Set Of Standardized Measures Research Articles

Morphometric Analysis of the External Auditory Canal by Computed Tomography in Indian Population.

Various studies have shown variations in size and shape of different anthropometric measurements of external auditory canal. We conducted an anthropometric study of the three-dimensional anatomy of the osseous external auditory canal (OEAC) using high-resolution computed tomography the temporal bone to identify the variations in subset of Indian population from North India. A retrospective review of high-resolution computed tomography images of the temporal bones of 125 patients (250 external auditory canals) of different ages (mean 28.43years) acquired from September 2014 to February of 2015 was performed. Using a method, as proposed by Mahboubio et al. (Otol Neurotol 33:715-720, 2012), six defined dimensions of the OEAC in the parasagittal planes were recorded at the level of annulus, midcanal and the outermost point of osseous external auditory canal at bony-cartilaginous junction. The length and shape of the OEAC were also studied and the frequency rate of each was recorded. The most prevalent shape of the OEAC was found to be conical (64%) and the mean osseous external auditory canal length was 9.61mm. The length of the OEAC was significantly different between ages above and below 12years while the 6 defined cross sectional dimensions were statistically significant between ages above and below 8years. The history of chronic suppurative otitis media had a significant bearing on the inferior mid-anteroposterior dimension at the level of bony-cartilaginous junction. There was statistically significant difference in supero-inferior diameter in the posterior half at the level of mid-canal and outer bony-cartilaginous junction between males and females. The comprehensive set of standardized measurements collected in this study provides three-dimensional information on osseous external auditory canal geometry. These measurements and the methodology will contribute to the development of element models of the osseous canal for computational modeling purposes and also provide important measurements for design of in-the-canal hearing aids, specialized earplugs and for defining average sizes for canalplasty procedures, in pre- and postoperative surgical planning and assessment of canal atresia and stenosis in Indian population. No such previous study has been done in North Indian population.

Pathways to care and patterns of care in first episode psychosis patients treated in community based-mental health services. A 5-years follow-up from the PICOS

IntroductionInternational treatment guidelines recommend that key elements to reduce the burden of psychosis are the early identification of people and the adoption of specific evidence based interventions.ObjectivesTo investigate the pathway to care and patterns of interventions provided by community based-mental health services (CMHS) to a cohort of first-episode psychosis (FEP) patients over 5-years period, exploring in which degree guidelines are met in routine clinical practice.MethodsStudy conducted in the context of the Psychosis Incident Cohort Outcome Study (PICOS), a multisite naturalistic research conducted in the Veneto Region (Italy) on FEP patients in a 4.6 million inhabitants catchment area. A comprehensive set of standardized measures was used, including ad hoc schedules to collect information on referrals to psychiatric services and on pharmacological and psycho-social treatments according to a multiwave follow-up design (1-, 2- and 5 years).ResultsThree hundred and ninety-seven FEP patients were assessed at BL, 286 at 1 year, 233 at 2 years and 205 at 5 years. 47.4% of patients were helped to seek care by a relative and more than one half entered the treatment route through an emergency access. Regarding the interventions received, 96% of patients had been prescribed neuroleptics and atypical were the most prescribed class (66.9%). Only half received a psychosocial intervention during the first year and this percentage progressively decreased at each FU.DiscussionFindings highlight discrepancies between interventions provided by CMHS and the best treatment options recommended by guidelines, suggesting the need to implement specific initiatives aiming to close the gap between research and clinical practice.

A Consensus Set of Outcomes for Parkinson's Disease from the International Consortium for Health Outcomes Measurement.

BackgroundParkinson’s disease (PD) is a progressive neurodegenerative condition that is expected to double in prevalence due to demographic shifts. Value-based healthcare is a proposed strategy to improve outcomes and decrease costs. To move towards an actual value-based health care system, condition-specific outcomes that are meaningful to patients are essential.ObjectivePropose a global consensus standard set of outcome measures for PD.MethodsEstablished methods for outcome measure development were applied, as outlined and used previously by the International Consortium for Health Outcomes Measurement (ICHOM). An international group, representing both patients and experts from the fields of neurology, psychiatry, nursing, and existing outcome measurement efforts, was convened. The group participated in six teleconferences over a six-month period, reviewed existing data and practices, and ultimately proposed a standard set of measures by which patients should be tracked, and how often data should be collected.ResultsThe standard set applies to all cases of idiopathic PD, and includes assessments of motor and non-motor symptoms, ability to work, PD-related health status, and hospital admissions. Baseline demographic and clinical variables are included to enable case mix adjustment.ConclusionsThe Standard Set is now ready for use and pilot testing in the clinical setting. Ultimately, we believe that using the set of outcomes proposed here will allow clinicians and scientists across the world to document, report, and compare PD-related outcomes in a standardized fashion. Such international benchmarks will improve our understanding of the disease course and allow for identification of ‘best practices’, ultimately leading to better informed treatment decisions.

Analysis of interpopulation and interspecies morphological differences between Far Eastern redfins of the genus Tribolodon (Teleostei: Cyprinidae)

The morphological variability in sympatric populations of the Far Eastern redfins Tribolodon brandti and T. hakonensis from bays of the Sea of Japan was studied by analyzing the standard set of measurements that is used for the description of cyprinid fishes. It has been established that the interpopulation morphological differences between individuals within each species exceed the differences between species. The main causes of intraand interspecies differences have been revealed.

Defining and assessing quality improvement outcomes: a framework for public health.

We describe an evidence-based framework to define and assess the impact of quality improvement (QI) in public health. Developed to address programmatic and research-identified needs for articulating the value of public health QI in aggregate, this framework proposes a standardized set of measures to monitor and improve the efficiency and effectiveness of public health programs and operations. We reviewed the scientific literature and analyzed QI initiatives implemented through the Centers for Disease Control and Prevention's National Public Health Improvement Initiative to inform the selection of 5 efficiency and 8 effectiveness measures. This framework provides a model for identifying the types of improvement outcomes targeted by public health QI efforts and a means to understand QI's impact on the practice of public health.

Measurement standards for human metacarpals.

Standards for measuring the metacarpals are absent from commonly used osteometric guides. Perhaps the closest to a set of standard measurements in common use today are those proposed by Scheuer and Elkington (Scheuer and Elkington: J Forensic Sci 38 (1993) 769-788) for forensic sex assessment. They include caliper measurements of interarticular length, base and head width, base and head height, and maximum midshaft diameter. Over the last decade, a new set of measurements that encompass similar dimensions to those used by Scheuer and Elkington, but which are taken with a mini-osteometric board (MOB) have been developed by the lead author. Use of the MOB avoids the need to manipulate both the bone and calipers in three-dimensional space and causes less strain on the hands. However, the question of intra- and interobserver accuracy has not been adequately addressed for either set of measurements. The purpose of this study was to test both the Scheuer/Elkington and MOB measurements on 20 hands from 10 anatomical skeletons for intra- and inter-observer accuracy. The study found that 92% of the MOB measures had a lower intraobserver error, and 88% had a lower interobserver error than did the caliper measurements. It also found that the maximum midshaft diameter measurement used by Scheuer and Elkington is more repeatable than a mediolateral diameter. Overall, 88% of the 25 MOB measurements had median intraobserver error rates of under 1.5%, compared with 60% of the caliper measurements. Furthermore, the MOB measurements as a set were taken 10 to 12% faster than the caliper measurements.

Malnutrition in the nursing home.

Malnutrition in the nursing home is increasingly recognized as a major international research priority, given the expanding geriatric populations, serious consequences, and challenges conducting research in nursing homes. This review examines the recent literature and suggests implications for research and practice. Across the recent studies, approximately 20% of nursing home residents had some form of malnutrition. However, malnutrition definitions were variable and prevalence ranged from 1.5 to 66.5%. Depression, cognitive impairment, functional impairment, and swallowing difficulty were consistently associated with malnutrition. Mortality was the major consequence of malnutrition among nursing home residents, whereas higher BMIs had lower risks of mortality. Beneficial interventions to reduce malnutrition in the nursing home included dietary supplements, greater resident role in food choice, and staff training programs. To truly tackle the issue of malnutrition in the nursing home setting, a consistent definition is needed. We strongly recommend that an expert consensus panel identify a standard set of measures to more accurately compare the prevalence across countries. Given the mortality consequences of malnutrition and the paucity of intervention studies, research on interventions for malnutrition in the nursing home needs to be a higher priority for facilities, researchers, and funding agencies.

Long-term performance of the Kiel carbonate device with a new correction scheme for clumped isotope measurements.

Carbonate clumped isotope thermometry is a powerful new technique increasingly used in many fields in earth science. Recently, it has been shown that clumped isotope measurements can be performed with a Kiel carbonate preparation device and micro-volume analyses, allowing measurements of small (1.5-2 mg) carbonate samples. However, common data correction schemes rely on measurements of gases prepared offline, potentially leading to unrecognized biases in the results. We propose a new correction scheme for the Kiel device method including: (1) A pressure-sensitive baseline correction (PBL) of the raw beam signals; (2) Transfer of data to the absolute reference frame; (3) Correction for acid fractionation; (4) Correction for average standard offsets; (5) When necessary, correction for Δ47 scale compression based on offsets among standards with different ordering state. The long-term performance of the new scheme was tested with a large set of standard measurements (N = 432) obtained over the course of 15 months. The PBL correction reliably removes composition-dependent artifacts, which are commonly corrected for with gas measurements, and offsets observed in micro-volume measurements when ion beams are imbalanced. We show that the shape of the PBL can vary strongly and needs to be properly characterized. Combined PBL and standard correction resulted in long-term stability with standard deviations in Δ47 of 0.012-0.016 ‰ for the five standards over the whole period, close to the average error of 0.011 ‰ observed for individual measurements consisting of 10 replicate analyses. Our correction scheme eliminates the need for routine gas measurements, allowing for equal treatment of samples and standards with the Kiel device setup. While the PBL and standard data obtained over 15 months reveal variable mass spectrometer behavior, they provide a robust means of correction, yielding reproducible results from small carbonate samples in the long term.

Efficiency, effectiveness, equity (E3). Evaluating hospital performance in three dimensions

There are well-established frameworks for comparing the performance of health systems cross-nationally on multiple dimensions. A sub-set of such comprehensive schema is taken up by criteria specifically applied to health service delivery, including hospital performance.We focus on evaluating hospital performance, using the New Zealand public hospital sector over the period 2001–2009 as a pragmatic and illustrative case study for cross-national application. We apply a broad three-dimensional matrix – efficiency, effectiveness, equity – each based on two measures, and we undertake ranking comparisons of 35 hospitals.On the efficiency dimension – relative stay, day surgery – we find coefficients of variation of 10.8% and 8.5% respectively in the pooled data, and a slight trend towards a narrowing of inter-hospital variation over time. The correlation between these indicators is low (.20). For effectiveness – post-admission mortality, unplanned readmission – the coefficient of variation is generally higher (24.1% and 12.2%), and the trend is flat. The correlation is again low (.21). The equity dimension is assessed by quantifying the degree of ethnic and socio-economic variation for each hospital. The coefficient of variation is much higher – 40.7–66.5% for ethnicity, 55.8–84.4% for socio-economic position – the trend over time is mixed, and the correlation is moderate (.41). On averaging the rank of hospitals across all measures it is evident that there is limited consistency across the three constituent dimensions.While it is possible to assess hospital performance across three dimensions using an illustrative set of standard measures derived from routine data, there appears to be little consistency in hospital rankings on these New Zealand data for the period 2001–2009. However, the methodology of using rankings derived from readily available data – possibly allied with multiple or composite indicator models – has potential for the cross-national comparison of hospital profiles, and assessments in three dimensions provide a more holistic and rounded account of performance.

Standard measuring instruments in high-resolution optical interferometry

A system of standard measuring instruments forming part of a set of standard measures of the height of a step and the value of a period, designed for the three-dimensional calibration of monitoring-measuring equipment based on optical interference and scanning probe microscopes, used for measuring small distances, is considered.

Performance Measurement for Nonprofits

The capital market for financing charitable work is far from efficient, and could be improved dramatically. Donors and the nonprofit agencies they fund do not share a standard set of measures and procedures to evaluate performance. Lacking measures of impact, donors—a group that includes government agencies, foundations, corporate CSR programs, and individuals—and charity “watchdogs” often focus on available information that typically has one main focus: the overhead expenses reported by nonprofits in public disclosures.The problem, however, is that the use of overhead expense as a proxy for operational efficiency and effectiveness has many shortcomings. There is no shared understanding of what expenses constitute overhead; overhead spending says nothing about the quality of a nonprofit's programs; and an excessive focus on this single dimension can cause management to underinvest in infrastructure.Management of nonprofits should be encouraged to communicate the results of their key programs—in particular, their impact on the communities they serve. For example, for at least their largest programs, nonprofits could describe the key performance indicators established at outset of their programs, and how they are currently performing against these benchmarks. A substantive management discussion that includes an explanation for any underperformance, and the corrective actions being taken, would help other agencies avoid similar pitfalls while providing potential donors with valuable information that improves not only their decision‐making, but the “efficiency” of the entire market for charitable giving.

Dynamic Metabolic Flux Analysis for Online Estimation of Recombinant Protein Productivity in Pichia pastoris Cultures

AbstractOne approach to model living cells is based on successively imposing the (known) constraints–such as enzyme capacities, mass balances or thermodynamic laws– that limit their behaviour. This process results in a constraint-based model that encloses all the functional states that cells might exhibit. By combining the model with experimental measurements, it is possible to determine the particular cellular state at given conditions, an exercise that is generally referred to as Metabolic Flux Analysis (MFA). In this work we use a previously validated model (Tortajada et al., 2010) and an MFA-wise method (Llaneras et al., 2009) for on-line monitoring of industrial cultures of the yeast Pichia pastoris. Given a set of standard measurements –substrates, gases and biomass growth–, Possibilistic dynamic MFA provides estimates for unmeasured, time-varying extracellular metabolites and intracellular fluxes, while accounting for the imprecision and uncertainty common in industrial settings. The production of the recombinant protein of interest can be estimated by means of a relationship among ATP consumption rate and specific growth rate, which is integrated into the model. To test the viability of the approach some preliminary experimental results are shown, using data from a set of batch cultivations performed in microbioreactors. The procedure is of great industrial interest because it can provide not only a way to monitor the metabolic state of P. pastoris cultures during a running process, but also a direct online estimation of the protein production rate.

Characterizing cognitive aging in humans with links to animal models.

With the population of older adults expected to grow rapidly over the next two decades, it has become increasingly important to advance research efforts to elucidate the mechanisms associated with cognitive aging, with the ultimate goal of developing effective interventions and prevention therapies. Although there has been a vast research literature on the use of cognitive tests to evaluate the effects of aging and age-related neurodegenerative disease, the need for a set of standardized measures to characterize the cognitive profiles specific to healthy aging has been widely recognized. Here we present a review of selected methods and approaches that have been applied in human research studies to evaluate the effects of aging on cognition, including executive function, memory, processing speed, language, and visuospatial function. The effects of healthy aging on each of these cognitive domains are discussed with examples from cognitive/experimental and clinical/neuropsychological approaches. Further, we consider those measures that have clear conceptual and methodological links to tasks currently in use for non-human animal studies of aging, as well as those that have the potential for translation to animal aging research. Having a complementary set of measures to assess the cognitive profiles of healthy aging across species provides a unique opportunity to enhance research efforts for cross-sectional, longitudinal, and intervention studies of cognitive aging. Taking a cross-species, translational approach will help to advance cognitive aging research, leading to a greater understanding of associated neurobiological mechanisms with the potential for developing effective interventions and prevention therapies for age-related cognitive decline.

Activated sludge characteristics affecting sludge filterability in municipal and industrial MBRs: Unraveling correlations using multi-component regression analysis

In the field of membrane bioreactors (MBRs) many membrane fouling related questions still remain unanswered. The goal of this research is to unveil some of the black-box features of activated sludge filterability by correlating the results from activated sludge filterability measurements following the Delft Filtration Characterization method (DFCm) with a large set of activated sludge characteristics. Ten different MBRs in Belgium and the Netherlands were sampled in both winter and summer. All samples were subjected to the DFCm, automated image analysis and an extensive set of standardized measurements. No clear correlation could be found between a single sludge parameter and activated sludge filterability. However, a combination of sludge morphology and relative hydrophobicity (RH) allows for a clear classification of activated sludge into two classes, i.e., bad and poor to good, implying that deflocculation and a low RH have a negative impact on activated sludge filterability. Furthermore, for sludge samples having poor to good filterability, accurate estimations of sludge filterability can be made when including more parameters. The main conclusion is that filterability can be predicted by analyzing the bioflocculation state of the activated sludge.

Development and pilot of an internationally standardized measure of cardiovascular risk management in European primary care

BackgroundPrimary care can play an important role in providing cardiovascular risk management in patients with established Cardiovascular Diseases (CVD), patients with a known high risk of developing CVD, and potentially for individuals with a low risk of developing CVD, but who have unhealthy lifestyles. To describe and compare cardiovascular risk management, internationally valid quality indicators and standardized measures are needed. As part of a large project in 9 European countries (EPA-Cardio), we have developed and tested a set of standardized measures, linked to previously developed quality indicators.MethodsA structured stepwise procedure was followed to develop measures. First, the research team allocated 106 validated quality indicators to one of the three target populations (established CVD, at high risk, at low risk) and to different data-collection methods (data abstraction from the medical records, a patient survey, an interview with lead practice GP/a practice survey). Secondly, we selected a number of other validated measures to enrich the assessment. A pilot study was performed to test the feasibility. Finally, we revised the measures based on the findings.ResultsThe EPA-Cardio measures consisted of abstraction forms from the medical-records data of established Coronary Heart Disease (CHD)-patients - and high-risk groups, a patient questionnaire for each of the 3 groups, an interview questionnaire for the lead GP and a questionnaire for practice teams. The measures were feasible and accepted by general practices from different countries.ConclusionsAn internationally standardized measure of cardiovascular risk management, linked to validated quality indicators and tested for feasibility in general practice, is now available. Careful development and pilot testing of the measures are crucial in international studies of quality of healthcare.

Criteria for the selection of foster families and monitoring of placements.: Comparative study of the application of the Casey Foster Applicant Inventory- Applicant Version (CFAI-A)

Based on a literature review, this article frames different stages of the foster care process, identifying a set of standardized measures in the American and Portuguese contexts which, if implemented, could contribute towards higher levels of foster success. The article continues with the presentation of a comparative study, based on the application of the Casey Foster Applicant Inventory-Applicant Version (CFAI-A) questionnaire, in the aforementioned contexts. Taking a comparative analyses of CFAI-A's psychometric characteristics in four different samples as a starting point, one discovered that despite the fact that the questionnaire was adapted to Portuguese reality, it kept the quality values presented on the American samples. It specifically shows significant values regarding reliability and validity. This questionnaire, which aims to assess the potential of foster families, also supports the technical staff's decision making process regarding the monitoring and support of foster families, while it also promotes a better decision in the placement process towards the child's integration and development.

The Use of Sociocultural Constructs in Cancer Screening Research Among African Americans

Studies are increasingly examining the role of sociocultural values, beliefs, and attitudes in cancer prevention. However, these studies vary widely in how sociocultural constructs are defined and measured, how they are conceived as affecting cancer beliefs, behaviors, and screening, and how they are applied in interventions. To characterize the current state of this research literature, we conducted a critical review of studies published between 1990 and 2006 to describe the current use of sociocultural constructs in cancer screening research among African Americans. We included quantitative and qualitative studies with cancer as a primary focus that included African American participants, assessed screening behaviors, reported race-specific analyses, and considered one or more sociocultural factors. Studies were evaluated for type of cancer and screening analyzed, study population, methodology, sociocultural constructs considered, definitions of constructs, provision of psychometric data for measures, and journal characteristics. Of 94 studies identified for review, 35 met the inclusion criteria and were evaluated. Most focused on breast cancer screening, and thus African American women. Sociocultural constructs were seldom clearly defined, and the sources and psychometric properties of sociocultural measures were rarely reported. A multidisciplinary approach to developing a common language and a standardized set of measures for sociocultural constructs will advance research in this area. Specific recommendations are made for future research.

Long-Duration Head-Down Bed Rest: Project Overview, Vital Signs, and Fluid Balance

Spaceflight has profound effects on the human body. Many of these effects can be induced with head-down bed rest, which has been a useful ground-based analog. With limited resources aboard the International Space Station for human research, the bed rest analog will be a primary platform on which countermeasures will be developed and tested for lunar and Mars mission scenarios. NASA Johnson Space Center, in conjunction with the University of Texas Medical Branch (UTMB), has created the NASA Flight Analogs Project (FAP), a research program with the overall objective of using head-down bed rest to evaluate, compare, and refine candidate countermeasures to spaceflight deconditioning. This paper serves as an overview and describes the standard conditions, the standard set of subject screening criteria, and the standard set of measurements for all FAP bed rest subjects. Heart rate and diastolic pressures decreased transiently at the onset of bed rest. Fluid balance showed an early diuresis, which stabilized within 3 d. In this supplement, detailed results from multiple disciplines are presented in a series of reports. The following reports describe multi-disciplinary results from the standard measurements by which the responses to bed rest will be assessed and by which countermeasures will be evaluated. The data presented in this overview are meant to serve as a context in which to view the data presented in the discipline specific manuscripts. The dietary support and behavioral health papers provide additional information regarding those aspects of implementing bed rest studies successfully.

Acceptance, Mindfulness, and Values-Based Action May Counteract Fear and Avoidance of Emotions in Chronic Pain: An Analysis of Anxiety Sensitivity

People often respond with distress and avoidance to their own negative experiences, such as the physical, cognitive, and emotional aspects of depression or anxiety. When people with chronic pain respond this way, their overall level of distress may increase, they may struggle to avoid their emotional experiences, and their daily functioning may decrease. The purpose of this study was to examine the role of anxiety sensitivity (AS), or "fear of anxiety," in relation to these processes. It was predicted that those persons with chronic pain who report higher AS will also report higher emotional distress and greater disability caused by chronic pain. A second purpose was to examine whether therapeutic processes designed to reduce emotional avoidance, namely, acceptance, mindfulness, and values, could be demonstrated to reduce the role of AS in relation to this distress and disability based on a statistical model including these variables. Subjects were 125 consecutive adult patients (64.8% women) seeking services from a specialty pain service in the United Kingdom. All patients completed a standard set of measures of AS, acceptance of pain, mindfulness, and values-based action, as well as measures of pain, disability, and emotional functioning, at their initial consultation, and these data formed the basis for the current study. In correlation and regression analyses, AS was associated with greater pain, disability, and distress. In regression analyses, the 3 proposed therapeutic processes reduced the average variance accounted for by AS in patient functioning from DeltaR(2) = .21 to DeltaR(2) = .048. This means that when the 3 therapeutic variables are taken into account statistically, AS alone retained relatively little association with patient functioning. These results suggest that AS may amplify the impact of emotional distress on patient functioning in chronic pain and that processes of acceptance, mindfulness, and values-based action may reduce this effect. Humans can fear and struggle to avoid their own emotional experiences, even when these cannot harm them. Data presented here show individuals with chronic pain have more distress and disability when they manifest more fear of anxiety symptoms, and behavior patterns of "acceptance" and "mindfulness" may reduce this effect.

Enhancing Nurse-Physician Collaboration Using Pediatric Simulation

The purpose of this study was to determine the level of nurse-physician collaboration during simulation training. A human patient simulator (HPS) of three mock codes with life-threatening scenarios in children, an understudied population, was used. A set of standardized measures and observational techniques were used to determine levels of nurse-physician collaboration and interaction on multiple dimensions found to improve patient outcomes. High levels of group cohesion (GC) and collaboration and satisfaction with patient care decisions (CSPCD) were identified among both physicians and nurses. The male respondents, regardless of discipline, had significantly higher GC scores (p = .029) and significantly higher CSPCD scores (p = .005) than the female respondents. Although the nurses and physicians self-reported good collaboration following the scenarios, analysis of the videotapes revealed that collaboration improved over time. The results of this study hold promise for this critical area of science that seeks to improve the outcomes of patients who experience life-threatening events.