Stand-alone Measure Research Articles

Use of Drivers’ Jerk Profiles in Computer Vision–Based Traffic Safety Evaluations

A traffic conflict is usually composed of a chain of events in which at least one of the involved road users performs some sort of evasive action to avoid a collision. An evasive action usually involves powerful braking, which leads to sudden, negative change in acceleration (deceleration). The temporal dynamics (variation over time) of the acceleration of a vehicle is represented by the jerk profile. More formally, jerk is the derivative of the acceleration. In the case of an evasive action by braking, the jerk profile is characterized by strong, negative values. This study examined two issues in the quest to understand the benefits of evasive action analysis. The first issue was whether jerk profiles can be used to identify critical traffic events (conflicts). The second issue addressed the validity of the assumption that the deceleration profile is inadequate as a stand-alone measure for conflict identification. Automated video analysis was used to collect traffic data and analysis was applied on two data sets with distinct traffic patterns. The study revealed a significant difference between the jerk behavior of the groups of drivers involved in conflictive and normal traffic interactions. It also showed instances in which automated jerk evaluation was successful in finding conflicts undetected by conventional conflict indicators. The same could not be demonstrated for the road users’ deceleration behavior. These findings support earlier studies on the shortcomings of the use of deceleration data for conflict identification.

Alternative methods for estimating common descriptors for QSAR studies of dyes and fluorescent probes using molecular modeling software. 2. Correlations between log P and the hydrophilic/lipophilic index, and new methods for estimating degrees of amphiphilicity

The log P descriptor, despite its usefulness, can be difficult to use, especially for researchers lacking skills in physical chemistry. Moreover this classic measure has been determined in numerous ways, which can result in inconsistant estimates of log P values, especially for relatively complex molecules such as fluorescent probes. Novel measures of hydrophilicity/lipophilicity (the Hydrophilic/Lipophilic Index, HLI) and amphiphilicity (hydrophilic/lipophilic indices for the head group and tail, HLIT and HLIHG, respectively) therefore have been devised. We compare these descriptors with measures based on log P, the standard method for quantitative structure activity relationships (QSAR) studies. HLI can be determined using widely available molecular modeling software, coupled with simple arithmetic calculations. It is based on partial atomic charges and is intended to be a stand-alone measure of hydrophilicity/lipophilicity. Given the wide application of log P, however, we investigated the correlation between HLI and log P using a test set of 56 fluorescent probes of widely different physicochemical character. Overall correlation was poor; however, correlation of HLI and log P for probes of narrowly specified charge types, i.e., non-ionic compounds, anions, conjugated cations, or zwitterions, was excellent. Values for probes with additional nonconjugated quaternary cations, however, were less well correlated. The newly devised HLI can be divided into domain-specific descriptors, HLIT and HLIHG in amphiphilic probes. Determinations of amphiphilicity, made independently by the authors using their respective methods, showed excellent agreement. Quantifying amphiphilicity from partial log P values of the head group (head group hydrophilicity; HGH) and tail (amphiphilicity index; AI) has proved useful for undertanding fluorescent probe action. The same limitations of log P apply to HGH and AI, however. The novel descriptors, HLIT and HLIHG, offer analogous advantages to those seen with HLI over log P. The high correlation between log P and HLI, and the concordance between the two systems for assessing amphiphilicity, provide a powerful tool for QSAR studies. It is possible now to select a probe with missing fragments, and thus no log P, AI or HGH; and to estimate these important descriptors from parameters derived from HLI.

Comparison of Select Advanced Clinical Solutions Embedded Effort Measures to the Word Memory Test in the Detection of Suboptimal Effort

This brief report sought to evaluate the classification statistics of the Advanced Clinical Solutions (ACS) embedded measures of symptom validity in relation to the Word Memory Test (WMT), a well-established standalone measure of effort in a sample of active duty military service members with a history of mild traumatic brain injury. Results demonstrated that relative to the WMT, the ACS embedded measures had adequate specificity, but lacked sensitivity. This result is in agreement with previous studies demonstrating poor sensitivity for embedded effort measures relative to standalone Symptom Validity Tests.

Judgment of Line Orientation: An examination of eight short forms

The Judgment of Line Orientation (JLO) test is a commonly used measure of visuospatial perception. Because of its length, several short forms have appeared in the literature. We examined the internal consistency of the JLO and eight of its published short forms among 128 undergraduates, 203 healthy older adults, and 55 chronic kidney disease patients. The full test demonstrated good reliability for traditional neuropsychological assessment, but the majority of short forms were adequate only for screening purposes, where greater measurement error is typically permitted in exchange for brevity. In contrast, a recently developed short form based upon item response theory demonstrated promise as a stand-alone measure.

Growth pattern of tumor recurrence following bis-chloroethylnitrosourea (BCNU) wafer implantation in malignant glioma

Bis-chloroethylnitrosourea (BCNU; Gliadel, Eisai, Tokyo, Japan) is the only therapeutic agent for local chemotherapy of malignant gliomas approved by the US Food and Drug Administration and the European Medicines Agency. In a small patient cohort, it has previously been shown that glioblastomas recur locally despite treatment with BCNU. This raises concern about local treatment with BCNU as a stand-alone measure. The goal of this study was to analyze the growth pattern of tumor recurrence in a larger patient group: 41 patients were included in this study. Tumor recurrences were morphologically categorized as: local, diffuse, distant or multilocular. Thirty-three of the tumors (80%) that recurred were local or diffuse. These results show that BCNU implantation does not provide lasting local tumor control. Our data support the need to incorporate BCNU in to multimodal therapy schemes. The improved survival rates of patients who receive concomitant local and systemic adjuvant treatment support using local therapy to bridge the therapy-free interval of the initial postoperative phase.

Cross-cultural development of the EORTC QLQ-SWB36: A stand-alone measure of spiritual wellbeing for palliative care patients with cancer

Background: No existing stand-alone measures of spiritual wellbeing have been developed in cross-cultural and multiple linguistic contexts. Aim: Cross-cultural development of a stand-alone European Organisation for Research and Treatment of Cancer (EORTC) measure of spiritual wellbeing for palliative care patients with cancer. Design: Broadly following EORTC Quality of Life Group (QLG) guidelines for developing questionnaires, the study comprised three phases. Phase I identified relevant issues and obtained the views of palliative care patients and professionals about those issues. Phase II operationalised issues into items. Phase III pilot-tested those items with palliative care patients. Amendments to the guidelines included an intermediate Phase IIIa, and debriefing questions specific to the measure. Setting/participants: Phase III pilot-testing recruited 113 people with incurable cancer from hospitals and hospices in six European countries and Japan. Results: A provisional 36-item measure ready for Phase IV field-testing, the EORTC QLQ-SWB36, has been developed. Careful attention to translation and simultaneous development in multiple languages means items are acceptable and consistent between different countries and languages. Phase III data from 113 patients in seven countries show that the items are comprehensible across languages and cultures. Phase III patient participants in several countries used the measure as a starting point for discussing the issues it addresses. Conclusion: The EORTC QLG’s rigorous cross-cultural development process ensures that the EORTC QLQ-SWB36 identifies key issues for spiritual wellbeing in multiple cultural contexts, and that items are comprehensible and consistent across languages. Some cross-cultural differences were observed, but data were insufficient to enable generalisation. Phase IV field-testing will investigate these differences further.

Enhancing the Jacquez k nearest neighbor test for space–time interaction

The Jacquez k nearest neighbor test, originally developed to improve upon shortcomings of existing tests for space-time interaction, has been shown to be a robust and powerful method of detecting interaction. Despite its flexibility and power, however, the test has three main shortcomings: (i) it discards important information regarding the spatial and temporal scales at which the detected interaction takes place; (ii) the results of the test have not been visualized; and (iii) recent research demonstrates the test to be susceptible to population shift bias. This study presents enhancements to the Jacquez k nearest neighbors test with the goal of addressing each of these three shortcomings and of improving the utility of the test. Data on Burkitt's lymphoma cases in Uganda between 1961 and 1975 are used to illustrate the modifications and enhanced visual output of the test. Output from the enhanced test is compared with that provided by alternative tests of space-time interaction. Results show the enhancements presented in this study transform the Jacquez test into a complete, descriptive, and informative metric that can be used as a stand-alone measure of global space-time interaction.

Comparison of the EORTC QLQ-BM22 and the FACT-BP for assessment of quality of life in cancer patients with bone metastases

Introduction: Maintenance or improvement in quality of life (QoL) is the main goal of palliative treatments for bone metastases. Validated and comprehensive tools assessing QoL for specific patient subgroups are required in order to accurately assess and make informed decisions about palliative treatments. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire for patients with bone metastases (QLQ-BM22) and the Functional Assessment of Cancer Therapy Quality of Life Measurement in patients with bone pain (FACT-BP) are the only two palliative QoL tools available that have been validated for use specifically for bone metastases patients. The purpose of this study was to compare the development and characteristics of these two tools, as well as their current use in palliative research. Methods: Studies detailing the development process for the QLQ-BM22 and the FACT-BP were identified. A comparison between both questionnaires in terms of development, characteristics, validation and use was conducted. Results: The QLQ-BM22 was developed with collaboration from patients, healthcare professionals and review of the literature, whereas the FACT-BP was created strictly through interviews with patients. Scoring, organization, response options and item format are different; however, recall period is the same. Both tools showed good internal consistency and construct validity. The QLQ-BM22 showed good test–retest reliability, while this has not been tested with the FACT-BP. The QLQ-BM22 has been internationally validated among a large sample of patients undergoing a variety of treatments, demonstrating its ability of detect meaningful QoL changes in diverse bone metastases populations. On the other hand, the FACT-BP demonstrated high internal consistency at all assessments, indicating that it may be utilized as a stand-alone measure of bone pain. Conclusion: Both the QLQ-BM22 and FACT-BP are designed for assessment of QoL issues specific to cancer patients with bone metastases. Each instrument has unique strengths and weaknesses and choice between these tools is dependent on the investigator and study needs.

Association Between Leapfrog Safe Practices Score and Hospital Mortality in Major Surgery

The Leapfrog Group reports on hospitals' adoption of the National Quality Forum Patient Safety Practices. However, it is unknown whether hospital compliance with these safe practices is associated with improved outcomes in patients undergoing major surgery. We analyzed the association between hospital mortality and Leapfrog Safe Practices among patients undergoing coronary artery bypass graft surgery (n=18,565), abdominal aortic aneurysm repair (n=2777), and hip replacement (n=25,067) in hospitals participating in the 2007 Leapfrog Hospital Survey using logistic regression. After adjusting for patient and hospital factors, we found that the total safety score (adjusted odds ratio: 1.000, 95% confidence interval: 0.999-1.001) was not associated with hospital mortality. Computerized physician order entry and ICU physician staffing were also not associated with hospital mortality. We did not find evidence that patients undergoing major surgery at hospitals which scored higher on the Leapfrog Safe Practices Survey had lower mortality rates. The Leapfrog safe practices score as a standalone quality measure may have limited power to distinguish between high-quality and low-quality hospitals.

Does the Female Sexual Distress Scale‐Revised Cover the Feelings of Women with HSDD?

Distress associated with low sexual desire is a key feature of hypoactive sexual desire disorder (HSDD). Accurate, reliable, and easy-to-use diagnostic tools to measure such distress are required. The Female Sexual Distress Scale-Revised (FSDS-R) has been shown to have good discriminant validity, test-retest reliability, and internal consistency in measuring sex-related personal distress in women with HSDD. However, the content validity (relevance, clarity, comprehensiveness) of the scale must also be established. The aim of this study was to assess the content validity of the FSDS-R and to examine the potential of Item 13 as a stand-alone measure of distress associated with decreased sexual desire. A single-visit content validation study was conducted in three centers in the United States. Women were screened for HSDD; those with HSDD completed the FSDS-R and then underwent debriefing to capture information on their perceptions of the instrument. Participants also rated the relevancy of every FSDS-R item, from 0 ("not at all relevant") to 4 ("extremely relevant"). Female HSDD patients' ratings of the relevance and ease of understanding of the 13 items of the FSDS-R. Twenty-five women with HSDD were interviewed. Mean relevancy ratings ranged from 1.96 (Item 9) to 3.33 (Item 13). Most participants (76-100%) found every item clear and easy to understand. Item 13 alone demonstrated good content validity, and 56% of participants felt that it covered all of their feelings about their low sexual desire. This study established the content validity of the FSDS-R and demonstrated that the FSDS-R total score is a relevant endpoint for women with HSDD. The tool's one item specific to low sexual desire (Item 13) was given the highest score and highest relevancy of all items, and over half the sample felt that it covered all of their feelings about their low sexual desire.

Host-parasite dynamics of Sorghum bicolor and Striga hermonthica – The influence of soil organic matter amendments of different C:N ratio

The effect of organic amendments on the interactions between Striga hermonthica and a sorghum host was studied in a field experiment during three cropping seasons, following a three-factorial design with (i) bare fallow versus continuous cropping, (ii) two Striga hermonthica infection levels and (iii) five organic matter levels, a single inorganic fertiliser treatment of 120 kg N ha −1 and a control. The effects of two different cotton by-products and their mixtures on sorghum yield were well described by their N-mineralisation pattern. The impact of organic amendments in the sorghum production system was directly related to N-mineralisation in the three cropping seasons. There was an increasing negative effect of organic matter on S. hermonthica as the quality of the applied material increased. The emerged numbers of S. hermonthica were well described by N-release after one month, while S. hermonthica biomass and sorghum biomass were well described by N-release after three months. As a stand-alone measure, addition of low-quality organic matter is disadvantageous in cropping systems with high S. hermonthica seed densities, as it does not improve sorghum performance compared to no addition of organic matter, while S. hermonthica numbers increase. Implications for integrated soil fertility and S. hermonthica management under different infection levels of S. hermonthica are discussed.

Childhood Sexual Abuse Severity Reconsidered: A Factor Structure of CSA Characteristics

To address the lack of empirically grounded measures of childhood sexual abuse severity, a survey of self-report items was developed following a thorough review of the childhood sexual abuse literature. An exploratory factor analysis was conducted using data collected from a convenience sample of college students that included 275 females and males with a history of childhood sexual abuse. The solution produced seven factors interpreted as the following: (a) less intrusive forms of childhood sexual abuse (e.g., sexual invitations, kissing), (b) more intrusive forms of childhood sexual abuse (e.g., oral sex, intercourse), (c) humiliation/fear, (d) childhood sexual abuse involving photography, (e) familiarity with the perpetrator, (f) physical force/rape, and (g) active digital penetration. Correlations among these factors further suggested the existence of two relatively independent second-order factors, one based on the levels of physical intrusiveness and the other composed of the psychological/emotional factors. While arguably the most common measurement of severity, physical intrusiveness had little association with critical factors such as humiliation, fear, and association with the perpetrator. Consequently, physical intrusiveness appears to be an inadequate stand-alone measure of childhood sexual abuse severity. These results are proposed to lay the groundwork for an improved, more comprehensive measure of childhood sexual abuse severity.

The Relationship Between Adaptive Behavior and Specific Toileting Problems According to the Profile on Toileting Issues (POTI)

Toileting problems in people with intellectual disabilities are common but have rarely been studied. Recently, the Profile on Toileting Issues (POTI) was developed as a standalone measure to evaluate these problems. The POTI has established psychometrics. Research on interface between toileting problems in persons with intellectual disability and adaptive functioning is lacking. Eighty adults from two developmental centers were assessed to establish relationships between these skills. Greater toileting problems were strongly associated with greater deficits in adaptive skills. The implications of these findings are discussed.

Summary of: Modelling the impact of process variables in community fluoridated milk schemes on a population of UK schoolchildren

Background Dental caries is a public health problem. Fluoridated milk (FM) schemes are used as a preventive measure. The impact of process variables in these schemes is not understood. Methods Process variable data on the number of days of consumption, attendance, volume consumed, parental consent together with the proportion of children drinking FM at 7 and 11 years old were aggregated from eight schemes in the UK. The impact of process variables was modelled in an 'averaged' scheme (reduced in effectiveness by process variables) and compared with a notional 'ideal' one in which no process variables operate. Parental consent was analysed according to socio-economic groupings. Results Proportion of days per year FM was consumed: 0.52. Values for process variables were: attendance rate 0.94; proportion of milk consumed 0.91; proportion of children with parental consent at 5 years 0.65; proportion drinking FM at 7 and 11 years respectively 0.54 and 0.27. No clear trends were observed for parental consent across socio-economic groupings. Conclusion Modelling suggests that due to the cumulative impact of process variables, there is cause for concern about the effectiveness of FM schemes as currently managed in the UK as a standalone public health measure for the prevention of caries.

Modelling the impact of process variables in community fluoridated milk schemes on a population of UK schoolchildren

Dental caries is a public health problem. Fluoridated milk (FM) schemes are used as a preventive measure. The impact of process variables in these schemes is not understood. Process variable data on the number of days of consumption, attendance, volume consumed, parental consent together with the proportion of children drinking FM at 7- and 11-years old were aggregated from eight schemes in the UK. The impact of process variables was modelled in an 'averaged' scheme (reduced in effectiveness by process variables) and compared with a notional 'ideal' one in which no process variables operate. Parental consent was analysed according to socio-economic groupings. Proportion of days per year FM was consumed: 0.52. Values for process variables were: attendance rate 0.94; proportion of milk consumed 0.91; proportion of children with parental consent at 5 years 0.65; proportion drinking FM at 7 and 11 years respectively 0.54 and 0.27. No clear trends were observed for parental consent across socio-economic groupings. Modelling suggests that due to the cumulative impact of process variables, there is cause for concern about the effectiveness of FM schemes as currently managed in the UK as a standalone public health measure for the prevention of caries.

The Development of a Systematic Coding System for Elementary Students’ Drawings of Engineers

The Draw an Engineer Test (DAET) is a common measure of students’ perceptions of engineers. The coding systems currently used for K- 12 research are general rubrics or checklists to capture the images presented in the drawing, which leave out some of the richness of students’ perceptions, currently only captured with an accompanying student interview. The purpose of this study is to build a reliable coding system, which first establishes an inventory of pictorial elements irrespective of their potential relationship with engineering and second captures aspects of students’ engineering perceptions inductively (from the ground up) while at the same time incorporating categories from previous research. The coding system will be used to help researchers understand how young students’ perceptions of engineering, engineers, and the work of engineers evolve and are impacted by interventions. The longterm goal of this project is to create a standalone measure that can be broadly applied to diverse populations, and to create a large multiinstitution student database, with both K- 12 and university populations represented. This database would provide a rich dataset for better understanding common misconceptions about engineering and thus enabling the development of methods to address them.

Positive Predictive Value of the AHRQ Patient Safety Indicator “Postoperative Sepsis”: Implications for Practice and Policy

Patient Safety Indicator (PSI) 13, or "Postoperative Sepsis," of the Agency for Healthcare Quality and Research (AHRQ), was recently adopted as part of a composite measure of patient safety by the Centers for Medicare and Medicaid Services (CMS). We sought to examine its positive predictive value (PPV) by determining how well it identifies true cases of postoperative sepsis. Two retrospective cross-sectional studies of hospitalization records that met PSI 13 criteria were conducted, one within the Veterans Administration (VA) Hospitals from fiscal years (FY) 2003 to 2007, and one within community hospitals between October 1, 2005 and March 31, 2007. Trained abstractors reviewed medical records from each database using standardized abstraction instruments. We determined the PPV of the indicator and performed descriptive analyses of cases. Of 112 cases flagged and reviewed within the VA system, 59 were true events of postoperative sepsis, yielding a PPV of 53% (95% CI 42% to 64%). Within the community hospital sector, of 164 flagged and reviewed cases, 67 were true cases of postoperative sepsis, yielding a PPV of 41% (95% CI 28% to 54%). False positives were due to infections that were present on admission, urgent or emergent cases, no clinical diagnosis of sepsis, or other coding limitations such as nonspecific shock in postoperative patients. PSI 13 has relatively poor predictive ability to identify true cases of postoperative sepsis in both the VA and nonfederal sectors. The lack of information on diagnosis timing, confusion about the definition of elective admission, and coding limitations were the major reasons for false positives. As it currently stands, the use of PSI 13 as a stand-alone measure for hospital reporting appears premature.

Organic carbon in soils of Central Asia—status quo and potentials for sequestration

Expectations have been raised that carbon sequestration in soils could provide a short-term bridge to reduce the impacts of increasing carbon emissions until low-carbon technologies are available. To assess the role of Central Asia in this regard, the organic carbon in soils of Central Asia and losses in response to land use were quantified in a spatially explicit way. Based on literature information on soil organic carbon contents and in combination with the FAO-UNESCO Soil Map of the Word, the organic carbon stocks in the upper 30 cm of native soils of Central Asia were estimated to amount to 20,17 ± 4,03 Pg. The extent of conversion of native land into agricultural land and the degradation of rangelands was assessed by a land use land cover change map of the region. This type of land use (change) was responsible for a reduction of the soil organic carbon by about 828 ± 166 Tg C, or on average 4.1% of the total stocks. To this reduction, degradation of rangeland (observed on 4.9 Mha) with 50 Tg contributed only 6%. Most of the losses resulted from past conversion of rangelands into rainfed or irrigated agricultural land in the north of Kazakhstan. Hotspots of high soil organic matter depletion were former wetlands, drained for cultivation during the last decades. Assuming that improved agronomic and grazing management could be put in place and that therewith SOC levels in all of Central Asia’s cropland and degraded rangeland could be brought back to native levels in the next 50 years, each year 16.6 Tg C could be sequestered. This is equal to the sizeable amount of 15.5% of the 2004 annual anthropogenic C-emissions of the five Central Asian countries (107 Tg C yr−1). However, Central Asia contributed only 1.4% of CO2 that is set free worldwide by fossil fuel burning. Therefore, the mitigation effect on rising atmospheric CO2 levels and climate change of such ambitious sequestration plans, if put into practice, would be hardly notable. The central Asian example shows that, unfortunately, the strategy of soil C sequestration as a stand-alone measure is not a viable bridge to a future in which alternative energy source can substitute fossil fuel burning, but can only be part of a set of mitigating measures.

An Examination of Alarm System Deterrence and Rational Choice Theory: The Need to Increase Risk

A growing body of evidence is indicating that burglary prevention can be achieved through the strategic application of target hardening measures developed under rational choice theory. Many of these measures are supported by scientific research and include information suggesting that alarm systems act as a deterrent. However, the application of alarm systems as a stand-alone deterrent measure is only supported by rational choice theory if the risk of apprehension is increased. During the last decade, advances in technology have resulted in a significant change in the fundamental nature of burglary. Burglary is an increasingly profitable business, to which alarm systems may no longer pose a significant risk of apprehension. Complicating matters further, practices are being implemented by the alarm industry to reduce burden of false alarms on police services. I will, through literature review, and data analysis, examine two seemingly separate issues, the changing nature of burglary and false alarm verification. These issues will be inextricably linked and contrary to rational choice theory shown to be reducing the risk of apprehension resulting from alarm response. Additionally, it will be shown that the alarm industry's singular focus on alarms as a deterrent may be impairing the application of other effective situational security measures. The use of alarm systems as a stand-alone security strategy are being impacted negatively and more complex solutions are supported under rational choice theory. When combined as part of an overall security strategy including effective false alarm verification technology, alarm systems can play a vital role in increasing the risk of apprehension.

Endpoints in pulmonary arterial hypertension: the role of clinical worsening

Design and selection of endpoints used in clinical trials is a complex and compelling topic; the diverse needs of clinicians, patients and regulatory authorities represent a challenge in devising the most relevant, meaningful yet practical measures. In trials of therapies for pulmonary arterial hypertension (PAH), a variety of endpoints have been used, including assessments of exercise capacity (6-min walk distance [6MWD]), functional class, hemodynamics, and time to clinical worsening. Most have relied upon 6MWD as the primary endpoint. Accumulating experience and expertise suggests that the relevance of the 6-min walk test as a stand-alone measure of efficacy is now a topic for consideration. Furthermore, 6MWD tends to correlate poorly with other endpoints and, most importantly, there is no linear relationship between 6MWD and morbidity/mortality. Although no linear relationship has been identified with other endpoints, time to clinical worsening may be considered a better endpoint for assessing the effectiveness of PAH therapies, in particular the impact of treatment on disease progression, because it is very relevant to the clinical outcome of patients. Treatment of mildly symptomatic patients, for example, has demonstrated a clear delay in time to clinical worsening and the endpoint might be better suited than others to demonstrate the efficacy of combination therapy. As the field of PAH develops and progresses, time to clinical worsening may be the best way currently of distinguishing between the increasing number of treatment options available. A clear definition must, therefore, be established, with adjudication by an expert panel; the needs of clinicians, patients, and regulators should be balanced when selecting the most appropriate endpoints.