAL, EMBASE, MEDLINE, Scopus and the Cochrane Library, and for unpublished material was conducted. All studies assessing the reliability, validity, sensitivity or specificity of magnetic resonance imaging (MRI), computed tomography (CT) or ultrasound (US) of the patellofemoral joint of patients following patellar dislocation, subluxation or instability, were included. A meta-analysis was performed to assess the difference in radiological measurements between healthy controls and subjects with patellar instability in order to assess discrimination validity. A narrative assessment was used to evaluate the inter- and intra-observer reliability as well as the sensitivity and specificity of specific radiological measurements. A total of 27 studies were reviewed. The findings indicated that there was acceptable inter-observer and intra-observer reliability and validity for different methods of assessing patellar height and the sulcus angle with X-ray, MRI and CT methods, and the tibial tubercle-trochlear groove (TT-TG) assessed using CT. There was poor reliability or validity for the assessment of severity of trochlear dysplasia and the sulcus angle using US. There is insufficient evidence to determine the reliability, validity, sensitivity or specificity of tests such as the congruence angle, lateral patellar displacement, lateral patellar tilt, trochlear depth, boss height, the crossing sign or Wiberg patellar classification. A critical appraisal of the literature identified a number of recurrent methodological limitations. Further study is recommended to evaluate the reliability and validity of these radiological outcomes using well-designed radiological trials. (orig.)

  4. Validity and Reliability of Published Comprehensive Theory of Mind Tests for Normal Preschool Children: A Systematic Review

    Science.gov (United States)

    Ziatabar Ahmadi, Seyyede Zohreh; Jalaie, Shohreh; Ashayeri, Hassan

    2015-01-01

    Objective: Theory of mind (ToM) or mindreading is an aspect of social cognition that evaluates mental states and beliefs of oneself and others. Validity and reliability are very important criteria when evaluating standard tests; and without them, these tests are not usable. The aim of this study was to systematically review the validity and reliability of published English comprehensive ToM tests developed for normal preschool children. Method: We searched MEDLINE (PubMed interface), Web of Science, Science direct, PsycINFO, and also evidence base Medicine (The Cochrane Library) databases from 1990 to June 2015. Search strategy was Latin transcription of ‘Theory of Mind’ AND test AND children. Also, we manually studied the reference lists of all final searched articles and carried out a search of their references. Inclusion criteria were as follows: Valid and reliable diagnostic ToM tests published from 1990 to June 2015 for normal preschool children; and exclusion criteria were as follows: the studies that only used ToM tests and single tasks (false belief tasks) for ToM assessment and/or had no description about structure, validity or reliability of their tests. Methodological quality of the selected articles was assessed using the Critical Appraisal Skills Programme (CASP). Result: In primary searching, we found 1237 articles in total databases. After removing duplicates and applying all inclusion and exclusion criteria, we selected 11 tests for this systematic review. Conclusion: There were a few valid, reliable and comprehensive ToM tests for normal preschool children. However, we had limitations concerning the included articles. The defined ToM tests were different in populations, tasks, mode of presentations, scoring, mode of responses, times and other variables. Also, they had various validities and reliabilities. Therefore, it is recommended that the researchers and clinicians select the ToM tests according to their psychometric characteristics

  5. Notes on critical care-review of seminal management and leadership papers in the United Kingdom.

    Science.gov (United States)

    Coombs, Maureen

    2009-06-01

    Review of recent critical care provision reveals substantial changes in clinical unit operating, and policy drivers influencing international critical care delivery. Practitioners who have worked in healthcare environments over this time, will have witnessed substantial shifts in healthcare policy, changes in professional body guidance and greater service evaluation have impacted on critical care management and leadership. This paper offers a personal perspective on seminal management and leadership papers published in the critical care literature over the past decade. Presenting a range of national and international work that utilise diverse approaches, ten key papers are highlighted that have impacted in the United Kingdom setting. Through this, the influence of the modernisation agenda, the increasing significance of outcome studies, and the need for flexible, interdependent practice emerges. A key message to surface from this paper is the need for all in critical care to engage with, and understand the wider implications of management and leadership change for critical care delivery.

  6. Review of design conditions applicable to offshore wind energy systems in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Manwell, J.F.; Elkinton, C.N.; Rogers, A.L.; McGowan, J.G. [Renewable Energy Research Laboratory, Department of Mechanical and Industrial Engineering, University of Massachusetts, P.O. Box 32210, Amherst, MA 01003-2210 (United States)

    2007-02-15

    Offshore wind turbines are now being considered for use in the United States. Ensuring proper design of offshore wind turbines and wind farms requires knowledge of the external conditions in which the turbines and associated facilities are to operate. The primary external conditions are due to the wind and waves. Also, for many locations, floating ice will also be a major factor in the design. This review examines the following aspects of external conditions for the design of offshore wind turbines for the United States: (1) design requirements, (2) available offshore data sources, (3) data estimation and extrapolation techniques, (4) on-site data collection, and (5) likely sources of extreme events, including hurricanes and northeast storms. (author)

  7. Online Radiology Reporting with Peer Review as a Learning and Feedback Tool in Radiology; Implementation, Validity, and Student Impressions.

    Science.gov (United States)

    McEvoy, Fintan J; Shen, Nicholas W; Nielsen, Dorte H; Buelund, Lene E; Holm, Peter

    2017-02-01

    Communicating radiological reports to peers has pedagogical value. Students may be uneasy with the process due to a lack of communication and peer review skills or to their failure to see value in the process. We describe a communication exercise with peer review in an undergraduate veterinary radiology course. The computer code used to manage the course and deliver images online is reported, and we provide links to the executable files. We tested to see if undergraduate peer review of radiological reports has validity and describe student impressions of the learning process. Peer review scores for student-generated radiological reports were compared to scores obtained in the summative multiple choice (MCQ) examination for the course. Student satisfaction was measured using a bespoke questionnaire. There was a weak positive correlation (Pearson correlation coefficient = 0.32, p peer review scores students received and the student scores obtained in the MCQ examination. The difference in peer review scores received by students grouped according to their level of course performance (high vs. low) was statistically significant (p peer review scores awarded by the students and the scores they obtained in the MCQ examination (Pearson correlation coefficient = 0.17, p = 0.14). In conclusion, we have created a realistic radiology imaging exercise with readily available software. The peer review scores are valid in that to a limited degree they reflect student future performance in an examination. Students valued the process of learning to communicate radiological findings but do not fully appreciated the value of peer review.

  8. Oral care in patients on mechanical ventilation in intensive care unit: literature review

    Directory of Open Access Journals (Sweden)

    Selma Atay

    2014-06-01

    Full Text Available intensive care patients needs to oral assessment and oral care for avoid complications caused by orafarengeal bacteria. In this literature review, it is aimed to determine the practice over oral hygiene in mechanical ventilator patients in intensive care unit. For the purpose of collecting data, Medline/pub MED and EBSCO HOST databases were searched with the keywords and lsquo;oral hygiene, oral hygiene practice, mouth care, mouth hygiene, intubated, mechanical ventilation, intensive care and critical care and rdquo; between the years of 2000- 2012. Inclusion criteria for the studies were being performed in adult intensive care unit patients on mechanical ventilation, published in peer-reviewed journals in English between the years of 2000-2012, included oral care practice and presence of a nurse among researchers. A total of 304 articles were identified. Six descriptive evaluation studies, three randomised controlled trials, four literature reviews, three meta-Analysis randomized clinical trials, one qualitative study and one semi-experimental study total 18 papers met all of the inclusion criteria. Oral care is emphasized as an infection control practice for the prevention of Ventilator-Associated Pneumonia (VAP. In conclusion, we mention that oral care is an important nursing practice to prevent VAP development in intensive care unit patients; however, there is no standard oral evaluation tool and no clarity on oral care practice frequency, appropriate solution and appropriate material. It can be recommended that the study projects on oral care in intensive care patients to have high proof level and be experimental, and longitudinal. [Int J Res Med Sci 2014; 2(3.000: 822-829

  9. The ASCAT Soil Moisture Product: A Review of its Specifications, Validation Results, and Emerging Applications

    Directory of Open Access Journals (Sweden)

    Wolfgang Wagner

    2013-02-01

    applications. To provide a comprehensive overview of the major characteristics and caveats of the ASCAT soil moisture product, this paper describes the ASCAT instrument and the soil moisture processor and near-real-time distribution service implemented by the European Organisation for the Exploitation of Meteorological Satellites (EUMETSAT. A review of the most recent validation studies shows that the quality of ASCAT soil moisture product is - with the exception of arid environments -comparable to, and over some regions (e.g. Europe even better than currently available soil moisture data derived from passive microwave sensors. Further, a review of applications studies shows that the use of the ASCAT soil moisture product is particularly advanced in the fields of numerical weather prediction and hydrologic modelling. But also in other application areas such as yield monitoring, epidemiologic modelling, or societal risks assessment some first progress can be noted. Considering the generally positive evaluation results, it is expected that the ASCAT soil moisture product will increasingly be used by a growing number of rather diverse land applications.

  10. Outcomes for women admitted to a mother and baby unit: a systematic review.

    Science.gov (United States)

    Gillham, Rebecca; Wittkowski, Anja

    2015-01-01

    Mother and baby units (MBUs) provide inpatient psychiatric care for mothers and their infants up to a year after childbirth. They are commissioned to support the mother-infant relationship as well as stabilize maternal mental health. As their efficacy at meeting these aims had not previously been systematically assessed, this paper reviewed the international literature relating to psychological outcomes following MBU admission. A systematic search of five databases identified 23 papers eligible for inclusion, reporting on a range of outcomes indicating positive effects on maternal mental health and the mother-infant relationship and an absence of adverse effects on child development. The review also highlighted specific groups responding less favorably to MBU admission, eg, mothers with a diagnosis of schizophrenia. Although the included studies were of variable methodological quality, the research findings consistently indicated positive effects. Implications for research and clinical practice are outlined in the discussion.

  11. Palliative medicine physician education in the United States: a historical review.

    Science.gov (United States)

    Case, Amy A; Orrange, Susan M; Weissman, David E

    2013-03-01

    In this review we discuss the history of Hospice and Palliative Medicine (HPM) physician education in the United States over the last 20 years, as there has been dramatic growth in our specialty during this time. A Medline literature search was completed and we surveyed leaders in the field of HPM education regarding their experiences in promoting palliative medicine education. Educators were selected based on their peer reviewed publications on key educational initiatives since 1990. A survey tool was designed and emailed to 18 educators across the country and follow-up phone interviews were done to further explore specific questions. The survey and interviews sought information about major palliative care education milestones, instrumental projects, and barriers to further development of palliative medicine education.

  12. The Reliability and Validity of Discrete and Continuous Measures of Psychopathology: A Quantitative Review

    Science.gov (United States)

    Markon, Kristian E.; Chmielewski, Michael; Miller, Christopher J.

    2011-01-01

    In 2 meta-analyses involving 58 studies and 59,575 participants, we quantitatively summarized the relative reliability and validity of continuous (i.e., dimensional) and discrete (i.e., categorical) measures of psychopathology. Overall, results suggest an expected 15% increase in reliability and 37% increase in validity through adoption of a…

  13. The Reliability and Validity of Discrete and Continuous Measures of Psychopathology: A Quantitative Review

    Science.gov (United States)

    Markon, Kristian E.; Chmielewski, Michael; Miller, Christopher J.

    2011-01-01

    In 2 meta-analyses involving 58 studies and 59,575 participants, we quantitatively summarized the relative reliability and validity of continuous (i.e., dimensional) and discrete (i.e., categorical) measures of psychopathology. Overall, results suggest an expected 15% increase in reliability and 37% increase in validity through adoption of a…

  14. A review of changes in composition of hot mix asphalt in the United States.

    Science.gov (United States)

    Mundt, Diane J; Marano, Kristin M; Nunes, Anthony P; Adams, Robert C

    2009-11-01

    This review researched the materials, methods, and practices in the hot mix asphalt industry that might impact future exposure assessments and epidemiologic research on road paving workers. Since World War II, the U.S. interstate highway system, increased traffic volume, transportation speeds, and vehicle axle loads have necessitated an increase in demand for hot mix asphalt for road construction and maintenance, while requiring a consistent road paving product that meets state-specific physical performance specifications. We reviewed typical practices in hot mix asphalt paving in the United States to understand the extent to which materials are and have been added to hot mix asphalt to meet specifications and how changes in practices and technology could affect evaluation of worker exposures for future research. Historical documents were reviewed, and industry experts from 16 states were interviewed to obtain relevant information on industry practices. Participants from all states reported additive use, with most being less than 2% by weight. Crumb rubber and recycled asphalt pavement were added in concentrations approximately 10% per unit weight of the mix. The most frequently added materials included polymers and anti-stripping agents. Crumb rubber, sulfur, asbestos, roofing shingles, slag, or fly ash have been used in limited amounts for short periods of time or in limited geographic areas. No state reported using coal tar as an additive to hot mix asphalt or as a binder alternative in hot mix pavements for high-volume road construction. Coal tar may be present in recycled asphalt pavement from historical use, which would need to be considered in future exposure assessments of pavers. Changes in hot mix asphalt production and laydown emission control equipment have been universally implemented over time as the technology has become available to reduce potential worker exposures. This work is a companion review to a study undertaken in the petroleum refining

  15. A Review of Underground Coal Gasification Research and Development in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Camp, D. W. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-06-26

    An intense and productive period of research and development on underground coal gasification (UCG) took place in the United States from the mid-1970’s through the late 1980’s. It began with the translation and review of Soviet literature and ended with the Rocky Mountain 1 field test. This demonstrated the feasibility of newly-developed technologies that form the basis of many UCG projects around the world today. This period began with little domestic understanding of UCG and ended with an accurate observation-based conceptual model and a corresponding predictive multi-physics mathematical model of the process. The many accomplishments of this period form the main content of this report. This report also covers recent U.S. activities and accomplishments during the period 2004-2015, and touches briefly on the Bureau of Mines efforts between 1948 and 1963. Most of the activities were funded by the United States Department of Energy and its predecessors. While private/commercially-funded activities are reviewed here, the emphasis is on government-funded work. It has a much greater extent of publicly available reports and papers, and they generally contain much greater technical detail. Field tests were the marquis activities around which an integrated multi-faceted program was built. These are described in detail in Section 4. Highlights from modeling efforts are briefly covered, as the program was integrated and well-rounded, with field results informing models and vice-versa. The primary goal of this report is to review what has been learned about UCG from the U.S. experience in aggregate. This includes observations, conclusions, lessons-learned, phenomena understood, and technology developed. The latter sections of this report review these things.

  16. Cognitive Training for Ethnic Minority Older Adults in the United States: A Review.

    Science.gov (United States)

    Tzuang, Marian; Owusu, Jocelynn T; Spira, Adam P; Albert, Marilyn S; Rebok, George W

    2017-05-30

    Interest in cognitive training for healthy older adults to reduce cognitive decline has grown considerably over the past few decades. Given the shift toward a more diverse society, the purpose of this review is to examine the extent of race/ethnic minority participation in cognitive training studies and characteristics of studies that included race/ethnic minority participants. This review considered peer-reviewed studies reporting cognitive training studies for cognitively healthy, community-dwelling older adults (age 55+) in the United States published in English before December 31, 2015. A total of 31 articles published between 1986 and 2015 meeting inclusion criteria were identified and included in the review. A total of 6,432 participants were recruited across all of the studies, and ranged in age from 55 to 99 years. Across all studies examined, 39% reported racial/ethnic background information. Only 3 of these studies included a substantial number of minorities (26.7% in the ACTIVE study; 28.4% in the SeniorWISE study; 22.7% in the TEAM study). Race/ethnic minority older adults were disproportionately underrepresented in cognitive training studies. Further research should aim to enroll participants representative of various race/ethnic minority populations. Strategies for recruitment and retention of ethnic minority participants in cognitive training research are discussed, which could lead to the development of more culturally appropriate and perhaps more effective cognitive interventions.

  17. Evaluation Protocol for Review of Method Validation Data by the AOAC Stakeholder Panel on Infant Formula and Adult Nutritionals Expert Review Panel.

    Science.gov (United States)

    Gill, Brendon D; Indyk, Harvey E; Blake, Christopher J; Konings, Erik J M; Jacobs, Wesley A; Sullivan, Darryl M

    2015-01-01

    Methods under consideration as part of the AOAC Stakeholder Panel on Infant Formula and Adult Nutritionals process are to be evaluated against a set of Standard Method Performance RequirementsSM (SMPRs) via peer review by an expert review panel (ERP). A validation protocol and a checklist have been developed to assist the ERP to evaluate experimental data and to compare multiple candidate methods for each nutrient. Method performance against validation parameters mandated in the SMPRs as well as additional criteria are to be scored, with the method selected by the ERP proceeding to multilaboratory study prior to Final Action approval. These methods are intended to be used by the infant formula industry for the purposes of dispute resolution.

  18. International Comparative Assessments: Broadening the Interpretability, Application and Relevance to the United States. Research in Review 2012-5

    Science.gov (United States)

    Di Giacomo, F. Tony; Fishbein, Bethany G.; Buckley, Vanessa W.

    2013-01-01

    Many articles and reports have reviewed, researched, and commented on international assessments from the perspective of exploring what is relevant for the United States' education systems. Researchers make claims about whether the top-performing systems have transferable practices or policies that could be applied to the United States. However,…

  19. Telephone-based screening tools for mild cognitive impairment and dementia in aging studies: a review of validated instruments

    Directory of Open Access Journals (Sweden)

    Teresa Costa Castanho

    2014-02-01

    Full Text Available The decline of cognitive function in old age is a great challenge for modern society. The simultaneous increase in dementia and other neurodegenerative diseases justifies a growing need for accurate and valid cognitive assessment instruments. Although in-person testing is considered the most effective and preferred administration mode of assessment, it can pose not only a research difficulty in reaching large and diverse population samples, but it may also limit the assessment and follow-up of individuals with either physical or health limitations or reduced motivation. Therefore, telephone-based cognitive screening instruments pose an alternative and attractive strategy to in-person assessments. In order to give a current view of the state of the art of telephone-based tools for cognitive assessment in aging, this review highlights some of the existing instruments with particular focus on data validation, cognitive domains assessed, administration time and instrument limitations and advantages. From the review of the literature, performed using the databases EBSCO, Science Direct and PubMed, it was possible to verify that while telephone-based tools are useful in research and clinical practice, providing a promising approach, the methodologies still need refinement in the validation steps, including comparison with either single instruments or neurocognitive test batteries, to improve specificity and sensitivity to validly detect subtle changes in cognition that may precede cognitive impairment.

  20. A review of the reliability and validity of Likert-type scales for people with intellectual disability.

    Science.gov (United States)

    Hartley, S L; MacLean, W E

    2006-11-01

    Likert-type scales are increasingly being used among people with intellectual disability (ID). These scales offer an efficient method for capturing a wide range of variance in self-reported attitudes and behaviours. This review is an attempt to evaluate the reliability and validity of Likert-type scales in people with ID. Fifty-one studies reporting response rates, response bias, reliability and validity of Likert-type scales among adolescents and adults with ID were reviewed. Low response rates were found among adolescents and adults with moderate to profound ID, when pictorial representations of response alternatives were not employed, and for Likert-type scales with self-descriptive statements. Response bias was evident, particularly among adolescents and adults with moderate to profound ID. Likert-type scales have better reliability and validity among adolescents and adults with borderline IQ or mild ID. Pretests and clarifying questions increase reliability and validity. Likert-type scales should include pictorial representations of response alternatives, a single set of one or two word response descriptors, clarifying questions, and pretests, and are best used with adolescents and adults with borderline IQ to mild ID.

  1. Telephone-based screening tools for mild cognitive impairment and dementia in aging studies: a review of validated instruments

    Science.gov (United States)

    Castanho, Teresa C.; Amorim, Liliana; Zihl, Joseph; Palha, Joana A.; Sousa, Nuno; Santos, Nadine C.

    2013-01-01

    The decline of cognitive function in old age is a great challenge for modern society. The simultaneous increase in dementia and other neurodegenerative diseases justifies a growing need for accurate and valid cognitive assessment instruments. Although in-person testing is considered the most effective and preferred administration mode of assessment, it can pose not only a research difficulty in reaching large and diverse population samples, but it may also limit the assessment and follow-up of individuals with either physical or health limitations or reduced motivation. Therefore, telephone-based cognitive screening instruments can be an alternative and attractive strategy to in-person assessments. In order to give a current view of the state of the art of telephone-based tools for cognitive assessment in aging, this review highlights some of the existing instruments with particular focus on data validation, cognitive domains assessed, administration time and instrument limitations and advantages. From the review of the literature, performed using the databases EBSCO, Science Direct and PubMed, it was possible to verify that while telephone-based tools are useful in research and clinical practice, providing a promising approach, the methodologies still need refinement in the validation steps, including comparison with either single instruments or neurocognitive test batteries, to improve specificity and sensitivity to validly detect subtle changes in cognition that may precede cognitive impairment. PMID:24611046

  2. Telephone-based screening tools for mild cognitive impairment and dementia in aging studies: a review of validated instruments.

    Science.gov (United States)

    Castanho, Teresa C; Amorim, Liliana; Zihl, Joseph; Palha, Joana A; Sousa, Nuno; Santos, Nadine C

    2014-01-01

    The decline of cognitive function in old age is a great challenge for modern society. The simultaneous increase in dementia and other neurodegenerative diseases justifies a growing need for accurate and valid cognitive assessment instruments. Although in-person testing is considered the most effective and preferred administration mode of assessment, it can pose not only a research difficulty in reaching large and diverse population samples, but it may also limit the assessment and follow-up of individuals with either physical or health limitations or reduced motivation. Therefore, telephone-based cognitive screening instruments can be an alternative and attractive strategy to in-person assessments. In order to give a current view of the state of the art of telephone-based tools for cognitive assessment in aging, this review highlights some of the existing instruments with particular focus on data validation, cognitive domains assessed, administration time and instrument limitations and advantages. From the review of the literature, performed using the databases EBSCO, Science Direct and PubMed, it was possible to verify that while telephone-based tools are useful in research and clinical practice, providing a promising approach, the methodologies still need refinement in the validation steps, including comparison with either single instruments or neurocognitive test batteries, to improve specificity and sensitivity to validly detect subtle changes in cognition that may precede cognitive impairment.

  3. Validity of peptic ulcer disease and upper gastrointestinal bleeding diagnoses in administrative databases: a systematic review protocol.

    Science.gov (United States)

    Montedori, Alessandro; Abraha, Iosief; Chiatti, Carlos; Cozzolino, Francesco; Orso, Massimiliano; Luchetta, Maria Laura; Rimland, Joseph M; Ambrosio, Giuseppe

    2016-09-15

    Administrative healthcare databases are useful to investigate the epidemiology, health outcomes, quality indicators and healthcare utilisation concerning peptic ulcers and gastrointestinal bleeding, but the databases need to be validated in order to be a reliable source for research. The aim of this protocol is to perform the first systematic review of studies reporting the validation of International Classification of Diseases, 9th Revision and 10th version (ICD-9 and ICD-10) codes for peptic ulcer and upper gastrointestinal bleeding diagnoses. MEDLINE, EMBASE, Web of Science and the Cochrane Library databases will be searched, using appropriate search strategies. We will include validation studies that used administrative data to identify peptic ulcer disease and upper gastrointestinal bleeding diagnoses or studies that evaluated the validity of peptic ulcer and upper gastrointestinal bleeding codes in administrative data. The following inclusion criteria will be used: (a) the presence of a reference standard case definition for the diseases of interest; (b) the presence of at least one test measure (eg, sensitivity, etc) and (c) the use of an administrative database as a source of data. Pairs of reviewers will independently abstract data using standardised forms and will evaluate quality using the checklist of the Standards for Reporting of Diagnostic Accuracy (STARD) criteria. This systematic review protocol has been produced in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P) 2015 statement. Ethics approval is not required given that this is a protocol for a systematic review. We will submit results of this study to a peer-reviewed journal for publication. The results will serve as a guide for researchers validating administrative healthcare databases to determine appropriate case definitions for peptic ulcer disease and upper gastrointestinal bleeding, as well as to perform outcome research using

  4. Psychometric validation of the Brief Pain Inventory-Short Form in patients with systemic lupus erythematosus in the United States.

    Science.gov (United States)

    Naegeli, A N; Tomaszewski, E L; Al Sawah, S

    2015-11-01

    This study evaluated the Brief Pain Inventory-Short Form (BPI-SF) in patients with moderate-to-severe systemic lupus erythematosus (SLE). Patients ≥18 years old who self-reported a physician diagnosis of SLE (confirmed by medical record review) and active SLE (Systemic Lupus Activity Questionnaire (SLAQ) score of ≥11) were included. The BPI-SF and Short Form Health Survey version 2 (SF-36v2) were administered electronically at baseline, week 2 and week 12. Psychometric properties of the BPI-SF were evaluated. Cronbach alphas were >0.9 for all BPI-SF items, domains and total score. Test-retest reliability correlations for responses between baseline and week 2 of the BPI-SF had intraclass correlation coefficients (ICCs) ≥0.5. The BPI-SF domains and total score were moderately positively correlated to the SLAQ score (r ≥ 0.4), but negatively correlated to the SF-36v2 bodily pain domain (r ≤ -0.6). The BPI-SF domains and total score were moderately negatively correlated to the SF-36v2 physical functioning domain and physical component summary (r ≤ -0.4), with low correlations between the BPI-SF severity domain and SF-36v2 mental component summary (r = -0.16). Assessment of pain, as measured by the BPI-SF, demonstrated validity and reliability in a sample of patients with moderate-to-severe SLE. © The Author(s) 2015.

  5. Criterion-concurrent validity of spinal mobility tests in ankylosing spondylitis: a systematic review of the literature.

    Science.gov (United States)

    Castro, Marcelo P; Stebbings, Simon M; Milosavljevic, Stephan; Bussey, Melanie D

    2015-02-01

    To examine the level of evidence for criterion-concurrent validity of spinal mobility assessments in patients with ankylosing spondylitis (AS). Guidelines proposed in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses were used to undertake a search strategy involving 3 sets of keywords: accura*, truth, valid*; ankylosing spondylitis, spondyloarthritis, spondyloarthropathy, spondylarthritis; mobility, spinal measure*, (a further 16 keywords with similar meaning were used). Seven databases were searched from their inception to February 2014: AMED, Embase, ProQuest, PubMed, Science Direct, Scopus, and Web of Science. The Quality Assessment of Diagnostic Accuracy Studies (with modifications) was used to assess the quality of articles reviewed. An article was considered high quality when it received "yes" in at least 9 of the 13 items. From the 741 records initially identified, 10 articles were retained for our systematic review. Only 1 article was classified as high quality, and this article suggests that 3 variants of the Schober test (original, modified, and modified-modified) poorly reflect lumbar range of motion where radiographs were used as the reference standard. The level of evidence considering criterion-concurrent validity of clinical tests used to assess spinal mobility in patients with AS is low. Clinicians should be aware that current practice when measuring spinal mobility in AS may not accurately reflect true spinal mobility.

  6. A review of ground penetrating radar research and practice in the United Kingdom

    Science.gov (United States)

    Giannopoulos, Antonios; Alani, Amir

    2014-05-01

    Ground penetrating radar has been playing an important role for many years in assisting in the non-destructive evaluation of UK's built environment as well as being employed in more general shallow depth geophysical investigations. Ground penetrating radar, in the United Kingdom, has a long history of original work both in developing original research ideas on fundamental aspects of the technique, both in hardware and in software, and in exploring innovative ideas relating to the practical implementation of ground penetrating radar in a number of interesting projects. For example, the base of one of the biggest organisations that connects ground penetrating radar practitioners is in the United Kingdom. This paper will endeavour to review the current status of ground penetrating radar research - primarily carried out in UK Universities - and present some key areas and work that is carried out at a practical level - primarily by private enterprises. Although, the main effort is to concentrate on ground penetrating radar applications relating to civil engineering problems other related areas of ground penetrating radar application will also be reviewed. The aim is to create a current picture of ground penetrating radar use with a view to inform and potentially enhance the possibility of new developments and collaborations that could lead to the advancement of ground penetrating radar as a geophysical investigative method. This work is a contribution to COST Action TU1208 "Civil Engineering Applications of Ground Penetrating Radar.

  7. Critical care medicine beds, use, occupancy and costs in the United States: a methodological review

    Science.gov (United States)

    Halpern, Neil A; Pastores, Stephen M.

    2017-01-01

    This article is a methodological review to help the intensivist gain insights into the classic and sometimes arcane maze of national databases and methodologies used to determine and analyze the intensive care unit (ICU) bed supply, occupancy rates, and costs in the United States (US). Data for total ICU beds, use and occupancy can be derived from two large national healthcare databases: the Healthcare Cost Report Information System (HCRIS) maintained by the federal Centers for Medicare and Medicaid Services (CMS) and the proprietary Hospital Statistics of the American Hospital Association (AHA). Two costing methodologies can be used to calculate ICU costs: the Russell equation and national projections. Both methods are based on cost and use data from the national hospital datasets or from defined groups of hospitals or patients. At the national level, an understanding of US ICU beds, use and cost helps provide clarity to the width and scope of the critical care medicine (CCM) enterprise within the US healthcare system. This review will also help the intensivist better understand published studies on administrative topics related to CCM and be better prepared to participate in their own local hospital organizations or regional CCM programs. PMID:26308432

  8. The Western Denmark Cardiac Computed Tomography Registry: a review and validation study

    Directory of Open Access Journals (Sweden)

    Nielsen LH

    2014-12-01

    . Compared with the Danish National Patient Registry, the overall procedure completeness was 72%. However, an additional medical record review of 282 patients registered in the Danish National Patient Registry, but not in the WDHR-CCTR, showed that coronary CT angiographies accounted for only 23% of all nonregistered cardiac CTs, indicating >90% completeness of coronary CT angiographies in the WDHR-CCTR. The completeness of individual variables varied substantially (range: 0%–100%, but was >85% for more than 70% of all variables. Using medical record review of 250 randomly selected patients as reference standard, the positive predictive value for the 19 variables ranged from 89% to 100% (overall 97%, whereas the negative predictive value ranged from 97% to 100% (overall 99%. Stratification by center status showed consistently high positive and negative predictive values for both university (96%/99% and nonuniversity centers (97%/99%.Conclusion: WDHR-CCTR provides ongoing prospective registration of all cardiac CTs performed in Western Denmark since 2008. Overall, the registry data have a high degree of completeness and validity, making it a valuable tool for clinical epidemiological research. Keywords: coronary computed tomography angiography, database, epidemiology, registries

  9. Assessing trauma and mental health in refugee children and youth: a systematic review of validated screening and measurement tools.

    Science.gov (United States)

    Gadeberg, A K; Montgomery, E; Frederiksen, H W; Norredam, M

    2017-06-01

    : It is estimated that children below 18 years constitute 50% of the refugee population worldwide, which is the highest figure in a decade. Due to conflicts like the Syrian crises, children are continuously exposed to traumatic events. Trauma exposure can cause mental health problems that may in turn increase the risk of morbidity and mortality. Tools such as questionnaires and interview guides are being used extensively, despite the fact that only a few have been tested and their validity confirmed in refugee children and youth. : Our aim was to provide a systematic review of the validated screening and measurement tools available for assessment of trauma and mental health among refugee children and youth. : We systematically searched the databases PubMed, PsycINFO and PILOTS. The search yielded 913 articles and 97 were retained for further investigation. In accordance with the PRISMA guidelines two authors performed the eligibility assessment. The full text of 23 articles was assessed and 9 met the eligibility criteria. Results : Only nine studies had validated trauma and mental health tools in refugee children and youth populations. A serious lack of validated tools for refugee children below the age of 6 was identified. : There is a lack of validated trauma and mental health tools, especially for refugees below the age of 6. Detection and treatment of mental health issues among refugee children and youth should be a priority both within the scientific community and in practice in order to reduce morbidity and mortality.

  10. Changing Epidemiology of Hepatocellular Adenoma in the United States: Review of the Literature

    Directory of Open Access Journals (Sweden)

    Charissa Y. Chang

    2013-01-01

    Full Text Available Hepatocellular adenoma (HCA is a benign neoplasm arising from hepatocytes. There is evidence that the inflammatory subtype may be associated with obesity and alcohol use and that men with metabolic syndrome may be at risk for malignant transformation of HCA. We sought to explore the combined experience of US centers as reported in the literature to document the epidemiologic shift in risk factors for HCA formation in the United States, namely, a shift from oral contraceptive pills (OCPs to an emerging role of obesity as a contributing factor. Methods. Publications reporting HCA in the United States were identified through a PubMed search and a review of the literature. We excluded publications prior to 1970, single case reports, and publications for which there was no data available regarding patient characteristics including OCP use and the number of adenomas. Conclusion. Whereas earlier reports of HCA in the United States described cases exclusively in women exposed to OCPs, there is a trend towards an increase in HCAs reported in men, HCAs in the absence of OCP use, and increased reporting of multiple HCAs. This may be a result of newer OCP formulations and increasing prevalence of obesity.

  11. Window Spacers and Edge Seals in Insulating Glass Units: A State-of-the-Art Review and Future Perspectives

    Energy Technology Data Exchange (ETDEWEB)

    SINTEF Building and Infrastructure; Norwegian University of Science and Technology (NTNU); Bergh, Sofie Van Den; Hart, Robert; Jelle, Bjrn Petter; Gustavsen, Arild

    2013-01-31

    Insulating glass (IG) units typically consist of multiple glass panes that are sealed and held together structurally along their perimeters. This report describes a study of edge seals in IG units. First, we summarize the components, requirements, and desired properties of edge construction in IG units, based on a survey of the available literature. Second, we review commercially available window edge seals and describe their properties, to provide an easily accessible reference for research and commercial purposes. Finally, based on the literature survey and review of current commercial edge seal systems, we identify research opportunities for future edge seal improvements and solutions.

  12. Variation in use of antipsychotic medications in nursing homes in the United States: A systematic review.

    Science.gov (United States)

    Cioltan, Hannah; Alshehri, Samah; Howe, Carol; Lee, Jeannie; Fain, Mindy; Eng, Howard; Schachter, Kenneth; Mohler, Jane

    2017-01-26

    The use of antipsychotic medications (APMs) in nursing home residents in the U.S. is an increasingly prominent issue and has been associated with increased risk of hospitalization, cardiovascular events, hip fractures, and mortality, among other adverse health events. The Food and Drug Administration has placed a black box warning on these drugs, specifying that they are not meant for residents with dementia, and has asked providers to review their treatment plans. The purpose of this systematic PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses)-based review was to summarize original research studies on facility level characteristics contributing to the use of antipsychotics in nursing homes across the United States, in order to investigate the variation of use. We searched Ovid Medline, Embase, Cochrane Library, Web of Science, CINAHL, PsycInfo, and Sociological Abstracts. Articles were selected according to the following criteria: (1) Population of interest: older adults (≥60 years of age) residing in nursing homes (not home-based or inpatient hospital settings) in the U.S. (2) Receiving APMs, typical and/or atypical. Specifically excluded were studies of psychotropic medications such as antidepressants, benzodiazepines, anxiolytics, hypnotics, mood stabilizers, and stimulants. All study designs were considered, though reviews, editorials, letters to the editor and opinion pieces were excluded. An expert consultant panel was consulted to categorize facility characteristics into domains and determine possible etiologies of APM use based upon each characteristic. Nineteen observational studies, both quantitative and qualitative, published from 2000 to 2015, met full inclusion criteria and were included in this review. APM use varied based on multiple facility characteristics across several domains: 1) physical, 2) staffing, 3) occupancy, 4) market, and 5) quality. Variation in use of APMs in U.S. nursing homes based upon facility

  13. Assessing Predictive Validity of Pressure Ulcer Risk Scales- A Systematic Review and Meta-Analysis

    OpenAIRE

    2016-01-01

    Background: The purpose of this study was to present a scientific reason for pressure ulcer risk scales: Cubbin& Jackson modified Braden, Norton, and Waterlow, as a nursing diagnosis tool by utilizing predictive validity of pressure sores. Methods: Articles published between 1966 and 2013 from periodicals indexed in the Ovid Medline, Embase, CINAHL, KoreaMed, NDSL, and other databases were selected using the key word “pressure ulcer”. QUADAS-II was applied for assessment for internal validity...

  14. Draft audit report, human factors engineering control room design review: Saint Lucie Nuclear Power Plant, Unit No. 2

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, L.R.; Lappa, D.A.; Moore, J.W.

    1981-09-03

    A human factors engineering preliminary design review of the Saint Lucie Unit 2 control room was performed at the site on August 3 through August 7, 1981. This design review was carried out by a team from the Human Factors Engineering Branch, Division of Human Factors Safety. This report was prepared on the basis of the HFEB's review of the applicant's Preliminary Design Assessment and the human factors engineering design review/audit performed at the site. The review team included human factors consultants from BioTechnology, Inc., Falls Church, Virginia, and from Lawrence Livermore National Laboratory (University of California), Livermore, California.

  15. What factors predict length of stay in a neonatal unit: a systematic review

    Science.gov (United States)

    Seaton, Sarah E; Barker, Lisa; Jenkins, David; Draper, Elizabeth S; Abrams, Keith R; Manktelow, Bradley N

    2016-01-01

    Objective In the UK, 1 in 10 babies require specialist neonatal care. This care can last from hours to months depending on the need of the baby. The increasing survival of very preterm babies has increased neonatal care resource use. Evidence from multiple studies is crucial to identify factors which may be important for predicting length of stay (LOS). The ability to predict LOS is vital for resource planning, decision-making and parent counselling. The objective of this review was to identify which factors are important to consider when predicting LOS in the neonatal unit. Design A systematic review was undertaken which searched MEDLINE, EMBASE and Scopus for papers from 1994 to 2016 (May) for research investigating prediction of neonatal LOS. Strict inclusion and exclusion criteria were applied. Quality of each study was discussed, but not used as a reason for exclusion from the review. Main outcome measure Prediction of LOS in the neonatal unit. Results 9 studies were identified which investigated the prediction of neonatal LOS indicating a lack of evidence in the area. Inherent factors, particularly birth weight, sex and gestational age allow for a simple and objective prediction of LOS, which can be calculated on the first day of life. However, other early occurring factors may well also be important and estimates may need revising throughout the baby's stay in hospital. Conclusions Predicting LOS is vital to aid the commissioning of services and to help clinicians in their counselling of parents. The lack of evidence in this area indicates a need for larger studies to investigate methods of accurately predicting LOS. PMID:27797978

  16. Concurrent validity of accelerations measured using a tri-axial inertial measurement unit while walking on firm, compliant and uneven surfaces.

    Science.gov (United States)

    Cole, Michael H; van den Hoorn, Wolbert; Kavanagh, Justin K; Morrison, Steven; Hodges, Paul W; Smeathers, James E; Kerr, Graham K

    2014-01-01

    Although accelerometers are extensively used for assessing gait, limited research has evaluated the concurrent validity of these devices on less predictable walking surfaces or the comparability of different methods used for gravitational acceleration compensation. This study evaluated the concurrent validity of trunk accelerations derived from a tri-axial inertial measurement unit while walking on firm, compliant and uneven surfaces and contrasted two methods used to remove gravitational accelerations; i) subtraction of the best linear fit from the data (detrending); and ii) use of orientation information (quaternions) from the inertial measurement unit. Twelve older and twelve younger adults walked at their preferred speed along firm, compliant and uneven walkways. Accelerations were evaluated for the thoracic spine (T12) using a tri-axial inertial measurement unit and an eleven-camera Vicon system. The findings demonstrated excellent agreement between accelerations derived from the inertial measurement unit and motion analysis system, including while walking on uneven surfaces that better approximate a real-world setting (all differences accelerations requires consideration in future research, particularly when walking on compliant and uneven surfaces. These findings demonstrate trunk accelerations can be accurately measured using a wireless inertial measurement unit and are appropriate for research that evaluates healthy populations in complex environments.

  17. The Internal, External, and Diagnostic Validity of Sluggish Cognitive Tempo: A Meta-Analysis and Critical Review.

    Science.gov (United States)

    Becker, Stephen P; Leopold, Daniel R; Burns, G Leonard; Jarrett, Matthew A; Langberg, Joshua M; Marshall, Stephen A; McBurnett, Keith; Waschbusch, Daniel A; Willcutt, Erik G

    2016-03-01

    To conduct the first meta-analysis evaluating the internal and external validity of the sluggish cognitive tempo (SCT) construct as related to or distinct from attention-deficit/hyperactivity disorder (ADHD) and as associated with functional impairment and neuropsychological functioning. Electronic databases were searched through September 2015 for studies examining the factor structure and/or correlates of SCT in children or adults. The search procedures identified 73 papers. The core SCT behaviors included across studies, as well as factor loadings and reliability estimates, were reviewed to evaluate internal validity. Pooled correlation effect sizes using random effects models were used to evaluate SCT in relation to external validity domains (i.e., demographics, other psychopathologies, functional impairment, and neuropsychological functioning). Strong support was found for the internal validity of the SCT construct. Specifically, across factor analytic studies including more than 19,000 individuals, 13 SCT items loaded consistently on an SCT factor as opposed to an ADHD factor. Findings also support the reliability (i.e., internal consistency, test-retest reliability, interrater reliability) of SCT. In terms of external validity, there is some indication that SCT may increase with age (r = 0.11) and be associated with lower socioeconomic status (r = 0.10). Modest (potentially negligible) support was found for SCT symptoms being higher in males than females in children (r = 0.05) but not in adults. SCT is more strongly associated with ADHD inattention (r = 0.63 in children, r = 0.72 in adults) than with ADHD hyperactivity-impulsivity (r = 0.32 in children, r = 0.46 in adults), and it likewise appears that SCT is more strongly associated with internalizing symptoms than with externalizing symptoms. SCT is associated with significant global, social, and academic impairment (r = 0.38-0.44). Effects for neuropsychological functioning are mixed, although

  18. Computerized prediction of intensive care unit discharge after cardiac surgery: development and validation of a Gaussian processes model.

    Science.gov (United States)

    Meyfroidt, Geert; Güiza, Fabian; Cottem, Dominiek; De Becker, Wilfried; Van Loon, Kristien; Aerts, Jean-Marie; Berckmans, Daniël; Ramon, Jan; Bruynooghe, Maurice; Van den Berghe, Greet

    2011-10-25

    The intensive care unit (ICU) length of stay (LOS) of patients undergoing cardiac surgery may vary considerably, and is often difficult to predict within the first hours after admission. The early clinical evolution of a cardiac surgery patient might be predictive for his LOS. The purpose of the present study was to develop a predictive model for ICU discharge after non-emergency cardiac surgery, by analyzing the first 4 hours of data in the computerized medical record of these patients with Gaussian processes (GP), a machine learning technique. Non-interventional study. Predictive modeling, separate development (n = 461) and validation (n = 499) cohort. GP models were developed to predict the probability of ICU discharge the day after surgery (classification task), and to predict the day of ICU discharge as a discrete variable (regression task). GP predictions were compared with predictions by EuroSCORE, nurses and physicians. The classification task was evaluated using aROC for discrimination, and Brier Score, Brier Score Scaled, and Hosmer-Lemeshow test for calibration. The regression task was evaluated by comparing median actual and predicted discharge, loss penalty function (LPF) ((actual-predicted)/actual) and calculating root mean squared relative errors (RMSRE). Median (P25-P75) ICU length of stay was 3 (2-5) days. For classification, the GP model showed an aROC of 0.758 which was significantly higher than the predictions by nurses, but not better than EuroSCORE and physicians. The GP had the best calibration, with a Brier Score of 0.179 and Hosmer-Lemeshow p-value of 0.382. For regression, GP had the highest proportion of patients with a correctly predicted day of discharge (40%), which was significantly better than the EuroSCORE (p nurses (p = 0.044) but equivalent to physicians. GP had the lowest RMSRE (0.408) of all predictive models. A GP model that uses PDMS data of the first 4 hours after admission in the ICU of scheduled adult cardiac surgery

  19. 21st Century Parent-Child Sex Communication in the United States: A Process Review.

    Science.gov (United States)

    Flores, Dalmacio; Barroso, Julie

    2017-01-06

    Parent-child sex communication results in the transmission of family expectations, societal values, and role modeling of sexual health risk-reduction strategies. Parent-child sex communication's potential to curb negative sexual health outcomes has sustained a multidisciplinary effort to better understand the process and its impact on the development of healthy sexual attitudes and behaviors among adolescents. This review advances what is known about the process of sex communication in the United States by reviewing studies published from 2003 to 2015. We used the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, SocINDEX, and PubMed, and the key terms "parent child" AND "sex education" for the initial query; we included 116 original articles for analysis. Our review underscores long-established factors that prevent parents from effectively broaching and sustaining talks about sex with their children and has also identified emerging concerns unique to today's parenting landscape. Parental factors salient to sex communication are established long before individuals become parents and are acted upon by influences beyond the home. Child-focused communication factors likewise describe a maturing audience that is far from captive. The identification of both enduring and emerging factors that affect how sex communication occurs will inform subsequent work that will result in more positive sexual health outcomes for adolescents.

  20. Prescription Opioid Abuse: A Literature Review of the Clinical and Economic Burden in the United States

    Science.gov (United States)

    Patel, Anisha M.; Rattana, Stacy K.; Quock, Tiffany P.; Mody, Samir H.

    2014-01-01

    Abstract Between 2002 and 2007, the nonmedical use of prescription pain relievers grew from 11.0 million to 12.5 million people in the United States. Societal costs attributable to prescription opioid abuse were estimated at $55.7 billion in 2007. The purpose of this study was to comprehensively review the recent clinical and economic evaluations of prescription opioid abuse. A comprehensive literature search was conducted for studies published from 2002 to 2012. Articles were included if they were original research studies in English that reported the clinical and economic burden associated with prescription opioid abuse. A total of 23 studies (183 unique citations identified, 54 articles subjected to full text review) were included in this review and analysis. Findings from the review demonstrated that rates of opioid overdose-related deaths ranged from 5528 deaths in 2002 to 14,800 in 2008. Furthermore, overdose reportedly results in 830,652 years of potential life lost before age 65. Opioid abusers were generally more likely to utilize medical services, such as emergency department, physician outpatient visits, and inpatient hospital stays, relative to non-abusers. When compared to a matched control group (non-abusers), mean annual excess health care costs for opioid abusers with private insurance ranged from $14,054 to $20,546. Similarly, the mean annual excess health care costs for opioid abusers with Medicaid ranged from $5874 to $15,183. The issue of opioid abuse has significant clinical and economic consequences for patients, health care providers, commercial and government payers, and society as a whole. (Population Health Management 2014;17:372–387) PMID:25075734

  1. Peer review of the Three Mile Island Unit 2 Vessel Investigation Project metallurgical examinations

    Energy Technology Data Exchange (ETDEWEB)

    Bohl, R.W.; Gaydos, R.G.; Vander Voort, G.F.; Diercks, D.R. [Argonne National Lab., IL (United States)

    1994-07-01

    Fifteen samples recovered from the lower head of the Three Mile Island (TMI) Unit 2 nuclear reactor pressure vessel were subjected to detailed metallurgical examinations by the Idaho National Engineering Laboratory (INEL), with supporting work carried out by Argonne National Laboratory (ANL) and several of the European participants. These examinations determined that a portion of the lower head, a so-called elliptical ``hot spot`` measuring {approx}0.8 {times} 1 m, reached temperatures as high as 1100{degrees}C during the accident and cooled from these temperatures at {approx}10--100{degrees}C/min. The remainder of the lower head was found to have remained below the ferrite-toaustenite transformation temperature of 727{degrees}C during the accident. Because of the significance of these results and their importance to the overall analysis of the TMI accident, a panel of three outside peer reviewers, Dr. Robert W. Bohl, Mr. Richard G. Gaydos, and Mr. George F. Vander Voort, was formed to conduct an independent review of the metallurgical analyses. After a thorough review of the previous analyses and examination of photo-micrographs and actual lower head specimens, the panel determined that the conclusions resulting from the INEL study were fundamentally correct. In particular, the panel reaffirmed that four lower head samples attained temperatures as high as 1100{degrees}C, and perhaps as high as 1150--1200{degrees}C in one case, during the accident. They concluded that these samples subsequently cooled at a rate of {approx}50--125{degrees}C/min in the temperature range of 600--400{degrees}C, in good agreement with the original analysis. The reviewers also agreed that the remainder of the lower head samples had not exceeded the ferrite-to-austenite transformation temperature during the accident and suggested several refinements and alternative procedures that could have been employed in the original analysis.

  2. Prescription opioid abuse: a literature review of the clinical and economic burden in the United States.

    Science.gov (United States)

    Meyer, Roxanne; Patel, Anisha M; Rattana, Stacy K; Quock, Tiffany P; Mody, Samir H

    2014-12-01

    Between 2002 and 2007, the nonmedical use of prescription pain relievers grew from 11.0 million to 12.5 million people in the United States. Societal costs attributable to prescription opioid abuse were estimated at $55.7 billion in 2007. The purpose of this study was to comprehensively review the recent clinical and economic evaluations of prescription opioid abuse. A comprehensive literature search was conducted for studies published from 2002 to 2012. Articles were included if they were original research studies in English that reported the clinical and economic burden associated with prescription opioid abuse. A total of 23 studies (183 unique citations identified, 54 articles subjected to full text review) were included in this review and analysis. Findings from the review demonstrated that rates of opioid overdose-related deaths ranged from 5528 deaths in 2002 to 14,800 in 2008. Furthermore, overdose reportedly results in 830,652 years of potential life lost before age 65. Opioid abusers were generally more likely to utilize medical services, such as emergency department, physician outpatient visits, and inpatient hospital stays, relative to non-abusers. When compared to a matched control group (non-abusers), mean annual excess health care costs for opioid abusers with private insurance ranged from $14,054 to $20,546. Similarly, the mean annual excess health care costs for opioid abusers with Medicaid ranged from $5874 to $15,183. The issue of opioid abuse has significant clinical and economic consequences for patients, health care providers, commercial and government payers, and society as a whole.

  3. REVIEW OF EXPERIMENTAL CAPABILITIES AND HYDRODYNAMIC DATA FOR VALIDATION OF CFD BASED PREDICTIONS FOR SLURRY BUBBLE COLUMN REACTORS

    Energy Technology Data Exchange (ETDEWEB)

    Donna Post Guillen; Daniel S. Wendt

    2007-11-01

    The purpose of this paper is to document the review of several open-literature sources of both experimental capabilities and published hydrodynamic data to aid in the validation of a Computational Fluid Dynamics (CFD) based model of a slurry bubble column (SBC). The review included searching the Web of Science, ISI Proceedings, and Inspec databases, internet searches as well as other open literature sources. The goal of this study was to identify available experimental facilities and relevant data. Integral (i.e., pertaining to the SBC system), as well as fundamental (i.e., separate effects are considered), data are included in the scope of this effort. The fundamental data is needed to validate the individual mechanistic models or closure laws used in a Computational Multiphase Fluid Dynamics (CMFD) simulation of a SBC. The fundamental data is generally focused on simple geometries (i.e., flow between parallel plates or cylindrical pipes) or custom-designed tests to focus on selected interfacial phenomena. Integral data covers the operation of a SBC as a system with coupled effects. This work highlights selected experimental capabilities and data for the purpose of SBC model validation, and is not meant to be an exhaustive summary.

  4. REVIEW OF EXPERIMENTAL CAPABILITIES AND HYDRODYNAMIC DATA FOR VALIDATION OF CFD-BASED PREDICTIONS FOR SLURRY BUBBLE COLUMN REACTORS

    Energy Technology Data Exchange (ETDEWEB)

    Donna Post Guillen; Daniel S. Wendt; Steven P. Antal; Michael Z. Podowski

    2007-11-01

    The purpose of this paper is to document the review of several open-literature sources of both experimental capabilities and published hydrodynamic data to aid in the validation of a Computational Fluid Dynamics (CFD) based model of a slurry bubble column (SBC). The review included searching the Web of Science, ISI Proceedings, and Inspec databases, internet searches as well as other open literature sources. The goal of this study was to identify available experimental facilities and relevant data. Integral (i.e., pertaining to the SBC system), as well as fundamental (i.e., separate effects are considered), data are included in the scope of this effort. The fundamental data is needed to validate the individual mechanistic models or closure laws used in a Computational Multiphase Fluid Dynamics (CMFD) simulation of a SBC. The fundamental data is generally focused on simple geometries (i.e., flow between parallel plates or cylindrical pipes) or custom-designed tests to focus on selected interfacial phenomena. Integral data covers the operation of a SBC as a system with coupled effects. This work highlights selected experimental capabilities and data for the purpose of SBC model validation, and is not meant to be an exhaustive summary.

  5. Comparison of the Predictive Validity and Consistency among Preference Assessment Procedures: A Review of the Literature

    Science.gov (United States)

    Kang, Soyeon; O'Reilly, Mark; Lancioni, Giulio; Falcomata, Terry S.; Sigafoos, Jeff; Xu, Ziwei

    2013-01-01

    We reviewed 14 experimental studies comparing different preference assessments for individuals with developmental disabilities that were published in peer-reviewed journals between 1985 and 2012. Studies were summarized based on the following six variables: (a) the number of participants, (b) the type of disability, (c) the number and type of…

  6. Medication reconciliation is a prerequisite for obtaining a valid medication review

    DEFF Research Database (Denmark)

    Bjeldbak-Olesen, Mette; Danielsen, Anja Gadsbølle; Tomsen, Dorthe Vilstrup

    2013-01-01

    The objective of this study was to compare medication reconciliation and medication review based on number, type and severity of discrepancies and drug-related problems (DRPs), denoted errors.......The objective of this study was to compare medication reconciliation and medication review based on number, type and severity of discrepancies and drug-related problems (DRPs), denoted errors....

  7. A review of documented oral care practices in an intensive care unit.

    Science.gov (United States)

    Goss, Linda K; Coty, Mary-Beth; Myers, John A

    2011-05-01

    Oral care is recognized as an essential component of care for critically ill patients and nursing documentation provides evidence of this process. This study examined the practice and frequency of oral care among mechanically ventilated and nonventilated patients. A retrospective record review was conducted of patients admitted to an intensive care unit (ICU) between July 1, 2007 and December 31, 2007. Data were analyzed using bivariate and multivariate analyses to determine the variables related to patients receiving oral care. Frequency of oral care documentation was found to be performed, on average, every 3.17 to 3.51 hr with a range of 1 to 8 hr suggesting inconsistencies in nursing practice. This study found that although oral care is a Center for Disease Control and Prevention (CDC) recommendation for the prevention of hospital-associated infections like ventilator-associated pneumonia (VAP), indication of documentation of the specifics are lacking in the patients' medical record.

  8. Dysfunctional psychological responses among Intensive Care Unit nurses: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Maria Karanikola

    2015-10-01

    Full Text Available AbstractOBJECTIVETo systematically review evidence on dysfunctional psychological responses of Intensive Care Units nurses (ICUNs, with focus on anxiety and depressive symptoms and related factors.METHODA literature search was performed in CINAHL, PubMed and Scopus databases, from 1999 to present, along with a critical appraisal and synthesis of all relevant data. The following key words, separately and in combination, were used: "mental status" "depressive symptoms" "anxiety" "ICU nurses" "PTSD" "burnout" "compassion fatigue" "psychological distress".RESULTSThirteen quantitative studies in English and Greek were included. The results suggested increased psychological burden in ICUNs compared to other nursing specialties, as well as to the general population.CONCLUSIONSStudies investigating psychological responses of ICUNs are limited, internationally. Future longitudinal and intervention studies will contribute to a better understanding of the phenomenon.

  9. Critical review: regulatory incentives and impediments for onsite graywater reuse in the United States.

    Science.gov (United States)

    Yu, Zita L T; Rahardianto, Anditya; DeShazo, J R; Stenstrom, Michael K; Cohen, Yoram

    2013-07-01

    Graywater is a potential water source for reducing water demand. Accordingly, a review was undertaken of graywater reuse regulations and guidelines within the 50 United States. Major issues considered included acceptability for graywater segregation as a separate wastewater stream, allowable graywater storage, onsite treatment requirements, and permitted graywater use applications. Existing regulations and plumbing codes in the different states suggest that there are impediments to overcome but also potential incentives for graywater reuse. It is encouraging that regulations in 29 states promote safe graywater reuse, but there are also inconsistencies between plumbing codes and other regulations within and among the 50 states. Impediments to graywater reuse include disallowances of graywater segregation or collection, and restriction of graywater reuse to mostly subsurface irrigation with limited indoor use permission. Ease on restrictions and guidelines to promote development of low-cost and proven treatment technologies are needed to promote graywater reuse.

  10. Medication errors in the intensive care unit: literature review using the SEIPS model.

    Science.gov (United States)

    Frith, Karen H

    2013-01-01

    Medication errors in intensive care units put patients at risk for injury or death every day. Safety requires an organized and systematic approach to improving the tasks, technology, environment, and organizational culture associated with medication systems. The Systems Engineering Initiative for Patient Safety model can help leaders and health care providers understand the complicated and high-risk work associated with critical care. Using this model, the author combines a human factors approach with the well-known structure-process-outcome model of quality improvement to examine research literature. The literature review reveals that human factors, including stress, high workloads, knowledge deficits, and performance deficits, are associated with medication errors. Factors contributing to medication errors are frequent interruptions, communication problems, and poor fit of health information technology to the workflow of providers. Multifaceted medication safety interventions are needed so that human factors and system problems can be addressed simultaneously.

  11. Reproductive Health in the United States: A Review of the Recent Social Work Literature.

    Science.gov (United States)

    Wright, Rachel L; Bird, Melissa; Frost, Caren J

    2015-10-01

    Reproductive health is an important area affecting a woman's overall health and well-being. The examination of reproductive health and barriers to care is pertinent to the social work profession and should be a focus of social work practice, education, research, and advocacy. The authors conducted a literature search of articles published in the social work literature from 2010 to 2014. The findings reveal important published articles that increase our knowledge of the reproductive health of women in the United States. Most published articles focused on pregnancy and birth outcomes. Articles also addressed sexually transmitted infections; abortion; intimate partner violence; prostitution; access to care; cancer screening; views toward contraception; hysterectomies; breastfeeding; menopause; and the intersection of reproductive rights, religion, and social justice. This review also identified unexamined areas that require further social work attention and consideration.

  12. A Survey Study of Institutional Review Board Thought Processes in the United States and South Korea

    Directory of Open Access Journals (Sweden)

    Si-Kyung Jung

    2012-09-01

    Full Text Available Introduction: In the last several decades, South Korea has rapidly adopted Western customs and practices. Yet, cultural differences between South Korea and the United States exist. The purpose ofthis study was to identify and characterize potential cultural differences in the Korean and US institutional review board (IRB approach to certain topics.Methods: A qualitative analysis of a 9-item survey, describing 4 research study case scenarios, sent to IRB members from the United States and South Korea. The case scenarios involved the followingissues: (1 the need for consent for retrospective chart review when research subjects receive their care after the study is conceived; (2 child assent; (3 individual versus population benefit; and (4 exception from informed consent in emergency resuscitation research. The free-text responses were analyzed and abstracted for recurrent themes.Results: Twenty-three of the 45 survey recipients completed the survey, for an overall response rate of 51%. The themes that emerged were as follows: (1 the importance of parental authority among Korean participants versus the importance of child autonomy and child assent among US participants; (2 the recognition of the rights of a proxy or surrogate who can represent an individual’s values by all participants; and (3 the importance of the community, expressed by the Korean respondents, versus individualism, expressed by US respondents.Conclusion: Whereas US participants appear to emphasize the importance of the individual and the autonomy of a child, the Korean respondents stressed the importance of parental authority andbenefiting the community, above and beyond that of the individual person. However, there was substantial overlap in the themes expressed by respondents from both countries.

  13. A systematic review of administrative and clinical databases of infants admitted to neonatal units.

    Science.gov (United States)

    Statnikov, Yevgeniy; Ibrahim, Buthaina; Modi, Neena

    2017-05-01

    High quality information, increasingly captured in clinical databases, is a useful resource for evaluating and improving newborn care. We conducted a systematic review to identify neonatal databases, and define their characteristics. We followed a preregistered protocol using MesH terms to search MEDLINE, EMBASE, CINAHL, Web of Science and OVID Maternity and Infant Care Databases for articles identifying patient level databases covering more than one neonatal unit. Full-text articles were reviewed and information extracted on geographical coverage, criteria for inclusion, data source, and maternal and infant characteristics. We identified 82 databases from 2037 publications. Of the country-specific databases there were 39 regional and 39 national. Sixty databases restricted entries to neonatal unit admissions by birth characteristic or insurance cover; 22 had no restrictions. Data were captured specifically for 53 databases; 21 administrative sources; 8 clinical sources. Two clinical databases hold the largest range of data on patient characteristics, USA's Pediatrix BabySteps Clinical Data Warehouse and UK's National Neonatal Research Database. A number of neonatal databases exist that have potential to contribute to evaluating neonatal care. The majority is created by entering data specifically for the database, duplicating information likely already captured in other administrative and clinical patient records. This repetitive data entry represents an unnecessary burden in an environment where electronic patient records are increasingly used. Standardisation of data items is necessary to facilitate linkage within and between countries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. The Reliability and Validity of Protocols for the Assessment of Endurance Sports Performance: An Updated Review

    Science.gov (United States)

    Stevens, Christopher John; Dascombe, Ben James

    2015-01-01

    Sports performance testing is one of the most common and important measures used in sport science. Performance testing protocols must have high reliability to ensure any changes are not due to measurement error or inter-individual differences. High validity is also important to ensure test performance reflects true performance. Time-trial…

  15. Referencing Science: Teaching Undergraduates to Identify, Validate, and Utilize Peer-Reviewed Online Literature

    Science.gov (United States)

    Berzonsky, William A.; Richardson, Katherine D.

    2008-01-01

    Accessibility of online scientific literature continues to expand due to the advent of scholarly databases and search engines. Studies have shown that undergraduates favor using online scientific literature to address research questions, but they often do not have the skills to assess the validity of research articles. Undergraduates generally are…

  16. Referencing Science: Teaching Undergraduates to Identify, Validate, and Utilize Peer-Reviewed Online Literature

    Science.gov (United States)

    Berzonsky, William A.; Richardson, Katherine D.

    2008-01-01

    Accessibility of online scientific literature continues to expand due to the advent of scholarly databases and search engines. Studies have shown that undergraduates favor using online scientific literature to address research questions, but they often do not have the skills to assess the validity of research articles. Undergraduates generally are…

  17. Moral distress within neonatal and paediatric intensive care units: a systematic review.

    Science.gov (United States)

    Prentice, Trisha; Janvier, Annie; Gillam, Lynn; Davis, Peter G

    2016-08-01

    To review the literature on moral distress experienced by nursing and medical professionals within neonatal intensive care units (NICUs) and paediatric intensive care units (PICUs). Pubmed, EBSCO (Academic Search Complete, CINAHL and Medline) and Scopus were searched using the terms neonat*, infant*, pediatric*, prematur* or preterm AND (moral distress OR moral responsibility OR moral dilemma OR conscience OR ethical confrontation) AND intensive care. 13 studies on moral distress published between January 1985 and March 2015 met our inclusion criteria. Fewer than half of those studies (6) were multidisciplinary, with a predominance of nursing staff responses across all studies. The most common themes identified were overly 'burdensome' and disproportionate use of technology perceived not to be in a patient's best interest, and powerlessness to act. Concepts of moral distress are expressed differently within nursing and medical literature. In nursing literature, nurses are often portrayed as victims, with physicians seen as the perpetrators instigating 'aggressive care'. Within medical literature moral distress is described in terms of dilemmas or ethical confrontations. Moral distress affects the care of patients in the NICU and PICU. Empirical data on multidisciplinary populations remain sparse, with inconsistent definitions and predominantly small sample sizes limiting generalisability of studies. Longitudinal data reflecting the views of all stakeholders, including parents, are required. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  18. The applicability of a validated team-based learning student assessment instrument to assess United Kingdom pharmacy students’ attitude toward team-based learning

    Directory of Open Access Journals (Sweden)

    Leanne Marie Nation

    2016-08-01

    Full Text Available Purpose It aimed at testing the validity and reliability of a validated team-based learning student assessment instrument (TBL-SAI to assess United Kingdom pharmacy students’ attitude toward TBL. Methods TBL-SAI, consisting of 33 items, was administered to undergraduate pharmacy students from two schools of pharmacy each at University of Wolverhampton and University of Bradford were conducted on the data, along with comparison between the two schools. Results Students’ response rate was 80.0% (138/173 in completion of the instrument. Overall, the instrument demonstrated validity and reliability when used with pharmacy students. Sub-analysis between schools of pharmacy did, however, show that four items from Wolverhampton data, had factor loadings of less than 0.40. No item in the Bradford data had factor loadings less than 0.40. Cronbach’s alpha score was reliable at 0.897 for the total instrument: Wolverhampton, 0.793 and Bradford, 0.902. Students showed preference to TBL, with Bradford’s scores being statistically higher (P<0.005. Conclusion This validated instrument has demonstrated reliability and validity when used with pharmacy students. Furthermore students at both schools preferred TBL compared to traditional teaching.

  19. Construct validity of clinical spinal mobility tests in ankylosing spondylitis: a systematic review and meta-analysis.

    Science.gov (United States)

    Castro, Marcelo P; Stebbings, Simon M; Milosavljevic, Stephan; Bussey, Melanie D

    2016-07-01

    The study aimed to determine, using systematic review and meta-analysis, the level of evidence supporting the construct validity of spinal mobility tests for assessing patients with ankylosing spondylitis. Following the guidelines proposed in the Preferred Reporting Items for Systematic reviews and Meta-Analyses, three sets of keywords were used for data searching: (i) ankylosing spondylitis, spondyloarthritis, spondyloarthropathy, spondylarthritis; (ii) accuracy, association, construct, correlation, Outcome Measures in Rheumatoid Arthritis Clinical Trials, OMERACT, truth, validity; (iii) mobility, Bath Ankylosing Spondylitis Metrology Index-BASMI, radiography, spinal measures, cervical rotation, Schober (a further 19 keywords were used). Initially, 2558 records were identified, and from these, 21 studies were retained. Fourteen of these studies were considered high level of evidence. Compound indexes of spinal mobility showed mostly substantial to excellent levels of agreement with global structural damage. Individual mobility tests for the cervico-thoracic spine showed only moderate agreements with cervical structural damage, and considering structural damage at the lumbar spine, the original Schober was the only test that presented consistently substantial levels of agreement. Three studies assessed the construct validity of mobility measures for inflammation and low to fair levels of agreement were observed. Two meta-analyses were conducted, with assessment of agreement between BASMI and two radiological indexes of global structural damage. The spinal mobility indexes and the original Schober test show acceptable construct validity for inferring the extent of structural damage when assessing patients with ankylosing spondylitis. Spinal mobility measures do not reflect levels of inflammation at either the sacroiliac joints and/or the spine.

  20. The 6-minute walk test in outpatient cardiac rehabilitation: validity, reliability and responsiveness--a systematic review.

    Science.gov (United States)

    Bellet, R Nicole; Adams, Lewis; Morris, Norman R

    2012-12-01

    The 6-minute walk test (6MWT) is a common outcome measurement in cardiac rehabilitation. However, a search of the literature found no established guidelines for use of the 6MWT in cardiac rehabilitation. Systematic review of the validity, reliability and responsiveness of the 6MWT in cardiac rehabilitation. OvidMEDLINE, SPORTdiscus, EMBASE, CINAHL, Cochrane Reviews and Cochrane Clinical Trials between January 1948 and April 2011. Studies using 6MWTs in subjects with coronary artery disease undergoing cardiac rehabilitation on an outpatient basis, published in English, were included. STUDY APPRAISAL AND METHODS: Quantitative and qualitative analyses were conducted, including quality assessment of methodology, meta-analysis and assessment against level of evidence criteria. Fifteen articles met the inclusion criteria. One high-quality study was identified for reliability, six high-quality studies were identified for validity and 11 high-quality studies were identified for responsiveness. The meta-analysis found strong evidence that the 6MWT was responsive to change in clinical status following cardiac rehabilitation, with an estimated mean difference in 6-minute walk distance of 60.43m (95% confidence interval 54.57 to 66.30m; Prehabilitation, for a 2% to 8% learning effect between repeated 6MWTs, for a relationship between peak heart rate during the 6MWT and during cycle exercise at the ventilatory threshold, and for moderate-to-high correlation between the 6-minute walk distance and maximum metabolic equivalents achieved on symptom-limited exercise tests. Few studies assessed similar aspects of validity for the 6MWT. Strong evidence suggests that the 6MWT is responsive to clinical change following cardiac rehabilitation. Intra- and intertester reliability of the 6MWT and its validity in patients undergoing cardiac rehabilitation requires further research. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  1. Concurrent Validity of Accelerations Measured Using a Tri-Axial Inertial Measurement Unit while Walking on Firm, Compliant and Uneven Surfaces

    Science.gov (United States)

    Cole, Michael H.; van den Hoorn, Wolbert; Kavanagh, Justin K.; Morrison, Steven; Hodges, Paul W.; Smeathers, James E.; Kerr, Graham K.

    2014-01-01

    Although accelerometers are extensively used for assessing gait, limited research has evaluated the concurrent validity of these devices on less predictable walking surfaces or the comparability of different methods used for gravitational acceleration compensation. This study evaluated the concurrent validity of trunk accelerations derived from a tri-axial inertial measurement unit while walking on firm, compliant and uneven surfaces and contrasted two methods used to remove gravitational accelerations; i) subtraction of the best linear fit from the data (detrending); and ii) use of orientation information (quaternions) from the inertial measurement unit. Twelve older and twelve younger adults walked at their preferred speed along firm, compliant and uneven walkways. Accelerations were evaluated for the thoracic spine (T12) using a tri-axial inertial measurement unit and an eleven-camera Vicon system. The findings demonstrated excellent agreement between accelerations derived from the inertial measurement unit and motion analysis system, including while walking on uneven surfaces that better approximate a real-world setting (all differences <0.16 m.s−2). Detrending produced slightly better agreement between the inertial measurement unit and Vicon system on firm surfaces (delta range: −0.05 to 0.06 vs. 0.00 to 0.14 m.s−2), whereas the quaternion method performed better when walking on compliant and uneven walkways (delta range: −0.16 to −0.02 vs. −0.07 to 0.07 m.s−2). The technique used to compensate for gravitational accelerations requires consideration in future research, particularly when walking on compliant and uneven surfaces. These findings demonstrate trunk accelerations can be accurately measured using a wireless inertial measurement unit and are appropriate for research that evaluates healthy populations in complex environments. PMID:24866262

  2. Concurrent validity of accelerations measured using a tri-axial inertial measurement unit while walking on firm, compliant and uneven surfaces.

    Directory of Open Access Journals (Sweden)

    Michael H Cole

    Full Text Available Although accelerometers are extensively used for assessing gait, limited research has evaluated the concurrent validity of these devices on less predictable walking surfaces or the comparability of different methods used for gravitational acceleration compensation. This study evaluated the concurrent validity of trunk accelerations derived from a tri-axial inertial measurement unit while walking on firm, compliant and uneven surfaces and contrasted two methods used to remove gravitational accelerations; i subtraction of the best linear fit from the data (detrending; and ii use of orientation information (quaternions from the inertial measurement unit. Twelve older and twelve younger adults walked at their preferred speed along firm, compliant and uneven walkways. Accelerations were evaluated for the thoracic spine (T12 using a tri-axial inertial measurement unit and an eleven-camera Vicon system. The findings demonstrated excellent agreement between accelerations derived from the inertial measurement unit and motion analysis system, including while walking on uneven surfaces that better approximate a real-world setting (all differences <0.16 m.s(-2. Detrending produced slightly better agreement between the inertial measurement unit and Vicon system on firm surfaces (delta range: -0.05 to 0.06 vs. 0.00 to 0.14 m.s(-2, whereas the quaternion method performed better when walking on compliant and uneven walkways (delta range: -0.16 to -0.02 vs. -0.07 to 0.07 m.s(-2. The technique used to compensate for gravitational accelerations requires consideration in future research, particularly when walking on compliant and uneven surfaces. These findings demonstrate trunk accelerations can be accurately measured using a wireless inertial measurement unit and are appropriate for research that evaluates healthy populations in complex environments.

  3. Several submaximal exercise tests are reliable, valid and acceptable in people with chronic pain, fibromyalgia or chronic fatigue: a systematic review

    Directory of Open Access Journals (Sweden)

    Julia Ratter

    2014-09-01

    [Ratter J, Radlinger L, Lucas C (2014 Several submaximal exercise tests are reliable, valid and acceptable in people with chronic pain, fibromyalgia or chronic fatigue: a systematic review. Journal of Physiotherapy 60: 144–150

  4. Review of State Laws Restricting Local Authority to Impose Alcohol Taxes in the United States.

    Science.gov (United States)

    Mosher, James F; Adler, Sabrina S; Pamukcu, Aysha M; Treffers, Ryan D

    2017-03-01

    Building on the extensive research literature demonstrating that increasing alcohol prices reduces excessive alcohol consumption and related harms, this article presents the results of a 50-state review of local authority to tax alcohol in the United States. Between 2013 and 2015, legal databases and government websites were reviewed to collect and analyze relevant statutes, ordinances, and case law. Results reflect laws in effect as of January 1, 2015. Nineteen states allow local alcohol taxation, although 15 of those have one or more major restrictions on local authority to tax. The types of major restrictions are (a) restrictions on the type of beverage and alcohol content that can be taxed, (b) caps on local alcohol taxes, (c) restrictions on the type of retailer where taxes can be imposed, (d) restrictions on jurisdictions within the state that can levy taxes, and (e) requirements for how tax revenue can be spent. The number and severity of restrictions on local authority to tax alcohol vary across states. Previous research has shown that increases in alcohol taxes can lead to reduced excessive alcohol consumption, which provides public health and economic benefits. Taxes can also provide funds to support local prevention and treatment services. Local alcohol taxes therefore present an important policy opportunity, both in states that restrict local authority and in states where local authority exists but is underused.

  5. The Interagency Coordinating Committee on the Validation of Alternative Methods (ICCVAM): a review of the ICCVAM test method evaluation process and current international collaborations with the European Centre for the Validation of Alternative Methods (ECVAM).

    Science.gov (United States)

    Stokes, William S; Schechtman, Leonard M; Hill, Richard N

    2002-12-01

    Over the last decade, national authorities in the USA and Europe have launched initiatives to validate new and improved toxicological test methods. In the USA, the Interagency Coordinating Committee on the Validation of Alternative Methods (ICCVAM) and its supporting National Toxicology Program Interagency Center for the Evaluation of Alternative Toxicological Methods (NICEATM) were established by the Federal Government to work with test developers and Federal agencies to facilitate the validation, review, and adoption of new scientifically sound test methods, including alternatives that can refine, reduce, and replace animal use. In Europe, the European Centre for the Validation of Alternative Methods (ECVAM) was established to conduct validation studies on alternative test methods. Despite differences in organisational structure and processes, both organisations seek to achieve the adoption and use of alternative test methods. Accordingly, both have adopted similar validation and regulatory acceptance criteria. Collaborations and processes have also evolved to facilitate the international adoption of new test methods recommended by ECVAM and ICCVAM. These collaborations involve the sharing of expertise and data for test-method workshops and independent scientific peer reviews, and the adoption of processes to expedite the consideration of test methods already reviewed by the other organisation. More recently, NICEATM and ECVAM initiated a joint international validation study on in vitro methods for assessing acute systemic toxicity. These collaborations are expected to contribute to accelerated international adoption of harmonised new test methods that will support improved public health and provide for reduced and more-humane use of laboratory animals.

  6. Validity of recalled v. recorded birth weight: a systematic review and meta-analysis

    OpenAIRE

    Shenkin, S. D.; Zhang, M.G.; De, G.; Mathur, S.; Mina, T.H.; Reynolds, R. M.

    2016-01-01

    Low birth weight is associated with adverse health outcomes. If birth weight records are not available, studies may use recalled birth weight. It is unclear whether this is reliable. We performed a systematic review and meta-analysis of studies comparing recalled with recorded birth weights. We followed the Meta-Analyses of Observational Studies in Epidemiology (MOOSE) statement and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched MEDLINE, EM...

  7. Implementation and Validation of PACS Integrated Peer Review for Discrepancy Recording of Radiology Reporting.

    Science.gov (United States)

    Olthof, A W; van Ooijen, P M A

    2016-09-01

    The purpose of this work is to demonstrate the possibility of implementation of a PACS-integrated peer review system based on RADPEER™ classification providing a step-wise implementation plan utilizing features already present in the standard PACS implementation and without the requirement of additional software development. Furthermore, we show the usage and effects of the system during the first 30 months of usage. To allow fast and easy implementation into the daily workflow the key-word feature of the PACS was used. This feature allows to add a key-word to an imaging examination for easy searching in the PACS database (e.g. by entering keywords for different kinds of pathology). For peer review we implemented a keyword structure including a code for each of the existing RADPEER™ scoring language terms and a keyword with the phrase "second reading" followed by the name of the individual radiologist. The use of the short-keys to enter the codes in relation to the peer review was a simple to use solution. During the study 599 reports were peer reviewed. The active participation in this study of the radiologists varies and ranges from 3 to 327 reviews per radiologist. The number of peer review is highest in CT and CR. There are no significant technical obstacles to implement a PACS-integrated RADPEER™ -system based on key-words allowing easy integration of peer review into the daily routine without the requirement of additional software. Peer review implemented in a non-random setting based on relevant priors could already help in increasing the quality of radiological reporting and serve as continuing education among peers. Decisiveness, tact and trust are needed to promote use of the system and collaborative discussion of the results by radiologist.

  8. Critical review of black carbon and elemental carbon source apportionment in Europe and the United States

    Science.gov (United States)

    Briggs, Nicole L.; Long, Christopher M.

    2016-11-01

    An increasing number of air pollution source apportionment studies in Europe and the United States have focused on the black carbon (BC) fraction of ambient particulate matter (PM) given its linkage with adverse public health and climate impacts. We conducted a critical review of European and US BC source apportionment studies published since 2003. Since elemental carbon (EC) has been used as a surrogate measure of BC, we also considered source apportionment studies of EC measurements. This review extends the knowledge presented in previous ambient PM source apportionment reviews because we focus on BC and EC and critically examine the differences between source apportionment results for different methods and source categories. We identified about 50 BC and EC source apportionment studies that have been conducted in either Europe or the US since 2003, finding a striking difference in the commonly used source apportionment methods between the two regions and variations in the assigned source categories. Using three dominant methodologies (radiocarbon, aethalometer, and macro-tracer methods) that only allow for BC to be broadly apportioned into either fossil fuel combustion or biomass burning source categories, European studies generally support fossil fuel combustion as the dominant ambient BC source, but also show significant biomass burning contributions, in particular in wintertime at non-urban locations. Among US studies where prevailing methods such as chemical mass balance (CMB) and positive matrix factorization (PMF) models have allowed for estimation of more refined source contributions, there are fewer findings showing the significance of biomass burning and variable findings on the relative proportion of BC attributed to diesel versus gasoline emissions. Overall, the available BC source apportionment studies provide useful information demonstrating the significance of both fossil fuel combustion and biomass burning BC emission sources in Europe and the US

  9. Racial/Ethnic Disparities in Antenatal Depression in the United States: A Systematic Review.

    Science.gov (United States)

    Mukherjee, Soumyadeep; Trepka, Mary Jo; Pierre-Victor, Dudith; Bahelah, Raed; Avent, Tenesha

    2016-09-01

    Objectives More than 10 % of pregnant women in the United States (U.S.) suffer from depression, which has far-reaching consequences on maternal and fetal well-being. There is conflicting evidence regarding the prevalence of antenatal depression among different race and ethnic groups. This systematic review aimed to summarize the existing literature concerning racial/ethnic disparities in the prevalence and correlates of antenatal depression in the U.S. Methods PubMed, CINAHL and PsycINFO databases were searched online for research studies published in English in peer-reviewed journals until March 2015, using a pre-designed search strategy. Eligibility was determined using pre-specified criteria; and quality was assessed. Results Forty-one (41) articles met the criteria; 13 were cross-sectional, and 21 were longitudinal studies. Overall, the prevalence of antenatal depression was 10-30 %; it was higher among non-Hispanic blacks (NHBs) and Hispanics, compared to non-Hispanic whites (NHWs). Few studies looked at the correlates of depression by race/ethnicity. Among employed women, higher depression scores were observed among NHBs, compared to NHWs; while there was no racial difference among unemployed women. Racial difference and race-employment interaction disappeared once discrimination was accounted for. In another study, higher parity, higher stress, and lower self-esteem were significant correlates of depression among NHBs, while less satisfaction with social support, and higher stress predicted higher depression scores among NHWs and Hispanics respectively. Conclusions The findings of our review suggest that not only is antenatal depression a major public health issue that needs to be addressed, but different racial/ethnic groups seem to differ in their vulnerability and risk factors.

  10. Progress and outcomes of health systems reform in the United Arab Emirates: a systematic review.

    Science.gov (United States)

    Koornneef, Erik; Robben, Paul; Blair, Iain

    2017-09-20

    The United Arab Emirates (UAE) government aspires to build a world class health system to improve the quality of healthcare and the health outcomes for its population. To achieve this it has implemented extensive health system reforms in the past 10 years. The nature, extent and success of these reforms has not recently been comprehensively reviewed. In this paper we review the progress and outcomes of health systems reform in the UAE. We searched relevant databases and other sources to identify published and unpublished studies and other data available between 01 January 2002 and 31 March 2016. Eligible studies were appraised and data were descriptively and narratively synthesized. Seventeen studies were included covering the following themes: the UAE health system, population health, the burden of disease, healthcare financing, healthcare workforce and the impact of reforms. Few, if any, studies prospectively set out to define and measure outcomes. A central part of the reforms has been the introduction of mandatory private health insurance, the development of the private sector and the separation of planning and regulatory responsibilities from provider functions. The review confirmed the commitment of the UAE to build a world class health system but amongst researchers and commentators opinion is divided on whether the reforms have been successful although patient satisfaction with services appears high and there are some positive indications including increasing coverage of hospital accreditation. The UAE has a rapidly growing population with a unique age and sex distribution, there have been notable successes in improving child and maternal mortality and extending life expectancy but there are high levels of chronic diseases. The relevance of the reforms for public health and their impact on the determinants of chronic diseases have been questioned. From the existing research literature it is not possible to conclude whether UAE health system reforms are

  11. Predictors of maternal vaccination in the United States: An integrative review of the literature.

    Science.gov (United States)

    Myers, Kristen L

    2016-07-25

    The purpose of this literature review was to identify, analyze, and synthesize existing research related to patient, provider, and health system predictors of maternal vaccination in the United States, strategies used to increase maternal vaccination rates, and major theoretical frameworks used to guide maternal vaccination research. A search for evidence was conducted in CINAHL, PubMed, PsychINFO, Cochrane Systematic Reviews, and Google Scholar. Twenty-two articles were identified as best evidence for inclusion in this review: five randomized control trials, one cluster randomized trial, one mixed methods study, 12 observational studies, and three qualitative studies. Patient-focused predictors of maternal vaccination included provider recommendation; knowledge, attitudes, and beliefs; cues to action; and race and ethnicity. Provider-focused predictors included knowledge, attitudes, and beliefs; and multi-component intervention packages. Health system predictors included standing order protocols and practice site logistics. The major theoretical frameworks that emerged were the Health Belief Model, Theory of Reasoned Action/Theory of Planned Behavior, and Message Framing/Prospect Theory. Provider recommendation was the single most important predictor of vaccine acceptance among pregnant women. An abundance of theoretically-supported, patient-focused research was found in the literature. A minimal number of U.S.-based, provider-focused research was found and none of these used a theoretical framework. Minimal research examining health system barriers to maternal vaccination was found. Additional research into the logistical barriers to maternal vaccination programs within obstetrical practice locations in other geographical locations within the U.S. is warranted. Future provider- and health system-focused research needs to be grounded in theory. The field of implementation science may offer the theoretical guidance necessary to better understand problems in

  12. Annual Research Review: Threats to the validity of child psychiatry and psychology.

    Science.gov (United States)

    Rutter, Michael; Pickles, Andrew

    2016-03-01

    Suggestions have been made that many claims concern false-positive findings in the field of child psychology and psychiatry. The literature was searched for concepts and findings on the validity of child psychiatry and psychology. Substantial progress has been made in some, but not all, areas and considerable challenges remain in all. The two major threats to validity concern the inability to examine brain tissues in life and the evidence that there is a high overlap among disorders. We emphasize the need to follow published guidelines on preplanned analyses and we note the dangers associated with unregulated flexibility in data analysis. We note the very important clinical and developmental findings that have been ignored, perhaps partly because of an excessive focus on technologies. Nevertheless, we are positive about both the accomplishments and the ways in which challenges are being met. © 2015 Association for Child and Adolescent Mental Health.

  13. Alcohol consumption among university students in Ireland and the United Kingdom from 2002 to 2014: a systematic review

    OpenAIRE

    2016-01-01

    Background: Alcohol is a leading cause of global suffering. Europe reports the uppermost volume of alcohol consumption in the world, with Ireland and the United Kingdom reporting the highest levels of binge drinking and drunkenness. Levels of consumption are elevated among university students. Thus, this literature review aims to summarise the current research on alcohol consumption among university students in the Republic of Ireland and the United Kingdom. Methods: MEDLINE, CINAHL, EMBASE a...

  14. Prevalence of Financial Fraud and Scams Among Older Adults in the United States: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Burnes, David; Henderson, Charles R; Sheppard, Christine; Zhao, Rebecca; Pillemer, Karl; Lachs, Mark S

    2017-08-01

    The financial exploitation of older adults was recently recognized by the Centers for Disease Control and Prevention as a serious public health problem. Knowledge of the prevalence of elder financial exploitation is mostly limited to the category of financial abuse, which occurs in relationships involving an expectation of trust. Little is known about the other major category of elder financial exploitation-elder financial fraud and scams, which is perpetrated by strangers. A valid estimate of elder financial fraud-scam prevalence is necessary as a foundation for research and prevention efforts. To estimate the prevalence of elder financial fraud-scam victimization in the United States based on a systematic review and meta-analysis. Multiple investigators independently screened titles and abstracts and reviewed relevant full-text records from PubMed, Medline, PsycINFO, Criminal Justice Abstracts, Social Work Abstracts, and AgeLine databases. To maximize the validity and generalizability of prevalence estimation, we restricted eligibility to general population-based studies (English speaking, 1990 onward) using state- or national-level probability sampling and collecting data directly from older adults. Information on elder financial fraud-scam prevalence and study-level characteristics was extracted independently by 2 investigators. Meta-analysis of elder financial fraud-scam prevalence used generalized mixed models with individual studies as levels of a random classification factor. We included 12 studies involving a total of 41 711 individuals in the meta-analysis. Overall pooled elder financial fraud-scam prevalence (up to 5-year period) across studies was 5.6% (95% confidence interval [CI] = 4.0%, 7.8%), with a 1-year period prevalence of 5.4% (95% CI = 3.2%, 7.6%). Studies using a series of questions describing specific fraud-scam events to measure victimization found a significantly higher prevalence (7.1%; 95% CI = 4.8%, 9.4%) than studies

  15. Short- and Long-Term Validity of High School GPA for Admission to Colleges outside the United States

    Science.gov (United States)

    Al-Hattami, Abdulghani

    2014-01-01

    High school GPA is the only admission criterion that is currently used by many colleges in Yemen to select their potential students. Its predictive validity was investigated to ensure the accuracy of the admission decisions in these colleges. The relationship between students' persistence in the 4 years of college and high school GPA was studied…

  16. Usually Available Clinical and Laboratory Data Are Insufficient for a Valid Medication Review: A Crossover Study.

    Science.gov (United States)

    Hurkens, K P G M; Mestres-Gonzalvo, C; de Wit, H A J M; van der Kuy, P H M; Janknegt, R; Verhey, F; Schols, J M G A; Stehouwer, C D A; Winkens, B; Mulder, W

    2016-01-01

    To establish the quality of medication reviews performed by nursing home physicians, general practitioners and pharmacists. 15 Pharmacists, 13 general practitioners and 18 nursing home physicians performed a medication review for three cases (A, B and C), at three evaluation moments. First, they received the medication list. Secondly, they also received laboratory results and reason for admission and finally, we added medical history. Remarks were divided into 6 categories, i.e. indication without medication, medication without indication, contraindications/ interactions, dosage problems, double medication and wrong medication. Remarks were compared to the remarks made by our expert panel and scored according to our grading model as appropriate (0 to +3) or missed or potentially harmful (-1). For each medication error category, the percentage of participants who made this error was computed. After the first evaluation moment, the overall estimated mean percentage score was -1.7% for case A, 3.9% for case B, and 8.7% for case C. After the second review, this score was 15.0% for case A, 19.8% for case B, and 22.2% for case C. This further increased to 30.0% for case A, 36.7% for case B and 44% for case C at the final evaluation. The absence of medication where there was an indication (indication without medication) was frequently missed and did not improve after adding the extra information regarding laboratory results, reason for admission and finally medical history. Increasing clinical information helps physicians and pharmacists to improve their medication reviews, however, additional information was still related with a high margin of error. Detection of certain errors becomes easier with additional information, whereas other errors remain undetected. To achieve a high standard of medication review, we have to change the way medication reviews should be performed.

  17. A Review Of The United States Government’s Status Quo North Korean Foreign Policy Approach And Reasons For Change

    Science.gov (United States)

    2016-02-16

    Korea’s "Year of Friendship." Harvard International Review , 2015. 28 Nielsen, Suzanne C. "American Civil-Military Relations The Soldier and the State...AIR WAR COLLEGE AIR UNIVERSITY A REVIEW OF THE UNITED STATES GOVERNMENT’S STATUS QUO NORTH KOREAN FOREIGN POLICY APPROACH AND REASONS FOR...Colonel Spencer holds a Bachelor of Science degree in Mathematics, Masters of Education, and a Doctorate degree in Business Administration. She

  18. The Incremental Validity of the Trait Emotional Intelligence Questionnaire (TEIQue): A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Andrei, Federica; Siegling, A B; Aloe, Ariel M; Baldaro, Bruno; Petrides, K V

    2016-01-01

    A criticism leveled against the conceptualization of emotional intelligence (EI) as a personality trait is that it overlaps considerably with the higher order personality dimensions and, therefore, has weak utility. To investigate this criticism, a systematic review and meta-analysis were conducted to synthesize the literature examining the incremental validity of the 2 adult self-report forms of the Trait Emotional Intelligence Questionnaire (TEIQue). Twenty-four articles reporting 114 incremental validity analyses of the TEIQue were reviewed according to the studies' methodological features. Additionally, data from 18 studies (providing 105 effect sizes) were pooled in a meta-analysis. Results suggest that the TEIQue consistently explains incremental variance in criteria pertaining to different areas of functioning, beyond higher order personality dimensions and other emotion-related variables. The pooled effect size was relatively small, but statistically and practically significant (ΔR(2) = .06, SE = .0116; 95% CI [.03, .08]). The number of covariates controlled for, the form of the TEIQue, and the focus on higher order personality dimensions versus other individual-difference constructs as baseline predictors did not affect the effect size. Analyses conducted at the factor level indicated that the incremental contribution is mainly due to the well-being and self-control factors of trait EI. Methodological issues and directions for future research are discussed.

  19. Review of paediatric cardiology services in district general hospitals in the United Kingdom.

    Science.gov (United States)

    Andrews, Hannah; Singh, Yogen

    2016-03-01

    Following the Safe and Sustainable review of Paediatric Services in 2012/2013, National Health Service England recommended that local paediatric cardiology services should be provided by specially trained paediatricians with expertise in cardiology in all non-specialist hospitals. To understand the variation in local paediatric cardiology services provided across district general hospitals in the United Kingdom. An internet-based questionnaire was sent out via the Paediatrician with Expertise in Cardiology Special Interest Group and the Neonatologists with Interest in Cardiology and Haemodynamics contact databases and the National Health Service directory. Non-responders were followed-up via telephone. The response rate was 80% (141 of 177 hospitals), and paediatricians with expertise in cardiology were available in 68% of those. Local cardiology clinics led by paediatricians with expertise in cardiology were provided in 96 hospitals (68%), whereas specialist outreach clinics were held in 123 centres (87%). A total of 11 hospitals provided neither specialist outreach clinics nor any local cardiology clinics led by paediatricians with expertise in cardiology. Paediatric echocardiography services were provided in 83% of the hospitals, 12-lead electrocardiogram in 96%, Holter electrocardiogram in 91%, and exercise testing in only 47% of the responding hospitals. Telemedicine facilities were established in only 52% of the centres, where sharing echocardiogram images via picture archiving and communication system was used most commonly. There has been a substantial increase in the availability of paediatricians with expertise in cardiology since 2008. Most of the hospitals are well-supported by specialist cardiology centres via outreach clinics; however, there remains significant variation in the local paediatric cardiology services provided across district general hospitals in the United Kingdom.

  20. An integrative literature review and empirical validation of motives for introducing shared services in government organizations

    NARCIS (Netherlands)

    Paagman, Arnaud; Tate, Mary; Furtmueller, Elfi; Bloom, de Jessica

    2014-01-01

    This paper contributes to the understanding of the meaning of shared services and motives for introducing shared services in government organizations. We review and clarify definitions of shared services and derive a definition applicable for the government context. Based on an extensive literature

  1. The Reliability and Validity of Peer Review of Writing in High School AP English Classes

    Science.gov (United States)

    Schunn, Christian; Godley, Amanda; DeMartino, Sara

    2016-01-01

    One approach to writing instruction that has been shown to improve secondary students' academic writing without increasing demands on teachers' time is peer review. However, many teachers and students worry that students' feedback and assessment of their peers' writing is less accurate than teachers'. This study investigated whether Advanced…

  2. Validity and reliability of instruments to assess potential mediators of children's physical activity: A systematic review

    NARCIS (Netherlands)

    Brown, H.; Hume, C.; Chin A Paw, J.M.M.

    2009-01-01

    This paper aimed to (1) identify potential mediators reported in children's physical activity interventions; and (2) review the psychometric properties of measures of potential mediators included in such interventions. A systematic search of the literature was conducted and studies that reported

  3. Implementation and Validation of PACS Integrated Peer Review for Discrepancy Recording of Radiology Reporting

    NARCIS (Netherlands)

    Olthof, A. W.; van Ooijen, P. M. A.

    2016-01-01

    The purpose of this work is to demonstrate the possibility of implementation of a PACS-integrated peer review system based on RADPEER T classification providing a step-wise implementation plan utilizing features already present in the standard PACS implementation and without the requirement of addit

  4. The Effectiveness of Contingency Model Training: A Review of the Validation of LEADER MATCH.

    Science.gov (United States)

    Fiedler, Fred E.; Mahar, Linda

    1979-01-01

    Twelve studies are reviewed which tested the effectiveness of LEADER MATCH, a new leadership training method based on Fiedler's Contingency Model. The performance evaluations of 423 trained leaders were compared to those of 484 controls. All studies yielded statistically significant results supporting LEADER MATCH training. (Editor/SJL)

  5. 49 CFR Appendix D to Part 236 - Independent Review of Verification and Validation

    Science.gov (United States)

    2010-10-01

    ... assessment is to provide an independent evaluation of the product manufacturer's utilization of safety design... Product Safety Plan (PSP) for processor based systems developed under subpart H or, (2) PTC Product... (c) through (g) of this appendix. However, the reviewer shall not engage in any design...

  6. Child and Adolescent Behaviorally Based Disorders: A Critical Review of Reliability and Validity

    Science.gov (United States)

    Mallett, Christopher A.

    2014-01-01

    Objectives: The purpose of this study was to investigate the historical construction and empirical support of two child and adolescent behaviorally based mental health disorders: oppositional defiant and conduct disorders. Method: The study utilized a historiography methodology to review, from 1880 to 2012, these disorders' inclusion in…

  7. Voice-Related Patient-Reported Outcome Measures: A Systematic Review of Instrument Development and Validation

    Science.gov (United States)

    Francis, David O.; Daniero, James J.; Hovis, Kristen L.; Sathe, Nila; Jacobson, Barbara; Penson, David F.; Feurer, Irene D.; McPheeters, Melissa L.

    2017-01-01

    Purpose: The purpose of this study was to perform a comprehensive systematic review of the literature on voice-related patient-reported outcome (PRO) measures in adults and to evaluate each instrument for the presence of important measurement properties. Method: MEDLINE, the Cumulative Index of Nursing and Allied Health Literature, and the Health…

  8. Evaluating the Validity of Systematic Reviews to Identify Empirically Supported Treatments

    Science.gov (United States)

    Slocum, Timothy A.; Detrich, Ronnie; Spencer, Trina D.

    2012-01-01

    The "best available evidence" is one of the three basic inputs into evidence-based practice. This paper sets out a framework for evaluating the quality of systematic reviews that are intended to identify empirically supported interventions as a way of summarizing the best available evidence. The premise of this paper is that the process of…

  9. Validation of WIMS-AECL/(MULTICELL)/RFSP system by the results of phase-B test at Wolsung-II unit

    Energy Technology Data Exchange (ETDEWEB)

    Hong, In Seob; Min, Byung Joo; Suk, Ho Chun [Korea Atomic Energy Research Institute, Taejon (Korea)

    1999-03-01

    The object of this study is the validation of WIMS-AECL lattice code which has been proposed for the substitution of POWDERPUFS-V(PPV) code. For the validation of this code, WIMS-AECL/(MULTICELL)/RFSP (lattice calculation/(incremental cross section calculation)/core calculation) code system has been used for the Post-Simulation of Phase-B physics Test at Wolsung-II unit. This code system had been used for the Wolsong-I and Point Lepraeu reactors, but after a few modifications of WIMS-AECL input values for Wolsong-II, the results of WIMS-AECL/RFSP code calculations are much improved to those of the old ones. Most of the results show good estimation except moderator temperature coefficient test. And the verification of this result must be done, which is one of the further work. 6 figs., 15 tabs. (Author)

  10. Early rehabilitation in the intensive care unit: an integrative literature review.

    Science.gov (United States)

    Sosnowski, Kellie; Lin, Frances; Mitchell, Marion L; White, Hayden

    2015-11-01

    The aim of this review is to appraise current research which examines the impact of early rehabilitation practices on functional outcomes and quality of life in adult intensive care unit (ICU) survivors. A systematic literature search was undertaken; retrieved data was evaluated against a recognised evaluation tool; research findings were analysed and categorised into themes; and a synthesis of conclusions from each theme was presented as an integrated summation of the topic. Electronic databases of PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Ovid Medline and Google Scholar were searched using key search terms 'ICU acquired weakness', 'early rehabilitation' 'early mobility' and 'functional outcomes' combined with 'intensive care' and 'critical illness'. Additional literature was sourced from reference lists of relevant original publications. Five major themes related to the review objectives emerged from the analysis. These themes included: critically ill patients do not always receive physical therapy as a standard of care; ICU culture and resources determine early rehabilitation success; successful respiratory and physical rehabilitation interventions are tailored according to individual patient impairment; early exercise in the ICU prevents the neuromuscular complications of critical illness and improves functional status; early exercise in the ICU is effective, safe and feasible. A limited body of research supports early rehabilitation interventions to optimise the short term outcomes and long term quality of life for ICU survivors. Critical care nurses are in an excellent position to drive change within their departments ensuring that early rehabilitation practices are adopted and implemented. Copyright © 2015 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  11. Families on adult intensive care units: Are they really satisfied? A literature review.

    Science.gov (United States)

    Padilla Fortunatti, Cristóbal; Rojas Silva, Noelia

    2017-08-24

    Family satisfaction in intensive care units (ICU) is of increasing relevance for family-centred cared. The objective of this review was to explore the characteristics of studies that have used questionnaires to measure the satisfaction of family members of ICU patients. A literature review was performed for studies evaluating family satisfaction in the ICU, independent of design. The following data were obtained for each selected article: publication year, country of origin, design, number of family members, instrument for family satisfaction, instrument score range, response rate, moment at which satisfaction was evaluated, and average level of reported satisfaction. The following databases were systematically searched: PubMed, CINAHL, ProQuest Nursing, ProQuest Social Science, ProQuest Psychology, Science Direct, PsycINFO, LILACS, and Scielo. Thirty-seven articles met inclusion criteria, showing high levels of family satisfaction. Among these, nine different questionnaires were identified. In 31.6% of the studies, family satisfaction was evaluated during the ICU stay, whereas 36.9% did not report the evaluation moment. The mean response rate was 65.5%, and response rates greater than 70% were found only in 28.2% of the studies. High satisfaction levels among family members of ICU patients must be contextualised in light of questionnaire heterogeneity, low response rates, and variability in the moment at which family satisfaction is evaluated. The creation of methodological standards for evaluating and reporting family satisfaction could facilitate comparing results between investigations in this field. Copyright © 2017 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  12. A systematic review of smartphone applications for chronic pain available for download in the United States.

    Science.gov (United States)

    Wallace, Lorraine S; Dhingra, Lara K

    2014-01-01

    A Smartphone app could be useful in aiding patients in self-monitoring and self-managing their chronic pain-related symptoms. The purpose of this study was to systematically review English-language pain-related Smartphone apps available for download in the United States. During July 2012, official Android, BlackBerry, and iPhone Smartphone app platform stores were searched. "Pain" was entered into the search-bar of each Smartphone app store. Of the pain apps meeting inclusion criteria, the following were retrieved: release date, download cost (US dollars [US $], file size, documentation of a healthcare professional's (HCP) involvement in app development, primary purpose of the app (pain education, pain self-management, or a combination of pain education and self-management), targeted pain-related condition(s), and inclusion of features that addressed four common self-monitoring and/or management strategies. Of the 220 apps meeting inclusion criteria, the majority were available through the iPhone (80.0 percent). The cost for downloading each app ranged from US $0.00 to 89.99; however, the majority of apps were ≤US $4.99. There was no evidence of HCP involvement in the development of the majority of apps (65.0 percent). Chronic, nonspecific pain was the focus of half (50.5 percent) of the apps, followed by back and/or neck pain (25.9 percent). The primary purpose of the apps was categorized as follows: pain education (n = 53, 24.1 percent), pain self-management (n = 137, 62.3 percent), and both pain education and self management (n = 30, 13.6 percent). Overall, most of the pain-related apps included within our review not only lacked evidence of HCP input regarding development but also contained few evidence-based pain management features.

  13. Human Factors Evaluation of Man-Machine Interface for Periodic Safety Review of Yonggwang Unit no. 1, 2

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yong Hee; Lee, Jung Woon; Park, Jae Chang (and others)

    2006-01-15

    This report describes the research results of human factors assessment on the MMI(Man Machine Interface) equipment as part of Periodic Safety Review(PSR) of Yonggwang Unit no. 1, 2. As MMI is a key factor among human factors to be reviewed in PSR, we reviewed the MMI components of nuclear power plants in aspect of human factors engineering. The availability, suitability, and effectiveness of the MMI devices were chosen to be reviewed. The MMI devices were investigated through the review of design documents related to the MMI, survey of control panels, evaluation of experts, and experimental assessment. Checklists were used to perform this assessment and record the review results. The items mentioned by the expert comments to review in detail in relation with task procedures were tested by experiments with operators' participation. For some questionable issues arisen during this MMI review, operator workload and possibility of errors in operator actions were analysed. The reviewed MMI devices contain MCR(Main Control Room), SPDS(Safety Parameter Display System), RSP(Remote Shutdown Panel), and the selected LCBs(Local Control Boards) importantly related to safety. As results of the assessments, any significant problem challenging the safety was not found on human factors in the MMI devices. However, several small items to be changed and improved in suitability of MMI devices were discovered. An action plan is recommended to accommodate the suggestions and review comments. It will enhance the plant safety on MMI area.

  14. Systematic review and meta-analysis of validation studies on a diabetes case definition from health administrative records.

    Directory of Open Access Journals (Sweden)

    Aaron Leong

    Full Text Available OBJECTIVES: Health administrative data are frequently used for diabetes surveillance. We aimed to determine the sensitivity and specificity of a commonly-used diabetes case definition (two physician claims or one hospital discharge abstract record within a two-year period and their potential effect on prevalence estimation. METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines, we searched Medline (from 1950 and Embase (from 1980 databases for validation studies through August 2012 (keywords: "diabetes mellitus"; "administrative databases"; "validation studies". Reviewers abstracted data with standardized forms and assessed quality using Quality Assessment of Diagnostic Accuracy Studies (QUADAS criteria. A generalized linear model approach to random-effects bivariate regression meta-analysis was used to pool sensitivity and specificity estimates. We applied correction factors derived from pooled sensitivity and specificity estimates to prevalence estimates from national surveillance reports and projected prevalence estimates over 10 years (to 2018. RESULTS: The search strategy identified 1423 abstracts among which 11 studies were deemed relevant and reviewed; 6 of these reported sensitivity and specificity allowing pooling in a meta-analysis. Compared to surveys or medical records, sensitivity was 82.3% (95%CI 75.8, 87.4 and specificity was 97.9% (95%CI 96.5, 98.8. The diabetes case definition underestimated prevalence when it was ≤10.6% and overestimated prevalence otherwise. CONCLUSION: The diabetes case definition examined misses up to one fifth of diabetes cases and wrongly identifies diabetes in approximately 2% of the population. This may be sufficiently sensitive and specific for surveillance purposes, in particular monitoring prevalence trends. Applying correction factors to adjust prevalence estimates from this definition may be helpful to increase accuracy of estimates.

  15. 75 FR 25032 - Biennial Review of the Progress of Cooperation Under the United States-Singapore Memorandum of...

    Science.gov (United States)

    2010-05-06

    ... Biennial Review of the Progress of Cooperation Under the United States-Singapore Memorandum of Intent on Cooperation in Environmental Matters and Suggestions for 2011-2012 U.S.-Singapore Plan of Action for... under the U.S.-Singapore Memorandum of Intent on Cooperation on Environmental Matters and...

  16. Review of Research for People with ID and Mental Health Problems: A View from the United Kingdom

    Science.gov (United States)

    Hemmings, Colin; Deb, Shoumitro; Chaplin, Eddie; Hardy, Steve; Mukherjee, Rittick

    2013-01-01

    This review of research into mental disorders in people with intellectual disabilities (ID) focuses on research in this field that has originated from the United Kingdom in the last 2 decades. It considers research developments into the epidemiology of mental disorders and problem behaviors, psychopharmacology, psychosocial interventions, and…

  17. Review of Research for People with ID and Mental Health Problems: A View from the United Kingdom

    Science.gov (United States)

    Hemmings, Colin; Deb, Shoumitro; Chaplin, Eddie; Hardy, Steve; Mukherjee, Rittick

    2013-01-01

    This review of research into mental disorders in people with intellectual disabilities (ID) focuses on research in this field that has originated from the United Kingdom in the last 2 decades. It considers research developments into the epidemiology of mental disorders and problem behaviors, psychopharmacology, psychosocial interventions, and…

  18. Disturbance and climate change in United States/Mexico borderland plant communities: a state-of-the-knowledge review

    Science.gov (United States)

    Guy R. McPherson; Jake F. Weltzin

    2000-01-01

    This review evaluates the effects and importance of disturbance and climate change on plant community dynamics in the United States/Mexico borderlands region. Our primary focus is on knowledge of physiognomic-level change in grasslands and woodlands of southeastern Arizona and southwestern New Mexico. Changes in vegetation physiognomy have broad implications for...

  19. The Nutritional Status of Low-Income Preschool Children in the United States: A Review of the Literature.

    Science.gov (United States)

    Kotch, Jonathan; Shackelford, Jo

    This review of the nutritional status of low-income preschool children in the United States discusses the topic in historical perspective and details current knowledge of the nutritional status of preschoolers. Discussion first focuses on the National Health and Nutrition Examination Survey II of 1976-80, and then turns to the National Food…

  20. Validity of recalled v. recorded birth weight: a systematic review and meta-analysis.

    Science.gov (United States)

    Shenkin, S D; Zhang, M G; Der, G; Mathur, S; Mina, T H; Reynolds, R M

    2017-04-01

    Low birth weight is associated with adverse health outcomes. If birth weight records are not available, studies may use recalled birth weight. It is unclear whether this is reliable. We performed a systematic review and meta-analysis of studies comparing recalled with recorded birth weights. We followed the Meta-Analyses of Observational Studies in Epidemiology (MOOSE) statement and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched MEDLINE, EMBASE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) to May 2015. We included studies that reported recalled birth weight and recorded birth weight. We excluded studies investigating a clinical population. Two reviewers independently reviewed citations, extracted data, assessed risk of bias. Data were pooled in a random effects meta-analysis for correlation and mean difference. In total, 40 studies were eligible for qualitative synthesis (n=78,997 births from 78,196 parents). Agreement between recalled and recorded birth weight was high: pooled estimate of correlation in 23 samples from 19 studies (n=7406) was 0.90 [95% confidence interval (CI) 0.87-0.93]. The difference between recalled and recorded birth weight in 29 samples from 26 studies (n=29,293) was small [range -86-129 g; random effects estimate 1.4 g (95% CI -4.0-6.9 g)]. Studies were heterogeneous, with no evidence for an effect of time since birth, person reporting, recall bias, or birth order. In post-hoc subgroup analysis, recall was higher than recorded birth weight by 80 g (95% CI 57-103 g) in low and middle income countries. In conclusion, there is high agreement between recalled and recorded birth weight. If birth weight is recalled, it is suitable for use in epidemiological studies, at least in high income countries.

  1. Quality and safety in adult epilepsy monitoring units: A systematic review and meta-analysis.

    Science.gov (United States)

    Sauro, Khara M; Wiebe, Natalie; Macrodimitris, Sophie; Wiebe, Samuel; Lukmanji, Sara; Jetté, Nathalie

    2016-11-01

    The epilepsy monitoring unit (EMU) is a valuable resource for optimizing management of persons with epilepsy, but may place patients at risk for adverse events due to withdrawal of treatment and induction of symptoms. The purpose of this study was to synthesize data on the safety and quality of care in EMUs to inform the development of quality indicators for EMUs. A systematic review was conducted according to the Preferred Reporting and Items for Systematic Review and Meta-Analysis (PRISMA) statement. The search strategy, which included broad search terms and synonyms pertaining to the EMU, was run in six medical databases and included conference proceedings. Data abstracted included patient and EMU demographics and quality and safety variables. Study quality was evaluated using a modified 15-item Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Descriptive statistics and meta-analyses were used to describe and synthesize the evidence. The search yielded 7,601 references, of which 604 were reviewed in full text. One-hundred thirty-five studies were included. The quality and safety data came from 181,823 patients and reported on 34 different quality and safety variables. Included studies commonly reported the number of patients (108 studies; median number patients, 171.5), age (49 studies; mean age 35.7 years old), and the reason for admission (34 studies). The most common quality and safety data reported were the utility of the EMU admission (38 studies). Thirty-three studies (24.4%) reported on adverse events, and yielded a pooled proportion of adverse events of 7% (95% confidence interval [CI] 5-9%). The mean quality score was 73.3% (standard deviation [SD] 17.2). This study demonstrates that there is a great deal of variation in the reporting of quality and safety measures and in the quality and safety in EMUs. Study quality also varied considerably from one study to the next. These findings highlight the need to develop

  2. A review of the relationships between drought and forest fire in the United States

    Science.gov (United States)

    Littell, Jeremy; Peterson, David L.; Riley, Karin L.; Yongquiang Liu,; Luce, Charles H.

    2016-01-01

    The historical and pre-settlement relationships between drought and wildfire are well documented in North America, with forest fire occurrence and area clearly increasing in response to drought. There is also evidence that drought interacts with other controls (forest productivity, topography, fire weather, management activities) to affect fire intensity, severity, extent, and frequency. Fire regime characteristics arise across many individual fires at a variety of spatial and temporal scales, so both weather and climate—including short- and long-term droughts—are important and influence several, but not all, aspects of fire regimes. We review relationships between drought and fire regimes in United States forests, fire-related drought metrics and expected changes in fire risk, and implications for fire management under climate change. Collectively, this points to a conceptual model of fire on real landscapes: fire regimes, and how they change through time, are products of fuels and how other factors affect their availability (abundance, arrangement, continuity) and flammability (moisture, chemical composition). Climate, management, and land use all affect availability, flammability, and probability of ignition differently in different parts of North America. From a fire ecology perspective, the concept of drought varies with scale, application, scientific or management objective, and ecosystem.

  3. Intensive Care Unit Acquired Weakness (ICU-AW: a brief and practical review

    Directory of Open Access Journals (Sweden)

    Daniel Agustin Godoy

    2015-01-01

    Full Text Available Intensive care unit-acquired weakness (ICU-AW is an increasingly complication of survivors of critical illness. It should be suspected in the presence of  a patient with a flaccid  tetraparesis or tetraplegia with hyporeflexia or absent deep tendon reflexes and difficult to weaning from mechanical ventilation in the absence of different diagnoses. Important risk factors are age, sepsis, illness duration and severity, some drugs (neuromuscular blockers, steroids. Electrophysiological studies have shown an axonal damage of involved peripheral nerves (critical illness polyneuropathy. However, muscle can also be primitively affected (critical illness myopathy leading to ICUAW with inconstant myopathic damage patterns in electromyographic studies. Mixed forms can are present (critical illness polyneuromyopathy. Although the pathophysiology remains obscure, the hypothesis of an acquired channelopathy is substantial.Electroneuromyography is crucial for diagnosis. Muscular and nerve biopsy are necessary for diagnosis confirmation. Aggressive treatment of baseline disease, prevention, through avoiding or minimizing precipitating factors, strict glycemic control, and early rehabilitation combining mobilization with physiotherapy and muscle electrical muscle stimulation, are the keys to improving recovery of the affected individuals. This narrative review highlights the current literature regarding the etiology and diagnosis of ICU-AW.http://dx.doi.org/10.7175/rhc.v6i1.1037

  4. Drug-nutrient interactions in the intensive care unit: literature review and current recommendations

    Science.gov (United States)

    Heldt, Tatiane; Loss, Sergio Henrique

    2013-01-01

    Objective To describe the interactions between drugs and nutrients and their frequency in the intensive care unit and to assess the professional team's awareness regarding this subject. Methods The keywords "drug interactions" and "nutrition therapy" were searched in the PubMed (specifically MeSH) electronic database. The studies were systematically reviewed for descriptions of the types of interactions between drugs and nutrients, including their frequency and consequences. Results Sixty-seven articles were found. Among these, 20 articles were appropriate for the methodology adopted and accomplished the objectives of the study. Of these 20 articles, 14 articles described interactions between drugs and enteral nutrition, three described interactions between drugs and parenteral nutrition, and three described the importance and care required to avoid such interactions. Conclusions The literature about drug and nutrient interactions is limited and suggests the inability of health care teams to recognize the potential for these interactions. Possibly, the elaboration of a protocol to evaluate drug-nutrient interactions will increase the safety and efficacy of therapeutics. PMID:23917982

  5. Women's perceptions of access to prenatal care in the United States: a literature review.

    Science.gov (United States)

    Phillippi, Julia C

    2009-01-01

    Women report many barriers to accessing prenatal care. This article reviews the literature from 1990 to the present on women's perceptions of access to prenatal care within the United States. Barriers can be classified into societal, maternal, and structural dimensions. Women may not be motivated to seek care, especially for unintended pregnancies. Societal and maternal reasons cited for poor motivation include a fear of medical procedures or disclosing the pregnancy to others, depression, and a belief that prenatal care is unnecessary. Structural barriers include long wait times, the location and hours of the clinic, language and attitude of the clinic staff and provider, the cost of services, and a lack of child-friendly facilities. Knowledge of women's views of access can help in development of policies to decrease barriers. Structural barriers could be reduced through changes in clinic policy and prenatal care format, and the creation of child-friendly waiting and examination rooms. Maternal and societal barriers can be addressed through community education. A focus in future research on facilitators of access can assist in creating open pathways to perinatal care for all women.

  6. Preparation and characterization of masonry units, lightweight concrete based and agro-industrial wastes: a review

    Science.gov (United States)

    Díaz-Fuentes, C. X.

    2013-11-01

    Discussion about the new composite materials that integrate agro industrial residues for the masonry unit's production, which are directed towards its implementation in projects of affordable housing, is a subject of interest to the public and productive sector of the country. For this reason, it presents a descriptive review of primary and secondary sources, which support the project under study. The methodology consisted in finding research articles in databases supported by the scientific community, which are ordered, integrated and prioritized, creating a matrix synthesis, which condensed the objectives, type of material, studied properties and main results found. It was found that the composite materials for masonry use mainly clay or cement as matrix and as reinforcement, agro waste like paper fibers, bamboo, rice husks, among others are used. Moreover, the properties that determine its potential use are low density, stress resistance and low thermal conductivity. Comparing the results with traditional specimens as the block of clay, concrete, adobe vs. experimental models made of the compounds analyzed, favorable results were obtained in the case of integrating waste materials into its composition, optimized their properties. Thus, science and architecture converge through recognition of the properties of materials that expand the alternatives of building spaces, economic and environmentally sustainable.

  7. Mobile screening units for the early detection of cancer: a systematic review.

    Science.gov (United States)

    Greenwald, Zoë R; El-Zein, Mariam; Bouten, Sheila; Ensha, Heydar; Vazquez, Fabiana L; Franco, Eduardo L

    2017-10-04

    Mobile Screening Units (MSUs) provide cancer screening services outside of fixed clinical sites, thereby increasing access to early detection services. We conducted a systematic review of the performance of MSUs for the early detection of cancer. Databases (MEDLINE, EMBASE, Cochrane Library, WHO Global Health Library, Web of Science, PsycINFO) were searched up to July 2015. Studies describing screening for breast, cervical and colon cancer using MSUs were included. Data was collected for operational aspects including the performance of exams, screening tests used, and outcomes of case-detection. Of 268 identified studies, 78 were included. Studies investigated screening for cancers including breast (n=55), cervical (n=12), colon (n=1) and multiphasic screening for multiple cancers (n=10). The median number of screening exams performed per intervention was 1767 (interquartile range 5656-38,233). Programs operated in 20 countries, mostly in North America (36%) and Europe (36%). 52% served mixed rural/urban regions, while 35% and 13% served rural or urban regions, respectfully. MSUs have served to expand access to screening in diverse contexts. Further research on the implementation of MSUs in low-resource settings and health economic research on cost-effectiveness of MSUs compared with fixed clinics to inform policymakers is needed. Copyright ©2017, American Association for Cancer Research.

  8. Mood and anxiety problems in perinatal Indigenous women in Australia, New Zealand, Canada, and the United States: a critical review of the literature.

    Science.gov (United States)

    Bowen, Angela; Duncan, Vicky; Peacock, Shelley; Bowen, Rudy; Schwartz, Laura; Campbell, Diane; Muhajarine, Nazeem

    2014-02-01

    We conducted a review of research literature related to anxiety, depression, and mood problems in Indigenous women in Canada, the United States (including Hawaii), Australia, and New Zealand. Quantitative and qualitative research studies published between 1980 and March 2010 were reviewed. The initial search revealed 396 potential documents, and after being checked for relevance by two researchers, data were extracted from 16 quantitative studies, one qualitative research article, and one dissertation. Depression is a common problem in Indigenous pregnant and postpartum women; however, the prevalence and correlates of anxiety and mood disorders are understudied. The review identified four key areas where further research is needed: (a) longitudinal, population-based studies; (b) further validation and modification of appropriate screening tools; (c) exploration of cultural diversity and meaning of the lived experiences of antenatal and postpartum depression, anxiety, and mood disorders; and (d) development of evidence-informed practices for researchers and practitioners through collaborations with Aboriginal communities to better understand and improve mental health of women of childbearing age.

  9. VALIDATION OF FILM COATED MULTIVITAMIN TABLETS

    Directory of Open Access Journals (Sweden)

    Vipin Kumar

    2013-06-01

    Full Text Available The validation is fundamental segment that supports to a commitment of company towards quality assurance. It also assures that product meets its predetermined quality specification and quality. Validation of each steps of manufacturing during multivitamin tablet formulation is called process validation of multivitamin tablets. During past film coating is not much favorable but now for multivitamin tablets film coating is used. The objective is to present a review and to discuss aspects of validation of film coated multivitamin tablets in terms of unit operations; that is, those individual technical operations that comprise the various steps involved in product design and evaluation.

  10. Voluntary peer review as innovative tool for quality improvement in the intensive care unit – a retrospective descriptive cohort study in German intensive care units

    Directory of Open Access Journals (Sweden)

    Kumpf, Oliver

    2014-12-01

    Full Text Available [english] Introduction: Quality improvement and safety in intensive care are rapidly evolving topics. However, there is no gold standard for assessing quality improvement in intensive care medicine yet. In 2007 a pilot project in German intensive care units (ICUs started using voluntary peer reviews as an innovative tool for quality assessment and improvement. We describe the method of voluntary peer review and assessed its feasibility by evaluating anonymized peer review reports and analysed the thematic clusters highlighted in these reports.Methods: Retrospective data analysis from 22 anonymous reports of peer reviews. All ICUs – representing over 300 patient beds – had undergone voluntary peer review. Data were retrieved from reports of peers of the review teams and representatives of visited ICUs. Data were analysed with regard to number of topics addressed and results of assessment questionnaires. Reports of strengths, weaknesses, opportunities and threats (SWOT reports of these ICUs are presented. Results: External assessment of structure, process and outcome indicators revealed high percentages of adherence to predefined quality goals. In the SWOT reports 11 main thematic clusters were identified representative for common ICUs. 58.1% of mentioned topics covered personnel issues, team and communication issues as well as organisation and treatment standards. The most mentioned weaknesses were observed in the issues documentation/reporting, hygiene and ethics. We identified several unique patterns regarding quality in the ICU of which long-term personnel problems und lack of good reporting methods were most interestingConclusion: Voluntary peer review could be established as a feasible and valuable tool for quality improvement. Peer reports addressed common areas of interest in intensive care medicine in more detail compared to other methods like measurement of quality indicators.

  11. Voluntary peer review as innovative tool for quality improvement in the intensive care unit – a retrospective descriptive cohort study in German intensive care units

    Science.gov (United States)

    Kumpf, Oliver; Bloos, Frank; Bause, Hanswerner; Brinkmann, Alexander; Deja, Maria; Marx, Gernot; Kaltwasser, Arnold; Dubb, Rolf; Muhl, Elke; Greim, Clemens-A.; Weiler, Norbert; Chop, Ines; Jonitz, Günther; Schaefer, Henning; Felsenstein, Matthias; Liebeskind, Ursula; Leffmann, Carsten; Jungbluth, Annemarie; Waydhas, Christian; Pronovost, Peter; Spies, Claudia; Braun, Jan-Peter

    2014-01-01

    Introduction: Quality improvement and safety in intensive care are rapidly evolving topics. However, there is no gold standard for assessing quality improvement in intensive care medicine yet. In 2007 a pilot project in German intensive care units (ICUs) started using voluntary peer reviews as an innovative tool for quality assessment and improvement. We describe the method of voluntary peer review and assessed its feasibility by evaluating anonymized peer review reports and analysed the thematic clusters highlighted in these reports. Methods: Retrospective data analysis from 22 anonymous reports of peer reviews. All ICUs – representing over 300 patient beds – had undergone voluntary peer review. Data were retrieved from reports of peers of the review teams and representatives of visited ICUs. Data were analysed with regard to number of topics addressed and results of assessment questionnaires. Reports of strengths, weaknesses, opportunities and threats (SWOT reports) of these ICUs are presented. Results: External assessment of structure, process and outcome indicators revealed high percentages of adherence to predefined quality goals. In the SWOT reports 11 main thematic clusters were identified representative for common ICUs. 58.1% of mentioned topics covered personnel issues, team and communication issues as well as organisation and treatment standards. The most mentioned weaknesses were observed in the issues documentation/reporting, hygiene and ethics. We identified several unique patterns regarding quality in the ICU of which long-term personnel problems und lack of good reporting methods were most interesting Conclusion: Voluntary peer review could be established as a feasible and valuable tool for quality improvement. Peer reports addressed common areas of interest in intensive care medicine in more detail compared to other methods like measurement of quality indicators. PMID:25587245

  12. Bacteriophage removal efficiency as a validation and operational monitoring tool for virus reduction in wastewater reclamation: Review.

    Science.gov (United States)

    Amarasiri, Mohan; Kitajima, Masaaki; Nguyen, Thanh H; Okabe, Satoshi; Sano, Daisuke

    2017-09-15

    The multiple-barrier concept is widely employed in international and domestic guidelines for wastewater reclamation and reuse for microbiological risk management, in which a wastewater reclamation system is designed to achieve guideline values of the performance target of microbe reduction. Enteric viruses are one of the pathogens for which the target reduction values are stipulated in guidelines, but frequent monitoring to validate human virus removal efficacy is challenging in a daily operation due to the cumbersome procedures for virus quantification in wastewater. Bacteriophages have been the first choice surrogate for this task, because of the well-characterized nature of strains and the presence of established protocols for quantification. Here, we performed a meta-analysis to calculate the average log10 reduction values (LRVs) of somatic coliphages, F-specific phages, MS2 coliphage and T4 phage by membrane bioreactor, activated sludge, constructed wetlands, pond systems, microfiltration and ultrafiltration. The calculated LRVs of bacteriophages were then compared with reported human enteric virus LRVs. MS2 coliphage LRVs in MBR processes were shown to be lower than those of norovirus GII and enterovirus, suggesting it as a possible validation and operational monitoring tool. The other bacteriophages provided higher LRVs compared to human viruses. The data sets on LRVs of human viruses and bacteriophages are scarce except for MBR and conventional activated sludge processes, which highlights the necessity of investigating LRVs of human viruses and bacteriophages in multiple treatment unit processes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. A Review of the External Validity of Clinical Trials with Beta-Blockers in Heart Failure

    Science.gov (United States)

    Iyngkaran, Pupalan; Toukhsati, Samia R.; Thomas, Merlin C.; Jelinek, Michael V.; Hare, David L.; Horowitz, John D.

    2016-01-01

    BACKGROUND Beta-blockers (BBs) are the mainstay prognostic medication for all stages of chronic heart failure (CHF). There are many classes of BBs, each of which has varying levels of evidence to support its efficacy in CHF. However, most CHF patients have one or more comorbid conditions such as diabetes, renal impairment, and/or atrial fibrillation. Patient enrollment to randomized controlled trials (RCTs) often excludes those with certain comorbidities, particularly if the symptoms are severe. Consequently, the extent to which evidence drawn from RCTs is generalizable to CHF patients has not been well described. Clinical guidelines also underrepresent this point by providing generic advice for all patients. The aim of this review is to examine the evidence to support the use of BBs in CHF patients with common comorbid conditions. METHODS We searched MEDLINE, PubMed, and the reference lists of reviews for RCTs, post hoc analyses, systematic reviews, and meta-analyses that report on use of BBs in CHF along with patient demographics and comorbidities. RESULTS In total, 38 studies from 28 RCTs were identified, which provided data on six BBs against placebo or head to head with another BB agent in ischemic and nonischemic cardiomyopathies. Several studies explored BBs in older patients. Female patients and non-Caucasian race were underrepresented in trials. End points were cardiovascular hospitalization and mortality. Comorbid diabetes, renal impairment, or atrial fibrillation was detailed; however, no reference to disease spectrum or management goals as a focus could be seen in any of the studies. In this sense, enrollment may have limited more severe grades of these comorbidities. CONCLUSIONS RCTs provide authoritative information for a spectrum of CHF presentations that support guidelines. RCTs may provide inadequate information for more heterogeneous CHF patient cohorts. Greater Phase IV research may be needed to fill this gap and inform guidelines for a more

  14. Microbiological safety of mayonnaise, salad dressings, and sauces produced in the United States: a review.

    Science.gov (United States)

    Smittle, R B

    2000-08-01

    The literature on the death and survival of foodborne pathogens in commercial mayonnaise, dressing, and sauces was reviewed and statistically analyzed with emphasis on Salmonella, Escherichia coli O157:H7, and Listeria monocytogenes. The absence of reports of foodborne illness associated directly with the consumption of commercially prepared acidic dressings and sauces is evidence of their safety. Salmonella, E. coli O157:H7, E. coli, L. monocytogenes, Staphylococcus aureus, and Yersinia enterocolitica die when inoculated into mayonnaise and dressings. Historically, mayonnaise and dressings have been exempt from the acidified food regulations and have justly deserved this status due primarily to the toxic effect of acetic and to a lesser extent lactic and citric acids. These organic acids are inimical to pathogenic bacteria and are effective natural preservatives with acetic being the most effective in killing pathogenic bacteria at the pH values encountered in these products. Statistical analysis on data reported in the literature shows that the most important and significant factor in destroying pathogenic bacteria is pH as adjusted with acetic acid followed by the concentration of acetic acid in the water phase. The reported highest manufacturing target pH for dressings and sauces is 4.4, which is below the 4.75 pKa of acetic acid and below the reported inhibitory pH of 4.5 for foodborne pathogens in the presence of acetic acid. The overall conclusion is that these products are very safe. They should remain exempt from the acidified food regulations providing adequate research has been done to validate their safety, and the predominant acid is acetic and reasonable manufacturing precautions are taken.

  15. Sociodemographic Antecedent Validators of Suicidal Behavior: A Review of Recent Literature.

    Science.gov (United States)

    Conejero, Ismael; Lopez-Castroman, Jorge; Giner, Lucas; Baca-Garcia, Enrique

    2016-10-01

    Suicidal behavior and its prevention constitute a major public health issue. Etiology of suicidal behavior is multifactorial. Whereas current research is mostly focused on clinical and biological risk factors, the sociodemographic risk factors for suicidal behavior, first highlighted by Durkheim, have received less attention. Besides the well-known impact of age and gender, sociodemographic variables such as marital and parental status, education, occupation, income, employment status, religion, migration or minority status, and sexual orientation are repeatedly reported to play an important role in suicidal behavior. This narrative review aimed to summarize recent research on sociodemographic risk factors for suicidal behavior and to elicit possible implications for suicide prevention.

  16. 77 FR 67804 - Federal Acquisition Regulation; Submission for OMB Review; Integrity of Unit Prices

    Science.gov (United States)

    2012-11-14

    ... threshold, construction and architect-engineering services, utility services, service contracts where... valid assumptions and methodology; ways to enhance the quality, utility, and clarity of the...

  17. The Validity of the Interpersonal Theory of Suicide in Adolescence: A Review.

    Science.gov (United States)

    Stewart, Sunita M; Eaddy, Michael; Horton, Sarah E; Hughes, Jennifer; Kennard, Beth

    2017-01-01

    Adolescence, when suicidal ideation and behaviors often begin, might offer an important window to understand the causes and prevent the progression of suicide phenomena. The need for frameworks to organize the fragmented field has been noted, but few studies are theoretically driven. An important recent contribution to understanding suicidality is Joiner's (2005) Interpersonal-Psychological Theory of Suicide (IPTS). This article reviews the evidence for the applicability of the IPTS in adolescence. Seventeen studies of adolescents that specifically tested or interpreted findings in the light of Joiner's theory or the IPTS were located. In addition, several recent reviews of the literature on suicidality in adolescence covered information relevant to the IPTS. There is some support for the theory in adolescence, particularly with regard to its most novel component, the association between acquired capability and suicide attempt. In summary, we find this theory to be a promising heuristic to organize the disparate studies in suicide research. Future challenges and directions for researchers seeking to test and elaborate the applicability of the IPTS in adolescence include: adaptations of instruments to the developmental stage, capturing of imminent risk, and consideration of whether the current model is underspecified. Age might moderate adult findings that give impulsivity an indirect role in suicide attempts.

  18. Validity of bond strength tests: A critical review-Part II

    Directory of Open Access Journals (Sweden)

    Kantheti Sirisha

    2014-01-01

    Full Text Available Background: Macro-bond strength tests resulted in cohesive failures and overestimation of bond strengths. To reduce the flaws, micro-bond strength tests were introduced. They are the most commonly used bond-strength tests. Objective: Thus the objective of this review is to critically review the reliability of micro-bond strength tests used to evaluate resin-tooth interface. Data Collection: Relevant articles published between January 1994 and July 2013 were collected from Pubmed database, Google scholar and hand searched journals of Conservative Dentistry, Endodontics and Dental materials. Data Synthesis: Variables that influence the test outcome are categorized into substrate related factors, factors related to specimen properties, specimen preparation and test methodology. Impact of these variables on the test outcome is critically analyzed. Conclusion: Micro-bond tests are more reliable than macro-bond tests. However, no standard format exists for reporting the bond strength tests which could lead to misinterpretation of the data and bonding abilities of adhesives.

  19. Managing Highway Maintenance: Instructor's Manual for Management by Objectives Review, Unit 11, All Levels.

    Science.gov (United States)

    Federal Highway Administration (DOT), Washington, DC. Offices of Research and Development.

    Part of the series "Managing Highway Maintenance," the unit is designed for the training group leader and contains selected highlights and suggested discussion questions from six units of training: maintenance activities, work units, and classifying work; maintenance feature inventories; how to conduct a maintenance feature inventory;…

  20. Systematic review of systemic sclerosis-specific instruments for the EULAR Outcome Measures Library: An evolutional database model of validated patient-reported outcomes.

    Science.gov (United States)

    Ingegnoli, Francesca; Carmona, Loreto; Castrejon, Isabel

    2017-04-01

    The EULAR Outcome Measures Library (OML) is a freely available database of validated patient-reported outcomes (PROs). The aim of this study was to provide a comprehensive review of validated PROs specifically developed for systemic sclerosis (SSc) to feed the EULAR OML. A sensitive search was developed in Medline and Embase to identify all validation studies, cohort studies, reviews, or meta-analyses in which the objective were the development or validation of specific PROs evaluating organ involvement, disease activity or damage in SSc. A reviewer screened title and abstracts, selected the studies, and collected data concerning validation using ad hoc forms based on the COSMIN checklist. From 13,140 articles captured, 74 met the predefined criteria. After excluding two instruments as they were unavailable in English the selected 23 studies provided information on seven SSc-specific PROs on different SSc domains: burden of illness (symptom burden index), functional status (Scleroderma Assessment Questionnaire), functional ability (scleroderma Functional Score), Raynaud's phenomenon (Raynaud's condition score), mouth involvement (Mouth Handicap in SSc), gastro-intestinal involvement (University of California Los Angeles-Scleroderma Clinical Trial Consortium Gastro-Intestinal tract 2.0), and skin involvement (skin self-assessment). Each of them is partially validated and has different psychometric requirements. Seven SSc-specific PROs have a minimum validation and were included in the EULAR OML. Further development in the area of disease-specific PROs in SSc is warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Re-validation of the Van Rie HIV/AIDS-related stigma scale for use with people living with HIV in the United States.

    Science.gov (United States)

    Kipp, Aaron M; Audet, Carolyn M; Earnshaw, Valerie A; Owens, Jared; McGowan, Catherine C; Wallston, Kenneth A

    2015-01-01

    There is little consensus about which of the many validated human immunodeficiency virus (HIV) stigma scales should be regularly used, with few being re-validated in different contexts or evaluated for how they compare to other, existing HIV stigma scales. The purpose of this exploratory study was to re-validate the Van Rie HIV/AIDS-Related Stigma Scale, originally validated in Thailand and using a third-person wording structure, for use with people living with HIV in the United States. Adult HIV clinic patients completed a survey including the Berger and Van Rie scales, and measures of social support and depression. Eighty-five of 211 (40%) eligible participants provided data for both stigma scales. Exploratory factor analyses identified three factors to the Van Rie scale: Loss of Social Relationships (new subscale), Managing HIV Concealment (new subscale), and Perceived Community Stigma (original subscale). These subscales were moderately inter-related (r = 0.51 to 0.58) with acceptable to excellent reliability (Cronbach's alpha = 0.69 to 0.90). The Van Rie subscales were also moderately inter-correlated with the Berger subscales (r = 0.44 to 0.76), had similar construct validity, and tended to have higher mean stigma scores when compared with Berger subscales that were conceptually most similar. The revised Van Rie HIV-related Stigma Scale demonstrates good validity and internal consistency, offering a valid measure of HIV stigma with a three-factor structure. The third-person wording may be particularly suitable for measuring stigmatizing attitudes during an individual's transition from at-risk and undergoing HIV testing to newly diagnosed, a time when experiences of discrimination and processing issues of disclosure have not yet occurred. The stigma mechanisms for individuals making this transition have not been well explored. These scenarios, combined with the observed non-response to the Berger Enacted Stigma subscale items (a surprise finding), highlight

  2. Re-validation of the Van Rie HIV/AIDS-related stigma scale for use with people living with HIV in the United States.

    Directory of Open Access Journals (Sweden)

    Aaron M Kipp

    Full Text Available There is little consensus about which of the many validated human immunodeficiency virus (HIV stigma scales should be regularly used, with few being re-validated in different contexts or evaluated for how they compare to other, existing HIV stigma scales. The purpose of this exploratory study was to re-validate the Van Rie HIV/AIDS-Related Stigma Scale, originally validated in Thailand and using a third-person wording structure, for use with people living with HIV in the United States. Adult HIV clinic patients completed a survey including the Berger and Van Rie scales, and measures of social support and depression. Eighty-five of 211 (40% eligible participants provided data for both stigma scales. Exploratory factor analyses identified three factors to the Van Rie scale: Loss of Social Relationships (new subscale, Managing HIV Concealment (new subscale, and Perceived Community Stigma (original subscale. These subscales were moderately inter-related (r = 0.51 to 0.58 with acceptable to excellent reliability (Cronbach's alpha = 0.69 to 0.90. The Van Rie subscales were also moderately inter-correlated with the Berger subscales (r = 0.44 to 0.76, had similar construct validity, and tended to have higher mean stigma scores when compared with Berger subscales that were conceptually most similar. The revised Van Rie HIV-related Stigma Scale demonstrates good validity and internal consistency, offering a valid measure of HIV stigma with a three-factor structure. The third-person wording may be particularly suitable for measuring stigmatizing attitudes during an individual's transition from at-risk and undergoing HIV testing to newly diagnosed, a time when experiences of discrimination and processing issues of disclosure have not yet occurred. The stigma mechanisms for individuals making this transition have not been well explored. These scenarios, combined with the observed non-response to the Berger Enacted Stigma subscale items (a surprise finding

  3. The Dating Violence Questionnaire: Validation of the Cuestionario de Violencia de Novios Using a College Sample From the United States.

    Science.gov (United States)

    López-Cepero, Javier; Fabelo, Humberto Eduardo; Rodríguez-Franco, Luis; Rodríguez-Díaz, F Javier

    2016-01-01

    This study provides psychometric information for the Dating Violence Questionnaire (DVQ), an instrument developed to assess intimate partner victimization among adolescents and youths. This instrument, an English version of Cuestionario de Violencia de Novios, assesses both frequency and discomfort associated with 8 types of abuse (detachment, humiliation, sexual, coercion, physical, gender-based, emotional punishment, and instrumental). Participant included 859 U.S. students enrolled in undergraduate psychology courses in a mid-Atlantic university (M = 19 years; SD = 1.5 years). One-third of the participants were males, and two-thirds were females. Regarding racial identity, around 55% of participants identified themselves as White, 22% as African American, 12% as Asian, whereas 11% selected other identities. Around 9% of participants identified themselves as Hispanic. Confirmatory factor analysis shows that the DVQ achieved adequate goodness-of-fit indexes for the original eight-factor model (X(2)/df .700), surpassing those found in the original Spanish validation. Descriptive analysis suggests higher victimization experience on subtle aggressions (detachment, coercion, and emotional punishment), with overt abuses (physical, instrumental) obtaining the smallest means; these findings were similar across gender, race identity, and ethnicity. Results of this validation study encourage the inclusion of DVQ in both research and applied contexts.

  4. A review of the design and validation of web- and computer-based 24-h dietary recall tools.

    Science.gov (United States)

    Timon, Claire M; van den Barg, Rinske; Blain, Richard J; Kehoe, Laura; Evans, Katie; Walton, Janette; Flynn, Albert; Gibney, Eileen R

    2016-12-01

    Technology-based dietary assessment offers solutions to many of the limitations of traditional dietary assessment methodologies including cost, participation rates and the accuracy of data collected. The 24-h dietary recall (24HDR) method is currently the most utilised method for the collection of dietary intake data at a national level. Recently there have been many developments using web-based platforms to collect food intake data using the principles of the 24HDR method. This review identifies web- and computer-based 24HDR tools that have been developed for both children and adult population groups, and examines common design features and the methods used to investigate the performance and validity of these tools. Overall, there is generally good to strong agreement between web-based 24HDR and respective reference measures for intakes of macro- and micronutrients.

  5. HIV Testing Among Internet-Using MSM in the United States: Systematic Review.

    Science.gov (United States)

    Noble, Meredith; Jones, Amanda M; Bowles, Kristina; DiNenno, Elizabeth A; Tregear, Stephen J

    2017-02-01

    Regular HIV testing enables early identification and treatment of HIV among at-risk men who have sex with men (MSM). Characterizing HIV testing needs for Internet-using MSM informs development of Internet-facilitated testing interventions. In this systematic review we analyze HIV testing patterns among Internet-using MSM in the United States who report, through participation in an online study or survey, their HIV status as negative or unknown and identify demographic or behavioral risk factors associated with testing. We systematically searched multiple electronic databases for relevant English-language articles published between January 1, 2005 and December 16, 2014. Using meta-analysis, we summarized the proportion of Internet-using MSM who had ever tested for HIV and the proportion who tested in the 12 months preceding participation in the online study or survey. We also identified factors predictive of these outcomes using meta-regression and narrative synthesis. Thirty-two studies that enrolled 83,186 MSM met our inclusion criteria. Among the studies reporting data for each outcome, 85 % (95 % CI 82-87 %) of participants had ever tested, and 58 % (95 % CI 53-63 %) had tested in the year preceding enrollment in the study, among those for whom those data were reported. Age over 30 years, at least a college education, use of drugs, and self-identification as being homosexual or gay were associated with ever having tested for HIV. A large majority of Internet-using MSM indicated they had been tested for HIV at some point in the past. A smaller proportion-but still a majority-reported they had been tested within the year preceding study or survey participation. MSM who self-identify as heterosexual or bisexual, are younger, or who use drugs (including non-injection drugs) may be less likely to have ever tested for HIV. The overall findings of our systematic review are encouraging; however, a subpopulation of MSM may benefit from targeted outreach. These

  6. Adherence: a review of education, research, practice, and policy in the United States

    Directory of Open Access Journals (Sweden)

    Brown TA

    2010-03-01

    Full Text Available Objective: To describe the education, research, practice, and policy related to pharmacist interventions to improve medication adherence in community settings in the United States.Methods: Authors used MEDLINE and International Pharmaceutical Abstracts (since 1990 to identify community and ambulatory pharmacy intervention studies which aimed to improve medication adherence. The authors also searched the primary literature using Ovid to identify studies related to the pharmacy teaching of medication adherence. The bibliographies of relevant studies were reviewed in order to identify additional literature. We searched the tables of content of three US pharmacy education journals and reviewed the American Association of Colleges of Pharmacy website for materials on teaching adherence principles. Policies related to medication adherence were identified based on what was commonly known to the authors from professional experience, attendance at professional meetings, and pharmacy journals.Results: Research and Practice: 29 studies were identified: 18 randomized controlled trials; 3 prospective cohort studies; 2 retrospective cohort studies; 5 case-controlled studies; and one other study. There was considerable variability in types of interventions and use of adherence measures. Many of the interventions were completed by pharmacists with advanced clinical backgrounds and not typical of pharmacists in community settings. The positive intervention effects had either decreased or not been sustained after interventions were removed. Although not formally assessed, in general, the average community pharmacy did not routinely assess and/or intervene on medication adherence. Education: National pharmacy education groups support the need for pharmacists to learn and use adherence-related skills. Educational efforts involving adherence have focused on students’ awareness of adherence barriers and communication skills needed to engage patients in behavioral

  7. Experimental Validation of Methods for Prophylaxis against Deep Venous Thrombosis: A Review and Proposal

    Directory of Open Access Journals (Sweden)

    Paul S. Agutter

    2012-01-01

    Full Text Available The experimental procedure by which the valve cusp hypoxia (VCH hypothesis of the etiology of deep venous thrombosis (DVT was confirmed lends itself to testing of methods of prophylaxis. Similar animal experiments could end the present exclusive reliance on statistical analysis of data from large patient cohorts to evaluate prophylactic regimes. The reduction of need for such (usually retrospective analyses could enable rationally-based clinical trials of prophylactic methods to be conducted more rapidly, and the success of such trials would lead to decreased incidences of DVT-related mortality and morbidity. This paper reviews the VCH hypothesis (“VCH thesis”, following its corroboration and its implications for understanding DVT and its sequelae, and outlines the experimental protocol for testing prophylactic methods. The advantages and limitations of the protocol are briefly discussed.

  8. Experimental Validation of Methods for Prophylaxis against Deep Venous Thrombosis: A Review and Proposal.

    Science.gov (United States)

    Agutter, Paul S; Malone, P Colm; Silver, Ian A

    2012-01-01

    The experimental procedure by which the valve cusp hypoxia (VCH) hypothesis of the etiology of deep venous thrombosis (DVT) was confirmed lends itself to testing of methods of prophylaxis. Similar animal experiments could end the present exclusive reliance on statistical analysis of data from large patient cohorts to evaluate prophylactic regimes. The reduction of need for such (usually retrospective) analyses could enable rationally-based clinical trials of prophylactic methods to be conducted more rapidly, and the success of such trials would lead to decreased incidences of DVT-related mortality and morbidity. This paper reviews the VCH hypothesis ("VCH thesis", following its corroboration) and its implications for understanding DVT and its sequelae, and outlines the experimental protocol for testing prophylactic methods. The advantages and limitations of the protocol are briefly discussed.

  9. The validity of using analogue patients in practitioner-patient communication research: systematic review and meta-analysis.

    Science.gov (United States)

    van Vliet, Liesbeth M; van der Wall, Elsken; Albada, Akke; Spreeuwenberg, Peter M M; Verheul, William; Bensing, Jozien M

    2012-11-01

    When studying the patient perspective on communication, some studies rely on analogue patients (patients and healthy subjects) who rate videotaped medical consultations while putting themselves in the shoes of the video-patient. To describe the rationales, methodology, and outcomes of studies using video-vignette designs in which videotaped medical consultations are watched and judged by analogue patients. Pubmed, Embase, Psychinfo and CINAHL databases were systematically searched up to February 2012. Data was extracted on: study characteristics and quality, design, rationales, internal and external validity, limitations and analogue patients' perceptions of studied communication. A meta-analysis was conducted on the distribution of analogue patients' evaluations of communication. Thirty-four studies were included, comprising both scripted and clinical studies, of average-to-superior quality. Studies provided unspecific, ethical as well as methodological rationales for conducting video-vignette studies with analogue patients. Scripted studies provided the most specific methodological rationales and tried the most to increase and test internal validity (e.g. by performing manipulation checks) and external validity (e.g. by determining identification with video-patient). Analogue patients' perceptions of communication largely overlap with clinical patients' perceptions. The meta-analysis revealed that analogue patients' evaluations of practitioners' communication are not subject to ceiling effects. Analogue patients' evaluations of communication equaled clinical patients' perceptions, while overcoming ceiling effects. This implies that analogue patients can be included as proxies for clinical patients in studies on communication, taken some described precautions into account. Insights from this review may ease decisions about including analogue patients in video-vignette studies, improve the quality of these studies and increase knowledge on communication from the

  10. 如何上好单元复习课%How to Give a Good Unit Review Class

    Institute of Scientific and Technical Information of China (English)

    包晓明

    2014-01-01

    如何把单元复习课上得有新意,又有效呢?仅以Unit 3 Teenagers should be allowed to choose their own clothes?(义务教育课程标准实验教科书人教版新目标英语九年级)为例,谈谈如何上好单元复习课。这堂课的主要任务是帮助学生复习本单元的基础知识,梳理基本信息,最后达到温故而知新。%How to put the unit review class to have the fresh idea,and effective? Only with the Unit 3 Teenagers should be allowed to choose their own clothes?(the experimental textbooks of compulsory education curriculum standard person teaching edition“English”)New (grade nine)as an example about how to teach unit review class. The main task of this course is to help students review the basic knowledge, combed the basic information,and finally reached the entrance.

  11. Model performance evaluation (validation and calibration) in model-based studies of therapeutic interventions for cardiovascular diseases : a review and suggested reporting framework.

    Science.gov (United States)

    Haji Ali Afzali, Hossein; Gray, Jodi; Karnon, Jonathan

    2013-04-01

    Decision analytic models play an increasingly important role in the economic evaluation of health technologies. Given uncertainties around the assumptions used to develop such models, several guidelines have been published to identify and assess 'best practice' in the model development process, including general modelling approach (e.g., time horizon), model structure, input data and model performance evaluation. This paper focuses on model performance evaluation. In the absence of a sufficient level of detail around model performance evaluation, concerns regarding the accuracy of model outputs, and hence the credibility of such models, are frequently raised. Following presentation of its components, a review of the application and reporting of model performance evaluation is presented. Taking cardiovascular disease as an illustrative example, the review investigates the use of face validity, internal validity, external validity, and cross model validity. As a part of the performance evaluation process, model calibration is also discussed and its use in applied studies investigated. The review found that the application and reporting of model performance evaluation across 81 studies of treatment for cardiovascular disease was variable. Cross-model validation was reported in 55 % of the reviewed studies, though the level of detail provided varied considerably. We found that very few studies documented other types of validity, and only 6 % of the reviewed articles reported a calibration process. Considering the above findings, we propose a comprehensive model performance evaluation framework (checklist), informed by a review of best-practice guidelines. This framework provides a basis for more accurate and consistent documentation of model performance evaluation. This will improve the peer review process and the comparability of modelling studies. Recognising the fundamental role of decision analytic models in informing public funding decisions, the proposed

  12. Reflections from a systematic review of dietary energy density and weight gain: is the inclusion of drinks valid?

    Science.gov (United States)

    Johnson, L; Wilks, D C; Lindroos, A K; Jebb, S A

    2009-11-01

    The association between dietary energy density, increased energy intake and weight gain is supported by experimental evidence, but confirmation of an effect in free-living humans is limited. Experimental evidence supports a role of energy density in obesity through changes in food composition, not drinks consumption. The inclusion of drinks in the calculation creates a variable of questionable validity and has a substantive impact on the estimated energy density of the diet. We posit, based on the experimental evidence, that calculating the energy density of diets by excluding drinks and including calories from drinks as a covariate in the analysis is the most valid and reliable method of testing the relationship between energy density and weight gain in free-living humans. We demonstrate, by systematically reviewing existing observational studies of dietary energy density and weight gain in free-living humans, how current variation in the method for calculating energy density hampers the interpretation of these data. Reaching an a priori decision on the appropriate methodology will reduce the error caused by multiple comparisons and facilitate meaningful interpretation of epidemiological evidence to inform the development of effective obesity prevention strategies.

  13. Antisocial personality disorder and psychopathy in women: a literature review on the reliability and validity of assessment instruments.

    Science.gov (United States)

    Dolan, Mairead; Völlm, Birgit

    2009-01-01

    Crime rates are low in women compared to men. The two disorders most commonly associated with offending behaviour, antisocial personality disorder (ASPD) and psychopathy, are also less prevalent in female samples. However, developments in forensic psychiatry have often ignored gender, and the utility of constructs such as psychopathy and their assessment instruments in female samples remains unclear. This article presents a review of studies looking at rates of ASPD and psychopathy and on the reliability and validity of assessment instruments of these disorders in women. Gender differences in symptom patterns will be considered. The literature seems to suggest that DSM-IV criteria for ASPD may lead to an underestimation of the prevalence of the disorder in women due to the requirement of childhood conduct disorder symptoms. The Psychopathy Checklist-Revised (PCL-R) is a valid and reliable instrument to identify psychopathy in women but there are gender differences in the factor structure and item loadings on this measure. Research to date seems to suggest a three-factor model may be most strongly supported in females. Preliminary evidence suggests the PCL-R may have some value in predicting future offending while the PCL:SV may be useful in predicting institutional violence. Clinical implications are discussed.

  14. Assessing teamwork performance in obstetrics: A systematic search and review of validated tools.

    Science.gov (United States)

    Fransen, Annemarie F; de Boer, Liza; Kienhorst, Dieneke; Truijens, Sophie E; van Runnard Heimel, Pieter J; Oei, S Guid

    2017-09-01

    Teamwork performance is an essential component for the clinical efficiency of multi-professional teams in obstetric care. As patient safety is related to teamwork performance, it has become an important learning goal in simulation-based education. In order to improve teamwork performance, reliable assessment tools are required. These can be used to provide feedback during training courses, or to compare learning effects between different types of training courses. The aim of the current study is to (1) identify the available assessment tools to evaluate obstetric teamwork performance in a simulated environment, and (2) evaluate their psychometric properties in order to identify the most valuable tool(s) to use. We performed a systematic search in PubMed, MEDLINE, and EMBASE to identify articles describing assessment tools for the evaluation of obstetric teamwork performance in a simulated environment. In order to evaluate the quality of the identified assessment tools the standards and grading rules have been applied as recommended by the Accreditation Council for Graduate Medical Education (ACGME) Committee on Educational Outcomes. The included studies were also assessed according to the Oxford Centre for Evidence Based Medicine (OCEBM) levels of evidence. This search resulted in the inclusion of five articles describing the following six tools: Clinical Teamwork Scale, Human Factors Rating Scale, Global Rating Scale, Assessment of Obstetric Team Performance, Global Assessment of Obstetric Team Performance, and the Teamwork Measurement Tool. Based on the ACGME guidelines we assigned a Class 3, level C of evidence, to all tools. Regarding the OCEBM levels of evidence, a level 3b was assigned to two studies and a level 4 to four studies. The Clinical Teamwork Scale demonstrated the most comprehensive validation, and the Teamwork Measurement Tool demonstrated promising results, however it is recommended to further investigate its reliability. Copyright © 2017

  15. Protocol management of severe traumatic brain injury in intensive care units: a systematic review.

    Science.gov (United States)

    English, Shane W; Turgeon, Alexis F; Owen, Elliott; Doucette, Steve; Pagliarello, Giuseppe; McIntyre, Lauralyn

    2013-02-01

    To examine clinical trials and observational studies that compared use of management protocols (MPs) versus usual care for adult intensive care unit (ICU) patients with acute severe traumatic brain injury (TBI) on 6-month neurologic outcome (Glasgow Outcome Scale, GOS) and mortality, major electronic databases were searched from 1950 to April 18, 2011. Abstracts from major international meetings were searched to identify gray literature. A total of 6,151 articles were identified; 488 were reviewed in full and 13 studies were included. Data on patient and MP characteristics, outcomes and methodological quality were extracted. All 13 included studies were observational. A random effects model showed that use of MPs was associated with a favorable neurologic outcome (GOS 4 or 5) at 6 months (odds ratio [OR] and 95 % confidence interval [CI] 3.84 (2.47-5.96)) but not 12 months (OR, 95 % CI 0.87 (0.56-1.36)). Use of MPs was associated with reduced mortality at hospital discharge and 6 months (OR and 95 % CI 0.72 (0.45-1.14) and 0.33 (0.13-0.82) respectively), but not 12 months (OR, 95 % CI 0.79 (0.5-1.24)). Sources of heterogeneity included variation in study design, methodological quality, MP design, MP neurophysiologic endpoints, and type of ICU. MPs for severe TBI were associated with reductions in death and improved neurologic outcome. Although no definitive conclusions about the efficacy of MPs for severe TBI can be drawn from our study, these results should encourage the conduct of randomized controlled trials to more rigorously examine the efficacy of MPs for severe TBI.

  16. Tires as habitats for mosquitoes: a review of studies within the eastern United States.

    Science.gov (United States)

    Yee, Donald A

    2008-07-01

    Discarded vehicle tires are a common habitat for a variety of container mosquito species. I reviewed the literature from the last 50 yr on mosquitoes collected within tires in the eastern United States with four objectives: to examine the historical and contemporary issues of tires as a habitat for mosquitoes, to identify tire-inhabiting species, to summarize findings from studies that focused on biotic and abiotic characteristics of tires, and to offer future directions to aid our understanding of tire-inhabiting mosquitoes. Thirty-two species have been documented, including seven invasives, with the most frequently encountered being Aedes triseriatus, Ae. albopictus, Ae. atropalpus, Culex restuans, Cx. pipiens, Cx. territans, Anopheles punctipennis, and Toxorhynchites rutilus. The proclivity of these species to occupy small containers is one possible explanation for their occurrence in tires. The native species Ae. triseriatus was abundant and the most often collected, particularly in central and northern regions, whereas the invasive Ae. albopictus was most abundant in the south. One half of the studies investigating aspects of the tire environment compared mosquito populations between sunlit and shaded tires, with the general finding that this factor alone led to dramatic differences in larval species composition and abundance patterns. Less frequently investigated factors, e.g., tire orientation, detritus, and proximity to humans, also were found to affect patterns of occupancy by mosquitoes. For the future, I suggest more surveys are needed in understudied areas, as well as quantitative experiments to determine habitat associations and community dynamics in tires, which are especially necessary to assist in understanding invasions. Discarded tires are important for studies of vector dynamics, because of their abundance near human populations and because they expand the habitat range of mosquitoes that vector pathogens.

  17. Entrepreneurial nurses and midwives in the United Kingdom: an integrative review.

    Science.gov (United States)

    Drennan, Vari; Davis, Kathy; Goodman, Claire; Humphrey, Charlotte; Locke, Rachel; Mark, Annabelle; Murray, Susan F; Traynor, Michael

    2007-12-01

    This paper is a report of an integrative literature review to investigate: (a) the extent of entrepreneurial activity by nurses, midwives and health visitors in the United Kingdom and (b) the factors that influenced these activities. Internationally, social and commercial entrepreneurial activity is regarded as important for economic growth and social cohesion. Seventeen bibliographic databases were searched using single and combined search terms: 'entrepreneur$', 'business', 'private practice', 'self-employ$', 'intrapreneur$''social enterprise$''mutuals', 'collectives', 'co-op' and 'social capital' which were related to a second layer of terms 'Nurs$', 'Midwi$', 'Visit$'. 'Entrepreneur$' Private Midwi$, Independent Midwi$, and 'nursing workforce'. In addition, hand searches of non-indexed journals and grey literature searches were completed. The following inclusion criteria were: (a) describing nurses, midwife and/or health visitor entrepreneurship (b) undertaken in the UK, and (c) reported between January 1996 and December 2005. Of 154 items included only three were empirical studies; the remainder were narrative accounts. While quality of these accounts cannot be verified, they provide as complete an account as possible in this under-researched area. The numbers of nurses, midwives and health visitors acting entrepreneurially were very small and mirror international evidence. A categorization of entrepreneurial activity was inductively constructed by employment status and product offered. 'Push' and 'pull' influencing factors varied between types of entrepreneurial activity. Empirical investigation into the extent to which nurses and midwives respond to calls for greater entrepreneurialism should take account of the complex interplay of contextual factors (e.g. healthcare legislation), professional and managerial experience and demographic factors.

  18. Uncovering the decision-making work of transferring dying patients home from critical care units: An integrative review.

    Science.gov (United States)

    Lin, Yanxia; Myall, Michelle; Jarrett, Nikki

    2017-06-21

    To understand how decisions are made to transfer dying patients home from critical care units. Many people prefer a home death, but a high proportion die in critical care units. Transferring dying patients home is recognized to be complex but transfer decision-making itself remains unclear. Integrative review. Seven bibliographic databases (origin-2015), grey literature and reference lists were searched. An integrative review method was used to synthesize data from diverse sources. Papers were selected through title and abstract screening and full-text reviewing, using inclusion and exclusion criteria derived from review questions. Following quality appraisal, data were extracted and synthesized using normalization process theory as a framework. The number of patients transferred home ranged from 1-346, with most papers reporting on the transfer of one or two patients. Four themes regarding transfer decision-making work were generated: divergent views and practice, multiple stakeholders' involvement in decision-making, collective work and limited understanding of individuals' experiences. The practice of transferring patients home to die and its decision-making varies internationally and is usually influenced by the care system, culture or religion. It is less common to transfer patients home to die from critical care units in western societies. A better understanding of the decision-making work was obtained but mainly from the perspective of hospital-based healthcare professionals. Further research is needed to develop decision-making practice guidance to facilitate patients' wishes to die at home. © 2017 John Wiley & Sons Ltd.

  19. Global review of open access risk assessment software packages valid for global or continental scale analysis

    Science.gov (United States)

    Daniell, James; Simpson, Alanna; Gunasekara, Rashmin; Baca, Abigail; Schaefer, Andreas; Ishizawa, Oscar; Murnane, Rick; Tijssen, Annegien; Deparday, Vivien; Forni, Marc; Himmelfarb, Anne; Leder, Jan

    2015-04-01

    Over the past few decades, a plethora of open access software packages for the calculation of earthquake, volcanic, tsunami, storm surge, wind and flood have been produced globally. As part of the World Bank GFDRR Review released at the Understanding Risk 2014 Conference, over 80 such open access risk assessment software packages were examined. Commercial software was not considered in the evaluation. A preliminary analysis was used to determine whether the 80 models were currently supported and if they were open access. This process was used to select a subset of 31 models that include 8 earthquake models, 4 cyclone models, 11 flood models, and 8 storm surge/tsunami models for more detailed analysis. By using multi-criteria analysis (MCDA) and simple descriptions of the software uses, the review allows users to select a few relevant software packages for their own testing and development. The detailed analysis evaluated the models on the basis of over 100 criteria and provides a synopsis of available open access natural hazard risk modelling tools. In addition, volcano software packages have since been added making the compendium of risk software tools in excess of 100. There has been a huge increase in the quality and availability of open access/source software over the past few years. For example, private entities such as Deltares now have an open source policy regarding some flood models (NGHS). In addition, leaders in developing risk models in the public sector, such as Geoscience Australia (EQRM, TCRM, TsuDAT, AnuGA) or CAPRA (ERN-Flood, Hurricane, CRISIS2007 etc.), are launching and/or helping many other initiatives. As we achieve greater interoperability between modelling tools, we will also achieve a future wherein different open source and open access modelling tools will be increasingly connected and adapted towards unified multi-risk model platforms and highly customised solutions. It was seen that many software tools could be improved by enabling user

  20. Experimental results of fingerprint comparison validity and reliability: A review and critical analysis.

    Science.gov (United States)

    Haber, Ralph Norman; Haber, Lyn

    2014-09-01

    Our purpose in this article is to determine whether the results of the published experiments on the accuracy and reliability of fingerprint comparison can be generalized to fingerprint laboratory casework, and/or to document the error rate of the Analysis-Comparison-Evaluation (ACE) method. We review the existing 13 published experiments on fingerprint comparison accuracy and reliability. These studies comprise the entire corpus of experimental research published on the accuracy of fingerprint comparisons since criminal courts first admitted forensic fingerprint evidence about 120years ago. We start with the two studies by Ulery, Hicklin, Buscaglia and Roberts (2011, 2012), because they are recent, large, designed specifically to provide estimates of the accuracy and reliability of fingerprint comparisons, and to respond to the criticisms cited in the National Academy of Sciences Report (2009). Following the two Ulery et al. studies, we review and evaluate the other eleven experiments, considering problems that are unique to each. We then evaluate the 13 experiments for the problems common to all or most of them, especially with respect to the generalizability of their results to laboratory casework. Overall, we conclude that the experimental designs employed deviated from casework procedures in critical ways that preclude generalization of the results to casework. The experiments asked examiner-subjects to carry out their comparisons using different responses from those employed in casework; the experiments presented the comparisons in formats that differed from casework; the experiments enlisted highly trained examiners as experimental subjects rather than subjects drawn randomly from among all fingerprint examiners; the experiments did not use fingerprint test items known to be comparable in type and especially in difficulty to those encountered in casework; and the experiments did not require examiners to use the ACE method, nor was that method defined

  1. Interventions for the prevention of catheter associated urinary tract infections in intensive care units: An integrative review.

    Science.gov (United States)

    Galiczewski, Janet M

    2016-02-01

    Catheter associated urinary tract infections (CAUTIs) put an unnecessary burden on patients and health care systems. The purpose of this integrative review was to examine existing evidence on preventative interventions and protocols currently implemented in intensive care units (ICUs) and the impact they have on CAUTI rates and patient outcomes. This review analysed 14 research articles obtained from electronic databases and included adult patients with urinary catheters in an ICU setting. Evidence demonstrated interventions that included criteria for catheter use, daily review of catheter necessity and discontinuation of catheter prior to day seven were successful in decreasing CAUTI rates. This review provides a scientific basis for the effectiveness of these interventions and protocols. Identification and use of interventions with the greatest positive impact on CAUTI rates are an asset to healthcare professional caring for patients with indwelling catheters and nurse clinicians developing policies.

  2. Physical activity promotion in Latin American populations: a systematic review on issues of internal and external validity.

    Science.gov (United States)

    Galaviz, Karla I; Harden, Samantha M; Smith, Erin; Blackman, Kacie Ca; Berrey, Leanna M; Mama, Scherezade K; Almeida, Fabio A; Lee, Rebecca E; Estabrooks, Paul A

    2014-06-17

    The purpose of this review was to determine the degree to which physical activity interventions for Latin American populations reported on internal and external validity factors using the RE-AIM framework (reach & representativeness, effectiveness, adoption, implementation, maintenance). We systematically identified English (PubMed; EbscoHost) and Spanish (SCIELO; Biblioteca Virtual en Salud) language studies published between 2001 and 2012 that tested physical activity, exercise, or fitness promotion interventions in Latin American populations. Cross-sectional/descriptive studies, conducted in Brazil or Spain, published in Portuguese, not including a physical activity/fitness/exercise outcome, and with one time point assessment were excluded. We reviewed 192 abstracts and identified 46 studies that met the eligibility criteria (34 in English, 12 in Spanish). A validated 21-item RE-AIM abstraction tool was used to determine the quality of reporting across studies (0-7 = low, 8-14 = moderate, and 15-21 = high). The number of indicators reported ranged from 3-14 (mean = 8.1 ± 2.6), with the majority of studies falling in the moderate quality reporting category. English and Spanish language articles did not differ on the number of indicators reported (8.1 vs. 8.3, respectively). However, Spanish articles reported more across reach indicators (62% vs. 43% of indicators), while English articles reported more across effectiveness indicators (69% vs 62%). Across RE-AIM dimensions, indicators for reach (48%), efficacy/effectiveness (67%), and implementation (41%) were reported more often than indicators of adoption (25%) and maintenance (10%). Few studies reported on the representativeness of participants, staff that delivered interventions, or the settings where interventions were adopted. Only 13% of the studies reported on quality of life and/or potential negative outcomes, 20% reported on intervention fidelity, and 11% on cost of implementation

  3. Sharing privacy-sensitive access to neuroimaging and genetics data: a review and preliminary validation

    Science.gov (United States)

    Sarwate, Anand D.; Plis, Sergey M.; Turner, Jessica A.; Arbabshirani, Mohammad R.; Calhoun, Vince D.

    2014-01-01

    The growth of data sharing initiatives for neuroimaging and genomics represents an exciting opportunity to confront the “small N” problem that plagues contemporary neuroimaging studies while further understanding the role genetic markers play in the function of the brain. When it is possible, open data sharing provides the most benefits. However, some data cannot be shared at all due to privacy concerns and/or risk of re-identification. Sharing other data sets is hampered by the proliferation of complex data use agreements (DUAs) which preclude truly automated data mining. These DUAs arise because of concerns about the privacy and confidentiality for subjects; though many do permit direct access to data, they often require a cumbersome approval process that can take months. An alternative approach is to only share data derivatives such as statistical summaries—the challenges here are to reformulate computational methods to quantify the privacy risks associated with sharing the results of those computations. For example, a derived map of gray matter is often as identifiable as a fingerprint. Thus alternative approaches to accessing data are needed. This paper reviews the relevant literature on differential privacy, a framework for measuring and tracking privacy loss in these settings, and demonstrates the feasibility of using this framework to calculate statistics on data distributed at many sites while still providing privacy. PMID:24778614

  4. Validity of claims made in weight management research: a narrative review of dietetic articles

    Directory of Open Access Journals (Sweden)

    Aphramor Lucy

    2010-07-01

    Full Text Available Abstract Background The best available evidence demonstrates that conventional weight management has a high long-term failure rate. The ethical implications of continued reliance on an energy deficit approach to weight management are under-explored. Methods A narrative literature review of journal articles in The Journal of Human Nutrition and Dietetics from 2004 to 2008. Results Although the energy deficit approach to weight management has a high long-term failure rate it continues to dominate research in the field. In the current research agenda, controversies and complexities in the evidence base are inadequately discussed, and claims about the likely success of weight management misrepresent available evidence. Conclusions Dietetic literature on weight management fails to meet the standards of evidence based medicine. Research in the field is characterised by speculative claims that fail to accurately represent the available data. There is a corresponding lack of debate on the ethical implications of continuing to promote ineffective treatment regimes and little research into alternative non-weight centred approaches. An alternative health at every size approach is recommended.

  5. Accuracy validation of incident photon fluence on DQE for various measurement conditions and X-ray units.

    Science.gov (United States)

    Haba, Tomonobu; Kondo, Shimpei; Hayashi, Daiki; Koyama, Shuji

    2013-07-01

    Detective quantum efficiency (DQE) is widely used as a comprehensive metric for X-ray image evaluation in digital X-ray units. The incident photon fluence per air kerma (SNR²(in)) is necessary for calculating the DQE. The International Electrotechnical Commission (IEC) reports the SNR²(in) under conditions of standard radiation quality, but this SNR²(in) might not be accurate as calculated from the X-ray spectra emitted by an actual X-ray tube. In this study, we evaluated the error range of the SNR²(in) presented by the IEC62220-1 report. We measured the X-ray spectra emitted by an X-ray tube under conditions of standard radiation quality of RQA5. The spectral photon fluence at each energy bin was multiplied by the photon energy and the mass energy absorption coefficient of air; then the air kerma spectrum was derived. The air kerma spectrum was integrated over the whole photon energy range to yield the total air kerma. The total photon number was then divided by the total air kerma. This value is the SNR²(in). These calculations were performed for various measurement parameters and X-ray units. The percent difference between the calculated value and the standard value of RQA5 was up to 2.9%. The error range was not negligibly small. Therefore, it is better to use the new SNR²(in) of 30694 (1/(mm(2) μGy)) than the current [Formula: see text] of 30174 (1/(mm(2) μGy)).

  6. The Diagnostic Validity of Clinical Tests in Temporomandibular Internal Derangement: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Chaput, Eve; Gross, Anita; Stewart, Ryan; Nadeau, Gordon; Goldsmith, Charlie H

    2012-01-01

    To assess the diagnostic validity of clinical tests for temporomandibular internal derangement relative to magnetic resonance imaging (MRI). MEDLINE and Embase were searched from 1994 through 2009. Independent reviewers conducted study selection; risk of bias was assessed using Quality Assessment of studies of Diagnostic Accuracy included in Systematic reviews (QUADAS); ≥9/14) and data abstraction. Overall quality of evidence was profiled using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Agreement was measured using quadratic weighted kappa (κw). Positive (+) or negative (-) likelihood ratios (LR) with 95% CIs were calculated and pooled using the DerSimonian-Laird method and a random-effects model when homogeneous (I(2)≥0.40, Q-test p≤0.10). We selected 8 of 36 studies identified. There is very low quality evidence that deflection (+LR: 6.37 [95% CI, 2.13-19.03]) and crepitation (LR:5.88 [95% CI, 1.95-17.76]) as single tests and crepitation, deflection, pain, and limited mouth opening as a cluster of tests are the most valuable for ruling in internal derangement without reduction (+LR:6.37 [95% CI, 2.13-19.03]), (-LR:0.27 [95% CI, 0.11-0.64]) while the test cluster click, deviation, and pain rules out internal derangement with reduction (-LR: 0.09 [95% CI, 0.01-0.72]). No single test or cluster of tests was conclusive and of significant value for ruling in internal derangement with reduction. Findings of this review will assist clinicians in deciding which diagnostic tests to use when internal derangement is suspected. The literature search revealed a lack of high-quality studies; further research with adequate description of patient populations, blinded assessments, and both sagittal and coronal MRI planes is therefore recommended. Purpose: To assess the diagnostic validity of clinical tests for temporomandibular internal derangement relative to magnetic resonance imaging (MRI). Methods: MEDLINE and Embase were searched from

  7. A systematic review of relocation stress following in-house transfer out of critical/intensive care units.

    Science.gov (United States)

    Salmond, Susan Warner; Evans, Benjamin; Hamdi, Hanaa A; Saimbert, Marie K

    2011-01-01

    Objective The objective was to conduct a mixed methods systematic review to determine the occurrence and meaningfulness of relocation stress and the effectiveness of strategies for decreasing transfer anxiety in patients and their families upon transfer from an intensive care unit to a non-intensive care unit and to offer evidence-based recommendations for best practice.Inclusion criteria The review included quantitative and qualitative studies where the participants were adult intensive care patients, family members of adult intensive care patients, intensive care nurses caring for the adult critically ill patient, and ward/unit nurses receiving transfer patients from the ICU (intensive care unit). Studies examining the transfer experience for infants, children or psychiatric patients were excluded from this review.Search strategy The search strategy sought to find both published and unpublished studies and papers limited to the English language. An initial limited search of MEDLINE and CINAHL was undertaken followed by an analysis of text words contained in the title and abstract, and of index terms to describe the article. A second extensive search was then undertaken using identified key words and index terms.Methodological quality Each paper was assessed by two independent reviewers for quality prior to inclusion in the review using the Joanna Briggs Critical Appraisal Tools for experimental, cohort, descriptive, qualitative and expert text papers. Disagreements were discussed and resolved among the reviewers without needing to rely on a third reviewer.Data collection Information was extracted from each paper independently by two reviewers using the JBI extraction tools for quantitiative, qualitaitive and expert opinion papers and narrative table summaries were prepared.Data synthesis Data synthesis aimed to portray an accurate interpretation and synthesis of concepts arising from the experiences of patients and families transferring out of ICU and the nurses

  8. Deposition times in the northeastern United States during the Holocene: establishing valid priors for Bayesian age models

    Science.gov (United States)

    Goring, S.; Williams, J. W.; Blois, J. L.; Jackson, S. T.; Paciorek, C. J.; Booth, R. K.; Marlon, J. R.; Blaauw, M.; Christen, J. A.

    2012-08-01

    Age-depth relationships in sedimentary archives such as lakes, wetlands and bogs are non-linear with irregular probability distributions associated with calibrated radiocarbon dates. Bayesian approaches are thus well-suited to understanding relationships between age and depth for use in paleoecological studies. Bayesian models for the accumulation of sediment and organic matter within basins combine dated material from one or more records with prior information about the behavior of deposition times (yr/cm) based on expert knowledge. Well-informed priors are essential to good modeling of the age-depth relationship, but are particularly important in cases where data may be sparse (e.g., few radiocarbon dates), or unclear (e.g., age-reversals, coincident dates, age offsets, outliers and dates within a radiocarbon plateau). Here we assessed Holocene deposition times using 204 age-depth models obtained from the Neotoma Paleoecology Database (www.neotomadb.org) for both lacustrine and palustrine environments across the northeastern United States. These age-depth models were augmented using biostratigraphic events identifiable within pollen records from the northeastern United States during the Holocene and late-Pleistocene. Deposition times are significantly related to depositional environment (palustrine and lacustrine), sediment age, and sediment depth. Spatial variables had non-significant relationships with deposition time when site effects were considered. The best-fit model was a generalized additive mixed model that relates deposition time to age, stratified by depositional environment with site as a random factor. The best-fit model accounts for 63.3% of the total deviance in deposition times. The strongly increasing accumulation rates of the last 500-1000 years indicate that gamma distributions describing lacustrine deposition times (α = 1.08, β = 18.28) and palustrine deposition times (α = 1.23, β = 22.32) for the entire Holocene may be insufficient for

  9. HIV and Mexican migrant workers in the United States: a review applying the vulnerable populations conceptual model.

    Science.gov (United States)

    Albarrán, Cynthia R; Nyamathi, Adeline

    2011-01-01

    Mexican migrant workers residing in the United States are a vulnerable population at high risk for HIV infection. This article critically appraises the published data surrounding HIV prevalence in this vulnerable group, as seen through the lens of the Vulnerable Populations Conceptual Model. This model demonstrates how exposure to risk and resource availability affect health status. The health status of Mexican migrants in the United States is compromised by a number of factors that increase risk of HIV: limited access to health services, multiple sexual partners, low rates of condom use, men having sex with men, and lay injection practices. Migration from Mexico to the United States has increased the prevalence of HIV in rural Mexico, making this an issue of urgent binational concern. This review highlights the implications for further nursing research, practice, and policy.

  10. Severe imported malaria in an intensive care unit: a review of 59 cases

    Directory of Open Access Journals (Sweden)

    Santos Lurdes C

    2012-03-01

    Full Text Available Abstract Background In view of the close relationship of Portugal with African countries, particularly former Portuguese colonies, the diagnosis of malaria is not a rare thing. When a traveller returns ill from endemic areas, malaria should be the number one suspect. World Health Organization treatment guidelines recommend that adults with severe malaria should be admitted to an intensive care unit (ICU. Methods Severe cases of malaria in patients admitted to an ICU were reviewed retrospectively (1990-2011 and identification of variables associated with in-ICU mortality performed. Malaria prediction score (MPS, malaria score for adults (MSA, simplified acute physiology score (SAPSII and a score based on WHO's malaria severe criteria were applied. Statistical analysis was performed using StataV12. Results Fifty nine patients were included in the study, all but three were adults; 47 (79,6% were male; parasitaemia on admission, quantified in 48/59 (81.3% patients, was equal or greater than 2% in 47 of them (97.9%; the most common complications were thrombocytopaenia in 54 (91.5% patients, associated with disseminated intravascular coagulation (DIC in seven (11.8%, renal failure in 31 (52.5% patients, 18 of which (30.5% oliguric, shock in 29 (49.1% patients, liver dysfunction in 27 (45.7% patients, acidaemia in 23 (38.9% patients, cerebral dysfunction in 22 (37.2% patients, 11 of whom with unrousable coma, pulmonary oedema/ARDS in 22 (37.2% patients, hypoglycaemia in 18 (30.5% patients; 29 (49.1% patients presented five or more dysfunctions. The case fatality rate was 15.2%. Comparing the four scores, the SAPS II and the WHO score were the most sensitive to death prediction. In the univariate analysis, death was associated with the SAPS II score, cerebral malaria, acute renal and respiratory failure, DIC, spontaneous bleeding, acidosis and hypoglycaemia. Age, partial immunity to malaria, delay in malaria diagnosis and the level of parasitaemia were

  11. Cooperative Fish and Wildlife Research Units Program—2016 year in review

    Science.gov (United States)

    Organ, John F.; Thompson, John D.; Dennerline, Donald E.; Childs, Dawn E.

    2017-02-22

    SummaryThe Cooperative Fish and Wildlife Research Units (CRU) Program had a productive year in 2016. Despite vacancies in our scientist ranks exceeding 20 percent, our research, training, and teaching portfolio was full and we graduated 93 students and published 398 manuscripts primarily focused on addressing the real conservation challenges of our cooperators. As I’ve stated before, our mission is our legacy: meeting the actionable science needs of our cooperators, providing them technical guidance and assistance in interpreting and applying new advances in science, and developing the future workforce through graduate education and mentoring. Our scientists and the manner in which they approach our mission continue to inspire me. The most rewarding part of my job is meeting and engaging with the students they recruit—the conservation professionals of the future. I cannot help but feel uplifted after discussions with and presentations by these young men and women. Personally, I owe my place in the profession today to the mentoring I received as a CRU student, and today’s CRU scientists have raised the bar. It gives me hope for the future of conservation, and added motivation to see our vacancies filled so that we can expand our portfolio.The National Cooperators’ Coalition has been active and is strategically working to build support on our behalf. Sincere thanks to the American Fisheries Society, the Association of Fish and Wildlife Agencies, the Boone and Crockett Club, the National Association of University Fish and Wildlife Programs, the Wildlife Management Institute, and The Wildlife Society for their efforts and those of their affiliated members.We co-sponsored a workshop at the 2016 North American Wildlife and Natural Resources Conference along with the American Fisheries Society, the Association of Fish and Wildlife Agencies, the Wildlife Management Institute, and The Wildlife Society, titled “Barriers and Bridges in Reconnecting Natural Resources

  12. Validate Tomography with Broadband Waveform Modeling: An Example at La Ristra Transect in the Southwestern United States

    Science.gov (United States)

    Song, T. A.; Helmberger, D. V.

    2005-12-01

    Travel time tomography has been the main tool for seismologists in developing mantle structure and studying regional tectonics. Standard practice for geodynamists is to convert the velocity anomalies into temperature and density and fit geophysical observables such as topography and gravity. However, tomographic models produced by smooth, damped inversions usually underestimate the amplitude and sharpness of the velocity structure. To validate these tomographic models, it is important to propagate seismic waves through them and compare synthetic waveforms with obvervations directly, which enable us to enhance and sharpen these models. Here we illustrate an example using the Rio Grande Rift PASSCAL observations in the southwestern US. The La Ristra passive experiment was designed to cross the Rio Grande Rift system and study the tranition in mantle structure from Great Plain to Colorado Plateau (e.g. Gao et al. 2004; West et al. 2004, Wilson et al. 2005). Ray-based body wave travel time tomography (Gao et al. 2004) indicated a linear, south-east dipping slab-like fast velocity anomaly under the western edge of the Great Plain. They interpreted it as a downwelling lithosphere produced by a small scale convection. We take advantages of the dense linear array and examine data from two deep events in south America. After deconvolving the source wavelet from the raw data, deconvolved waveforms of both events consistently show that P and S waveforms are severely distorted at stations across the slab boundary by a factor of 2-3. The waveform amplitude also diminishs in proportional to the wavefrom broadening. The waveform shape becomes simple again for stations near the center of the rift. We implement the tomography model into the 2-D finite difference scheme (Vidale, 1985; Helmberger and Vidale, 1988). Preliminary result shows that amplifying the tomography model by a factor of 3 starts to produce the waveform distortions observed.

  13. Partnered medication review and charting between the pharmacist and medical officer in the Emergency Short Stay and General Medicine Unit.

    Science.gov (United States)

    Tong, Erica Y; Roman, Cristina P; Smit, De Villiers; Newnham, Harvey; Galbraith, Kirsten; Dooley, Michael J

    2015-08-01

    A partnered medication review and charting model involving a pharmacist and medical officer was implemented in the Emergency Short Stay Unit and General Medicine Unit of a major tertiary hospital. The aim of the study was to describe the safety and effectiveness of partnered medication charting in this setting. A partnered medication review and charting model was developed. Credentialed pharmacists charted pre-admission medications and venous thromboembolism prophylaxis in collaboration with the admitting medical officer. The pharmacist subsequently had a clinical discussion with the treating nurse regarding the medication management plan for the patient. A prospective audit was undertaken of all patients from the initiation of the service. A total of 549 patients had medications charted by a pharmacist from the 14th of November 2012 to the 30th of April 2013. A total of 4765 medications were charted by pharmacists with 7 identified errors, corresponding to an error rate of 1.47 per 1000 medications charted. Partnered medication review and charting by a pharmacist in the Emergency Short Stay and General Medicine unit is achievable, safe and effective. Benefits from the model extend beyond the pharmacist charting the medications, with clinical value added to the admission process through early collaboration with the medical officer. Further research is required to provide evidence to further support this collaborative model. Copyright © 2015. Published by Elsevier Ltd.

  14. A Poisson Cluster Stochastic Rainfall Generator That Accounts for the Interannual Variability of Rainfall Statistics: Validation at Various Geographic Locations across the United States

    Directory of Open Access Journals (Sweden)

    Dongkyun Kim

    2014-01-01

    Full Text Available A novel approach for a Poisson cluster stochastic rainfall generator was validated in its ability to reproduce important rainfall and watershed response characteristics at 104 locations in the United States. The suggested novel approach, The Hybrid Model (THM, as compared to the traditional Poisson cluster rainfall modeling approaches, has an additional capability to account for the interannual variability of rainfall statistics. THM and a traditional approach of Poisson cluster rainfall model (modified Bartlett-Lewis rectangular pulse model were compared in their ability to reproduce the characteristics of extreme rainfall and watershed response variables such as runoff and peak flow. The results of the comparison indicate that THM generally outperforms the traditional approach in reproducing the distributions of peak rainfall, peak flow, and runoff volume. In addition, THM significantly outperformed the traditional approach in reproducing extreme rainfall by 2.3% to 66% and extreme flow values by 32% to 71%.

  15. Validity aspects of erythrocyte sedimentation rate and C-reactive protein in ankylosing spondylitis: a literature review.

    Science.gov (United States)

    Ruof, J; Stucki, G

    1999-04-01

    The preliminary core set for endpoints in disease controlling antirheumatic therapy includes acute phase reactants. The objective of this clinically oriented literature review was to examine and compare the validity of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in ankylosing spondylitis (AS) clinical trials. A MEDLINE search was performed covering the years 1967 through April 1998. AS studies were identified and selected if they included ESR and/or CRP and either presented data about their relation with disease activity or were designed as longitudinal clinical trials. Additional studies were identified by scrutinizing references cited in the retrieved studies. The selected studies were examined for truth (association with disease activity), discriminative power (sensitivity to change and discrimination between active and inactive treatment in longitudinal clinical trials), and feasibility (e.g., applicability and costs) of ESR and CRP in AS. We identified 12 articles on the association of ESR and/or CRP with disease activity and 13 longitudinal clinical trials reporting ESR and/or CRP data. Although the applied definitions or disease activity proved very inhomogenous, there was some evidence that both acute phase reactants are correlated with disease activity. In terms of discriminative capacity the available data are inconclusive. Relevant feasibility aspects are general availability, technically simple measurement, and an advantage in the cost of ESR and central laboratory facilities for CRP. Acute phase reactants do not comprehensively represent the disease process in AS. Their worth in AS clinical trials is limited. Based on the currently existing data neither measure is clearly superior in terms of validity. When selecting an acute phase reactant, feasibility aspects may be most relevant in choice of measure.

  16. Systematic review of validated case definitions for diabetes in ICD-9-coded and ICD-10-coded data in adult populations.

    Science.gov (United States)

    Khokhar, Bushra; Jette, Nathalie; Metcalfe, Amy; Cunningham, Ceara Tess; Quan, Hude; Kaplan, Gilaad G; Butalia, Sonia; Rabi, Doreen

    2016-08-05

    With steady increases in 'big data' and data analytics over the past two decades, administrative health databases have become more accessible and are now used regularly for diabetes surveillance. The objective of this study is to systematically review validated International Classification of Diseases (ICD)-based case definitions for diabetes in the adult population. Electronic databases, MEDLINE and Embase, were searched for validation studies where an administrative case definition (using ICD codes) for diabetes in adults was validated against a reference and statistical measures of the performance reported. The search yielded 2895 abstracts, and of the 193 potentially relevant studies, 16 met criteria. Diabetes definition for adults varied by data source, including physician claims (sensitivity ranged from 26.9% to 97%, specificity ranged from 94.3% to 99.4%, positive predictive value (PPV) ranged from 71.4% to 96.2%, negative predictive value (NPV) ranged from 95% to 99.6% and κ ranged from 0.8 to 0.9), hospital discharge data (sensitivity ranged from 59.1% to 92.6%, specificity ranged from 95.5% to 99%, PPV ranged from 62.5% to 96%, NPV ranged from 90.8% to 99% and κ ranged from 0.6 to 0.9) and a combination of both (sensitivity ranged from 57% to 95.6%, specificity ranged from 88% to 98.5%, PPV ranged from 54% to 80%, NPV ranged from 98% to 99.6% and κ ranged from 0.7 to 0.8). Overall, administrative health databases are useful for undertaking diabetes surveillance, but an awareness of the variation in performance being affected by case definition is essential. The performance characteristics of these case definitions depend on the variations in the definition of primary diagnosis in ICD-coded discharge data and/or the methodology adopted by the healthcare facility to extract information from patient records. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Systematic review of validated case definitions for diabetes in ICD-9-coded and ICD-10-coded data in adult populations

    Science.gov (United States)

    Khokhar, Bushra; Jette, Nathalie; Metcalfe, Amy; Cunningham, Ceara Tess; Kaplan, Gilaad G; Butalia, Sonia; Rabi, Doreen

    2016-01-01

    Objectives With steady increases in ‘big data’ and data analytics over the past two decades, administrative health databases have become more accessible and are now used regularly for diabetes surveillance. The objective of this study is to systematically review validated International Classification of Diseases (ICD)-based case definitions for diabetes in the adult population. Setting, participants and outcome measures Electronic databases, MEDLINE and Embase, were searched for validation studies where an administrative case definition (using ICD codes) for diabetes in adults was validated against a reference and statistical measures of the performance reported. Results The search yielded 2895 abstracts, and of the 193 potentially relevant studies, 16 met criteria. Diabetes definition for adults varied by data source, including physician claims (sensitivity ranged from 26.9% to 97%, specificity ranged from 94.3% to 99.4%, positive predictive value (PPV) ranged from 71.4% to 96.2%, negative predictive value (NPV) ranged from 95% to 99.6% and κ ranged from 0.8 to 0.9), hospital discharge data (sensitivity ranged from 59.1% to 92.6%, specificity ranged from 95.5% to 99%, PPV ranged from 62.5% to 96%, NPV ranged from 90.8% to 99% and κ ranged from 0.6 to 0.9) and a combination of both (sensitivity ranged from 57% to 95.6%, specificity ranged from 88% to 98.5%, PPV ranged from 54% to 80%, NPV ranged from 98% to 99.6% and κ ranged from 0.7 to 0.8). Conclusions Overall, administrative health databases are useful for undertaking diabetes surveillance, but an awareness of the variation in performance being affected by case definition is essential. The performance characteristics of these case definitions depend on the variations in the definition of primary diagnosis in ICD-coded discharge data and/or the methodology adopted by the healthcare facility to extract information from patient records. PMID:27496226

  18. Convergent validity of the ACC/AHA pooled cohort equations in associating with health-related quality of life among adults in the United States.

    Science.gov (United States)

    Nooe, Allison; Edwards, Meghan K; Addoh, Ovuokerie; Loprinzi, Paul D

    2017-01-01

    Background: The potential convergent validity of the pooled cohort risk (PCR) equations in predicting health-related quality of life (HRQOL) has yet to be evaluated, which was this study's purpose. Methods: Data from the 2001-2011 National Health and Nutrition Examination Survey (NHANES) were used (N = 8978 adults, 40-79 years, free of cardiovascular disease at baseline). Calculation of an individual's 10-year risk of a first atherosclerotic cardiovascular disease (ASCVD) event was determined via the PCR equation. The Centers for Disease Control and Prevention (CDC) HRQOL measure was assessed utilizing 4 questions regarding participants' perceived mental and physical health status from the past 30 days. Results: When adjusting for moderate-to-vigorous physical activity (MVPA), obesity, age, gender and race-ethnicity, an ASCVD score of >20% (vs. <20%) was associated with a 0.53-unit (95% CI: 0.34-0.71) higher HRQOL score. A higher HRQOL score indicates a poorer patient perception of their mental and physical health. Conclusion: The observed association between PCR-determined ASCVD-risk scores and HRQOL provides evidence for the convergent validity of the PCR algorithms, indicating that individuals with a higher risk for a first time ASCVD-event may also have an overall worse HRQOL. As such, employing ASCVD risk reduction efforts may be an important strategy in improving an individual's HRQOL.

  19. A physical function test for use in the intensive care unit: validity, responsiveness, and predictive utility of the physical function ICU test (scored).

    Science.gov (United States)

    Denehy, Linda; de Morton, Natalie A; Skinner, Elizabeth H; Edbrooke, Lara; Haines, Kimberley; Warrillow, Stephen; Berney, Sue

    2013-12-01

    Several tests have recently been developed to measure changes in patient strength and functional outcomes in the intensive care unit (ICU). The original Physical Function ICU Test (PFIT) demonstrates reliability and sensitivity. The aims of this study were to further develop the original PFIT, to derive an interval score (the PFIT-s), and to test the clinimetric properties of the PFIT-s. A nested cohort study was conducted. One hundred forty-four and 116 participants performed the PFIT at ICU admission and discharge, respectively. Original test components were modified using principal component analysis. Rasch analysis examined the unidimensionality of the PFIT, and an interval score was derived. Correlations tested validity, and multiple regression analyses investigated predictive ability. Responsiveness was assessed using the effect size index (ESI), and the minimal clinically important difference (MCID) was calculated. The shoulder lift component was removed. Unidimensionality of combined admission and discharge PFIT-s scores was confirmed. The PFIT-s displayed moderate convergent validity with the Timed "Up & Go" Test (r=-.60), the Six-Minute Walk Test (r=.41), and the Medical Research Council (MRC) sum score (rho=.49). The ESI of the PFIT-s was 0.82, and the MCID was 1.5 points (interval scale range=0-10). A higher admission PFIT-s score was predictive of: an MRC score of ≥48, increased likelihood of discharge home, reduced likelihood of discharge to inpatient rehabilitation, and reduced acute care hospital length of stay. Scoring of sit-to-stand assistance required is subjective, and cadence cutpoints used may not be generalizable. The PFIT-s is a safe and inexpensive test of physical function with high clinical utility. It is valid, responsive to change, and predictive of key outcomes. It is recommended that the PFIT-s be adopted to test physical function in the ICU.

  20. Studying primate cognition in a social setting to improve validity and welfare: a literature review highlighting successful approaches

    Directory of Open Access Journals (Sweden)

    Katherine A. Cronin

    2017-08-01

    Full Text Available Background Studying animal cognition in a social setting is associated with practical and statistical challenges. However, conducting cognitive research without disturbing species-typical social groups can increase ecological validity, minimize distress, and improve animal welfare. Here, we review the existing literature on cognitive research run with primates in a social setting in order to determine how widespread such testing is and highlight approaches that may guide future research planning. Survey Methodology Using Google Scholar to search the terms “primate” “cognition” “experiment” and “social group,” we conducted a systematic literature search covering 16 years (2000–2015 inclusive. We then conducted two supplemental searches within each journal that contained a publication meeting our criteria in the original search, using the terms “primate” and “playback” in one search and the terms “primate” “cognition” and “social group” in the second. The results were used to assess how frequently nonhuman primate cognition has been studied in a social setting (>3 individuals, to gain perspective on the species and topics that have been studied, and to extract successful approaches for social testing. Results Our search revealed 248 unique publications in 43 journals encompassing 71 species. The absolute number of publications has increased over years, suggesting viable strategies for studying cognition in social settings. While a wide range of species were studied they were not equally represented, with 19% of the publications reporting data for chimpanzees. Field sites were the most common environment for experiments run in social groups of primates, accounting for more than half of the results. Approaches to mitigating the practical and statistical challenges were identified. Discussion This analysis has revealed that the study of primate cognition in a social setting is increasing and taking place across

  1. A Unit on "Fahrenheit 451" That Uses Cooperative Learning (Resources and Reviews).

    Science.gov (United States)

    Ebbers, Frances A.

    1991-01-01

    Provides a curriculum unit using the novel "Fahrenheit 451" to provide student-centered activities based on solid pedagogical methodology. Emphasizes value-centered analysis of the novel, comparison of alternative arguments, and integration of cooperative learning activities. (PRA)

  2. 75 FR 16837 - Public Review of Draft United States Thoroughfare, Landmark, and Postal Address Data Standard

    Science.gov (United States)

    2010-04-02

    ... public on the FGDC Web site. DATES: Comments on the draft United States Thoroughfare, Landmark, and... principles can be extended to all addresses. Dated: March 18, 2010. Ivan DeLoatch, FGDC Executive...

  3. Unremarked or Unperformed? Systematic Review on Reporting of Validation Efforts of Health Economic Decision Models in Seasonal Influenza and Early Breast Cancer

    NARCIS (Netherlands)

    de Boer, Pieter T.; Frederix, G.W.J.; Feenstra, Talitha L.; Vemer, Pepijn

    2016-01-01

    BACKGROUND: Transparent reporting of validation efforts of health economic models give stakeholders better insight into the credibility of model outcomes. In this study we reviewed recently published studies on seasonal influenza and early breast cancer in order to gain insight into the reporting of

  4. Unremarked or Unperformed? : Systematic Review on Reporting of Validation Efforts of Health Economic Decision Models in Seasonal Influenza and Early Breast Cancer

    NARCIS (Netherlands)

    de Boer, Pieter T; Frederix, Geert W J; Feenstra, Talitha L; Vemer, Pepijn

    2016-01-01

    BACKGROUND: Transparent reporting of validation efforts of health economic models give stakeholders better insight into the credibility of model outcomes. In this study we reviewed recently published studies on seasonal influenza and early breast cancer in order to gain insight into the reporting of

  5. Unremarked or Unperformed? : Systematic Review on Reporting of Validation Efforts of Health Economic Decision Models in Seasonal Influenza and Early Breast Cancer

    NARCIS (Netherlands)

    de Boer, Pieter T.; Frederix, Geert W. J.; Feenstra, Talitha L.; Vemer, Pepijn

    2016-01-01

    Background Transparent reporting of validation efforts of health economic models give stakeholders better insight into the credibility of model outcomes. In this study we reviewed recently published studies on seasonal influenza and early breast cancer in order to gain insight into the reporting of

  6. Patient-reported outcome measures for systemic lupus erythematosus clinical trials: a review of content validity, face validity and psychometric performance

    OpenAIRE

    Holloway, Laura; Humphrey, Louise; Heron, Louise; Pilling, Claire; Kitchen, Helen; Højbjerre, Lise; Strandberg-Larsen, Martin; Hansen, Brian Bekker

    2014-01-01

    Background Despite overall progress in treatment of autoimmune diseases, patients with systemic lupus erythematosus (SLE) experience many inflammatory symptoms representing an unmet medical need. This study aimed to create a conceptual model of the humanistic and economic burden of SLE, and review the patient-reported outcomes (PROs) used to measure such concepts in SLE clinical trials. Methods A conceptual model for SLE was developed from structured review of published articles from 2007 to ...

  7. Review of Available Data for Validation of Nuresim Two-Phase CFD Software Applied to CHF Investigations

    Directory of Open Access Journals (Sweden)

    D. Bestion

    2009-01-01

    Full Text Available The NURESIM Project of the 6th European Framework Program initiated the development of a new-generation common European Standard Software Platform for nuclear reactor simulation. The thermal-hydraulic subproject aims at improving the understanding and the predictive capabilities of the simulation tools for key two-phase flow thermal-hydraulic processes such as the critical heat flux (CHF. As part of a multi-scale analysis of reactor thermal-hydraulics, a two-phase CFD tool is developed to allow zooming on local processes. Current industrial methods for CHF mainly use the sub-channel analysis and empirical CHF correlations based on large scale experiments having the real geometry of a reactor assembly. Two-phase CFD is used here for understanding some boiling flow processes, for helping new fuel assembly design, and for developing better CHF predictions in both PWR and BWR. This paper presents a review of experimental data which can be used for validation of the two-phase CFD application to CHF investigations. The phenomenology of DNB and Dry-Out are detailed identifying all basic flow processes which require a specific modeling in CFD tool. The resulting modeling program of work is given and the current state-of-the-art of the modeling within the NURESIM project is presented.

  8. Can a threshold value be used to classify chondrichthyan reproductive modes: systematic review and validation using an oviparous species.

    Directory of Open Access Journals (Sweden)

    Holly A Frazer

    Full Text Available The maternal-embryonic nutritional relationship in chondrichthyans has been poorly explored. Consequently, accurately discerning between their different reproductive modes is difficult; especially lecithotrophy and incipient histotrophy. This present study is the first to assess changes in mass throughout embryonic development of an oviparous chondrichthyan other than Scyliorhinus canicula. Heterodontus portusjacksoni egg cases were collected and used to quantify the gain or loss of wet mass, dry mass, water content, inorganic and organic matter from freshly deposited eggs (without macroscopically visible embryos to near full-term embryos. A loss in organic mass of ~40% found from this study is approximately double the values previously obtained for S. canicula. This raises concerns for the validity of the current threshold value used to discern between lecithotrophic and matrotrophic species. Accordingly, 26 studies published in the primary literature between 1932 and 2012 addressing the maternal-embryonic nutritional relationship in sharks were reviewed. Values for changes in mass reported for over 20 different shark species were synthesised and recalculated, revealing multiple typographical, transcribing, calculation and rounding errors across many papers. These results suggest that the current threshold value of -20% established by previous studies is invalid and should be avoided to ascertain the reproductive mode of aplacental viviparous species.

  9. Can a threshold value be used to classify chondrichthyan reproductive modes: systematic review and validation using an oviparous species.

    Science.gov (United States)

    Frazer, Holly A; Ellis, Megan; Huveneers, Charlie

    2012-01-01

    The maternal-embryonic nutritional relationship in chondrichthyans has been poorly explored. Consequently, accurately discerning between their different reproductive modes is difficult; especially lecithotrophy and incipient histotrophy. This present study is the first to assess changes in mass throughout embryonic development of an oviparous chondrichthyan other than Scyliorhinus canicula. Heterodontus portusjacksoni egg cases were collected and used to quantify the gain or loss of wet mass, dry mass, water content, inorganic and organic matter from freshly deposited eggs (without macroscopically visible embryos) to near full-term embryos. A loss in organic mass of ~40% found from this study is approximately double the values previously obtained for S. canicula. This raises concerns for the validity of the current threshold value used to discern between lecithotrophic and matrotrophic species. Accordingly, 26 studies published in the primary literature between 1932 and 2012 addressing the maternal-embryonic nutritional relationship in sharks were reviewed. Values for changes in mass reported for over 20 different shark species were synthesised and recalculated, revealing multiple typographical, transcribing, calculation and rounding errors across many papers. These results suggest that the current threshold value of -20% established by previous studies is invalid and should be avoided to ascertain the reproductive mode of aplacental viviparous species.

  10. Questionnaires used to assess barriers of clinical guideline use among physicians are not comprehensive, reliable, or valid: a scoping review.

    Science.gov (United States)

    Willson, Melina L; Vernooij, Robin W M; Gagliardi, Anna R

    2017-06-01

    This study described the number and characteristics of questionnaires used to assess barriers of guideline use among physicians. A scoping review was conducted. MEDLINE and EMBASE were searched from 2005 to June 2016. English-language studies that administered a questionnaire to assess barriers of guideline use among practicing physicians were eligible. Summary statistics were used to report study and questionnaire characteristics. Questionnaire content was assessed with a checklist of 57 known barriers. Each of the 178 included studies administered a unique questionnaire. The number of questionnaires increased yearly from 2005 to 2015. Few were pilot-tested (50, 28.1%) or tested for psychometric properties (3, 1.7%). Two were based on theory. None probed for the full range of known barriers. Ten included a free-text option. The majority assessed professional barriers (177, 99.4%) but few of the 14 factors within this domain. Questionnaire characteristics did not change over time. Organizations administered questionnaires that were not reliable or valid and did not comprehensively assess barriers and may have selected interventions unlikely to promote guideline use. Research is needed to construct a questionnaire that is practical, adaptable, and robust and leads to the selection of interventions that support guideline use. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  11. Cross-species approaches to pathological gambling: a review targeting sex differences, adolescent vulnerability and ecological validity of research tools.

    Science.gov (United States)

    van den Bos, Ruud; Davies, William; Dellu-Hagedorn, Francoise; Goudriaan, Anna E; Granon, Sylvie; Homberg, Judith; Rivalan, Marion; Swendsen, Joel; Adriani, Walter

    2013-12-01

    Decision-making plays a pivotal role in daily life as impairments in processes underlying decision-making often lead to an inability to make profitable long-term decisions. As a case in point, pathological gamblers continue gambling despite the fact that this disrupts their personal, professional or financial life. The prevalence of pathological gambling will likely increase in the coming years due to expanding possibilities of on-line gambling through the Internet and increasing liberal attitudes towards gambling. It therefore represents a growing concern for society. Both human and animal studies rapidly advance our knowledge on brain-behaviour processes relevant for understanding normal and pathological gambling behaviour. Here, we review in humans and animals three features of pathological gambling which hitherto have received relatively little attention: (1) sex differences in (the development of) pathological gambling, (2) adolescence as a (putative) sensitive period for (developing) pathological gambling and (3) avenues for improving ecological validity of research tools. Based on these issues we also discuss how research in humans and animals may be brought in line to maximize translational research opportunities.

  12. A Critical Review of Air Pollution Index Systems in the United States and Canada

    Science.gov (United States)

    Ott, Wayne R.; Thom, Gary C.

    1976-01-01

    An extensive survey of air pollution indices reveals great diversity in calculation and descriptor categories. This lack of uniformity creates confusion, suggests questionable technical validity, and discourages a national picture. The authors recombined indices currently in use to develop a Standardized Urban Air Quality Index for national use.…

  13. A Review of United States Air Force and Department of Defense Aerospace Propulsion Needs

    Science.gov (United States)

    2006-01-01

    ROBERT F. RAGGIO, Dayton Aerospace, Inc. GENE W. RAY, GMT Ventures ELI RESHOTKO, Case Western Reserve University (emeritus) LOURDES SALAMANCA -RIBA...although funding is being actively sought. Nonequilibrium Flow A number of programs are being conducted to validate direct simulation Monte Carlo

  14. A Brief Review of High Entropy Alloys and Serration Behavior and Flow Units

    Institute of Scientific and Technical Information of China (English)

    Yong ZHANG; Jun-wei QIAO; Peter KLIAW

    2016-01-01

    Multicomponent alloys with high entropy of mixing,e.g.,high entropy alloys (HEAs)and/or multiprin-cipal-element alloys (MEAs),are attracting increasing attentions,because the materials with novel properties are being developed,based on the design strategy of the equiatomic ratio,multicomponent,and high entropy of mixing in their liquid or random solution state.Recently,HEAs with the ultrahigh strength and fracture toughness,excel-lent magnetic properties,high fatigue,wear and corrosion resistance,great phase stability/high resistance to heat-softening behavior,sluggish diffusion effects,and potential superconductivity,etc.,were developed.The HEAs can even have very high irradiation resistance and may have some self-healing effects,and can potentially be used as the first wall and nuclear fuel cladding materials.Serration behaviors and flow units are powerful methods to understand the plastic deformation or fracture of materials.The methods have been successfully used to study the plasticity of amorphous alloys (also bulk metallic glasses,BMGs).The flow units are proposed as:free volumes,shear transi-tion zones (STZs),tension-transition zones (TTZs),liquid-like regions,soft regions or soft spots,etc.The flow units in the crystalline alloys are usually dislocations,which may interact with the solute atoms,interstitial types,or sub-stitution types.Moreover,the flow units often change with the testing temperatures and loading strain rates,e.g., at the low temperature and high strain rate,plastic deformation will be carried out by the flow unit of twinning,and at high temperatures,the grain boundary will be the weak area,and play as the flow unit.The serration shapes are related to the types of flow units,and the serration behavior can be analyzed using the power law and modified power law.

  15. Burn Injuries Resulting from Hot Water Bottle Use: A Retrospective Review of Cases Presenting to a Regional Burns Unit in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Shehab Jabir

    2013-01-01

    Full Text Available Introduction. Hot water bottles are commonly used to relieve pain and for warmth during the colder months of the year. However, they pose a risk of serious burn injuries. The aim of this study is to retrospectively review all burn injuries caused by hot water bottles presenting to our regional burns unit. Methods. Patients with burns injuries resulting from hot water bottle use were identified from our burns database between the periods of January 2004 and March 2013 and their cases notes reviewed retrospectively. Results. Identified cases involved 39 children (aged 17 years or younger and 46 adults (aged 18 years or older. The majority of burns were scald injuries. The mean %TBSA was 3.07% (SD ± 3.40. Seven patients (8.24% required debridement and skin grafting while 3 (3.60% required debridement and application of Biobrane. One patient (1.18% required local flap reconstruction. Spontaneous rupture accounted for 48.20% of injuries while accidental spilling and contact accounted for 33% and 18.80% of injuries, respectively. The mean time to heal was 28.87 days (SD ± 21.60. Conclusions. This study highlights the typical distribution of hot water bottle burns and the high rate of spontaneous rupture of hot water bottles, which have the potential for significant burn injuries.

  16. Literature Review of Multi-Unit Franchise%多店特许文献综述

    Institute of Scientific and Technical Information of China (English)

    赵小涛

    2012-01-01

    多店特许近期发展非常迅速,中外研究者识别了区域发展、主特许、区域代理、特许中介、顺序多店特许、合资特许等多店特许方式,从特许人与受许人动机、多店特许优缺点进行了实证研究,使用了代理理论、国际化理论、集体行为与社会选择等理论方法。国内有关研究强调主特许经营"三层两关系",指出法律不能也不应该对经营模式进行保护。这些研究绝大多数将国内与国际分开,存在局限性;且将多店特许与单店特许比较,而实质上多店特许更应该与特许体系分支机构对应。%Researchers identified several modes of multi-unit franchise,such as area development,master franchise,area representative,franchise broke,sequential multi-unit franchise,joint-venture franchise.Some empirical study concentrated on the motivation of franchisor and franchisee,or advantage and disadvantage of multi-unit franchise.Theories for multi-unit franchise conclude agency theory,internationalization theory,collective behavior and social choice theory and so on.The domestic research analyzes the master franchise in law angle,emphasizes "three layers and two relationships" is the characteristic of the mode,and points out that the law cannot and should not protect the business model.For most of these researches have separated multi-unit franchise into domestic and international expansion.In fact,both of them are market expansion modes of a franchise system.The division research has very large limitation.At the same time,the empirical research to multi-unit franchise compares multi-unit franchise with single-unit franchise,but multi-unit franchise should be more corresponding with the branches of a franchise system in fact.

  17. Prospective gas turbine and combined-cycle units for power engineering (a Review)

    Science.gov (United States)

    Ol'khovskii, G. G.

    2013-02-01

    The modern state of technology for making gas turbines around the world and heat-recovery combined-cycle units constructed on their basis are considered. The progress achieved in this field by Siemens, Mitsubishi, General Electric, and Alstom is analyzed, and the objectives these companies set forth for themselves for the near and more distant future are discussed. The 375-MW gas turbine unit with an efficiency of 40% produced by Siemens, which is presently the largest one, is subjected to a detailed analysis. The main specific features of this turbine are that the gas turbine unit's hot-path components have purely air cooling, due to which the installation has enhanced maneuverability. The single-shaft combined-cycle plant constructed on the basis of this turbine has a capacity of 570 MW and efficiency higher than 60%. Programs adopted by different companies for development of new-generation gas turbine units firing synthesis gas and fitted with low-emission combustion chambers and new cooling systems are considered. Concepts of rotor blades for new gas turbine units with improved thermal barrier coatings and composite blades different parts of which are made of materials selected in accordance with the conditions of their operation are discussed.

  18. Effect of Early Rehabilitation during Intensive Care Unit Stay on Functional Status: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Castro-Avila, Ana Cristina; Serón, Pamela; Fan, Eddy; Gaete, Mónica; Mickan, Sharon

    2015-01-01

    Critically ill survivors may have functional impairments even five years after hospital discharge. To date there are four systematic reviews suggesting a beneficial impact for mobilisation in mechanically ventilated and intensive care unit (ICU) patients, however there is limited information about the influence of timing, frequency and duration of sessions. Earlier mobilisation during ICU stay may lead to greater benefits. This study aims to determine the effect of early rehabilitation for functional status in ICU/high-dependency unit (HDU) patients. Systematic review and meta-analysis. MEDLINE, EMBASE, CINALH, PEDro, Cochrane Library, AMED, ISI web of science, Scielo, LILACS and several clinical trial registries were searched for randomised and non-randomised clinical trials of rehabilitation compared to usual care in adult patients admitted to an ICU/HDU. Results were screened by two independent reviewers. Primary outcome was functional status. Secondary outcomes were walking ability, muscle strength, quality of life, and healthcare utilisation. Data extraction and methodological quality assessment using the PEDro scale was performed by primary reviewer and checked by two other reviewers. The authors of relevant studies were contacted to obtain missing data. 5733 records were screened. Seven articles were included in the narrative synthesis and six in the meta-analysis. Early rehabilitation had no significant effect on functional status, muscle strength, quality of life, or healthcare utilisation. However, early rehabilitation led to significantly more patients walking without assistance at hospital discharge (risk ratio 1.42; 95% CI 1.17-1.72). There was a non-significant effect favouring intervention for walking distance and incidence of ICU-acquired weakness. Early rehabilitation during ICU stay was not associated with improvements in functional status, muscle strength, quality of life or healthcare utilisation outcomes, although it seems to improve walking

  19. Effect of Early Rehabilitation during Intensive Care Unit Stay on Functional Status: Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Ana Cristina Castro-Avila

    Full Text Available Critically ill survivors may have functional impairments even five years after hospital discharge. To date there are four systematic reviews suggesting a beneficial impact for mobilisation in mechanically ventilated and intensive care unit (ICU patients, however there is limited information about the influence of timing, frequency and duration of sessions. Earlier mobilisation during ICU stay may lead to greater benefits. This study aims to determine the effect of early rehabilitation for functional status in ICU/high-dependency unit (HDU patients.Systematic review and meta-analysis. MEDLINE, EMBASE, CINALH, PEDro, Cochrane Library, AMED, ISI web of science, Scielo, LILACS and several clinical trial registries were searched for randomised and non-randomised clinical trials of rehabilitation compared to usual care in adult patients admitted to an ICU/HDU. Results were screened by two independent reviewers. Primary outcome was functional status. Secondary outcomes were walking ability, muscle strength, quality of life, and healthcare utilisation. Data extraction and methodological quality assessment using the PEDro scale was performed by primary reviewer and checked by two other reviewers. The authors of relevant studies were contacted to obtain missing data.5733 records were screened. Seven articles were included in the narrative synthesis and six in the meta-analysis. Early rehabilitation had no significant effect on functional status, muscle strength, quality of life, or healthcare utilisation. However, early rehabilitation led to significantly more patients walking without assistance at hospital discharge (risk ratio 1.42; 95% CI 1.17-1.72. There was a non-significant effect favouring intervention for walking distance and incidence of ICU-acquired weakness.Early rehabilitation during ICU stay was not associated with improvements in functional status, muscle strength, quality of life or healthcare utilisation outcomes, although it seems to

  20. Review of the status of validation of the computer codes used in the severe accident source term reassessment study (BMI-2104). [PWR; BWR

    Energy Technology Data Exchange (ETDEWEB)

    Kress, T. S. [comp.

    1985-04-01

    The determination of severe accident source terms must, by necessity it seems, rely heavily on the use of complex computer codes. Source term acceptability, therefore, rests on the assessed validity of such codes. Consequently, one element of NRC's recent efforts to reassess LWR severe accident source terms is to provide a review of the status of validation of the computer codes used in the reassessment. The results of this review is the subject of this document. The separate review documents compiled in this report were used as a resource along with the results of the BMI-2104 study by BCL and the QUEST study by SNL to arrive at a more-or-less independent appraisal of the status of source term modeling at this time.

  1. Peer-Delivered Recovery Support Services for Addictions in the United States: A Systematic Review.

    Science.gov (United States)

    Bassuk, Ellen L; Hanson, Justine; Greene, R Neil; Richard, Molly; Laudet, Alexandre

    2016-04-01

    This systematic review identifies, appraises, and summarizes the evidence on the effectiveness of peer-delivered recovery support services for people in recovery from alcohol and drug addiction. Nine studies met criteria for inclusion in the review. They were assessed for quality and outcomes including substance use and recovery-related factors. Despite significant methodological limitations found in the included studies, the body of evidence suggests salutary effects on participants. Current limitations and recommendations for future research are discussed.

  2. Understanding How Organized Youth Sport May Be Harming Individual Players within the Family Unit: A Literature Review

    Science.gov (United States)

    Bean, Corliss N.; Fortier, Michelle; Post, Courtney; Chima, Karam

    2014-01-01

    Within the United States, close to 45 million youths between the ages of 6 and 18 participate in some form of organized sports. While recent reviews have shown the positive effects of youth sport participation on youth health, there are also several negative factors surrounding the youth sport environment. To date, a comprehensive review of the negative physical and psychological effects of organized sport on youth has not been done and little thus far has documented the effect organized sport has on other players within a family, particularly on parents and siblings. Therefore the purpose of this paper is to conduct a review of studies on the negative effects of organized sport on the youth athlete and their parents and siblings. Articles were found by searching multiple databases (Physical Education Index and Sociology, Psychology databases (Proquest), SPORTDiscus and Health, History, Management databases (EBSCOhost), Science, Social Science, Arts and Humanities on Web of Science (ISI), SCOPUS and Scirus (Elsevier). Results show the darker side of organized sport for actors within the family unit. A model is proposed to explain under which circumstances sport leads to positive versus negative outcomes, ideas for future research are drawn and recommendations are made to optimize the youth sport experience and family health. PMID:25275889

  3. Climate Justice in Rural Southeastern United States: A Review of Climate Change Impacts and Effects on Human Health.

    Science.gov (United States)

    Gutierrez, Kristie S; LePrevost, Catherine E

    2016-02-03

    Climate justice is a local, national, and global movement to protect at-risk populations who are disproportionately affected by climate change. The social context for this review is the Southeastern region of the United States, which is particularly susceptible to climate change because of the geography of the area and the vulnerabilities of the inhabiting populations. Negative human health effects on variable and vulnerable populations within the Southeast region due to changing climate are concerning, as health threats are not expected to produce parallel effects among all individuals. Vulnerable communities, such as communities of color, indigenous people, the geographically isolated, and those who are socioeconomically disadvantaged and already experiencing poor environmental quality, are least able to respond and adapt to climate change. Focusing on vulnerable populations in the Southeastern United States, this review is a synthesis of the recent (2010 to 2015) literature-base on the health effects connected to climate change. This review also addresses local and regional mitigation and adaptation strategies for citizens and leaders to combat direct and indirect human health effects related to a changing climate.

  4. Climate Justice in Rural Southeastern United States: A Review of Climate Change Impacts and Effects on Human Health

    Directory of Open Access Journals (Sweden)

    Kristie S. Gutierrez

    2016-02-01

    Full Text Available Climate justice is a local, national, and global movement to protect at-risk populations who are disproportionately affected by climate change. The social context for this review is the Southeastern region of the United States, which is particularly susceptible to climate change because of the geography of the area and the vulnerabilities of the inhabiting populations. Negative human health effects on variable and vulnerable populations within the Southeast region due to changing climate are concerning, as health threats are not expected to produce parallel effects among all individuals. Vulnerable communities, such as communities of color, indigenous people, the geographically isolated, and those who are socioeconomically disadvantaged and already experiencing poor environmental quality, are least able to respond and adapt to climate change. Focusing on vulnerable populations in the Southeastern United States, this review is a synthesis of the recent (2010 to 2015 literature-base on the health effects connected to climate change. This review also addresses local and regional mitigation and adaptation strategies for citizens and leaders to combat direct and indirect human health effects related to a changing climate.

  5. The quality of work life of registered nurses in Canada and the United States: a comprehensive literature review.

    Science.gov (United States)

    Nowrouzi, Behdin; Giddens, Emilia; Gohar, Basem; Schoenenberger, Sandrine; Bautista, Mary Christine; Casole, Jennifer

    2016-10-01

    Workplace environment is related to the physical and psychological well-being, and quality of work life (QWL) for nurses. The aim of this paper was to perform a comprehensive literature review on nurses' quality of work life to identify a comprehensive set of QWL predictors for nurses employed in the United States and Canada. Using publications from 2004-2014, contributing factors to American and Canadian nurses' QWL were analyzed. The review was structured using the Work Disability Prevention Framework. Sixty-six articles were selected for analysis. Literature indicated that changes are required within the workplace and across the health care system to improve nurses' QWL. Areas for improvement to nurses' quality of work life included treatment of new nursing graduates, opportunities for continuing education, promotion of positive collegial relationships, stress-reduction programs, and increased financial compensation. This review's findings support the importance of QWL as an indicator of nurses' broader work-related experiences. A shift in health care systems across Canada and the United States is warranted where health care delivery and services are improved in conjunction with the health of the nurses working in the system.

  6. Understanding How Organized Youth Sport May Be Harming Individual Players within the Family Unit: A Literature Review

    Directory of Open Access Journals (Sweden)

    Corliss N. Bean

    2014-10-01

    Full Text Available Within the United States, close to 45 million youths between the ages of 6 and 18 participate in some form of organized sports. While recent reviews have shown the positive effects of youth sport participation on youth health, there are also several negative factors surrounding the youth sport environment. To date, a comprehensive review of the negative physical and psychological effects of organized sport on youth has not been done and little thus far has documented the effect organized sport has on other players within a family, particularly on parents and siblings. Therefore the purpose of this paper is to conduct a review of studies on the negative effects of organized sport on the youth athlete and their parents and siblings. Articles were found by searching multiple databases (Physical Education Index and Sociology, Psychology databases (Proquest, SPORTDiscus and Health, History, Management databases (EBSCOhost, Science, Social Science, Arts and Humanities on Web of Science (ISI, SCOPUS and Scirus (Elsevier. Results show the darker side of organized sport for actors within the family unit. A model is proposed to explain under which circumstances sport leads to positive versus negative outcomes, ideas for future research are drawn and recommendations are made to optimize the youth sport experience and family health.

  7. Review of Continuous Infusion Neuromuscular Blocking Agents in the Adult Intensive Care Unit.

    Science.gov (United States)

    Smetana, Keaton S; Roe, Neil A; Doepker, Bruce A; Jones, G Morgan

    The use of continuous infusion neuromuscular blocking agents remains controversial. The clinical benefit of these medications may be overshadowed by concerns of propagating intensive care unit-acquired weakness, which may prolong mechanical ventilation and impair the inability to assess neurologic function or pain. Despite these risks, the use of neuromuscular blocking agents in the intensive care unit is indicated in numerous clinical situations. Understanding pharmacologic nuances and clinical roles of these agents will aid in facilitating safe use in a variety of acute disease processes. This article provides clinicians with information regarding pharmacologic differences, indication for use, adverse effects, recommended doses, ancillary care, and monitoring among agents used for continuous neuromuscular blockade.

  8. Risk factors for pressure injury development in critically ill patients in the intensive care unit: a systematic review protocol.

    Science.gov (United States)

    Coyer, Fiona; Tayyib, Nahla

    2017-03-20

    Pressure injuries (PIs) create a significant burden in the health care system. Up to 49% of critically ill patients develop PIs. Identifying and understanding potential risk factors is essential to the provision of effective targeted prevention strategies to mitigate risk. The objectives of this review are to identify patient-centred clinical factors that may be associated with PI development in the adult intensive care environment and to determine the effect size of the relationship between identified factors and PI development in this unique population. The review will follow the PRISMA reporting guidelines for systematic reviews. Electronic databases (Cochrane; PubMed/MEDLINE; CINAHL (EBSCOhost); Embase; Scopus; PsycINFO; Proquest; Networked Digital Library of Theses and Dissertations; Australian Digital Theses Program, Grey literature, Google scholar, and Clinical Trial Registries) will be systematically searched. A suite of search terms will identify articles that have examined the patient-centred risk factors for PI development in adult intensive care units. The search strategy will be designed to retrieve studies published since inception to 2016 in English language. Quality of the studies will be assessed by using an assessment framework designed to appraise quality in prognostic studies and methodological considerations in the analysis and publication of observational studies. Screening, study selection process, and data extraction will be undertaken by two independent reviewers. Disagreement will be resolved by discussion and, if required, a third independent reviewer. Clinical and methodological heterogeneity across studies will be assessed and, if possible, meta-analyses will be performed. The evidence synthesis arising from this review will identify person-centred risk factors that are associated with PI development among critically ill patients in intensive care. Findings from this review will demonstrate potential patient risk factors that may

  9. Dental age estimation utilizing third molar development: A review of principles, methods, and population studies used in the United States.

    Science.gov (United States)

    Lewis, James M; Senn, David R

    2010-09-10

    When an individual reaches the age of legal majority, their treatment within the criminal and civil legal systems is changed dramatically in the United States. Forensic odontologists are often asked to assist government agencies in estimating the ages of persons who may or may not have reached that legally important age. The third molars are the only teeth useful as forensic estimators of chronological age in the target age group. This study reviews the principles, methodology, and population data of the most commonly used technique in the United States, the analysis of the third molar development based on modified Demirjian staging. The method analyzes the developing third molar to estimate mean age, age intervals and the empirical probability that an individual has reached the anniversary of her or his eighteenth birthday.

  10. A review of the current geographic distribution of and debate surrounding electronic cigarette clean air regulations in the United States.

    Science.gov (United States)

    Kadowaki, Joy; Vuolo, Mike; Kelly, Brian C

    2015-01-01

    In this article, we present the results of a systematic review of state, county, and municipal restrictions on the use of electronic cigarettes (e-cigarettes) in public spaces within the United States, alongside an overview of the current legal landscape. The lack of federal guidance leaves lower-level jurisdictions to debate the merits of restrictions on use in public spaces without sufficient scientific research. As we show through a geographic assessment of restrictions, this has resulted in an inconsistent patchwork of e-cigarette use bans across the United States of varying degrees of coverage. Bans have emerged over time in a manner that suggests a "bottom up" diffusion of e-cigarette clean air policies. Ultimately, the lack of clinical and scientific knowledge on the risks and potential harm reduction benefits has led to precautionary policymaking, which often lacks grounding in empirical evidence and results in spatially uneven diffusion of policy.

  11. Technical cooperation on nuclear security between the United States and China : review of the past and opportunities for the future.

    Energy Technology Data Exchange (ETDEWEB)

    Pregenzer, Arian Leigh

    2011-12-01

    The United States and China are committed to cooperation to address the challenges of the next century. Technical cooperation, building on a long tradition of technical exchange between the two countries, can play an important role. This paper focuses on technical cooperation between the United States and China in the areas of nonproliferation, arms control and other nuclear security topics. It reviews cooperation during the 1990s on nonproliferation and arms control under the U.S.-China Arms Control Exchange, discusses examples of ongoing activities under the Peaceful Uses of Technology Agreement to enhance security of nuclear and radiological material, and suggests opportunities for expanding technical cooperation between the defense nuclear laboratories of both countries to address a broader range of nuclear security topics.

  12. Social and Economic Statistics in the United Kingdom: A Review of Information Sources.

    Science.gov (United States)

    Tanenbaum, Eric; Nunez, Alfonso

    1982-01-01

    A new system is needed to monitor socioeconomic statistical data for the United Kingdom (UK). The current state of UK socioeconomic statistics, an assessment of methods used to communicate available information, and the resource requirements of a successful monitoring service are discussed. (AM)

  13. Neuroleptic Malignant Syndrome Requiring Neurological Intensive Care Unit Follow-up: Review with Nine Cases

    Directory of Open Access Journals (Sweden)

    Nazlı Gamze Bülbül

    2014-12-01

    Full Text Available Neuroleptic malignant syndrome (NMS is a rare but life-threatening clinical manifestation induced by neuroleptic medication. Although NMS is regarded as a psychiatric diagnosis, its treatment requires a systematic approach and thus intensive care follow-up. In this paper, we report nine cases with NMS followed up in our Neurology Intensive Care Unit over the last three years.

  14. A Review Of The History Of Gender Equality In The United States Of America

    Directory of Open Access Journals (Sweden)

    Wedad Andrada Quffa

    2016-12-01

    Full Text Available Gender inequality is one of the important challenges in all modern societies, the United States of America being no exception, despite the progress and significant advances that have been made in the past century. There still is a significant gender gap in many areas - most notable being the pay gap, social norms and practices, education, political participation and social institutions. The present article aims to analyse the legal framework and social framework that has evolved in the United States of America in order to diminish or completely abolish gender inequality and discrimination. After the 1920 ratification of the Nineteenth Amendment to the Constitution of the United States of America, which empowered women with political rights, there was a proposed amendment to the Constitution to guarantee equal rights for women, first introduced in Congress in 1923, passed by both houses in 1972, but which failed ratification - only 35 out of the 38 states needed ratified the amendment before the deadline - 1979, which later was extended to 1982. The United States has since taken some steps in reducing the gender gap and stopping gender discrimination

  15. The Case of Educational Peacebuilding inside the United Nations Universities: A Review and Critique

    Science.gov (United States)

    Kester, Kevin

    2017-01-01

    This article examines higher education for peace inside the United Nations (UN). It offers an overview and synthesis of core concepts, organizing frameworks and theoretical premises in the field of peace and conflict studies (PACS) higher education and in the UN universities in particular, as the field aspires toward transformative learning and…

  16. Reviewing colony losses and Colony Collapse Disorder in the United States

    Science.gov (United States)

    The beekeeping industry in the United States has faced a number of obstacles to healthy bee management in recent decades. These obstacles range from arthropod pests such as tracheal mites (Acrapis woodi), varroa mites (Varroa destructor), and small hive beetles (Aethina tumida) to pathogenic disease...

  17. "Index for Inclusion": A Framework for School Review in the United Arab Emirates

    Science.gov (United States)

    Alborno, Nadera Emran; Gaad, Eman

    2014-01-01

    This study uses the "Index for Inclusion", developed by Booth and Ainscow, as a framework for investigating inclusive provision in the United Arab Emirates (UAE), introduced through the "School for All" initiative. The study, by Nadera Emran Alborno of the American University in Dubai and Eman Gaad of the British University in…

  18. Thermal treatment of solid residues from WtE units: A review

    Energy Technology Data Exchange (ETDEWEB)

    Lindberg, Daniel, E-mail: daniel.lindberg@abo.fi; Molin, Camilla, E-mail: camilla.molin@abo.fi; Hupa, Mikko, E-mail: mikko.hupa@abo.fi

    2015-03-15

    Highlights: • We review the thermal treatment methods for ashes and residues from WtE plants. • We review the results from extensive laboratory work on vitrification, melting and vaporization of ash. • We analyze the results from the extensive patent literature on thermal treatment. • We review industrial concepts for thermal treatment of ash. - Abstract: Thermal treatment methods of bottom ash, fly ash and various types of APC (air pollution control) residues from waste-to-energy plants can be used to obtain environmentally stable material. The thermal treatment processes are meant to reduce the leachability of harmful residue constituents, destroy toxic organic compounds, reduce residue volume, and produce material suitable for utilization. Fly ash and APC residues often have high levels of soluble salts, particularly chlorides, metals such as cadmium, lead, copper and zinc, and trace levels of organic pollutants such as dioxins and furans. Different thermal treatment methods can be used to either decompose or stabilize harmful elements and compounds in the ash, or separate them from the ash to get a material that can be safely stored or used as products or raw materials. In the present paper, thermal treatment methods, such as sintering, vitrification, and melting have been reviewed. In addition to a review of the scientific literature, a survey has been made of the extensive patent literature in the field.

  19. Analysis System Design of Validity of Remote Sensing Image Segmentation Unit%遥感影像有效基元分析系统设计

    Institute of Scientific and Technical Information of China (English)

    刘兴权; 李全文

    2015-01-01

    It is belongs to posteriori that the remote sensing segments’validity judgment and analysis with the existing software,which gets appropriate result through comparing different remote sensing image segment scale.It is a static split judgment.Such approach limits the full use of additional information during the dynamic segmentation process in remote sensing image,such as the number of multi-scale segment images’layers,segments and the relationship between them and so on. However,the design of many remote image segmentation tactics often involves the dynamic segmentation process information, and the existing software does not provide effective tools to evaluate the effectiveness of segments created in the dynamic segmentation process.So,we design a soft system to simulate the remote sensing images’multi-scale segmentation process with ArcGIS Engine function interface,and achieving the dynamic judgment of the validity of egmentation units;lastly,completing the multi-scale adaptive segmentation simulation and the verification of segmentation tactics.This presented approach provides a useful evaluating tool to check the reasonableness of a new segmentation.%针对现有软件对遥感影像分割过程得到的斑块不提供动态的有效性评价机制,该文使用 ArcGIS Engine 的功能接口开发模拟遥感影像的多层次分割过程,并实现分割斑块有效性的动态判断。在此基础上完成自适应多层次分割策略的模拟分析验证,为验证影像分割策略是否合理提供有效的评价工具。

  20. External validation of the simple clinical score and the HOTEL score, two scores for predicting short-term mortality after admission to an acute medical unit.

    Science.gov (United States)

    Stræde, Mia; Brabrand, Mikkel

    2014-01-01

    Clinical scores can be of aid to predict early mortality after admission to a medical admission unit. A developed scoring system needs to be externally validated to minimise the risk of the discriminatory power and calibration to be falsely elevated. We performed the present study with the objective of validating the Simple Clinical Score (SCS) and the HOTEL score, two existing risk stratification systems that predict mortality for medical patients based solely on clinical information, but not only vital signs. Pre-planned prospective observational cohort study. Danish 460-bed regional teaching hospital. We included 3046 consecutive patients from 2 October 2008 until 19 February 2009. 26 (0.9%) died within one calendar day and 196 (6.4%) died within 30 days. We calculated SCS for 1080 patients. We found an AUROC of 0.960 (95% confidence interval [CI], 0.932 to 0.988) for 24-hours mortality and 0.826 (95% CI, 0.774-0.879) for 30-day mortality, and goodness-of-fit test, χ(2) = 2.68 (10 degrees of freedom), P = 0.998 and χ(2) = 4.00, P = 0.947, respectively. We included 1470 patients when calculating the HOTEL score. Discriminatory power (AUROC) was 0.931 (95% CI, 0.901-0.962) for 24-hours mortality and goodness-of-fit test, χ(2) = 5.56 (10 degrees of freedom), P = 0.234. We find that both the SCS and HOTEL scores showed an excellent to outstanding ability in identifying patients at high risk of dying with good or acceptable precision.

  1. Psychometric properties of the patient assessment of chronic illness care measure: acceptability, reliability and validity in United Kingdom patients with long-term conditions

    Directory of Open Access Journals (Sweden)

    Rick Jo

    2012-08-01

    Full Text Available Abstract Background The Patient Assessment of Chronic Illness Care (PACIC is a US measure of chronic illness quality of care, based on the influential Chronic Care Model (CCM. It measures a number of aspects of care, including patient activation; delivery system design and decision support; goal setting and tailoring; problem-solving and contextual counselling; follow-up and coordination. Although there is developing evidence of the utility of the scale, there is little evidence about its performance in the United Kingdom (UK. We present preliminary data on the psychometric performance of the PACIC in a large sample of UK patients with long-term conditions. Method We collected PACIC, demographic, clinical and quality of care data from patients with long-term conditions across 38 general practices, as part of a wider longitudinal study. We assess rates of missing data, present descriptive and distributional data, assess internal consistency, and test validity through confirmatory factor analysis, and through associations between PACIC scores, patient characteristics and related measures. Results There was evidence that rates of missing data were high on PACIC (9.6% - 15.9%, and higher than on other scales used in the same survey. Most PACIC sub-scales showed reasonable levels of internal consistency (alpha = 0.68 – 0.94, responses did not demonstrate high skewness levels, and floor effects were more frequent (up to 30.4% on the follow up and co-ordination subscale than ceiling effects (generally Conclusion The importance of improving care for long-term conditions means that the development and validation of measures is a priority. The PACIC scale has demonstrated potential utility in this regard, but further assessment is required to assess low levels of completion of the scale, and to explore the performance of the scale in predicting outcomes and assessing the effects of interventions.

  2. A review of water and greenhouse gas impacts of unconventional natural gas development in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Arent, Doug; Logan, Jeff; Macknick, Jordan; Boyd, William; Medlock , Kenneth; O' Sullivan, Francis; Edmonds, James A.; Clarke, Leon E.; Huntington, Hill; Heath, Garvin; Statwick, Patricia M.; Bazilian, Morgan

    2015-01-01

    This paper reviews recent developments in the production and use of unconventional natural gas in the United States with a focus on water and greenhouse gas emission implications. If unconventional natural gas in the U.S. is produced responsibly, transported and distributed with little leakage, and incorporated into integrated energy systems that are designed for future resiliency, it could play a significant role in realizing a more sustainable energy future; however, the increased use of natural gas as a substitute for more carbon intensive fuels will alone not substantially alter world carbon dioxide concentration projections.

  3. Ketamine in adult cardiac surgery and the cardiac surgery Intensive Care Unit: An evidence-based clinical review

    Directory of Open Access Journals (Sweden)

    Michael Mazzeffi

    2015-01-01

    Full Text Available Ketamine is a unique anesthetic drug that provides analgesia, hypnosis, and amnesia with minimal respiratory and cardiovascular depression. Because of its sympathomimetic properties it would seem to be an excellent choice for patients with depressed ventricular function in cardiac surgery. However, its use has not gained widespread acceptance in adult cardiac surgery patients, perhaps due to its perceived negative psychotropic effects. Despite this limitation, it is receiving renewed interest in the United States as a sedative and analgesic drug for critically ill-patients. In this manuscript, the authors provide an evidence-based clinical review of ketamine use in cardiac surgery patients for intensive care physicians, cardio-thoracic anesthesiologists, and cardio-thoracic surgeons. All MEDLINE indexed clinical trials performed during the last 20 years in adult cardiac surgery patients were included in the review.

  4. From Single Motor Unit Activity to Multiple Grip Forces: Mini‐review of Multi‐digit Grasping1

    Science.gov (United States)

    Winges, Sara A.; Santello, Marco

    2007-01-01

    SYNOPSIS This paper is a mini review of kinetic and kinematic evidence on the control of the hand with emphasis on grasping. It is not meant to be an exhaustive review, rather it summarizes current research examining the mechanisms through which specific patterns of coordination are elicited and observed during reach to grasp movements and static grasping. These coordination patterns include the spatial and temporal covariation of the rotation at multiple joints during reach to grasp movements. A basic coordination between grip forces produced by multiple digits also occurs during whole hand grasping such that normal forces tend to be produced in a synchronous fashion across pairs of digits. Finally, we address current research that suggests that motor unit synchrony across hand muscles and muscle compartments might be one of the neural mechanisms underlying the control of grasping. PMID:18414593

  5. A comparative review between the updated models of Brazilian, United Kingdom and American eye banks and lamellar transplants

    Directory of Open Access Journals (Sweden)

    Gustavo Victor

    2014-12-01

    Full Text Available The corneal transplantation (CT is the most commonly performed type of transplant in the world and the Eye Banks are organizations whose capture, evaluate, preserve, store and distribute ocular tissues. With the evolution of surgical techniques and equipment for CT, the BOs had to evolve to keep up with these requirements. This evolution goes from tissues capture techniques, donating money and clarification to the patient (e.g. internet-based, use of current equipment for more adequate tissues supply for the most current surgical techniques, integration of BOs of certain country and real-time management of stocks of ocular tissues, and adequacy of laws that manage the entire process. This review aims to make a comparative review between the updated models of Brazilian, United Kingdon and American Eye Banks. Like, check what the trend towards lamellar transplants in these three countries.

  6. A literature review of methods of analysis of organic analytes in radioactive wastes with an emphasis on sources from the United Kingdom

    Energy Technology Data Exchange (ETDEWEB)

    Clauss, S.A.; Bean, R.M.

    1993-09-01

    This report, compiled by Pacific Northwest Laboratory (PNL), examines literature originating through the United Kingdom (UK) nuclear industry relating to the analyses of organic constituents of radioactive waste. Additionally, secondary references from the UK and other counties, including the United States, have been reviewed. The purpose of this literature review was to find analytical methods that would apply to the mixed-waste matrices found at Hanford.

  7. Image-based medical expert teleconsultation in acute care of injuries. A systematic review of effects on information accuracy, diagnostic validity, clinical outcome, and user satisfaction.

    Directory of Open Access Journals (Sweden)

    Marie Hasselberg

    Full Text Available OBJECTIVE: To systematically review the literature on image-based telemedicine for medical expert consultation in acute care of injuries, considering system, user, and clinical aspects. DESIGN: Systematic review of peer-reviewed journal articles. DATA SOURCES: Searches of five databases and in eligible articles, relevant reviews, and specialized peer-reviewed journals. ELIGIBILITY CRITERIA: Studies were included that covered teleconsultation systems based on image capture and transfer with the objective of seeking medical expertise for the diagnostic and treatment of acute injury care and that presented the evaluation of one or several aspects of the system based on empirical data. Studies of systems not under routine practice or including real-time interactive video conferencing were excluded. METHOD: The procedures used in this review followed the PRISMA Statement. Predefined criteria were used for the assessment of the risk of bias. The DeLone and McLean Information System Success Model was used as a framework to synthesise the results according to system quality, user satisfaction, information quality and net benefits. All data extractions were done by at least two reviewers independently. RESULTS: Out of 331 articles, 24 were found eligible. Diagnostic validity and management outcomes were often studied; fewer studies focused on system quality and user satisfaction. Most systems were evaluated at a feasibility stage or during small-scale pilot testing. Although the results of the evaluations were generally positive, biases in the methodology of evaluation were concerning selection, performance and exclusion. Gold standards and statistical tests were not always used when assessing diagnostic validity and patient management. CONCLUSIONS: Image-based telemedicine systems for injury emergency care tend to support valid diagnosis and influence patient management. The evidence relates to a few clinical fields, and has substantial methodological

  8. Valid and reliable instruments for arm-hand assessment at ICF activity level in persons with hemiplegia: a systematic review

    Science.gov (United States)

    2012-01-01

    Background Loss of arm-hand performance due to a hemiparesis as a result of stroke or cerebral palsy (CP), leads to large problems in daily life of these patients. Assessment of arm-hand performance is important in both clinical practice and research. To gain more insight in e.g. effectiveness of common therapies for different patient populations with similar clinical characteristics, consensus regarding the choice and use of outcome measures is paramount. To guide this choice, an overview of available instruments is necessary. The aim of this systematic review is to identify, evaluate and categorize instruments, reported to be valid and reliable, assessing arm-hand performance at the ICF activity level in patients with stroke or cerebral palsy. Methods A systematic literature search was performed to identify articles containing instruments assessing arm-hand skilled performance in patients with stroke or cerebral palsy. Instruments were identified and divided into the categories capacity, perceived performance and actual performance. A second search was performed to obtain information on their content and psychometrics. Results Regarding capacity, perceived performance and actual performance, 18, 9 and 3 instruments were included respectively. Only 3 of all included instruments were used and tested in both patient populations. The content of the instruments differed widely regarding the ICF levels measured, assessment of the amount of use versus the quality of use, the inclusion of unimanual and/or bimanual tasks and the inclusion of basic and/or extended tasks. Conclusions Although many instruments assess capacity and perceived performance, a dearth exists of instruments assessing actual performance. In addition, instruments appropriate for more than one patient population are sparse. For actual performance, new instruments have to be developed, with specific focus on the usability in different patient populations and the assessment of quality of use as well as

  9. Valid and reliable instruments for arm-hand assessment at ICF activity level in persons with hemiplegia: a systematic review

    Directory of Open Access Journals (Sweden)

    Lemmens Ryanne JM

    2012-04-01

    Full Text Available Abstract Background Loss of arm-hand performance due to a hemiparesis as a result of stroke or cerebral palsy (CP, leads to large problems in daily life of these patients. Assessment of arm-hand performance is important in both clinical practice and research. To gain more insight in e.g. effectiveness of common therapies for different patient populations with similar clinical characteristics, consensus regarding the choice and use of outcome measures is paramount. To guide this choice, an overview of available instruments is necessary. The aim of this systematic review is to identify, evaluate and categorize instruments, reported to be valid and reliable, assessing arm-hand performance at the ICF activity level in patients with stroke or cerebral palsy. Methods A systematic literature search was performed to identify articles containing instruments assessing arm-hand skilled performance in patients with stroke or cerebral palsy. Instruments were identified and divided into the categories capacity, perceived performance and actual performance. A second search was performed to obtain information on their content and psychometrics. Results Regarding capacity, perceived performance and actual performance, 18, 9 and 3 instruments were included respectively. Only 3 of all included instruments were used and tested in both patient populations. The content of the instruments differed widely regarding the ICF levels measured, assessment of the amount of use versus the quality of use, the inclusion of unimanual and/or bimanual tasks and the inclusion of basic and/or extended tasks. Conclusions Although many instruments assess capacity and perceived performance, a dearth exists of instruments assessing actual performance. In addition, instruments appropriate for more than one patient population are sparse. For actual performance, new instruments have to be developed, with specific focus on the usability in different patient populations and the assessment of

  10. Acceptability, reliability, and validity of the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39) across languages: a systematic review.

    Science.gov (United States)

    Ahmadi, Akram; Tohidast, Seyed Abolfazl; Mansuri, Banafshe; Kamali, Mohammad; Krishnan, Gopee

    2017-09-01

    This systematic review aimed to explore the acceptability, reliability, and validity of the Stroke and Aphasia Quality of Life-39 (SAQOL-39) scale across languages. We employed a systematic search of the online databases including MEDLINE (Pubmed), Science direct, Web of science, Psychinfo, Scopus, ProQuest, Google Scholar, and Cochrane library published between 2003 and 2016. We used PRISMA guidelines for conducting and reporting this review. Subsequently, screening of the titles and abstracts, extraction of data as well as the appraisal of the quality of relevant studies were carried out. The initial search returned 8185 studies. Subsequent screening and study selection processes narrowed them to 20, needing detailed review. Forward-backward translation scheme was the preferred method for translation of the SAQOL-39 from English to other languages. Mainly, the socio-cultural and linguistic adaptations were performed in the translated versions. Most versions of the SAQOL-39 showed high test-retest reliability and internal consistency. However, several psychometric properties including the validity and responsiveness were seldom reported in these versions. The SAQOL-39 scale showed high acceptability, and reliability across the languages reviewed in this study. Future translations may additionally focus on reporting the validity and responsiveness of the instrument.

  11. Deployment of United Nations Peace Keeping Forces: The Nature of Transportation and Review of Current Methodologies.

    Science.gov (United States)

    1980-06-06

    the support by the western countries. For example, the Suez Canal is a vital sea lane for trade between the industrialized developed nations of the west...lines Authority: Security Council Size: Maximum 89 Contributing Countries: Australia, Belgium, Canada, Chile, Denmark, Finland, Italy, Mexico , New...other specific public tasks. 3. Royal Netherlands Air Force (a) Organizacion For peace-keeping operations of the United Nations are earmarked: (1

  12. Individual Characteristics and Unit Performance: A Review of Research and Methods

    Science.gov (United States)

    1985-02-01

    IU Individual in Characteristics and Unit Performance A Revlew of Research and Methods James P. Kahan, Noreen Webb, RIchard J. Shavelson, Ross M...Research and Methods James P. Kahan, Noreen Webb, Richard J. Shavelson, Ross M. Stolzenberg February 1985 Prepared for the Office of the Assistant Secretary...Members wore asked to name the people they would associate with in nonmilitary, garrison area, and field/tactical area recreational time. The number

  13. Platoon-Level After Action Review Aids in the SIMNET Unit Performance Assessment System

    Science.gov (United States)

    1992-07-01

    EXERCISE AS A FUNCTION OF UNIT SIDE, TIME, RESULT, AND RANGE TIME FIRING SIDE RESULT RANGE 06:45:00 Red Near Miss 1430 07:03:00 Blue Hit 1860 07:04:00 Blue...Hit 1781 Near Miss 1612 Red Near Miss 2263 Hit 1856 07:05:00 Blue Near Miss 1563 Near Miss 1836 Kill 1132 Hit 1894 Red Near Miss 1900 Hit 1918 11

  14. A Review of Greene (2002 High School Graduation Rates in the United States

    Directory of Open Access Journals (Sweden)

    Richard P. Phelps

    2005-09-01

    Full Text Available The - Greene Method- of calculating school - graduation rates- and the Manhattan Institute (MI criticisms of official graduation and completion statistics are outlined and scrutinized. The methodology fails to recognize the complexity of the issue and appears to ignore the considerable efforts that have been undertaken by education statisticians to remediate the problems inherent to these types of data. The Greene method for calculating completion ratios is simulated and found to have little to no reliability. It is recommended that anyone intent on reporting valid and reliable education indicators avoid use of the Greene Method.

  15. Book review: Biology and management of invasive quagga and zebra mussels in the western United States

    Science.gov (United States)

    Benson, Amy J.

    2017-01-01

    Water is a precious and limited commodity in the western United States and its conveyance is extremely important. Therefore, it is critical to do as much as possible to prevent the spread of two species of dreissenid mussels, both non-native and highly invasive aquatic species already well-established in the eastern half of the United States. This book addresses the occurrences of the two dreissenid mussels in the West, the quagga mussel and the zebra mussel, that are both known to negatively impact water delivery systems and natural ecosystems. It is edited by two researchers whom have extensive experience working with the mussels in the West and is composed of 34 chapters, or articles, written by a variety of experts.Book information: Biology and Management of Invasive Quagga and Zebra Mussels in the Western United States. Edited by Wai Hing Wong and Shawn L. Gerstenberger. Boca Raton (Florida): CRC Press (Taylor & Francis Group). $149.95. xx + 545 p.; ill.; index. ISBN: 978-1-4665-9561-3. [Compact Disc included.] 2015.

  16. DRUG MANAGEMENT REVIEWS IN DISTRICT DRUG MANAGEMENT UNIT AND GENERAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    Max Joseph Herman

    2009-12-01

    Full Text Available Drug is one of the essential elements in healthcare that should be effectively and efficiently managed. Following thedecentralization in 2001 in Indonesia, drug management has changed in district drug management units and also in District General Hospitals. Certainly this condition influences the sustainability of drug access in primary health care such as in Community Health Center and District General Hospital, especially in drug financing policy. A cross sectional descriptive study to obtain information on drug management in public healthcare in district had been carried out between July and December 2006 in 10 District Public Drug Management Units from 10 district health offices and 9 district general hospitals as samples. Data were collected by interviewing heads of Drug Section in District Health Offices and heads of Hospital Pharmacies using structured questionnaires and observing drug storage in District Drug Management Units, Community Health Centers, and Hospital Pharmacies. Results of the study show that drug planning in District Health Offices and General Hospitals did not meet the basic real need in some districts nor District Hospitals. The minimum health service standards had no been achieved yet. Furthermore, drug procurement, storage and recording as well as reporting was not good enough either, such as shown by the existence of expired drugs. Lead time for drug delivery to community health centers in some districts was longer than the average of lead time in the past 3 years.

  17. Indications and outcome for obstetric patients' admission to intensive care unit: a 7-year review.

    Science.gov (United States)

    Lataifeh, I; Amarin, Z; Zayed, F; Al-Mehaisen, L; Alchalabi, H; Khader, Y

    2010-05-01

    The objective of this retrospective study was to investigate the indications, interventions and clinical outcome of pregnant and newly delivered women admitted to the multidisciplinary intensive care unit at the King Abdullah University Hospital in Jordan over a 7-year period from January 2002 to December 2008. The collected data included demographic characteristics of the patients, mode of delivery, pre-existing medical conditions, reason for admission, specific intervention, length of stay and maternal outcome. A total of 43 women required admission to the intensive care unit (ICU), which represented 0.37% of all deliveries. The majority (95.3%) of patients were admitted to the ICU postpartum. The most common reasons for admissions were (pre)eclampsia (48.8%) and obstetric haemorrhage (37.2). The remainder included adult respiratory distress syndrome (6.9%), pulmonary embolism (2.3%) and neurological disorders (4.6%). Mechanical ventilation was required to support 18.6% of patients and transfusion of red blood cells was needed for 48.8% of patients. There were three maternal deaths (6.9%). A multidisciplinary team approach is essential to improve the management of hypertensive disorders and postpartum haemorrhage to achieve significant improvements in maternal outcome. A large, prospective study to know which women are at high risk of admission to the intensive care units and to prevent serious maternal morbidity and mortality is warranted.

  18. Independent dose per monitor unit review of eight U.S.A. proton treatment facilities

    Energy Technology Data Exchange (ETDEWEB)

    Moyers, M. F., E-mail: MFMoyers@roadrunner.com [Colton, California 92354 (United States); Ibbott, G. S.; Grant, R. L.; Summers, P. A.; Followill, D. S. [Department of Radiation Physics, University of Texas – M. D. Anderson Cancer Center, Houston, Texas 77030 (United States)

    2014-01-15

    Purpose: Compare the dose per monitor unit at different proton treatment facilities using three different dosimetry methods. Methods: Measurements of dose per monitor unit were performed by a single group at eight facilities using 11 test beams and up to six different clinical portal treatment sites. These measurements were compared to the facility reported dose per monitor unit values. Results: Agreement between the measured and reported doses was similar using any of the three dosimetry methods. Use of the ICRU 59 N{sub D,w} based method gave results approximately 3% higher than both the ICRU 59 N{sub X} and ICRU 78 (TRS-398) N{sub D,w} based methods. Conclusions: Any single dosimetry method could be used for multi-institution trials with similar conformity between facilities. A multi-institutional trial could support facilities using both the ICRU 59 N{sub X} based and ICRU 78 (TRS-398) N{sub D,w} based methods but use of the ICRU 59 N{sub D,w} based method should not be allowed simultaneously with the other two until the difference is resolved.

  19. Independent dose per monitor unit review of eight U.S.A. proton treatment facilities.

    Science.gov (United States)

    Moyers, M F; Ibbott, G S; Grant, R L; Summers, P A; Followill, D S

    2014-01-01

    Compare the dose per monitor unit at different proton treatment facilities using three different dosimetry methods. Measurements of dose per monitor unit were performed by a single group at eight facilities using 11 test beams and up to six different clinical portal treatment sites. These measurements were compared to the facility reported dose per monitor unit values. Agreement between the measured and reported doses was similar using any of the three dosimetry methods. Use of the ICRU 59 ND,w based method gave results approximately 3% higher than both the ICRU 59 NX and ICRU 78 (TRS-398) ND,w based methods. Any single dosimetry method could be used for multi-institution trials with similar conformity between facilities. A multi-institutional trial could support facilities using both the ICRU 59 NX based and ICRU 78 (TRS-398) ND,w based methods but use of the ICRU 59 ND,w based method should not be allowed simultaneously with the other two until the difference is resolved.

  20. Assessing the Effectiveness of One Approach to the Teaching of Thematic Unit Construction of Literature Reviews

    Science.gov (United States)

    Bitchener, John; Turner, Elizabeth

    2011-01-01

    Despite the availability of practitioner advice on the characteristics of a literature review, students often report that they are unclear about what content should be included and how it can be most effectively organised. To assist them, some institutions provide courses that are specially tailored to the writing of thesis part-genres but very…

  1. The Undergraduate Library at United States and Canadian Universities: A Bibliographic Review.

    Science.gov (United States)

    Person, Roland C.

    This bibliographic review of the literature on American and Canadian university undergraduate libraries was adapted from a PhD dissertation completed at Southern Illinois University at Carbondale in 1982. Included are books, dissertations, and journal articles which treat the undergraduate library as a whole, rather than looking at only one aspect…

  2. AUTOMOTIVE DIESEL MAINTENANCE 1. UNIT XXIX, REVIEWING THE CONSTRUCTION OF ENGINE COMPONENTS.

    Science.gov (United States)

    Human Engineering Inst., Cleveland, OH.

    THIS MODULE OF A 30-MODULE COURSE IS DESIGNED TO PROVIDE A REVIEW OF THE CONSTRUCTION AND OPERATION OF DIESEL ENGINE COMPONENTS. TOPICS ARE STATIONARY PARTS, ENGINE MOVING PARTS, PISTON RINGS, AND CONNECTING RODS AND PISTON PINS. THE MODULE CONSISTS OF AN INSTRUCTOR'S GUIDE, TRANSPARENCIES, A LIST OF SUGGESTED SUPPLEMENTARY MATERIALS, AND TRAINEE…

  3. Post-wildfire seeding in forests of the western United States: An evidence-based review

    Science.gov (United States)

    Donna Peppin; Peter Z. Fule; Carolyn Hull Sieg; Jan L. Beyers; Molly E. Hunter

    2010-01-01

    Broadcast seeding is one of the most widely used post-wildfire emergency response treatments intended to reduce soil erosion, increase vegetative ground cover, and minimize establishment and spread of non-native plant species. We conducted an evidence-based review to examine the effectiveness and effects of post-wildfire seeding treatments on soil stabilization, non-...

  4. 76 FR 31225 - Procedures Governing Administrative Review of a United States Trustee's Decision To Deny a...

    Science.gov (United States)

    2011-05-31

    ... remedies pertaining to a denial of a claim of actual, necessary expenses before seeking judicial review... to ensure a fair and just resolution is accomplished. In order to balance the competing interests of a quick resolution with that of obtaining the most equitable resolution that is fair to all...

  5. Assessing the Effectiveness of One Approach to the Teaching of Thematic Unit Construction of Literature Reviews

    Science.gov (United States)

    Bitchener, John; Turner, Elizabeth

    2011-01-01

    Despite the availability of practitioner advice on the characteristics of a literature review, students often report that they are unclear about what content should be included and how it can be most effectively organised. To assist them, some institutions provide courses that are specially tailored to the writing of thesis part-genres but very…

  6. 76 FR 44609 - United States-Peru Trade Promotion Agreement Notice of Determination Regarding Review of...

    Science.gov (United States)

    2011-07-26

    ... regulations, and practices thereunder, the effective recognition of the right to collective bargaining as stated in the International Labour Organization's Declaration on Fundamental Principles and Rights at... inconsistent with its commitments under the Labor Chapter. The objective of the review of the submission will...

  7. The Dynamics of Poverty in the United States: A Review of Data, Methods, and Findings

    Science.gov (United States)

    Cellini, Stephanie Riegg; McKernan, Signe-Mary; Ratcliffe, Caroline

    2008-01-01

    This paper reviews the literature on poverty dynamics in the U.S. It surveys the most prevalent data, theories, and methods used to answer three key questions: How likely are people to enter, exit, and reenter poverty? How long do people remain in poverty? And what events are associated with entering and exiting poverty? The paper then analyzes…

  8. Review of Paleomagnetic Age Constraints of Mid-Continent Rift Strata, Upper Midwestern United States

    Science.gov (United States)

    Houlihan, E.; Runkel, A.; Feinberg, J. M.; Cowan, C. A.; Titus, S.

    2016-12-01

    The Keweenawan Supergroup consists of 1.1 Ga volcanic units and overlying km-thick sedimentary succession that are associated with the Midcontinent Rift (MR), one of the most prominent geologic features in the Precambrian basement rocks of the North American craton (Morey and Green, 1982; Ojakangas et al., 2001; Ojakangas and Dickas, 2002). Recent studies targeting the sedimentary sequences of the rift highlight a longstanding problem that limits the impact of their results. The studies are based on data collected from a sedimentary package of the Keweenawan Supergroup that is very poorly constrained in age. Sedimentary strata low in the succession are constrained by dated intercalated volcanics, or mineralization ages, that indicate syn-rift filling commenced at about 1087 Ma as volcanism was waning (Davis and Paces, 1990). However, km-thick younger strata within the rift are constrained in maximum age only by virtue of overlying Cambrian fossil-bearing units (Morey and Ojakangas, 1982). Thus, the bulk of the MR sedimentary succession has a range in possible age of about 500 Ma, and potentially is in places as young as Middle Cambrian. Paleomagnetic methods may hold the most promise to date the MR sedimentary succession. Widespread paleomagnetic studies have been conducted on the igneous rocks of the rift, and several previous studies have used paleomagnetic techniques to date the sedimentary units as well (Dubois, 1962; Henry et al., 1976; Elmore and Van der Voo, 1978; Roy and Robertson, 1978; Halls and Palmer, 1981; Palmer et al., 1981; Watts, 1981; McCabe and Van der Voo, 1982; Diehl and Haig, 1994; Kulakov et al., 2013 and others). These authors generally considered the paleomagnetic signatures to be consistent with a Mesoproterozoic age for both the igneous and sedimentary rocks of the rift. Recently, however, authors have suggested that the uppermost sedimentary units are much younger in age, based on a combination of zircon and paleomagnetic analysis

  9. A new risk of bias checklist applicable to randomized trials, observational studies, and systematic reviews was developed and validated to be used for systematic reviews focusing on drug adverse events.

    Science.gov (United States)

    Faillie, Jean-Luc; Ferrer, Pili; Gouverneur, Amandine; Driot, Damien; Berkemeyer, Shoma; Vidal, Xavier; Martínez-Zapata, Maria José; Huerta, Consuelo; Castells, Xavier; Rottenkolber, Marietta; Schmiedl, Sven; Sabaté, Mònica; Ballarín, Elena; Ibáñez, Luisa

    2017-06-01

    The objective of the study was to develop and validate an adequate tool to evaluate the risk of bias of randomized controlled trials, observational studies, and systematic reviews assessing drug adverse events. We developed a structured risk of bias checklist applicable to randomized trials, cohort, case-control and nested case-control studies, and systematic reviews focusing on drug safety. Face and content validity was judged by three experienced reviewers. Interrater and intrarater reliability were determined using 20 randomly selected studies, assessed by three other independent reviewers including one performing a 3-week retest. The developed checklist examines eight domains: study design and objectives, selection bias, attrition, adverse events information bias, other information bias, statistical methods to control confounding, other statistical methods, and conflicts of interest. The total number of questions varied from 10 to 32 depending on the study design. Interrater and intrarater agreements were fair with Kendall's W of 0.70 and 0.74, respectively. Median time to complete the checklist was 8.5 minutes. The developed checklist showed face and content validity and acceptable reliability to assess the risk of bias for studies analyzing drug adverse events. Hence, it might be considered as a novel useful tool for systematic reviews and meta-analyses focusing on drug safety. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Critical review of the United Kingdom's "gold standard" survey of public attitudes to science.

    Science.gov (United States)

    Smith, Benjamin K; Jensen, Eric A

    2016-02-01

    Since 2000, the UK government has funded surveys aimed at understanding the UK public's attitudes toward science, scientists, and science policy. Known as the Public Attitudes to Science series, these surveys and their predecessors have long been used in UK science communication policy, practice, and scholarship as a source of authoritative knowledge about science-related attitudes and behaviors. Given their importance and the significant public funding investment they represent, detailed academic scrutiny of the studies is needed. In this essay, we critically review the most recently published Public Attitudes to Science survey (2014), assessing the robustness of its methods and claims. The review casts doubt on the quality of key elements of the Public Attitudes to Science 2014 survey data and analysis while highlighting the importance of robust quantitative social research methodology. Our analysis comparing the main sample and booster sample for young people demonstrates that quota sampling cannot be assumed equivalent to probability-based sampling techniques.

  11. Public Stigma of Mental Illness in the United States: A Systematic Literature Review

    OpenAIRE

    Parcesepe, Angela M.; Cabassa, Leopoldo J.

    2013-01-01

    Public stigma is a pervasive barrier that prevents many individuals in the U.S. from engaging in mental health care. This systematic literature review aims to: (1) evaluate methods used to study the public’s stigma toward mental disorders, (2) summarize stigma findings focused on the public’s stigmatizing beliefs and actions and attitudes toward mental health treatment for children and adults with mental illness, and (3) draw recommendations for reducing stigma towards individuals with mental...

  12. What factors predict length of stay in a neonatal unit: a systematic review

    OpenAIRE

    Seaton, Sarah E.; Barker, Lisa; Jenkins, David; Draper, Elizabeth S; Keith R Abrams; Manktelow, Bradley N.

    2016-01-01

    Objective In the UK, 1 in 10 babies require specialist neonatal care. This care can last from hours to months depending on the need of the baby. The increasing survival of very preterm babies has increased neonatal care resource use. Evidence from multiple studies is crucial to identify factors which may be important for predicting length of stay (LOS). The ability to predict LOS is vital for resource planning, decision-making and parent counselling. The objective of this review was to identi...

  13. 75 FR 504 - In the Matter of the Review of the Designation of Kahane Chai (aka American Friends of the United...

    Science.gov (United States)

    2010-01-05

    ... Matter of the Review of the Designation of Kahane Chai (aka American Friends of the United Yeshiva... Judea Police aka Judean Congress aka Kach aka Kahane aka Kahane Lives aka Kahane Tzadak aka Kahane.org... to Section 219 of the Immigration and Nationality Act, as amended Based upon a review of...

  14. A review of the potential effects of climate change on quaking aspen (Populus tremuloides) in the Western United States and a new tool for surveying sudden aspen decline

    Science.gov (United States)

    Toni Lyn Morelli; Susan C. Carr

    2011-01-01

    We conducted a literature review of the effects of climate on the distribution and growth of quaking aspen (Populus tremuloides Michx.) in the Western United States. Based on our review, we summarize models of historical climate determinants of contemporary aspen distribution. Most quantitative climate-based models linked aspen presence and growth...

  15. Review of the Reported Measures of Clinical Validity and Clinical Utility as Arguments for the Implementation of Pharmacogenetic Testing: A Case Study of Statin-Induced Muscle Toxicity

    Directory of Open Access Journals (Sweden)

    Marleen E. Jansen

    2017-08-01

    Full Text Available Advances from pharmacogenetics (PGx have not been implemented into health care to the expected extent. One gap that will be addressed in this study is a lack of reporting on clinical validity and clinical utility of PGx-tests. A systematic review of current reporting in scientific literature was conducted on publications addressing PGx in the context of statins and muscle toxicity. Eighty-nine publications were included and information was selected on reported measures of effect, arguments, and accompanying conclusions. Most authors report associations to quantify the relationship between a genetic variation an outcome, such as adverse drug responses. Conclusions on the implementation of a PGx-test are generally based on these associations, without explicit mention of other measures relevant to evaluate the test's clinical validity and clinical utility. To gain insight in the clinical impact and select useful tests, additional outcomes are needed to estimate the clinical validity and utility, such as cost-effectiveness.

  16. Voith power transmission systems in diesel multiple units and railcars. A review on recent developments

    Energy Technology Data Exchange (ETDEWEB)

    Paetzold, W. [Voith Turbo GmbH und Co. KG, Heidenheim (Germany). Rail Div.

    1999-04-01

    Voith today offers complete transmission systems consisting of hydrodynamic and hydromechanical transmissions with integrated retarders, cardan shafts, final drives and cooling units. For DMUs with underfloor powerpacks, the hydrodynamic power transmission system currently is the pre-eminent drive system worldwide and meets the established standards for rail service, i.e. high availability, low operating costs and a reasonable purchasing price. In this article, the author describes Voith`s contribution to the further development of these transmission systems in several modern dieselhydraulic railcars and DMUs for regional and main-line operations. (orig.)

  17. On hitting children: a review of corporal punishment in the United States.

    Science.gov (United States)

    Knox, Michele

    2010-01-01

    Research has clearly demonstrated associations between corporal punishment of children and maladaptive behavior patterns such as aggression and delinquency. Hitting children is an act of violence and a clear violation of children's human rights. In this article, the position of the United States on corporal punishment of children is discussed. Professional and international progress on ending corporal punishment is explained, and the relationship between corporal punishment and child abuse is discussed. An appeal is made for prevention efforts such as parent education and removal of social sanctions for hitting children that may hold significant promise for preventing child maltreatment.

  18. Which alternative communication methods are effective for voiceless patients in Intensive Care Units? A systematic review.

    Science.gov (United States)

    Carruthers, Helen; Astin, Felicity; Munro, Wendy

    2017-03-29

    To assess the effectiveness of Augmentative and Alternative Communication (AAC) strategies to enable people who are temporarily voiceless due to medical intervention, to communicate. A systematic review informed by a protocol published on an international register. Ten databases were searched from January 2004 to January 2017. Included studies assessed the effect of using AAC strategies on patient related outcomes and barriers to their use. All included studies were quality appraised. Due to the heterogeneity of interventions and outcome measures findings were narratively reviewed. Twelve studies met the inclusion criteria and were included in the review reporting outcomes from 1981 patient and 454 health professional participants. The quality of included studies were moderate to weak. AAC communication strategies increased the number of communication interactions, improved patient satisfaction with communication and reduced communication difficulties. Barriers to usage were device characteristics, the clinical condition of the patient, lack of timeliness in communication and staff constraints. There is preliminary, but inconsistent evidence that AAC strategies are effective in improving patient satisfaction with communication and reducing difficulties in communication. A lack of comparable studies precluded the identification of the most effective AAC strategy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. External validation of Acute Physiology and Chronic Health Evaluation IV in Dutch intensive care units and comparison with Acute Physiology and Chronic Health Evaluation II and Simplified Acute Physiology Score II

    NARCIS (Netherlands)

    S. Brinkman; F. Bakhshi-Raiez; A. Abu-Hanna; E. de Jonge; R.J. Bosman; L. Peelen; N.F. de Keizer

    2011-01-01

    Purpose: The aim of this study was to validate and compare the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) IV in the Dutch intensive care unit (ICU) population to the APACHE II and Simplified Acute Physiology Score (SAPS) II. Materials and Methods: This is a prospectiv

  20. Quality Assurance Peer Review Chart Rounds in 2011: A Survey of Academic Institutions in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, Yaacov Richard, E-mail: yaacovla@gmail.com [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Department of Radiation Oncology, Sheba Medical Center, Tel HaShomer (Israel); Sackler School of Medicine, Tel Aviv University (Israel); Whiton, Michal A. [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Department of Radiation Oncology, Skagit Valley Hospital Regional Cancer Care Center, Mt. Vernon, Washington (United States); Symon, Zvi [Department of Radiation Oncology, Sheba Medical Center, Tel HaShomer (Israel); Sackler School of Medicine, Tel Aviv University (Israel); Wuthrick, Evan J. [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Department of Radiation Oncology, Ohio State University, Columbus, Ohio (United States); Doyle, Laura; Harrison, Amy S.; Dicker, Adam P. [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States)

    2012-11-01

    Purpose: In light of concerns regarding the quality of radiation treatment delivery, we surveyed the practice of quality assurance peer review chart rounds at American academic institutions. Methods and Materials: An anonymous web-based survey was sent to the chief resident of each institution across the United States. Results: The response rate was 80% (57/71). The median amount of time spent per patient was 2.7 minutes (range, 0.6-14.4). The mean attendance by senior physicians and residents was 73% and 93%, respectively. A physicist was consistently present at peer review rounds in 66% of departments. There was a close association between attendance by senior physicians and departmental organization: in departments with protected time policies, good attendance was 81% vs. 31% without protected time (p = 0.001), and in departments that documented attendance, attending presence was 69% vs. 29% in departments without documentation (p < 0.05). More than 80% of institutions peer review all external beam therapy courses; however, rates were much lower for other modalities (radiosurgery 58%, brachytherapy 40%-47%). Patient history, chart documentation, and dose prescription were always peer reviewed in >75% of institutions, whereas dosimetric details (beams, wedges), isodose coverage, intensity-modulated radiation therapy constraints, and dose-volume histograms were always peer reviewed in 63%, 59%, 42%, and 50% of cases, respectively. Chart rounds led to both minor (defined as a small multileaf collimator change/repeated port film) and major (change to dose prescription or replan with dosimetry) treatment changes. Whereas at the majority of institutions changes were rare (<10% of cases), 39% and 11% of institutions reported that minor and major changes, respectively, were made to more than 10% of cases. Conclusion: The implementation of peer review chart rounds seems inconsistent across American academic institutions. Brachytherapy and radiosurgical procedures are

  1. Electronic self-monitoring of mood using IT platforms in adult patients with bipolar disorder: A systematic review of the validity and evidence

    DEFF Research Database (Denmark)

    Faurholt-Jepsen, Maria; Munkholm, Klaus; Frost, Mads

    2016-01-01

    in the majority of studies. Conclusions: Electronic self-monitoring of mood in depression appears to be a valid measure of mood in contrast to self-monitoring of mood in mania. There are yet few studies on the effect of electronic self-monitoring of mood in bipolar disorder. The evidence of electronic self......Background: Various paper-based mood charting instruments are used in the monitoring of symptoms in bipolar disorder. During recent years an increasing number of electronic self-monitoring tools have been developed. The objectives of this systematic review were 1) to evaluate the validity...... of electronic self-monitoring tools as a method of evaluating mood compared to clinical rating scales for depression and mania and 2) to investigate the effect of electronic self-monitoring tools on clinically relevant outcomes in bipolar disorder. Methods: A systematic review of the scientific literature...

  2. The development and validation of the Virtual Tissue Matrix, a software application that facilitates the review of tissue microarrays on line

    Directory of Open Access Journals (Sweden)

    Gallagher William M

    2006-05-01

    Full Text Available Abstract Background The Tissue Microarray (TMA facilitates high-throughput analysis of hundreds of tissue specimens simultaneously. However, bottlenecks in the storage and manipulation of the data generated from TMA reviews have become apparent. A number of software applications have been developed to assist in image and data management; however no solution currently facilitates the easy online review, scoring and subsequent storage of images and data associated with TMA experimentation. Results This paper describes the design, development and validation of the Virtual Tissue Matrix (VTM. Through an intuitive HTML driven user interface, the VTM provides digital/virtual slide based images of each TMA core and a means to record observations on each TMA spot. Data generated from a TMA review is stored in an associated relational database, which facilitates the use of flexible scoring forms. The system allows multiple users to record their interpretation of each TMA spot for any parameters assessed. Images generated for the VTM were captured using a standard background lighting intensity and corrective algorithms were applied to each image to eliminate any background lighting hue inconsistencies or vignetting. Validation of the VTM involved examination of inter-and intra-observer variability between microscope and digital TMA reviews. Six bladder TMAs were immunohistochemically stained for E-Cadherin, β-Catenin and PhosphoMet and were assessed by two reviewers for the amount of core and tumour present, the amount and intensity of membrane, cytoplasmic and nuclear staining. Conclusion Results show that digital VTM images are representative of the original tissue viewed with a microscope. There were equivalent levels of inter-and intra-observer agreement for five out of the eight parameters assessed. Results also suggest that digital reviews may correct potential problems experienced when reviewing TMAs using a microscope, for example, removal of

  3. The peer-reviewed literature on undergraduate education for public health in the United States, 2004-2014.

    Science.gov (United States)

    Evashwick, Connie J; Tao, Donghua; Arnold, Lauren D

    2014-01-01

    The education of undergraduate college students in the field of public health has burgeoned over the past decade. Professional literature in peer-reviewed journals is one indicator of the status of a field of study and its related body of knowledge. It is also a mechanism for sharing information among professionals about challenges, issues, experiences, and best practices. The purpose of the literature review conducted here was to describe the status of the peer-reviewed literature over the past decade pertaining to the education of undergraduates about the field of public health in the United States (U.S.). A literature search was conducted of three databases: PubMed, Scopus, and ERIC. Inclusion criteria were publication date from January 1, 2004 through July 31, 2014; written in the English language; pertaining to undergraduate education in the U.S.; and a focus on public health as the primary discipline. Public health was searched as an overarching discipline; articles focused on sub-disciplines or other health professions disciplines were excluded. The search resulted in 158 articles. Each of the authors reviewed the abstracts for all articles and read full articles when necessary. The result was 23 articles that were then considered in depth. The articles were categorized according to their primary theme: curriculum, courses, learning objectives (N = 14); evaluation of teaching method (N = 3); case study (N = 3); career path and advising (N = 2); accreditation (N = 1). Year of publication and journal were also examined. The results of the literature search lead to several observations about how the peer-reviewed literature has been used to date and how it could be used to advance the emerging field of undergraduate education for public health.

  4. Implementing health promotion in schools: protocol for a realist systematic review of research and experience in the United Kingdom (UK

    Directory of Open Access Journals (Sweden)

    Pearson Mark

    2012-10-01

    Full Text Available Abstract Background School-based interventions and campaigns are used to promote health and address a wide variety of public health problems. Schools are considered to be key sites for the implementation of health promotion programmes for their potential to reach the whole population in particular age-groups and instil healthy patterns of behavior early in life. However, evidence for the effectiveness of school-based health promotion interventions is highly variable. Systematic reviews of the evidence of school-based interventions tend to be highly problem- or intervention- specific, thereby missing potential generic insights into implementation and effectiveness of such programmes across problems. Methods/design A realist systematic review will be undertaken to explain how, why and in what circumstances schools can provide feasible settings for effective health promotion programmes in the United Kingdom (UK. The review will be conducted in two phases. Phase 1 will identify programme theories about implementation (ideas about what enables or inhibits effective health promotion to be delivered in a school setting. Phase 2 will test the programme theories so that they can be challenged, endorsed and/or refined. A Review Advisory Group of education and health professionals will be convened to help identify and choose potential programme theories, provide a ‘reality check’ on the clarity and explanatory strength of the mechanisms to be tested, and help shape the presentation of findings to be usable by practitioners and decision-makers. Review findings will be disseminated through liaison with decision-makers, and voluntary and professional groups in the fields of education and health.

  5. The potential for calcium depletion in forest ecosystems of southeastern United States: Review and analysis

    Science.gov (United States)

    Huntington, Thomas G.

    2000-06-01

    Biogeochemical mass balance assessments of calcium status in southeastern forests indicate that losses through harvesting and soil leaching often exceed inputs from atmospheric deposition and weathering. Many forest soils of the southeastern United States are particularly sensitive because these soils and the underlying saprolite from which these soils are derived are largely depleted of weatherable calcium. At most of the intensively studied sites in the southeastern United States, it is estimated that calcium depletion has already reduced or will likely reduce exchangeable soil calcium reserves to less than the estimated requirement for a merchantable forest stand in 150 years or less. At most sites, calcium uptake into merchantable wood equals or exceeds soil leaching losses. Chronic atmospheric deposition of sulfate and nitrate and declining atmospheric deposition of calcium are likely to accelerate calcium depletion. The southeastern U.S. regional distribution of soil calcium pools and calcium fluxes (deposition and uptake in merchantable wood) indicates that the depletion status of the intensively studied sites is representative of a substantially larger area. Where weathering inputs are insufficient to replace leaching and uptake losses, there is a potential for a regional problem in forest nutrition over the long term.

  6. Review: The feto-placental unit, pregnancy pathology and impact on long term maternal health.

    Science.gov (United States)

    Clifton, V L; Stark, M J; Osei-Kumah, A; Hodyl, N A

    2012-02-01

    Pregnancy induces a number of alterations to maternal physiology to accommodate the increased demands made by the developing fetus and placenta. These alterations appear at least in part to be driven by products derived from the feto-placental unit, including microchimeric cells, as well as placental exosomes and microparticles, inducing changes to maternal physiology both during pregnancy and beyond. Further, increasing evidence suggests that some of these alterations are dependent on the sex of the fetus. Pre-eclampsia and asthma represent two common pregnancy complications that have provided valuable insight into how the feto-placental unit influences maternal physiology in a sex-specific manner. Pregnancy-induced alterations in maternal physiology may expose pre-existing subclinical pathologies and provide insight into future maternal health and disease. While most pregnancy-induced alterations to the maternal system are reversed following delivery, some can persist after parturition leading to cardiovascular, metabolic and autoimmune disease and increased risk of early mortality. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  7. Infectious diseases of Afghan immigrants in the United States: review of published reports.

    Science.gov (United States)

    Pilsczek, Florian H

    2011-01-01

    Infectious diseases of immigrants may differ from patients born and resident in the same country, especially if immigrants from Africa or Asia live in Europe or North America. Because the available information is limited published reports of infections of Afghan immigrants in the United States and other countries were analysed. Four reports from the US and 15 reports from other countries were identified [7, (46.7%) Pakistan, 5 (33.3%) Iran, 1 (6.7%) United Kingdom, 1 (6.7%) Germany, 1 (6.7%) Israel)]. Reports from the US were case reports or case series of infections with gastro-intestinal parasites and Mycobacterium tuberculosis (1, 25%), Echinococcus species (2, 50%), and Plasmodium vivax (1, 25%). Reports from other countries were case reports, case series, or surveys and investigated infections with Echinococcus species (2, 13%), Hepatitis B virus (HBV) (1, 6.7%), M. tuberculosis (6, 40%), P. falciparum (1, 6.7%), Leishmania tropica (3, 20%), Fasciola hepatica (1, 6.7%), and M. leprae (1, 6.7%). The reports suggest that Echinococcus species and L. tropica infections can be encountered in Afghan immigrants in the US, and the frequency of a positive PPD (purified protein derivative) response or HBsAg test was increased. An infectious diseases database specific for the country of residence readily available to clinicians treating Afghan patients outside of Afghanistan may be useful.

  8. Electronic self-monitoring of mood using IT platforms in adult patients with bipolar disorder: A systematic review of the validity and evidence

    OpenAIRE

    2016-01-01

    Background Various paper-based mood charting instruments are used in the monitoring of symptoms in bipolar disorder. During recent years an increasing number of electronic self-monitoring tools have been developed. The objectives of this systematic review were 1) to evaluate the validity of electronic self-monitoring tools as a method of evaluating mood compared to clinical rating scales for depression and mania and 2) to investigate the effect of electronic self-monitoring tools on clinicall...

  9. An update on the validation of whole slide imaging systems following FDA approval of a system for a routine pathology diagnostic service in the United States.

    Science.gov (United States)

    Boyce, B F

    2017-08-24

    Pathologists have used light microscopes and glass slides to interpret the histologic appearance of normal and diseased tissues for more than 150 years. The quality of both microtomes used to cut tissue sections and microscopes has improved significantly during the past few decades, but the process of rendering diagnoses has changed little. By contrast, major advances in digital technology have occurred since the introduction of hand held electronic devices, including the development of whole slide imaging (WSI) systems with software packages that can convert microscope images into virtual (digital) slides that can be viewed on computer monitors and via the internet. To date, however, these technological developments have had minimal impact on the way pathologists perform their daily work, with the exception of using computers to access electronic medical records and scholarly web sites for pertinent information to assist interpretation of cases. Traditional practice is likely to change significantly during the next decade, especially since the Federal Drug Administration in the USA has approved the first WSI system for routine diagnostic practice. I review here the development and slow acceptance of WSI by pathology departments. I focus on recent advances in validation of WSI systems that is required for routine diagnostic reporting of pathology cases using this technology.

  10. Determinants of preventable readmissions in the United States: a systematic review

    Directory of Open Access Journals (Sweden)

    Slawson Kevin M

    2010-11-01

    Full Text Available Abstract Background Hospital readmissions are a leading topic of healthcare policy and practice reform because they are common, costly, and potentially avoidable events. Hospitals face the prospect of reduced or eliminated reimbursement for an increasing number of preventable readmissions under nationwide cost savings and quality improvement efforts. To meet the current changes and future expectations, organizations are looking for potential strategies to reduce readmissions. We undertook a systematic review of the literature to determine what factors are associated with preventable readmissions. Methods We conducted a review of the English language medicine, health, and health services research literature (2000 to 2009 for research studies dealing with unplanned, avoidable, preventable, or early readmissions. Each of these modifying terms was included in keyword searches of readmissions or rehospitalizations in Medline, ISI, CINAHL, The Cochrane Library, ProQuest Health Management, and PAIS International. Results were limited to US adult populations. Results The review included 37 studies with significant variation in index conditions, readmitting conditions, timeframe, and terminology. Studies of cardiovascular-related readmissions were most common, followed by all cause readmissions, other surgical procedures, and other specific-conditions. Patient-level indicators of general ill health or complexity were the commonly identified risk factors. While more than one study demonstrated preventable readmissions vary by hospital, identification of many specific organizational level characteristics was lacking. Conclusions The current literature on preventable readmissions in the US contains evidence from a variety of patient populations, geographical locations, healthcare settings, study designs, clinical and theoretical perspectives, and conditions. However, definitional variations, clear gaps, and methodological challenges limit translation of

  11. A systematic review of the reliability and validity of discrete choice experiments in valuing non-market environmental goods

    DEFF Research Database (Denmark)

    Rokotonarivo, Sarobidy; Schaafsma, Marije; Hockley, Neal

    2016-01-01

    reliability measures. DCE results were generally consistent with those of other stated preference techniques (convergent validity), but hypothetical bias was common. Evidence supporting theoretical validity (consistency with assumptions of rational choice theory) was limited. In content validity tests, 2......–90% of respondents protested against a feature of the survey, and a considerable proportion found DCEs to be incomprehensible or inconsequential (17–40% and 10–62% respectively). DCE remains useful for non-market valuation, but its results should be used with caution. Given the sparse and inconclusive evidence base...

  12. Gastrointestinal cryptosporidiosis in captive psittacine birds in the United States: a case review.

    Science.gov (United States)

    Ravich, Michelle L; Reavill, Drury R; Hess, Laurie; Childress, April L; Wellehan, James F X

    2014-12-01

    Histopathologic analysis performed on tissue samples from 34 captive psittacine birds over a 14-year period demonstrated gastrointestinal cryptosporidiosis. Although 8 birds had died unexpectedly, at least 10 showed gastrointestinal signs before death. Most birds had other significant pathologic lesions, unrelated to cryptosporidiosis, in which case Cryptosporidium was likely a secondary pathogen. However, in 11 birds the only significant histopathologic finding was gastrointestinal cryptosporidiosis. In 2 lovebird (Agapornis species) cases, direct sequencing of proventricular samples confirmed the presence of Cryptosporidium avian genotype III. A description and analysis of the pathologic findings in these 34 birds, as well as a review of avian gastrointestinal cryptosporidiosis, is provided.

  13. Disconnected, fragmented, or united? A trans-disciplinary review of network science

    OpenAIRE

    Hidalgo, Cesar A.

    2015-01-01

    During decades the study of networks has been divided between the efforts of social scientists and natural scientists, two groups of scholars who often do not see eye to eye. In this review I present an effort to mutually translate the work conducted by scholars from both of these academic fronts hoping to continue to unify what has become a diverging body of literature. I argue that social and natural scientists fail to see eye to eye because they have diverging academic goals. Social scient...

  14. Public stigma of mental illness in the United States: a systematic literature review.

    Science.gov (United States)

    Parcesepe, Angela M; Cabassa, Leopoldo J

    2013-09-01

    Public stigma is a pervasive barrier that prevents many individuals in the U.S. from engaging in mental health care. This systematic literature review aims to: (1) evaluate methods used to study the public's stigma toward mental disorders, (2) summarize stigma findings focused on the public's stigmatizing beliefs and actions and attitudes toward mental health treatment for children and adults with mental illness, and (3) draw recommendations for reducing stigma towards individuals with mental disorders and advance research in this area. Public stigma of mental illness in the U.S. was widespread. Findings can inform interventions to reduce the public's stigma of mental illness.

  15. Length of stay of general psychiatric inpatients in the United States: systematic review.

    LENUS (Irish Health Repository)

    Tulloch, Alex D

    2011-05-01

    Psychiatric length of stay (LOS) has reduced but is still longer than for physical disorders. Inpatient costs are 16% of total mental health spending. Regression analyses of the determinants of LOS for US adult psychiatric inpatients were systematically reviewed. Most studies predated recent LOS reductions. Psychosis, female gender and larger hospital size were associated with longer LOS, while discharge against medical advice, prospective payment, being married, being detained and either younger or middle age were associated with shorter LOS. Associations appeared consistent, especially where sample size was above 3,000. Updated studies should be adequately powered and include the variables above.

  16. International validation of the Chinese University Prognostic Index for staging of hepatocellular carcinoma:a joint United Kingdom and Hong Kong study

    Institute of Scientific and Technical Information of China (English)

    Stephen LChan; Anthony TC Chan; Winnie Yeo; Philip JJohnson; Frankie Mo; Sarah Berhane; Mabel Teng; Anthony WH Chan; Ming CPoon; Paul BS Lai; Simon Yu

    2014-01-01

    The outcome of hepatocellular carcinoma (HCC) patients significantly differs between western and eastern population centers. Our group previously developed and validated the Chinese University Prognostic Index (CUPI) for the prognostication of HCC among the Asian HCC patient population. In the current study, we aimed to validate the CUPI using an international cohort of patients with HCC and to compare the CUPI to two widely used staging systems, the Barcelona Clinic Liver Cancer (BCLC) classification and the Cancer of the Liver Italian Program (CLIP). To accomplish this goal, two cohorts of patients were enrolled in the United Kingdom (UK;n = 567; 2006-2011) and Hong Kong (HK;n = 517; 2007-2012). The baseline clinical data were recorded. The performances of the CUPI, BCLC, and CLIP were compared in terms of a concordance index (C-index) and were evaluated in subgroups of patients according to treatment intent. The results revealed that the median folow-up durations of the UK and HK cohorts were 27.9 and 29.8 months, respectively. The median overal survival of the UK and HK cohorts were 22.9 and 8.6 months, respectively. The CUPI stratified the patients in both cohorts into three risk subgroups corresponding to distinct outcomes. The median overal survival of the CUPI low-, intermediate-, and high-risk subgroups were 3.15, 1.24, and 0.29 years, respectively, in the UK cohort and were 2.07, 0.32, and 0.10 years, respectively, in the HK cohort. For the patients who underwent curative treatment, the prognostic performance did not differ between the three staging systems, and all were suboptimal. For those who underwent paliative treatment, the CUPI displayed the highest C-index, indicating that this staging system was the most informative for both cohorts. In conclusion, the CUPI is applicable to both western and eastern HCC patient populations. The performances of the three staging systems differed according to treatment intent, and the CUPI was demonstrated to be

  17. International validation of the Chinese University Prognostic Index for staging of hepatocellular carcinoma: a joint United Kingdom and Hong Kong study

    Science.gov (United States)

    Chan, Stephen L.; Johnson, Philip J.; Mo, Frankie; Berhane, Sarah; Teng, Mabel; Chan, Anthony W.H.; Poon, Ming C.; Lai, Paul B.S.; Yu, Simon; Chan, Anthony T.C.; Yeo, Winnie

    2014-01-01

    The outcome of hepatocellular carcinoma (HCC) patients significantly differs between western and eastern population centers. Our group previously developed and validated the Chinese University Prognostic Index (CUPI) for the prognostication of HCC among the Asian HCC patient population. In the current study, we aimed to validate the CUPI using an international cohort of patients with HCC and to compare the CUPI to two widely used staging systems, the Barcelona Clinic Liver Cancer (BCLC) classification and the Cancer of the Liver Italian Program (CLIP). To accomplish this goal, two cohorts of patients were enrolled in the United Kingdom (UK; n = 567; 2006-2011) and Hong Kong (HK; n = 517; 2007-2012). The baseline clinical data were recorded. The performances of the CUPI, BCLC, and CLIP were compared in terms of a concordance index (C-index) and were evaluated in subgroups of patients according to treatment intent. The results revealed that the median follow-up durations of the UK and HK cohorts were 27.9 and 29.8 months, respectively. The median overall survival of the UK and HK cohorts were 22.9 and 8.6 months, respectively. The CUPI stratified the patients in both cohorts into three risk subgroups corresponding to distinct outcomes. The median overall survival of the CUPI low-, intermediate-, and high-risk subgroups were 3.15, 1.24, and 0.29 years, respectively, in the UK cohort and were 2.07, 0.32, and 0.10 years, respectively, in the HK cohort. For the patients who underwent curative treatment, the prognostic performance did not differ between the three staging systems, and all were suboptimal. For those who underwent palliative treatment, the CUPI displayed the highest C-index, indicating that this staging system was the most informative for both cohorts. In conclusion, the CUPI is applicable to both western and eastern HCC patient populations. The performances of the three staging systems differed according to treatment intent, and the CUPI was demonstrated to

  18. Pathology of Haemonchus contortus in New World camelids in the southeastern United States: a retrospective review.

    Science.gov (United States)

    Edwards, Erin E; Garner, Bridget C; Williamson, Lisa H; Storey, Bob E; Sakamoto, Kaori

    2016-03-01

    Most small ruminant farms in tropical climates are plagued by Haemonchus contortus, a hematophagous, abomasal parasite. Heavy burdens of this parasite can cause anemia, hypoproteinemia, weight loss, and mortality in susceptible animals. Haemonchus contortus is becoming a major health concern in New World camelids as well, namely llamas (Llama glama) and alpacas (Vicugna pacos), yet little research has been conducted regarding its prevalence or pathology in these species. Herein, we present a retrospective review of llamas and alpacas that were admitted to The University of Georgia Veterinary Teaching Hospital and Athens Diagnostic Laboratory between the years 2002 and 2013. Antemortem fecal egg count (FEC) estimates performed on 30 alpacas were negatively correlated with hematocrit, hemoglobin, and red blood cell count. Total protein was not significantly correlated with FEC. On postmortem examination, 55 of 198 camelids, including 2 from the aforementioned antemortem review, were infected with H. contortus, with llamas (42.6%) having a significantly higher infection rate than alpacas (22.2%). In 15.7% of the total cases, the parasite was the major cause of death. Common gross lesions included peritoneal, thoracic, and pericardial effusions, visceral pallor, subcutaneous edema, and serous atrophy of fat. Histologic lesions included centrilobular hepatic necrosis, hepatic atrophy, lymphoplasmacytic inflammation of the mucosa of the third gastric compartment (C3), extramedullary hematopoiesis in both the liver and spleen, and the presence of nematodes in C3. Our study emphasizes the importance of H. contortus diagnosis and herd monitoring in New World camelids, particularly llamas.

  19. Facets of career satisfaction for women physicians in the United States: a systematic review.

    Science.gov (United States)

    Rizvi, Rabab; Raymer, Lindsay; Kunik, Mark; Fisher, Joslyn

    2012-01-01

    Women make up a growing proportion of the physician workforce, and their career satisfaction may affect their health. The authors hypothesized that many facets adversely affecting career satisfaction in women physicians were extrinsic, therefore, preventable or modifiable. The authors conducted a systematic review of the literature in English published through February 2010 to examine facets of career satisfaction of U.S. women physicians. The authors used the women physician AND job satisfaction OR career satisfaction Medical Subject Headings (MeSH) terms, and reviewed bibliographies of key articles to ensure inclusion of relevant studies. The authors used the "Strengthening the Reporting of Observation Studies in Epidemiology" quality tool. Of an initial 1,000 studies, only 30 met the inclusion criteria. Facets reported most frequently to influence career satisfaction for women physicians were income/prestige, practice characteristics, and personal/family characteristics. Overall, career satisfaction for women and men physicians was 73.4% (range = 56.4% to 90%) and 73.2% (range = 59% to 90%), respectively. When compared with men, women physicians were more concerned with perceived lack of time for relationships with patients, colleagues, and family; less satisfied with mentoring relationships and support from all sources; and less satisfied with career-advancement opportunities, recognition, and salary. Career satisfaction can affect health, as well as health and safety of patients. Many factors adversely affecting career satisfaction for women physicians are extrinsic and, therefore, modifiable.

  20. AN OVERVIEW: THE ROLE OF PROCESS VALIDATION IN PHARMACEUTICAL INDUSTRY

    Directory of Open Access Journals (Sweden)

    Gaganpreet kaur

    2012-01-01

    Full Text Available The present review article focus on introduction and general overview on process validation in pharmaceutical industry. The word validation simply means “Assessment of validation or action of proving effectiveness”. The process is developed in such a way that the required parameters are achieved and it ensures that the output of the process will consistently meet the required parameters during routine production, the process is validated. The process validation process parameters are derived from the specifications for the device, component or other entity to be produced by the process. A manufacturer can assure through careful design of the device, processes, process controls and packaging that all manufactured units will meet specifications and have uniform quality. However, in-process and finished product testing still play an important role in assuring that products meet specifications Validation is defined as a collection and evaluation of data , from the process design stage through commercial production, which establishes scientific evidence that a process is capable of consistently delivering quality product. The validation protocol includes inventory control and equipment inspection in the preliminary steps and in-process controls in the subsequent steps. Process controls are mandatory in good manufacturing practices (GMP. The goal of a quality system is to consistently produce products that are fit for their intended use. This review covers need of validation, elements of validation, principles of validation, phases of validation, types of validation.

  1. The Knowledge-about-Older-Patients - Quiz (KOP-Q) for nurses: Cross-cultural validation between the Netherlands and United States of America.

    Science.gov (United States)

    Dikken, Jeroen; Hoogerduijn, Jita G; Klaassen, Sharon; Lagerwey, Mary D; Shortridge-Baggett, Lillie; Schuurmans, Marieke J

    2017-08-01

    The Knowledge about Older Patients-Quiz (KOP-Q) is designed as a unidimensional scale measuring knowledge of hospital nurses about older patients. Furthermore, the KOP-Q measures a second unidimensional construct, certainty of hospital nurses about their knowledge. The KOP-Q is developed and validated in the Netherlands. Whether the KOP-Q can be used in other countries is unknown given the cultural and language differences. Investigate the level of measurement invariance of the KOP-Q between the Netherlands and United States of America (USA). A multicenter international cross-sectional design. Four general hospitals in the Netherlands and four general hospitals in the USA. Nurses from the Netherlands (n=201) and the USA (n=130) were invited to participate by email from the ward manager, distributing flyers and present messages on the online hospital communication boards. Questions of the KOP-Q were completed online. The level of measurement invariance (configural, metric or scalar invariance) across countries was tested by running increasingly constrained structural equation models, and testing whether these models fitted the data. Both the knowledge and certainty construct of the KOP-Q proved unidimensional in the Netherlands and USA sample. Test results of the measurement invariance across the Netherlands and USA indicated a stable, partial scalar invariance (15 items full scalar invariance) for the knowledge items and full scalar invariance for the certainty items. The KOP-Q shows to function uniformly across both language groups and can therefore be used to assess nurses' knowledge and their certainty about this knowledge which can be important for educational and/or quality improvement programs in the USA. Furthermore, the KOP-Q is suitable to make comparisons between the Netherlands and the USA using latent variable models. Before the KOP-Q can be used in other countries, cross-cultural tests should again be performed. Copyright © 2017 Elsevier Ltd. All

  2. A roadmap for the development and validation of coated particle fuel for future space radioisotope heater units (RHUs) and radioisotope power systems (RPSs)

    Science.gov (United States)

    Sholtis, Joseph A.

    2001-02-01

    In early 1999, coated particle fuel was identified as offering promising advancements in design flexibility, performance, specific mass and volume, as well as safety for future space radioisotope heater units (RHUs) and radioisotope power systems (RPSs). Subsequent study, conducted during Fiscal Year 1999, provided confidence that these potential benefits were substantial and demonstrable if a modest follow-on investigative test effort was pursued. This paper lays out a roadmap for both immediate and near-term decision making, as well as any full-scale development and validation of coated particle fuel undertaken for future space RHUs, and RPSs. In an effort to obtain adequate and timely information at a reasonable cost for immediate and near-term decision making, as well as any subsequent development, production, and application decisions, a four-phased regimen of testing is identified. The four phases of testing are: (1) Pre-Decisional Testing: (2) Pre-Production Analytical Verification Testing: (3) Production Quality Assurance Testing: and (4) Post-Production Safety Verification Testing. Although all four of these phases of testing are considered essential, the first two phases are especially important for immediate and near-term decisions to advance and pursue coated particle fuel for space RHUs and RPSs. The third and fourth phases of testing are primarily identified and included for completeness at this early stage. It is concluded that there is every reason to believe that the potential benefits of coated particle fuel can be readily demonstrated through a modest investigative test effort. If such an effort is pursued and proves successful, coated particle fuel could then be developed with assurance that its ultimate benefits would revolutionize the design and space use of future RHUs and RPSs. It is hoped that this paper will serve as a starting point for further discussions and more specific planning activities aimed at advancing coated particle fuel for

  3. A Critical Review of the Marketing Claims of Infant Formula Products in the United States.

    Science.gov (United States)

    Belamarich, Peter F; Bochner, Risa E; Racine, Andrew D

    2016-05-01

    A highly competitive infant formula market has resulted in direct-to-consumer marketing intended to promote the sale of modified formulas that claim to ameliorate common infant feeding problems. The claims associated with these marketing campaigns are not evaluated with reference to clinical evidence by the Food and Drug Administration. We aimed to describe the language of claims made on formula labels and compare it with the evidence in systematic reviews. Of the 22 product labels we identified, 13 product labels included claims about colic and gastrointestinal symptoms. There is insufficient evidence to support the claims that removing or reducing lactose, using hydrolyzed or soy protein or adding pre-/probiotics to formula benefits infants with fussiness, gas, or colic yet claims like "soy for fussiness and gas" encourage parents who perceive their infants to be fussy to purchase modified formula. Increased regulation of infant formula claims is warranted.

  4. Risk factors for domestic minor sex trafficking in the United States: a literature review.

    Science.gov (United States)

    Choi, Kristen R

    2015-01-01

    Domestic minor sex trafficking (DMST) is an important social and public health problem, but it has received little attention from healthcare professionals in research, practice, and policy. Prevention and early victim identification efforts for this population are severely limited or entirely absent. The aim of this study was to integrate evidence on risk factors for DMST and critically appraise the quality and quantity of nursing literature on DMST. This literature review was reported using PRISMA criteria. Three databases (CINAHL, PsychInfo, and PubMed) were searched using various terms for (a) human trafficking, (b) risk factors, and (c) children. Demographic factors were not important predictors of DMST. Childhood maltreatment trauma and running away from home were the most important risk factors for trafficking victimization. There was little nursing literature on the topic of DMST. Nurses and other healthcare professionals must engage in confronting DMST by improving early identification of victims and conducting high-quality research to inform practice.

  5. Cancer Survivors in the United States: A Review of the Literature and a Call to Action

    Directory of Open Access Journals (Sweden)

    Manuel Valdivieso, Ann M. Kujawa, Tisha Jones, Laurence H. Baker

    2012-01-01

    Full Text Available Background: The number of cancer survivors in the U.S. has increased from 3 million in 1971, when the National Cancer Act was enacted, to over 12 million today. Over 70% of children affected by cancer survive more than 10 years, and most are cured. Most cancer survivors are adults, with two-thirds of them 65 years of age or older and two-thirds alive at five years. The most common cancer diagnoses among survivors include breast, prostate and colorectal cancers. This review was conducted to better appreciate the challenges associated with cancer survivors and the opportunities healthcare providers have in making a difference for these patients.Methods: Comprehensive review of literature based on PubMed searches on topics related to cancer survivorship, and associated physical, cognitive, socio-economic, sexual/behavioral and legal issues.Results: At least 50% of cancer survivors suffer from late treatment-related side effects, often including physical, psychosocial, cognitive and sexual abnormalities, as well as concerns regarding recurrence and/or the development of new malignancies. Many are chronic in nature and some are severe and even life-threatening. Survivors also face issues involving lack of appropriate health maintenance counseling, increased unemployment rate and workplace discrimination.Conclusions: Advances in the diagnosis and treatment of cancer will lead to more survivors and better quality of life. However, tools to recognize potentially serious long-lasting side effects of cancer therapy earlier in order to treat and/or prevent them must be developed. It is incumbent upon our health care delivery systems to make meeting these patients' needs a priority.

  6. Cervical Cancer Screening Among Arab Women in the United States: An Integrative Review.

    Science.gov (United States)

    Abboud, Sarah; De Penning, Emily; Brawner, Bridgette M; Menon, Usha; Glanz, Karen; Sommers, Marilyn S

    2017-01-01

    Arab American women are an ethnic minority and immigrant population in the United States with unique and nuanced sociocultural factors that influence preventive health behaviors. The aims of this article are to evaluate and synthesize the existing evidence on cervical cancer screening behaviors, as well as determine factors that influence these behaviors, among Arab American women.
. Extensive literature searches were performed using PubMed, CINAHL®, Scopus, Embase, and Cochrane databases; articles published through October 2015 were sought. 
. Of 17 articles, 14 explicitly identified Arab and/or Muslim women and cervical cancer screening in either the title or the abstract; the remaining three focused on cancer attitudes and behaviors in Arab Americans in general but measured cervical cancer screening. Eleven articles reported different aspects of one intervention. Because of methodologic heterogeneity, the current authors synthesized results narratively.
. Key factors influencing cervical cancer screening were identified as the following. Cervical cancer screening rates among Arab American women are comparable to other ethnic minorities and lower than non-Hispanic White women. Findings are inconsistent regarding factors influencing cervical cancer screening behaviors in this underrepresented group. 
. Significant need exists for more research to better understand cervical cancer prevention behaviors in this group to inform culturally relevant interventions. Healthcare providers play a crucial role in increasing cervical cancer screening awareness and recommendations for Arab American women.

  7. Healthcare Laundry and Textiles in the United States: Review and Commentary on Contemporary Infection Prevention Issues.

    Science.gov (United States)

    Sehulster, Lynne M

    2015-09-01

    Healthcare professionals have questions about the infection prevention effectiveness of contemporary laundry processes for healthcare textiles (HCTs). Current industrial laundry processes achieve microbial reductions via physical, chemical, and thermal actions, all of which result in producing hygienically clean HCTs. European researchers have demonstrated that oxidative laundry additives have sufficient potency to meet US Environmental Protection Agency benchmarks for sanitizers and disinfectants. Outbreaks of infectious diseases associated with laundered HCTs are extremely rare; only 12 such outbreaks have been reported worldwide in the past 43 years. Root cause analyses have identified inadvertent exposure of clean HCTs to environmental contamination (including but not limited to exposure to dust in storage areas) or a process failure during laundering. To date, patient-to-patient transmission of infection has not been associated with hygienically clean HCTs laundered in accordance with industry process standards. Occupationally acquired infection involved mishandling of soiled HCTs and failure to use personal protective equipment properly. Laboratory studies of antimicrobial treatments for HCTs demonstrate a wide range of activity from 1 to 7 log10 reduction of pathogens under various experimental conditions. Clinical studies are needed to evaluate potential use of these treatments for infection prevention. Microbiological testing of clean HCTs for certification purposes is now available in the United States. Key features (eg, microbial sampling strategy, numbers of textiles sampled) and justification of the testing are discussed.

  8. [Ethics consultation unit in nephrology (UCEN): review of 10 years of operation in the Grenoble area].

    Science.gov (United States)

    Maurizi Balzan, Jocelyne; Moreaud, Olivier; Palacin, Pedro; Truche, Anne-Sophie; Zaoui, Philippe

    2013-07-01

    The existence of an ethics consultation unit in nephrology (UCEN) gives to the nephrologist the collegiality required to meet the difficulties of therapeutic choice on a legislative level, particularly in indications of stop dialysis. The discussion conducted, outside the emergency, is guided by a tool for reflexion that details successive steps necessary to the identification of elements required for decision-making. Thanks to complementary skills provided by the participants and training acquired, the UCEN can approach other ethic issues encountered during practice such as contrindication for a kidney transplantation or maintenance of conservative treatment, or performing invasive procedures on patients refusing transfusion. Propositions are not always relevant due to opposition or ambivalence of some patients, their relatives, an external or disagreements between teams or a mismatch between the technical and the patient's condition. These non-conformities decrypted always have an explanation, sometimes they are understood and accepted by the teams, and sometimes they became source of regrets when they extend life in very poor conditions. The UCEN, if it does not solve every single point, remains a place and a time of sharing that face difficult situations, help the nephrologist positioning himself on maintaining treatments that were first to avoid and prevent the realization of unreasonable acts and accept their limits.

  9. A systematic review of validated methods for identifying hypersensitivity reactions other than anaphylaxis (fever, rash, and lymphadenopathy), using administrative and claims data.

    Science.gov (United States)

    Schneider, Gary; Kachroo, Sumesh; Jones, Natalie; Crean, Sheila; Rotella, Philip; Avetisyan, Ruzan; Reynolds, Matthew W

    2012-01-01

    The Food and Drug Administration's Mini-Sentinel pilot program aims to conduct active surveillance to refine safety signals that emerge for marketed medical products. A key facet of this surveillance is to develop and understand the validity of algorithms for identifying health outcomes of interest from administrative and claims data. This article summarizes the process and findings of the algorithm review of hypersensitivity reactions. PubMed and Iowa Drug Information Service searches were conducted to identify citations applicable to the hypersensitivity reactions of health outcomes of interest. Level 1 abstract reviews and Level 2 full-text reviews were conducted to find articles using administrative and claims data to identify hypersensitivity reactions and including validation estimates of the coding algorithms. We identified five studies that provided validated hypersensitivity-reaction algorithms. Algorithm positive predictive values (PPVs) for various definitions of hypersensitivity reactions ranged from 3% to 95%. PPVs were high (i.e. 90%-95%) when both exposures and diagnoses were very specific. PPV generally decreased when the definition of hypersensitivity was expanded, except in one study that used data mining methodology for algorithm development. The ability of coding algorithms to identify hypersensitivity reactions varied, with decreasing performance occurring with expanded outcome definitions. This examination of hypersensitivity-reaction coding algorithms provides an example of surveillance bias resulting from outcome definitions that include mild cases. Data mining may provide tools for algorithm development for hypersensitivity and other health outcomes. Research needs to be conducted on designing validation studies to test hypersensitivity-reaction algorithms and estimating their predictive power, sensitivity, and specificity. Copyright © 2012 John Wiley & Sons, Ltd.

  10. Methylene blue, midodrine, and pseudoephedrine: a review of alternative agents for refractory hypotension in the intensive care unit.

    Science.gov (United States)

    Van Berkel, Megan A; Fuller, Laura A; Alexandrov, Anne W; Jones, G Morgan

    2015-01-01

    Hypotensive episodes are common among patients in the intensive care unit and can lead to multiorgan failure if uncontrolled. Fluid administration and continuous infusion of vasoactive agents are frequently used for management of hypotension; however, both therapies may be associated with adverse effects including pulmonary edema and tissue necrosis. In addition, availability of these first-line agents has been impacted by the increasing occurrence of drug shortages. Methylene blue, pseudoephedrine, and midodrine have been considered potential alternatives to standard therapy. These agents may not only be used when first-line agents are unavailable due to shortages, but they may also aid in reducing the cumulative dose of other vasoactive agents used. The purpose of this review was to discuss strategies for the safe and effective use of methylene blue, pseudoephedrine, and midodrine for the treatment of hypotension in the critically ill.

  11. Retrospective review of critical incidents in the post-anaesthesia care unit at a major tertiary hospital.

    Science.gov (United States)

    Bruins, Suze Dominique; Leong, Pauline Meng Choo; Ng, Shin Yi

    2017-08-01

    We reviewed patients with critical incidents that occurred in the post-anaesthesia care unit (PACU) at a major tertiary hospital, and assessed the effect of these incidents on PACU length of stay and discharge disposition. A retrospective review was conducted of patients in the PACU over a two-year period from 24 June 2011 to 23 August 2013. Data on critical incidents was recorded in the administrative database using a standardised data form. There were 701 incidents involving 364 patients; 203 (55.8%) patients had American Society of Anesthesiologists (ASA) physical status I or II. The most common critical incidents were cardiovascular-related (n = 293, 41.8%), respiratory (n = 155, 22.1%), neurological (n = 52, 7.4%), surgical (n = 47, 6.7%) and airway-related (n = 34, 4.9%). There were two incidents of cardiac arrest and 25 incidents of unexpected reintubations. Many patients (n = 186, 51.2%) stayed for over four hours in the PACU due to critical incidents and 184 (50.5%) patients required a higher level of care postoperatively than initially planned. Some patients (n = 34, 9.3%) returned to the operation theatre for further management. A proportion of patients (n = 64, 17.6%) had unplanned intensive care unit admissions due to adverse events in the PACU. A wide spectrum of critical incidents occur in the PACU, many of which are related to the cardiovascular and respiratory systems. Critical incidents have a major impact on healthcare utilisation and result in prolonged PACU stays and higher levels of postoperative care than initially anticipated.

  12. The Short Stay Unit as a new option for hospitals: A review of the scientific literature

    Science.gov (United States)

    Damiani, Gianfranco; Pinnarelli, Luigi; Sommella, Lorenzo; Vena, Valentina; Magrini, Patrizia; Ricciardi, Walter

    2011-01-01

    Summary Background The short stay unit (SSU) is a ward providing targeted care for patients requiring brief hospitalization and dischargeable as soon as clinical conditions are resolved. Therefore, SSU is an alternative to the ordinary ward (OW) for the treatment of selected patients. The SSU model has been tested in only a few hospitals, and the literature lacks systematic evaluation of the impact of SSU use. The aim of our study was to evaluate the use of SSUs in terms of length of hospital stay, mortality and readmission rate. Material/Methods A random effect meta-analysis was carried out by consulting electronic databases. Studies were selected that focused on comparison between use of SSUs and OWs. Mean difference of length of stay was calculated within 95% confidence intervals. Results Six articles were selected, for a total of 21 264 patients. The estimated mean difference was −3.06 days (95% CI −4.71, −1.40) in favor of the SSU. The selected articles did not show any differences in terms of mortality and readmission rate. Conclusions Use of SSUs could reduce patient length of stay in hospital, representing an alternative to the ordinary ward for selected patients. A shorter period of hospitalization could reduce the risk of hospital-acquired infections, increase patient satisfaction and yield more efficient use of hospital beds. Findings of this study are useful for institutional, managerial and clinical decision-makers regarding the implementation of the SSU in a hospital setting, and for better management of continuity of care. PMID:21629205

  13. Nurse-patient interaction in acute adult inpatient mental health units: a review and synthesis of qualitative studies.

    Science.gov (United States)

    Cleary, Michelle; Hunt, Glenn E; Horsfall, Jan; Deacon, Maureen

    2012-02-01

    Mental health nurses work with acutely unwell patients, and the busy setting is characterised by unpredictable events. This paper is a report of a review conducted to identify, analyse and synthesize research in adult acute inpatient mental health units, which focused on nurse-patient interaction. Several electronic databases were searched using relevant keywords to identify studies published from 1999-present. Qualitative studies published in English were included if they specifically investigated nurse-patient interaction in acute inpatient care in adult settings. Eighteen studies were included (23 papers). Findings were grouped