Preliminary Validation Tests Research Articles

Validating the personal health records adoption model using a modified e‐Delphi

To report the results of a preliminary test of validity of a proposed theoretical framework of electronic personal health record adoption by older adults. Personal health records can assist older adults in managing or co-managing their chronic health conditions. Although there is interest by this population, their adoption of this technology has been slow. Without a comprehensive understanding of the reasons for this phenomenon, facilitating adoption will be difficult. Therefore, we developed a theoretical framework of adoption barriers and facilitators. Survey. A modified e-Delphi methodology was used to validate the framework by obtaining consensus from a panel of experts in related healthcare fields. These data were collected over 3 months in 2010. Of 16 expert panellists, 13 completed Round 1, 12 completed Rounds 2 and 3, and 9 completed Round 4. Central tendencies and percent agreement were computed to establish consensus. The e-Delphi resulted in expert consensus on the concepts, variables, and empirical indicators that were retained in (or added to) the framework to describe barriers and/or facilitators to older adults' adoption of personal health records for self-management of chronic disease. The validated model will be used as the basis for developing an instrument to identify barriers and facilitators to personal health records adoption and use by older adults with chronic disease. With better understanding of the factors that influence personal health record adoption in this population, more effective strategies may be developed to increase adoption and thus improve chronic disease management.

THE DEVELOPMENT OF CULTURE-BASED INTEGRATED LEARNING MODEL TO IMPROVE STUDENTS’ APPRECIATION ON LOCAL CULTURE (The Study of Elementary School Social Study Subject)

Current practices of social studies at elementary school tends to be partial. The concept of social studies which is close to environment, especially local culture, has not been optimally used in the learning process so that students don’t really appreciate their own culture. This study is to develop a model of social study learning for elementary school that can help students master subject material as an effort to improve their appreciation on local culture, using RD preliminary study, model development and model validation testing. The subjects of study were teachers and students of elementary school in Bengkulu province,Sumatra. The result of study showed that Culture-Based Integrated Learning Model (MPTBB) is an appropriate learning model to help students master subject material as an effort to improve their appreciation on local culture. MPTBB is a learning model focusing on cultural themes developed on the basis of prior knowledge of students’ culture. MPTBB has been significantly proved more effective in improving students’ appreciation on local culture simultaneous with their mastery of subject material than the currently existing learning model used by teacher. Keywords: Learning model, social study for elementary school, culture appreciation

Expression of direct anger and hostility predict depression symptoms in formerly depressed women.

The focus of this two-part study was on distinguishing maladaptive expressions of anger (hostility) from adaptive forms (direct anger). Observational codes assessing the dimensions of hostility and direct anger were developed and applied to a videotaped task in which women discussed a conflictual topic with their romantic partners. Scales showed acceptable interrater reliability and convergent and discriminant validity. In a preliminary test of the predictive validity of these scales, their distinct roles in predicting psychological outcome were supported: Direct anger was negatively related and hostility was positively related to subsequent depressive symptoms in 23 formerly depressed women across a 6–18 month follow-up period. Results support the importance of further theoretical and empirical work to delineate adaptive and maladaptive expressions of anger.

Development of a Computerized Adaptive Test to Assess Health-Related Quality of Life in Adults with Asthma

Objective. The purpose of this research was to calibrate an item bank for a computerized adaptive test (CAT) of asthma impact on health-related quality of life (HRQOL), test CAT versions of varying lengths, conduct preliminary validity testing, and evaluate item bank readability. Methods. Asthma Impact Survey (AIS) bank items that passed focus group, cognitive testing, and clinical and psychometric reviews were administered to adults with varied levels of asthma control. Adults self-reporting asthma (N = 1106) completed an Internet survey including 88 AIS items, the Asthma Control Test, and other HRQOL outcome measures. Data were analyzed using classical and modern psychometric methods, real-data CAT simulations, and known groups validity testing. Results. A bi-factor model with a general factor (asthma impact) and several group factors (cognitive function, fatigue, mental health, physical function, role function, sexual function, self-consciousness/stigma, sleep, and social function) was tested. Loadings on the general factor were above 0.5 and were substantially larger than group factor loadings, and fit statistics were acceptable. Item functioning for most items and fit to the model was acceptable. CAT simulations demonstrated several options for administration and stopping rules. AIS distinguished between respondents with differing levels of asthma control. Conclusions. The new 50-item AIS item bank demonstrated favorable psychometric characteristics, preliminary evidence of validity, and accessibility at moderate reading levels. Developing item banks for CAT can improve the precise, efficient, and comprehensive monitoring of asthma outcomes and may facilitate patient-centered care.

The Role of Self-Efficacy in Quality of Life for Disadvantaged Men With Prostate Cancer

Self-efficacy is associated with increased participation in treatment decision making and improved health related quality of life. We examined the influence of perceived efficacy in patient-physician interactions on health related quality of life among low income, uninsured men with prostate cancer during a 2-year period. We analyzed data derived on participants enrolled in a state funded program providing free prostate cancer treatment and care to indigent men. We used validated instruments to measure patient self-efficacy (confidence in interacting with physicians), and the general and prostate specific health related quality of life outcomes of urinary, sexual and bowel bother, symptom distress, psychological well-being and vitality. We performed repeated measures analysis with general linear mixed modeling to estimate the association of sociodemographic and clinical covariates with health related quality of life. Our cohort included a total of 472 observations in 99 men. Self-efficacy had a measurable effect on subjective measurements of general and disease specific health related quality of life. Men with the lowest self-efficacy had inferior mean health related quality of life scores across all outcomes. Low self-efficacy was significantly associated with worse bowel bother and general symptom distress during the 2-year study period. Similar health related quality of life outcomes trajectories were observed across self-efficacy categories. Of disadvantaged men with clinically localized prostate cancer those with the lowest self-efficacy in physician interactions fared worst across all measured domains of health related quality of life. Interventions to improve patient-physician communication in this population may provide physicians with a supplemental method by which to address health perceptions, mitigate symptom experience and improve health outcomes.

Development of the Obstetric Nursing Self-Efficacy Scale Instrument

BackgroundThe objective of this study is the development of the Obstetric Nursing Self-Efficacy (ONSE) Scale instrument and the reporting of psychometric data gathered from a pilot completed in fall 2009 at 2 major universities. MethodThe ONSE is an 18-item instrument designed with the use of Bandura’s social-cognitive theory. Instrument development consisted of 2 rounds of expert review. The average content validity index of the scale was .91. ResultsFor preliminary reliability testing, students (N = 20) completed the ONSE survey after participating in a 45-hour clinical rotation in obstetric nursing. A range of split-half reliability scores was calculated at .85 to .96. For preliminary validity testing, students (N = 46) completed the ONSE pre- and postsimulation. Paired t tests revealed a statistically significant improvement in self-efficacy scores for both pre- and posttest scores. ConclusionThe findings were encouraging for initial validity and reliability testing of the ONSE as an instrument to measure self-efficacy of students caring for obstetric patients.

Interstitial Cystitis/Painful Bladder Syndrome and Associated Medical Conditions With an Emphasis on Irritable Bowel Syndrome, Fibromyalgia and Chronic Fatigue Syndrome

We characterized and compared the impact of clinical phenotypic associations between interstitial cystitis/painful bladder syndrome and controls in relation to potentially related conditions, particularly irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome. Female patients with interstitial cystitis/painful bladder syndrome and controls with no interstitial cystitis/painful bladder syndrome completed a biopsychosocial phenotyping questionnaire battery which included demographics/history form, self-reported history of associated conditions, and 10 validated questionnaires focused on symptoms, suffering/coping and behavioral/social factors. Questionnaires were completed by 205 patients with interstitial cystitis/painful bladder syndrome and 117 controls matched for age. Prevalence of self-reported associated condition diagnosis in interstitial cystitis/painful bladder syndrome vs controls was irritable bowel syndrome 38.6% vs 5.2%, fibromyalgia 17.7% vs 2.6% and chronic fatigue syndrome 9.5% vs 1.7% (all p <0.001). In the interstitial cystitis/painful bladder syndrome cohort 50.3% reported no other associated condition, 24.4% had interstitial cystitis/painful bladder syndrome + irritable bowel syndrome only, 2.5% had interstitial cystitis/painful bladder syndrome + fibromyalgia only, 1.5% had interstitial cystitis/painful bladder syndrome + chronic fatigue syndrome only, while 20.2% had multiple associated conditions. As the number of associated conditions increased (ie localized, regional, systemic), pain, stress, depression and sleep disturbance increased while social support, sexual functioning and quality of life deteriorated. Anxiety and catastrophizing remained increased in all groups. Symptom duration was associated with this apparent phenotypic progression. Irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome are more prevalent in patients with interstitial cystitis/painful bladder syndrome than in asymptomatic control subjects, and result in significant impact. There are at least 3 distinct clinical phenotypes based on identification of overlapping syndrome patterns. A suggestion that remains to be proven with longitudinal studies is that there may be progression over time from an organ centric to a regional and finally to a systemic pain syndrome with progression of symptom severity, and deterioration of cognitive and psychosocial parameters.

Development and validation of the Supervisory Relationship Questionnaire (SRQ) in UK trainee clinical psychologists

To develop a valid and reliable measure of the supervisory relationship (SR) from the supervisee perspective. A cross-sectional questionnaire design was used with a repeated measures component for a sub-sample. Qualitative data obtained from a previous study and from review of the literature were used to construct a 111 item self-report questionnaire measure [Supervisory Relationship Questionnaire (SRQ)]. This was administered to 284 British trainee clinical psychologists. Eighty-five participants completed the SRQ a second time to establish its test-retest reliability. Principal components analysis (PCA) identified six components of the SRQ. Three of these reflected the 'facilitative' relationship characteristics of the SR and were labelled 'safe base', 'commitment' and 'structure'. The second set of components reflected the educative and evaluative functions of supervision. These were labelled 'reflective education', 'role model' and 'formative feedback'. Safe base accounted for the greatest proportion of variance in SRQ scores (52 per cent). Analyses using the six subscales subsequently derived from the PCA, revealed the SRQ to have high internal reliability, good test-retest reliability and good construct (convergent and divergent) validity. A preliminary test of predictive validity was conducted. The SRQ (six subscales, total of 67 items) is a valid and reliable measure of the SR from the supervisee perspective. The present findings support existing models of the SR, and its distinct nature during training as an educative and evaluative process. The SRQ is a promising tool for further research, and is likely to be useful in supervisor training and clinical settings.

SPHysics-FUNWAVE hybrid model for coastal wave propagation

It is difficult to study the process of wave propagation from the deep ocean to the nearshore region using a single model due to the presence of multiple scales both in time and in space. Numerical models based on the Boussinesq equations are well known to accurately propagate waves from intermediate water depth to the nearshore region. Since they are 2D models, they are computationally efficient and can be applied to study wave transformations over large domains. Numerical models based on Smoothed Particle Hydrodynamics can inherently capture multiply connected free surfaces and hence can be naturally used to capture breaking free surfaces and estimate breaking induced runup and overtopping. Here, a hybrid model (SPHunwave) is developed combining the main advantages of a Boussinesq model (FUNWAVE) and a SPH model (SPHysics). The details of the coupling procedure along with preliminary validation tests are presented.

The Revised Cyber Bullying Inventory (RCBI): validity and reliability studies

The aim of this study is to revise Cyber Bullying Inventory (CBI) and to examine its basic psychometric characteristics. There were two independent samples. First sample consisting of 358 participants (178 female, 178 male, 2 unknown) aged 13-21 (M=16.58; SD=1.42) was used to test preliminary validity and reliability tests. Confirmatory analyses were conducted with the second data set which consisted of 339 participants (220 female, 117 male, 2 unknown) aged 13-21 (M=17.07; SD=1.45). RCBI appears to be a valid and reliable tool which can be utilized safely among Turkish adolescents to investigate the nature and extent of cyber bullying experience.

The International Military Intervention Dataset: An Updated Resource for Conflict Scholars

As major wars have become uncommon over recent decades and the efficacy of economic sanctions is questioned, foreign military intervention seems to have become increasingly prevalent on the international scene. Military intervention has also gained a degree of moral legitimacy, as it is now often launched for humanitarian ends rather than simply to further the intervener's strategic or material interests. Despite the apparent increase in the use of foreign military intervention as a policy tool in recent years, the quantitative international conflict literature continues to operate without either a comprehensive or a current inventory of foreign military interventions. The authors attempt to fill this gap by updating Pearson &amp; Baumann's International Military Intervention (IMI) dataset from 1989 to 2005. IMI has a number of attributes that should make it attractive to quantitative international conflict scholars. One is that it is one of a small handful of interstate conflict datasets that attempts to discern the motives behind state uses of force. Also, its substantive coverage is broad, allowing researchers to separate out and focus on the forms of intervention (supportive, hostile, humanitarian, territorial, etc.) that are relevant to their research. As a preliminary validity test of the updated data, the authors analyze patterns of Cold War and post-Cold War military intervention in the IMI collection to see if they correspond with conventional wisdom on real world events.

Measuring the impact of health problems among adults with limited mobility in Thailand: further validation of the Perceived Impact of Problem Profile

BackgroundThe Perceived Impact of Problem Profile (PIPP) was developed to provide a tool for measuring the impact of a health condition from the individual's perspective, using the ICF model as a framework. One of the aims of the ICF is to enable the comparison of data across countries, however, relatively little is known about the subjective experience of disability in middle and low-income countries. The aim of this study was to assess the validity of the Perceived Impact of Problem Profile (PIPP) for use among adults with a disability in Thailand using Rasch analysis.MethodsA total of 210 adults with mobility impairment from the urban, rural and remote areas of northeast Thailand completed the PIPP, which contains 23 items assessing both impact and distress across five key domains (Self-care, Mobility, Participation, Relationships, and Psychological Well-being). Rasch analysis, using RUMM2020, was conducted to assess the internal validity and psychometric properties of the PIPP Impact subscales. Validation of the PIPP Impact scales was conducted by comparing scores across the different response levels of the EQ5D items.ResultsRasch analysis indicated that participants did not clearly differentiate between 'impact' and 'distress,' the two aspects assessed by the PIPP. Further analyses were therefore limited to the PIPP Impact subscales. These showed adequate psychometric properties, demonstrating fit to the Rasch model and good person separation reliability. Preliminary validity testing using the EQ5D items provided support for the PIPP Impact subscales.ConclusionThe results provide further support for the psychometric properties of the PIPP Impact scales and indicate that it is a suitable tool for use among adults with a locomotor disability in Thailand. Further research is needed to validate the PIPP across different cultural contexts and health conditions and to assess the usefulness of separate Impact and Distress subscales.

Development and content validity testing of the Cardiac Symptom Survey in patients after coronary artery bypass grafting

Patients who have undergone coronary artery bypass grafting often experience numerous symptoms after surgery. There is a need for a symptom tool for this population that is disease-specific, comprehensive, and responsive to change. The aims of this study were to describe the development and preliminary content validity testing of the Cardiac Symptom Survey (CSS), assess further content validity of the CSS through an expert panel, and assess responsiveness of the CSS to change. The original development of the CSS is described. An expert panel of four judges was used to rate the clarity of the items (content validity) and the relevance of the symptoms and items to the domain. Responsiveness to change of the CSS was assessed in a sample of 90 subjects who underwent coronary artery bypass grafting. Percent agreement and content validity index coefficients ranged from .90 to 1.00. Repeated measures analyses of variance showed significant changes over time as hypothesized in some of the symptom evaluation and symptom response scores. Support is documented for both content validity and responsiveness of the CSS.

Scale effects on the response of composite structures under impact loading

For several years, composite materials have taken a significant part in the realization of structures designed for transport (aeronautical, nautical, automotive…). In order to qualify the behavior of such structures, preliminary validation tests have to be done. These specific tests are often very expensive and difficult to set up, especially when the structure dimensions are large (fuselages of aircraft, ship hulls…). An alternative way is then to employ small-scale models. The use of these reduced scale structures requires the identification of similitude models allowing the extrapolation of the small-scale model behavior to the real structure. Although largely developed in the case of homogeneous materials, such similitude techniques are not clearly identified for composite materials taking into account the damage evolution during an impact. The purpose of this article is firstly to present existing similitude techniques making it possible to predict the composite structure behaviour from the knowledge of small-scale model response. Secondly, experiments were done on two scale of samples carried out by stratification of unidirectional carbon/epoxy plies. These results were finally compared with the analytical predictions of similitude laws currently used. The aim of this paper is to contribute to similitude laws development applied to composite structures. These laws permit to extrapolate the small-scale model behavior to the real scale one. Existing approaches have been established following two different methods. They are summarized in this paper and applied to impact loadings on two laminated plate scales. In order to complete data collected by “conventional” instrumentation (force transducer, displacement sensor, accelerometer…), optical device such as an high-velocity CCD camera, associated with optical techniques for the monitoring of markers, were used. These techniques make possible to compare displacement lines corresponding to each scale. It is shown that existing similitude laws, used for elastic materials, do not allow to simulate the behavior of the real scale when this one is damaged.

Bacterial growth kinetics estimation by fluorescence in situ hybridization and spectrofluorometric quantification

The aim of this study was to develop a specific and rapid method to identify and quantify relevant bacterial populations in mixed biomass by spectrofluorometric quantification (SQ) of whole cells hybridized with fluorescently labelled oligonucleotide probes targeting mature 16S ribosomal RNA (rRNA). Probe targeting the precursor of rRNA synthesis was also employed because it was being suggested as more indicative of the activity state of the micro-organisms. Original fluorescence in situ hybridization protocol was modified to be applied to liquid samples and the fluorescence emission from the Cy3-labelled cells was measured by spectrofluorometry. The method was calibrated on an exponentially growing cell suspension of Acinetobacter johnsonii and was successfully applied to generate kinetic data. No substantial difference in the estimated maximum specific growth rate (mu(max)) values was found between the SQ method and the classical method, using absorbance at 420 nm (6.2 d(-1)). The preliminary validation tests showed their direct applicability to target enriched cultures. This study demonstrated the validity of the SQ method to easily quantify the concentration and to determine the growth rate of specific micro-organisms present in mixed cultures. The proposed method can be directly utilized for quantification and kinetic characterization of microbial enrichments. It has the advantage of being easily applicable using simple, inexpensive equipment suitable for routine analysis.

Familiality of Polarity at Illness Onset in Bipolar Affective Disorder

Objective: Bipolar affective disorder is clinically heterogeneous, and clinical features that run in families may help define more homogeneous phenotypes. The authors sought to establish whether polarity at illness onset, which is related to severity and course, is a familial feature of bipolar affective disorder. Method: The authors studied 971 subjects from 507 families ascertained through sibling pairs with bipolar I or schizoaffective bipolar disorder. Self-reported ages at onset of mania and major depression were used to code polarity at onset as manic, major depressive, or both (mania and major depression in the same onset year). Familial clustering was estimated by using mixed-effects regression analysis, and the relationship between polarity at onset and several other clinical features was assessed. As a preliminary test of genetic validity, the authors assessed the impact of polarity at onset on genetic linkage findings previously detected in this sample. Results: Polarity at onset was significantly familial in this sample. This largely reflected relative pairs concordant for mania at onset, which occurred significantly more frequently than would be expected by chance. Mania at onset substantially increased the genetic linkage signal on chromosome 16p (maximum lod score=4.5) but had no effect on linkage to chromosome 6q. Mania at onset occurred at a later age on average than major depression at onset and was less likely to be complicated by panic attacks or alcoholism. Conclusions: Polarity at illness onset is a familial feature of bipolar affective disorder and is associated with important clinical indicators, which may help define more homogeneous subtypes of bipolar affective disorder.

Familiality of Polarity at Illness Onset in Bipolar Affective Disorder

Bipolar affective disorder is clinically heterogeneous, and clinical features that run in families may help define more homogeneous phenotypes. The authors sought to establish whether polarity at illness onset, which is related to severity and course, is a familial feature of bipolar affective disorder. The authors studied 971 subjects from 507 families ascertained through sibling pairs with bipolar I or schizoaffective bipolar disorder. Self-reported ages at onset of mania and major depression were used to code polarity at onset as manic, major depressive, or both (mania and major depression in the same onset year). Familial clustering was estimated by using mixed-effects regression analysis, and the relationship between polarity at onset and several other clinical features was assessed. As a preliminary test of genetic validity, the authors assessed the impact of polarity at onset on genetic linkage findings previously detected in this sample. Polarity at onset was significantly familial in this sample. This largely reflected relative pairs concordant for mania at onset, which occurred significantly more frequently than would be expected by chance. Mania at onset substantially increased the genetic linkage signal on chromosome 16p (maximum lod score=4.5) but had no effect on linkage to chromosome 6q. Mania at onset occurred at a later age on average than major depression at onset and was less likely to be complicated by panic attacks or alcoholism. Polarity at illness onset is a familial feature of bipolar affective disorder and is associated with important clinical indicators, which may help define more homogeneous subtypes of bipolar affective disorder.

Measuring the impact and distress of health problems from the individual's perspective: development of the Perceived Impact of Problem Profile (PIPP)

BackgroundThe aim of this study was to develop and conduct preliminary validation of the Perceived Impact of Problem Profile (PIPP). Based on the biopsychosocial model of health and functioning, the PIPP was intended as a generic research and clinical measurement tool to assess the impact and distress of health conditions from the individuals' perspective. The ICF classification system was used to guide the structure of the PIPP with subscales included to assess impact on self-care, mobility, participation, relationships and psychological well-being. While the ICF focuses on the classification of objective health and health related status, the PIPP broadens this focus to address the individuals' subjective experience of their health condition.MethodsAn item pool of 23 items assessing both impact and distress on five key domains was generated. These were administered to 169 adults with mobility impairment. Rasch analysis using RUMM2020 was conducted to assess the psychometric properties of each set of items. Preliminary construct validation of the PIPP was performed using the EQ5D.ResultsFor both the Impact and Distress scales of the PIPP, the five subscales (Self-care, Mobility, Participation, Relationships, and Psychological Well-being) showed adequate psychometric properties, demonstrating fit to the Rasch model. All subscales showed adequate person separation reliability and no evidence of differential item functioning for sex, age, educational level or rural vs urban residence. Preliminary validity testing using the EQ5D items provided support for the subscales.ConclusionThis preliminary study, using a sample of adults with mobility impairment, provides support for the psychometric properties of the PIPP as a potential clinical and research measurement tool. The PIPP provides a brief, but comprehensive means to assess the key ICF components, focusing on the individuals' perspective of the impact and distress caused by their health condition. Further validation of its use across different health conditions and varying cultural settings is required.

A Structured Clinical Interview for Kleptomania (SCI-K): preliminary validity and reliability testing

Kleptomania presents difficulties in diagnosis for clinicians. This study aimed to develop and test a DSM-IV-based diagnostic instrument for kleptomania. To assess for current kleptomania the Structured Clinical Interview for Kleptomania (SCI-K) was administered to 112 consecutive subjects requesting psychiatric outpatient treatment for a variety of disorders. Reliability and validity were determined. Classification accuracy was examined using the longitudinal course of illness. The SCI-K demonstrated excellent test-retest (Phi coefficient = 0.956 (95% CI = 0.937, 0.970)) and inter-rater reliability (phi coefficient = 0.718 (95% CI = 0.506, 0.848)) in the diagnosis of kleptomania. Concurrent validity was observed with a self-report measure using DSM-IV kleptomania criteria (phi coefficient = 0.769 (95% CI = 0.653, 0.850)). Discriminant validity was observed with a measure of depression (point biserial coefficient = -0.020 (95% CI = -0.205, 0.166)). The SCI-K demonstrated both high sensitivity and specificity based on longitudinal assessment. The SCI-K demonstrated excellent reliability and validity in diagnosing kleptomania in subjects presenting with various psychiatric problems. These findings require replication in larger groups, including non-psychiatric populations, to examine their generalizability.

A new empirical model of middle latitude ionospheric response for space weather applications

A new model for nowcasting and forecasting foF2 disturbances at middle latitude ionosphere, suitable for both scientific and operational purposes is proposed in this paper. The data analysis is established on IMF observations from ACE spacecraft, D st records and foF2 critical frequency observations from four middle latitude stations distributed in longitude around the earth. The investigation concerns 15 impulse storm events occurred between 1998 and 2002. The modeling technique is based on the empirical formulation of the ionospheric storm variations in respect to interplanetary magnetic field (IMF) disturbances, on the determination of the type and the amplitude of the ionospheric response in each local time sector as well as on the estimation of the time delay of the ionospheric disturbance onset in respect to the storm onset disturbances. The proposed empirical ionospheric storm-time model is designed to scale quiet daily ionospheric variation taking into account the storm onset time in UT and the local time of the observation point. Preliminary validation tests give evidence for significant improvement over monthly median values.