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Greater Consistency (greater + consistency)
Selected AbstractsCross-Survey Differences in National Estimates of Numbers of Caregivers of Disabled Older AdultsTHE MILBANK QUARTERLY, Issue 3 2010ERIN R. GIOVANNETTI Context: Public policy regarding family caregiving for disabled older adults is affected by their estimated number, their attributes, and the services provided. The available national surveys, however, do not have a uniform approach to ascertaining the number of family caregivers, so their estimated number varies widely. Methods: This article looks at nationally representative, population-based surveys of family caregivers conducted between 1985 and 2010 to find methods pertinent to ascertaining the number of caregivers. The surveys' design, definition of disability, and approach to identifying and defining caregivers of disabled adults aged sixty-five and older were identified, and cross-survey estimates were compared. Findings: Published estimates of the numbers of caregivers of older disabled adults ranged from 2.7 million to 36.1 million in eight national surveys conducted between 1992 and 2009. The surveys were evenly divided between caregivers identified by disabled older adults (n= 4, "disability surveys") and self-identified (n= 4, "caregiver self-identification surveys"). The estimated number of family caregivers of disabled adults aged sixty-five and older was, on average, 4.8 million in disability surveys and 24.4 million in caregiver self-identification surveys. Conclusions: The number of family caregivers of disabled older adults estimated by national surveys varied substantially. Greater consistency in defining caregivers could yield more informative estimates and also advance policy efforts to more effectively monitor and support family caregivers. [source] A Delphi survey of the views of adult male patients with personality disorders on psychoeducation and social problem-solving therapyCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 5 2007Mary McMurran Background,Psychoeducation and social problem-solving therapy are treatment components that work well in tandem for offenders with personality disorders, hence it is worthwhile to maintain and improve their effectiveness. Aim,The aim was to seek patients' views of these therapies to contribute to their development. Method,A Delphi survey was conducted with all 12 male inpatients of a personality disorder hospital treatment unit. Results,Round 1 produced 30 statements for psychoeducation and 59 for social problem-solving therapy to be rated in Round 2. There was consensus at a level of 70% for all items. Both psychoeducation and social problem-solving therapies were viewed as useful by these patients. The men also suggested improvements in psychoeducation, including minimizing the delay between assessment and feedback, provision of reference material, preparation for the work and support afterwards. Areas identified for improvement in social problem-solving therapy included more frequent review of progress, greater consistency of delivery, eliciting problems more effectively, providing reference material, supporting patients in group work, and the development of an advanced therapy. Discussion,A Delphi approach to evaluation of therapies with the people receiving them is not only feasible but seems to offer a practical way of making useful clinical adjustments to the work. Further research with larger samples might usefully focus on whether such an approach enhances treatment compliance. Copyright © 2007 John Wiley & Sons, Ltd. [source] TOWARD A SEMIOTIC THEORY OF CHOICE AND OF LEARNINGEDUCATIONAL THEORY, Issue 3 2006Andrew Stables Such a view, Stables and Gough argue, has the potential to displace or circumvent essentially Cartesian models currently dominant within learning theory (cognitivism and responses to it) and within neoclassical economics (rational choice and responses to it). It thus enables synergies between theories of learning and of economic behavior, allowing for greater consistency in thinking about (but not necessarily prescribing for) both educational policy and provision, on the one hand, and curriculum and pedagogy, on the other. In addition, the authors claim that giving semiotics a foundational role in educational thinking provides a basis for the broader development of liberal political thought within a postmodern cultural context. [source] Revised Pacific M-anomaly geomagnetic polarity timescaleGEOPHYSICAL JOURNAL INTERNATIONAL, Issue 1 2010Masako Tominaga SUMMARY The current M-anomaly geomagnetic polarity timescale (GPTS) is mainly based on the Hawaiian magnetic lineations in the Pacific Ocean. M-anomaly GPTS studies to date have relied on a small number of magnetic profiles, a situation that is not ideal because any one profile contains an uncertain amount of geologic ,noise' that perturbs the magnetic field signal. Compiling a polarity sequence from a larger array of magnetic profiles is desirable to provide greater consistency and repeatability. We present a new compilation of the M-anomaly GPTS constructed from polarity models derived from magnetic profiles crossing the three lineation sets (Hawaiian, Japanese and Phoenix) in the western Pacific. Polarity reversal boundary locations were estimated with a combination of inverse and forward modelling of the magnetic profiles. Separate GPTS were established for each of the three Pacific lineation sets, to allow examination of variability among the different lineation sets, and these were also combined to give a composite timescale. Owing to a paucity of reliable direct dates of the M-anomalies on ocean crust, the composite model was time calibrated with only two ages; one at each end of the sequence. These two dates are 125.0 Ma for the base of M0r and 155.7 Ma for the base of M26r. Relative polarity block widths from the three lineation sets are similar, indicating a consistent Pacific-wide spreading regime. The new GPTS model shows slightly different spacings of polarity blocks, as compared with previous GPTS, with less variation in block width. It appears that the greater polarity chron irregularity in older models is mostly an artifact of modelling a small number of magnetic profiles. The greater averaging of polarity chron boundaries in our model gives a GPTS that is statistically more robust than prior GPTS models and a superior foundation for Late Jurassic,Early Cretaceous geomagnetic and chronologic studies. [source] Case-Mix Adjusting Performance Measures in a Veteran Population: Pharmacy- and Diagnosis-Based ApproachesHEALTH SERVICES RESEARCH, Issue 5 2003Chuan-Fen Liu Objective. To compare the rankings for health care utilization performance measures at the facility level in a Veterans Health Administration (VHA) health care delivery network using pharmacy- and diagnosis-based case-mix adjustment measures. Data Sources/Study Setting. The study included veterans who used inpatient or outpatient services in Veterans Integrated Service Network (VISN) 20 during fiscal year 1998 (October 1997 to September 1998; N=126,076). Utilization and pharmacy data were extracted from VHA national databases and the VISN 20 data warehouse. Study Design. We estimated concurrent regression models using pharmacy or diagnosis information in the base year (FY1998) to predict health service utilization in the same year. Utilization measures included bed days of care for inpatient care and provider visits for outpatient care. Principal Findings. Rankings of predicted utilization measures across facilities vary by case-mix adjustment measure. There is greater consistency within the diagnosis-based models than between the diagnosis- and pharmacy-based models. The eight facilities were ranked differently by the diagnosis- and pharmacy-based models. Conclusions. Choice of case-mix adjustment measure affects rankings of facilities on performance measures, raising concerns about the validity of profiling practices. Differences in rankings may reflect differences in comparability of data capture across facilities between pharmacy and diagnosis data sources, and unstable estimates due to small numbers of patients in a facility. [source] Infants' Behavioral Strategies for Emotion Regulation With Fathers and Mothers: Associations With Emotional Expressions and Attachment QualityINFANCY, Issue 2 2002Marissa L. Diener This study examined 12- and 13-month-old infants' behavioral strategies for emotion regulation, emotional expressions, regulatory styles, and attachment quality with fathers and mothers. Eighty-five infants participated in the Strange Situation procedure to assess attachment quality with mothers and fathers. Infants' behavioral strategies for emotion regulation were examined with each parent during a competing demands task. Emotion regulation styles were meaningfully related to infant-father attachment quality. Although expressions of distress and positive affect were not consistent across mothers and fathers, there was consistency in infant strategy use, emotion regulation style, and attachment quality with mothers and fathers. Furthermore, infants who were securely attached to both parents showed greater consistency in parent-oriented strategies than infants who were insecurely attached to one or both parents. Limitations of this study include the constrained laboratory setting, potential carryover effects, and a homogeneous, middle-class sample. [source] Association between extent of axillary lymph node dissection and patient, tumor, surgeon, and hospital factors in patients with early breast cancerJOURNAL OF SURGICAL ONCOLOGY, Issue 2 2003David W. Petrik MD Abstract Background and Objectives Axillary lymph node dissection (ALND) in patients with breast cancer is crucial for accurate staging, provides excellent regional tumor control, and is included in the standard of care for the surgical treatment of breast cancer. However, the extent of ALND varies, and the extent of dissection and the number of lymph nodes that comprise an optimal axillary dissection are under debate. Despite conflicting evidence, several studies have shown that improved survival is correlated with more lymph nodes removed in both node-negative and node-positive patients. The purpose of this study is to determine which patient, tumor, surgeon, and hospital characteristics are associated with the number of nodes excised in early breast cancer patients. Methods A random sample of 938 women with node-negative breast cancer was drawn from the Ontario Cancer Registry and the data supplemented with chart reviews. The extent of axillary dissection was studied by examining the number of nodes examined in relation to the patient, tumor, surgeon, and hospital factors. Results The mean number of lymph nodes excised was 9.8 (SD = 4.8; range, 1,31), and 49% of patients had ,10 nodes excised. Lower patient age was associated with the excision of more lymph nodes (,10 nodes: 63% of patients <40 years vs. 38% of patients ,80 years). Surgeon academic affiliation and surgery in a teaching hospital were highly correlated with each other and were significantly associated with the excision of ,10 nodes. The number of nodes excised was not associated with any tumor factors, nor with the breast operation performed. These results were confirmed with multivariable models. Conclusions Even though the number of lymph nodes found in the pathologic specimen can be influenced by factors other than surgical technique (e.g., number of nodes present, specimen handling, and pathologic examination), this study shows significant variation of this variable and an association with several patient and surgeon/hospital factors. This variation and the association with survival warrant further study and effort at greater consistency. J. Surg. Oncol. 2003;82:84,90. © 2003 Wiley-Liss, Inc. [source] Taking due account of religion in sentencingLEGAL STUDIES, Issue 3 2009Chara Bakalis This paper explores the relationship between religion and sentencing. It considers what problems may arise when a judge fails to take proper account of a defendant's religious beliefs at the sentencing stage, or takes improper account. It highlights the need for more guidance to be given to judges in order to ensure greater consistency and fairness in sentencing outcomes. [source] Histologic classification of ductal carcinoma in situMICROSCOPY RESEARCH AND TECHNIQUE, Issue 2 2002Shabnam Jaffer Abstract Prior to the current mammographic era, ductal carcinoma in situ (DCIS) usually presented as a large mass, was classified morphologically by architecture, and treated by mastectomy. The introduction of screening mammography led to an increase in the incidence of DCIS, a decrease in the average size of DCIS, and an increased emphasis on its heterogeneous nature. Thus, a reproducible and prognostically relevant classification system for DCIS is necessary. The ultimate goal of this classification is proper selection of patients for whom lumpectomy would suffice rather than mastectomy. Features to evaluate include: extent and size of disease, adequacy of resection margins, and histology. While none of the proposed histological classification systems were endorsed at the recent Consensus Conference on the Classification of DCIS, nuclear grade was the most important feature common to most of them. Architecture was given secondary importance. By definition, DCIS is a non-invasive clonal proliferation of epithelial cells originating in the terminal duct lobular unit, which would be expected to be monomorphic; however, it is the degree of nuclear pleomorphism that is primarily used to separate DCIS into low, intermediate, and high grades. Architecturally, DCIS has been divided into the following types: comedo, solid, cribriform, micropapillary, and papillary. Different architectural patterns and grades may be present in a given particular case; however, some combinations of patterns occur more frequently than others. Interobserver studies have shown nuclear grading to be interpreted with greater consistency than architecture, and nuclear grading methods have correlated with biological and molecular marker studies. Microsc. Res. Tech. 59:92,101, 2002. © 2002 Wiley-Liss, Inc. [source] Target setting in intensive insulin management is associated with metabolic control: the Hvidoere Childhood Diabetes Study Group Centre Differences Study 2005PEDIATRIC DIABETES, Issue 4 2010PGF Swift Swift PGF, Skinner TC, de Beaufort CE, Cameron FJ, Åman J, Aanstoot H-J, Castaño L, Chiarelli F, Daneman D, Danne T, Dorchy H, Hoey H, Kaprio EA, Kaufman F, Kocova M, Mortensen HB, Njølstad PR, Phillip M, Robertson KJ, Schoenle EJ, Urakami T, Vanelli M, Ackermann RW, Skovlund SE for the Hvidoere Study Group on Childhood Diabetes. Target setting in intensive insulin management is associated with metabolic control: the Hvidoere Childhood Diabetes Study Group Centre Differences Study 2005. Objective: To evaluate glycaemic targets set by diabetes teams, their perception by adolescents and parents, and their influence on metabolic control. Methods: Clinical data and questionnaires were completed by adolescents, parents/carers and diabetes teams in 21 international centres. HbA1c was measured centrally. Results: A total of 2062 adolescents completed questionnaires (age 14.4 ± 2.3 yr; diabetes duration 6.1 ± 3.5 yr). Mean HbA 1c = 8.2 ± 1.4% with significant differences between centres (F = 12.3; p < 0.001) range from 7.4 to 9.1%. There was a significant correlation between parent (r = 0.20) and adolescent (r = 0.21) reports of their perceived ideal HbA1c and their actual HbA1c result (p < 0.001), and a stronger association between parents' (r = 0.39) and adolescents' (r = 0.4) reports of the HbA1c they would be happy with and their actual HbA1c result. There were significant differences between centres on parent and adolescent reports of ideal and happy with HbA1c (8.1 < F > 17.4;p < 0.001). A lower target HbA1c and greater consistency between members of teams within centres were associated with lower centre HbA1c (F = 16.0; df = 15; p < 0.001). Conclusions: Clear and consistent setting of glycaemic targets by diabetes teams is strongly associated with HbA1c outcome in adolescents. Target setting appears to play a significant role in explaining the differences in metabolic outcomes between centres. [source] Personality in nonhuman primates: a review and evaluation of past researchAMERICAN JOURNAL OF PRIMATOLOGY, Issue 8 2010Hani D. Freeman Abstract Scientific reports of personality in nonhuman primates are now appearing with increasing frequency across a wide range of disciplines, including psychology, anthropology, endocrinology, and zoo management. To identify general patterns of research and summarize the major findings to date, we present a comprehensive review of the literature, allowing us to pinpoint the major gaps in knowledge and determine what research challenges lay ahead. An exhaustive search of five scientific databases identified 210 relevant research reports. These articles began to appear in the 1930s, but it was not until the 1980s that research on primate personality began to gather pace, with more than 100 articles published in the last decade. Our analyses of the literature indicate that some domains (e.g., sex, age, rearing conditions) are more evenly represented in the literature than are others (e.g., species, research location). Studies examining personality structure (e.g., with factor analysis) have identified personality dimensions that can be divided into 14 broad categories, with Sociability, Confidence/Aggression, and Fearfulness receiving the most research attention. Analyses of the findings pertaining to inter-rater agreement, internal consistency, test,retest reliability, generally support not only the reliability of primate personality ratings scales but also point to the need for more psychometric studies and greater consistency in how the analyses are reported. When measured at the level of broad dimensions, Extraversion and Dominance generally demonstrated the highest levels of inter-rater reliability, with weaker findings for the dimensions of Agreeableness, Emotionality, and Conscientiousness. Few studies provided data with regard to convergent and discriminant validity; Excitability and Dominance demonstrated the strongest validity coefficients when validated against relevant behavioral criterion measures. Overall, the validity data present a somewhat mixed picture, suggesting that high levels of validity are attainable, but by no means guaranteed. Discussion focuses on delineating major theoretical and empirical questions facing research and practice in primate personality. Am. J. Primatol. 72:653,671, 2010. © 2010 Wiley-Liss, Inc. [source] Supplemental wide field-of-view monitor improves performance in surgical telerobotic movement time,THE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 4 2006Alex Cao Abstract Background This study investigates the effect of a supplemental wide field-of-view (FOV) monitor on performance at high magnifications where the benefits of robotic surgery have greater importance. Methods Ten surgically naïve participants performed a simple aimed movement task under two different monitor conditions. The task is intended to emulate the need to locate an instrument outside the surgeon's FOV and return it to a ,home' position without the need to zoom. One monitor condition used a narrow FOV (25×) coupled with a supplemental wide FOV (3×). The second monitor condition used only a narrow FOV. Results Using a supplemental wide FOV in addition to a narrow FOV improved task performance by at least 33%, with greater consistency and reliability. Conclusion The supplemental wide FOV monitor provided additional information to the participant, allowing more efficient performance at high magnifications without the need for zooming. Copyright © 2006 John Wiley & Sons, Ltd. [source] | ||||||||||