Use Of Assessment Tools Research Articles

Esophagogastric junction distensibility assessed using the functional lumen imaging probe

AIMTo assess reference values in the literature for esophageal distensibility and cross-sectional area in healthy and diseased subjects measured by the functional lumen imaging probe (FLIP).METHODSSystematic search and review of articles in Medline and Embase pertaining to the use of FLIP in the esophagus was conducted in accordance with the PRISMA guidelines. Cross-sectional area and distensibility at the esophagogastric junction (EGJ) were abstracted for normal subjects, achalasia, and gastroesophageal reflux disease (GERD) patients, stratified by balloon length and volume of inflation.RESULTSSix achalasia studies (n = 154), 3 GERD (n = 52), and 5 studies including healthy controls (n = 98) were included in the systematic review. Normative data varied widely amongst studies of healthy volunteers. In contrast, studies in achalasia patients uniformly demonstrated low point estimates in distensibility ≤ 1.6 mm2/mmHg prior to treatment that increased to ≥ 3.4 mm2/mmHg following treatment at 40mL bag volume. In GERD patients, distensibility fell to the range of untreated achalasia (≤ 2.85 mm2/mmHg) following fundoplication.CONCLUSIONFLIP may be a useful tool in assessment of treatment efficacy in achalasia. The drastic drop in EGJ distensibility after fundoplication suggests that FLIP measurements need to be interpreted in the context of esophageal body motility and highlights the importance of pre-operative screening for dysmotility. Future studies using standardized FLIP protocol and balloon size are needed.

Validation of the tool assessment of clinical education (AssCE): A study using Delphi method and clinical experts

The aim of the present study was to establish the validity of the tool Assessment of Clinical Education (AssCE). The tool is widely used in Sweden and some Nordic countries for assessing nursing students' performance in clinical education. It is important that the tools in use be subjected to regular audit and critical reviews. The validation process, performed in two stages, was concluded with a high level of congruence. In the first stage, Delphi technique was used to elaborate the AssCE tool using a group of 35 clinical nurse lecturers. After three rounds, we reached consensus. In the second stage, a group of 46 clinical nurse lecturers representing 12 universities in Sweden and Norway audited the revised version of the AssCE in relation to learning outcomes from the last clinical course at their respective institutions. Validation of the revised AssCE was established with high congruence between the factors in the AssCE and examined learning outcomes. The revised AssCE tool seems to meet its objective to be a validated assessment tool for use in clinical nursing education.

Establishing a Process Utilizing Community Leaders as Mentors to Undergraduate Students

Mentoring has long been a method for passing experience from one generation to the next. This report outlines the creation, development, and application of a mentoring program linking undergraduate business students with community professionals. The goal of the program is to enhance career opportunities of students and to garner community support for the university. In addition, with the increased need from accrediting bodies to show impact of the educational processes, mentoring may be a useful tool for assessment of program impact as well as a tool for enhancing alumni and community relations and financial support.

A Resource-Oriented Music Therapy Assessment Tool for Use in a Skilled Nursing Facility: Development and Case Example

A Resource-Oriented Music Therapy Assessment Tool for Use in a Skilled Nursing Facility: Development and Case Example

Appropriate pain assessment tools for use in patients with dementia in the out-of-hospital environment

There is substantial evidence to suggest adults with cognitive impairment, caused by degenerative conditions such as dementia, are at a significantly higher risk of suboptimal pain assessment and management in the acute care setting when compared to adults without cognitive impairment. This paper aims to assess the pain assessment tools most appropriate for use in adults with cognitive impairment as a result of dementia within the out-of-hospital setting. A search of the literature was conducted in May 2016. The databases searched were Pubmed (Medline) and Embase. The primary types of literature retrieved were meta-reviews, systematic reviews or reviews. All subcategories of dementia were included in this review. From the search strategies, 12 relevant articles and 35 pain assessment tools for use in patients with dementia were identified. In this review, the Abbey Pain Scale and PAINAD have been identified as tools substantiated in the literature for use in detecting pain in adults with dementia, which likely have applications in the out-of-hospital environment. A trial of either the Abbey Pain Scale or PAINAD in an emergency ambulance service is appropriate and likely warranted to assess their impact on pain assessment in this vulnerable patient group.

Are diet diaries of value in recording dietary intake of sugars? A retrospective analysis of completion rates and information quality.

Objectives Current guidance recommends that dental practitioners should routinely give dietary advice to patients, with diet diaries as a tool to help diet assessment. We explored patients' compliance with diet-diaries usage in a paediatric clinic within a teaching hospital setting, where remuneration is not an issue. Objectives were to investigate associated factors affecting diet diaries return rate and the information obtained from returned diaries.Methods A retrospective study of 200 randomly selected clinical records of children aged 5-11 years who had received diet analysis and advice as part of a preventive dental care programme at a dental teaching hospital between 2010 and 2013. Clinical records, with a preventive care pro forma, were included in the study. Data on social and family history, DMFT-dmft, oral hygiene practices, dental attendance and dietary habits were obtained and compared with information given in completed diet-diaries. A deductive content analysis of returned diet-diaries was undertaken using a pre-developed coding scheme.Results Of 174 complete records included in this study, diet diaries were returned in 60 (34.5%) of them. Diet diaries were more likely to be returned by those children who reported that they regularly brushed their teeth (P <0.05), and those who came from smaller families (P <0.05). Content analysis of diet diaries enabled the identification of harmful types of foods and drinks in 100% of diaries. General dietary issues, frequency and between-meals intake of sugars were also all captured in the majority of diaries (95.0%, N = 56). Information on sugar amount (53.0%, N = 32), prolonged-contact with teeth (57.0%, N = 34) and near bedtime intakes (17.0%, N = 28) was reported in fewer diaries.Conclusions The return rate of diet-diaries in this setting was low, and associated with patients' demographic and oral health characteristics. Returned diet-diaries showed a varied range of missing important dietary information, such as sugar amount, which appears to compromise their validity as a diet assessment tool. Development of a more reliable and acceptable dietary assessment tool for use in the dental setting is needed.

Development and validation of the Learning Disabilities Needs Assessment Tool (LDNAT), a HoNOS-based needs assessment tool for use with people with intellectual disability.

In meeting the needs of individuals with intellectual disabilities (ID) who access health services, a brief, holistic assessment of need is useful. This study outlines the development and testing of the Learning Disabilities Needs Assessment Tool (LDNAT), a tool intended for this purpose. An existing mental health (MH) tool was extended by a multidisciplinary group of ID practitioners. Additional scales were drafted to capture needs across six ID treatment domains that the group identified. LDNAT ratings were analysed for the following: item redundancy, relevance, construct validity and internal consistency (n = 1692); test-retest reliability (n = 27); and concurrent validity (n = 160). All LDNAT scales were deemed clinically relevant with little redundancy apparent. Principal component analysis indicated three components (developmental needs, challenging behaviour, MH and well-being). Internal consistency was good (Cronbach alpha 0.80). Individual item test-retest reliability was substantial-near perfect for 20 scales and slight-fair for three scales. Overall reliability was near perfect (intra-class correlation = 0.91). There were significant associations with five of six condition-specific measures, i.e. the Waisman Activities of Daily Living Scale (general ability/disability), Threshold Assessment Grid (risk), Behaviour Problems Inventory for Individuals with Intellectual Disabilities-Short Form (challenging behaviour) Social Communication Questionnaire (autism) and a bespoke physical health questionnaire. Additionally, the statistically significant correlations between these tools and the LDNAT components made sense clinically. There were no statistically significant correlations with the Psychiatric Assessment Schedules for Adults with Developmental Disabilities (a measure of MH symptoms in people with ID). The LDNAT had clinically utility when rating the needs of people with ID prior to condition-specific assessment(s). Analyses of internal and external validity were promising. Further evaluation of its sensitivity to changes in needs is now required.

Reverberation index: a novel metric by which to quantify the impact of a scientific entity on a given field.

The authors propose a novel bibilometric index, the reverberation index (r-index), as a comparative assessment tool for use in determining differential reverberation between scientific fields for a given scientific entity. Conversely, this may allow comparison of 2 similar scientific entities within a single scientific field. This index is calculated using a relatively simple 3-step process. Briefly, Thompson Reuters' Web of Science is used to produce a citation report for a unique search parameter (this may be an author, journal article, or topical key word). From this citation report, a list of citing journals is retrieved from which a weighted ratio of citation patterns across journals can be calculated. This r-index is then used to compare the reverberation of the original search parameter across different fields of study or wherever a comparison is required. The advantage of this novel tool is its ability to transcend a specific component of the scientific process. This affords application to a diverse range of entities, including an author, a journal article, or a topical key word, for effective comparison of that entity's reverberation within a scientific arena. The authors introduce the context for and applications of the r-index, emphasizing neurosurgical topics and journals for illustration purposes. It should be kept in mind, however, that the r-index is readily applicable across all fields of study.

Assessment Tools for Use During Anesthesia-Centric Pediatric Advanced Life Support Training and Evaluation

BackgroundPediatric perioperative cardiac arrests are rare events that require rapid, skilled and coordinated efforts to optimize outcomes. We developed an assessment tool for assessing clinician performance during perioperative critical events termed Anesthesia-centric Pediatric Advanced Life Support (A-PALS). Here, we describe the development and evaluation of the A-PALS scoring instrument. MethodsA group of raters scored videos of a perioperative team managing simulated events representing a range of scenarios and competency. We assessed agreement with the reference standard grading, as well as interrater and intrarater reliability. ResultsOverall, raters agreed with the reference standard 86.2% of the time. Rater scores concerning scenarios that depicted highly competent performance correlated better with the reference standard than scores from scenarios that depicted low clinical competence (P < 0.0001). Agreement with the reference standard was significantly (P < 0.0001) associated with scenario type, item category, level of competency displayed in the scenario, correct versus incorrect actions and whether the action was performed versus not performed. Kappa values were significantly (P < 0.0001) higher for highly competent performances as compared to lesser competent performances (good: mean = 0.83 [standard deviation = 0.07] versus poor: mean = 0.61 [standard deviation = 0.14]). The intraclass correlation coefficient (interrater reliability) was 0.97 for the raters’ composite scores on correct actions and 0.98 for their composite scores on incorrect actions. ConclusionsThis study provides evidence for the validity of the A-PALS scoring instrument and demonstrates that the scoring instrument can provide reliable scores, although clinician performance affects reliability.

LC–MS/MS application for urine free pyridinoline and free deoxypyridinoline: Urine markers of collagen and bone degradation

BackgroundPyridinium cross-links pyridinoline (PYD) and deoxypyridinoline (DPD) are established markers of collagen degradation. Measurement of PYD and DPD can be used to evaluate changes in bone turnover in patients with metabolic bone disease and to monitor response to anti-resorptive treatment. ObjectiveTo develop a method to extract and measure urine free PYD (fPYD) and free DPD (fDPD) by liquid chromatography tandem mass spectrometry (LC–MS/MS). The method was used to quantify urine samples from 172 healthy individuals and 63 patients diagnosed with metabolic bone disease. MethodAcidified urine samples were extracted using solid phase extraction with cellulose slurry. PYD and DPD were separated by reversed-phase, ion-paired chromatography prior to MS/MS detection. ResultsThe fully validated method showed good agreement with other laboratories in the UK National External Proficiency Scheme (UK NEQAS). The method was compared against two commercial immunoassays for fDPD and pyridinium cross-links, r2 were 0.906 and 0.816 respectively. Urine concentrations of fDPD/Cr and fPYD/Cr were significantly higher in the patients than healthy individuals (p<0.001). An average (±SD) fDPD:fPYD ratio of 0.29 (±0.08) was consistently observed across all subgroups. A markedly increased fDPD:fPYD ratio of 8.9 was observed in a patient with type VI Ehlers–Danlos Syndrome (EDS). ConclusionSimultaneous measurement of two free pyridinium cross-links provides a valuable, cost effective assessment tool for use in the diagnostic work-up of patients with metabolic bone disease. Improvements in sample extraction efficiency have increased assay specificity and analysis throughput. The use of the fDPD:fPYD ratio can assist in the diagnosis of type VI EDS.

Consensus for NF clinical trials

The neurofibromatoses (NFs) can result in substantial morbidity in affected patients. In order to accelerate the development of effective therapies for NF-related tumor and nontumor manifestations, the development of standardized meaningful outcome measures for clinical trials is critical. The Response Evaluation in Neurofibromatosis and Schwannomatosis (REiNS) International Collaboration was established with the goal to develop consensus recommendations for outcome measures and endpoints in future NF trials and provided the first set of recommendations in a <i>Neurology</i>® supplement in 2013. This second supplement updates on clinical trials that have incorporated the recommended measures and provides new recommendations for (1) standardized and specific cognitive assessment tools for use in NF clinical trials, (2) patient-reported outcome measures including pain and physical functioning, (3) functional outcome measures for airway plexiform neurofibromas, (4) the use of whole-body MRI in NF, and (5) the development of biomarkers in NF and guidelines for collection of biospecimens and establishment of biobanks for neurofibromatosis 1 (NF1), neurofibromatosis 2 (NF2), and schwannomatosis. Through engagement of the NF research community, regulatory agencies, NF advocacy groups, industry, and patients with NF, REiNS will provide a framework for comprehensive review of these recommendations, continue development of outcome measures relevant to patients, and compare results of trials, which use identical outcome measures.

A Self-assessment Tool for Screening Young Adults at Risk of Type 2 Diabetes Using Strong Heart Family Study Data.

The purpose of this study is to characterize risk factors associated with type 2 diabetes in young adults aged 18 to 29 years to develop a noninvasive risk assessment tool for use with younger American populations. The self-assessment tool was developed with the Strong Heart Family Study data. A total of 590 young American Indian adults (242 men) who had normoglycemia and were not receiving diabetes treatment were included. Risk factors recommended by the American Diabetes Association were used to assess diabetes risk in these young adults. A logistic regression model was developed to calculate the predicted probability. The area under the receiver operating characteristic curve was used to evaluate the model. The final model showed that parental history of diabetes, obesity level, alcohol consumption, and high fasting glucose, even within normal range, were significantly associated with onset of prediabetes/diabetes in 5 years. The area under the receiver operating characteristic curve value was 0.68 with original and validated data, indicating that the risk assessment tool had reasonably good discrimination ability. This new noninvasive screening tool, based on data from American Indian young adults, has potential to screen young adults' early-onset diabetes risk. Future studies are warranted to test this risk assessment tool in other racial/ethnic young adults.

Identification of indices for accurate estimation of anthocyanin and carotenoids in different species of flowers using hyperspectral data

ABSTRACTQuantification of accessory pigments is very useful tool for assessment of quality of flowers. Available techniques for the quantification of accessory pigments are either time-consuming or highly laborious. However, till date, very few researchers have managed to provide an accurate solution of this problem. In present study, we have developed a model for accurate estimation of anthocyanin and carotenoids in different species of flowers using hyperspectral data. Numbers of bands sensitive towards the variation in the flower pigments were identified using different techniques such as correlation and stepwise discriminant analysis. Regression model developed using published indices worked well and gave moderately good results with highest R2 of 0.60 for anthocyanin and 0.66 for carotenoids. Likewise, developed simple ratio (SR) index (SR 331/581) gave best results for anthocyanins (R2 = 0.67) and SR 331/631 gave best results for carotenoids with R2 = 0.68.

The Northwick Park Examination of Cognition: A brief cognitive assessment tool for use in acute stroke services

Background/Aims: Assessment of cognitive impairment following stroke forms an important part of diagnosis, treatment and rehabilitation planning. However, none of the available and widely used tools were developed specifically for use in stroke services. Most screening tools were developed for dementia, and consequently are biased toward an evaluation of memory function, provide inadequate assessment of executive function and are mainly verbally administered, limiting their utility in aphasic patients. Methods: One hundred and sixty-six stroke patients admitted to a hyper acute stroke unit and a control sample of 100 healthy participants completed the Northwick Park Examination of Cognition (NPEC). The NPEC includes 22 sub-tests in the domains of reasoning, episodic memory, language, perception and attention/executive function. Multiple input (verbal, visual) and output (spoken, written, gesture) modalities increase accessibility to patients with various deficits/lesion locations. Findings: Mean time from stroke to assessment was 5.6 days (SD=7.9). Seventy five percent of patients gained impaired scores (mild, moderate or severe impairment), which was evident at the group level on all subtests. Left and right cortical stroke patients differed significantly (P&lt;0.05) on specific verbal (R&gt;L) and spatial attention (L&gt;R) subtests. Sensitivity and specificity for the detection of cognitive impairment (sensitivity=0.90; specificity=0.80; area-under-curve [AUC]=0.93) were equivalent or superior to data reported for established cognitive screening tools (AUC=0.53–0.89). Patients were disproportionately impaired on high vs low attentional demand cancellation tasks (P&lt;0.0001). Conclusions: The NPEC is brief, freely available and has good sensitivity and specificity for differentiating stroke patients from controls in terms of cognitive functioning. The inclusion of timed executive function measures and comparable verbal and non-verbal sub-tests permits characterisation of cognitive dysfunction in different stroke subtypes.

Application of TOPSIS for Selection and Assessment of Analytical Procedures for Ibuprofen Determination in Wastewater

This paper describes the possible implementation of the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) as green analytical chemistry metrics tools. TOPSIS is one of the multi-criteria decision analysis (MCDA) tools that is applied in the selection of the best alternative from many possible. In this case we have applied it to assess the nineteen analytical procedures for ibuprofen determination in wastewater samples. They were described by the eight different criteria, such as metrological, economic and environmental ones. We applied the weights for each criterion that were obtained from experts knowledge. The results were discussed by the examples of six different scenarios derived by application of TOPSIS technique. Relative importance of criteria depends on subjective estimation of the decision maker and has a significant influence on the final result. TOPSIS is useful tool in assessment of green analytical chemistry metrics and ranking of the alternatives. It is very straightforward in use, it can be easily implemented in Excel program. The results are numerical values that make the results very simple to interpret and compare. Keywords: Decision making, green analytical chemistry, ibuprofen determination, multi-criteria decision analysis, TOPSIS.

Adiposity estimated using air displacement plethysmography, body mass index and body adiposity index in a sample of severely obese patients

Abstract The body adiposity index (BAI) was developed as an alternative method to estimate body fat (BF), and it was found to be more sensitive than BMI for this purpose. For BF% estimation, BAI is calculated using a simple equation that includes only hip circumference and body height. Thus, BAI comprises a potentially rapid, inexpensive, and noninvasive assessment tool for use in clinical practice. However, some reports have suggested that BAI may perform poorly in estimating BF% in populations at the extreme limits of fat amount (very low or very high). In our recent study with severely obese subjects, BAI provided differing values for BF% from those estimated by air displacement plethysmography, applied as a reference method. Particularly, BAI exhibited a positive systematic bias to overestimate BF% for those severely obese subjects, with lower values of BF% provided by air displacement plethysmography. Taken together, our data indicates that BAI performance declines when used to estimate BF% in subjects with very high amount of body fat. As severely obese patients are at higher risk for complications associated with excess body fat, the development of a new, simple equation to estimate BF% in this patient population is of clinical interest.

A global approach to hierarchical classification of coastal waters at different spatial scales: the NEA case

Ecological classification of coastal waters has become increasingly important as one of the basic issues in the biology of conservation. Management and protection of coastal areas take place at different spatial scales. Thus, proper classification schemes should integrate equivalent information at various levels of definition in order to show its feasibility as a useful tool for assessment of coastal environments at the required scales. In this work, a global approach applied to the classification of the NE Atlantic coast is analysed in order to discuss pros and cons regarding different conceptual and technical issues for effective implementation of such a management tool. Using the hierarchical system applied at three different geographic scales: Biogeographic (NE Atlantic coast), Regional (Bay of Biscay) and Local (Cantabria region), five different topics were considered for debating strengths and weaknesses of the methodological alternatives at those spatial scales, using for validation the rocky shore macroalgae as a representative biological element of benthic communities. These included: (i) the spatial scales; (ii) the physical variables and indicators; (iii) the classification methodologies; (iv) the biological information; and (v) the validation procedure. Based on that analysis, the hierarchical support system summarized in this paper provides a management framework for classification of coastal systems at the most appropriate resolution, applicable to a wide range of coastal areas. Further applications of the physical classification for management of biodiversity in different environmental scenarios are also analysed.

Content Validation and Evaluation of an Endovascular Teamwork Assessment Tool

To modify, content validate, and evaluate a teamwork assessment tool for use in endovascular surgery. A multistage, multimethod study was conducted. Stage 1 included expert review and modification of the existing Observational Teamwork Assessment for Surgery (OTAS) tool. Stage 2 included identification of additional exemplar behaviours contributing to effective teamwork and enhanced patient safety in endovascular surgery (using real-time observation, focus groups, and semistructured interviews of multidisciplinary teams). Stage 3 included content validation of exemplar behaviours using expert consensus according to established psychometric recommendations and evaluation of structure, content, feasibility, and usability of the Endovascular Observational Teamwork Assessment Tool (Endo-OTAS) by an expert multidisciplinary panel. Stage 4 included final team expert review of exemplars. OTAS core team behaviours were maintained (communication, coordination, cooperation, leadership team monitoring). Of the 114 OTAS behavioural exemplars, 19 were modified, four removed, and 39 additional endovascular-specific behaviours identified. Content validation of these 153 exemplar behaviours showed that 113/153 (73.9%) reached the predetermined Item-Content Validity Index rating for teamwork and/or patient safety. After expert team review, 140/153 (91.5%) exemplars were deemed to warrant inclusion in the tool. More than 90% of the expert panel agreed that Endo-OTAS is an appropriate teamwork assessment tool with observable behaviours. Some concerns were noted about the time required to conduct observations and provide performance feedback. Endo-OTAS is a novel teamwork assessment tool, with evidence for content validity and relevance to endovascular teams. Endo-OTAS enables systematic objective assessment of the quality of team performance during endovascular procedures.

Investigating the Psychometric Properties of the ACEI Global Guidelines Assessment, Third Edition (GGA) in Nine Countries

The Third Edition of the ACEI Global Guidelines Assessment (GGA) was evaluated for its effectiveness as an international assessment tool for use by early childhood educators to develop, assess, and improve program quality worldwide. This expanded study was conducted in nine countries [People’s Republic of China (2 sites), Guatemala, India, Italy, Mexico (2 sites), Peru (2 sites), Taiwan, Thailand, United States] to continue the investigation of the psychometric properties of the GGA. A total of 346 programs and 678 early care and education professionals participated in this study. Results primarily confirmed the findings of the previous study, (Hardin et al. in Early Child Educ J 41(2): 91–101, 2013), indicating that the GGA showed strong to moderate internal consistency and interrater reliability for subscale ratings across this larger number of countries and programs. The congruence of item ratings and written evidence to support ratings was acceptable, although some programs had lower participation in providing evidence. To test concurrent validity of ratings, external raters also evaluated a subset of programs (n = 44 from Peru and United States) on both the GGA and the Early Childhood Environment Rating Scale-Revised that showed moderate positive correlations. Patterns of program practices were also identified within and across the participating sites and countries. Results suggest that the GGA can be used as an onsite evaluation method that can help stakeholder participants (teachers and administrators) increase their awareness of program quality standards and serve as an assessment method for their own programs. In particular, the results suggest the GGA is a reliable and useful instrument that can be used effectively by early childhood stakeholders for assessing and improving program quality worldwide (Bergen and Hardin in Child Educ 91(4): 259–264, 2015).

Modelling response of groundwater nitrate concentration in public supply wells to land-use change

As Britain's second largest aquifer, the Sherwood Sandstone is confronted by the threat of high nitrate concentrations caused by intensive agricultural activities. The aim of this study is to investigate the response of groundwater nitrate concentration in a public supply well to land-use change, discussing the effect of land-use change in tackling agricultural nitrate pollution in the aquifer. Six land-use scenarios were examined in predictive simulations of groundwater nitrate concentration. Groundwater flow modelling (MODFLOW) and mass transport modelling (MT3DMS), incorporating results from an export coefficient model, were used to predict groundwater nitrate concentration in the public supply well by 2025. Results from the quantitative comparison of scenarios revealed that the greatest decrease in nitrate concentration (35%) by 2025 in the public supply well was associated with the entire target zone being covered with forest, whereas a decrease dependent on the application of best agricultural practice achieved no more than a 20% reduction. It is concluded that the modelling framework constructed in this study is a useful tool for assessment of the impact of changes in land use and management on groundwater nitrate concentration in public supply wells.