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Objective Tool (objective + tool)
Selected AbstractsDeveloping a valid and reliable self-efficacy in clinical performance scaleINTERNATIONAL NURSING REVIEW, Issue 2 2009F. Cheraghi phd Aim:, This paper describes the development and testing of the Self-Efficacy in Clinical Performance (SECP) instrument for nursing students. Background:, Accurate measurement of self-efficacy can be used to predict nursing students' clinical performance. The literature review indicated there is no existing self-efficacy in clinical performance instrument for Iranian nursing students. Methods:, To clarify the concept of self-efficacy in clinical performance, 28 semi-structured interviews and three focus groups were conducted. A self-efficacy framework with well-developed theoretical constructs was formed. A review of literature and content analysis of the interview transcripts identified subscales and items to be included in the instrument. Then, a methodological design was used. The SECP was developed into 69 Likert-format items, which were evaluated by 20 nursing experts in the form of content validity index. The scale's validity and reliability were tested in a randomized sample of 207 final year nursing students. Findings:, The final scale consists of four dimensions with 37 items. The overall scale internal reliability had , = 0.96; the dimensions Cronbach's , ranged from 0.90 to 0.92. Test,retest reliability with a 2-week time interval was: r = 0.94. In addition, concurrent validity was obtained (r = 0.73, P = 0.01). Conclusions:, The SECP has demonstrated evidence of content validity, construct validity, concurrent validity, internal consistency reliability and stability. Statistical analysis provided an objective tool for assessing nursing students' self-efficacy in clinical performance. It may have been fruitful to further test the instrument with students from other years of their education. [source] Accuracy and precision of radiostereometric analysis in the measurement of three-dimensional micromotion in a fracture model of the distal radiusJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 2 2005Rami Madanat Abstract The purpose of the current study was to verify the feasibility of radiostereometric analysis (RSA) in monitoring three-dimensional fracture micromotion in fractures of the distal radius. The experimental set-up consisted of a simulated model of an extra-articular Colles' fracture, including metallic beads inserted into the bone on either side of the fracture site. The model was rigidly fixed to high precision micrometer stages allowing controlled translation in three axes and rotation about the longitudinal and transverse axes. The whole construct was placed inside a RSA calibration cage with two perpendicular radiographic film cassettes. Accuracy was calculated as the 95% prediction intervals from the regression analyses between the micromotion measured by RSA and actual displacements measured by micrometers. Precision was determined as the standard deviation of five repeated measurements of a 200 ,m displacement or a 0.5° rotation along a specific axis. Translations from 25 ,m to 5 mm were measured with an accuracy of ±6,m and translations of 200,m were measured with a precision of 2,6 ,m. Rotations ranging from 1/6° to 2° were measured with an accuracy of ±0.073° and rotations of 1/2° were measured with a precision of 0.025°,0.096°. The number of markers and their configuration had greater impact on the accuracy and precision of rotation than on those of translation. Aside from the unknown rate of clinical marker loosening, the current results favor the use of at least four markers in each bone fragment in distal radius fractures. These results suggest a strong rationale for the use of RSA as an objective tool for comparing different treatment modalities and novel bone graft substitutes aimed at stabilization of fractures of the distal radius. © 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source] Quantitative assessment of daytime motor activity provides a responsive measure of functional decline in patients with Huntington's diseaseMOVEMENT DISORDERS, Issue 3 2001J.P.P. van Vugt MD Abstract Voluntary motor impairment is a functionally important aspect of Huntington's disease (HD). Therefore, quantitative assessment of disturbed voluntary movement might be important in follow-up. We investigated the relation between quantitatively assessed daytime motor activity and symptom severity in HD and evaluated whether assessment of daytime motor activity is a responsive measure in the follow-up of patients. Sixty-four consecutive HD patients and 67 age- and sex-matched healthy controls were studied. Daytime motor activity was recorded using a wrist-worn activity monitor that counts all movements during a period of five consecutive days. Patients were rated clinically for voluntary motor impairment, dyskinesias, posture & gait, depression, cognitive impairment and functional capacity. Follow-up was available from 40 patients (mean follow-up 2.0 years) and 29 controls (mean follow-up 5.9 years). Despite chorea, patients had less daytime motor activity than controls (P < 0.005). This hypokinesia correlated with impaired voluntary movements (r = 0.37; P < 0.01), disturbed posture & gait (r = 0.38; P < 0.005) and especially with reduced functional capacity (r = 0.51; P < 0.0005). During follow-up, hypokinesia remained unchanged in clinically stable patients, but became worse in those whose functional disability progressed (P < 0.005). Hypokinesia seems a core symptom of HD which is related to functional capacity. Actimetric assessment of hypokinesia is responsive to disease progression and can be used as an objective tool for follow-up. © 2001 Movement Disorder Society. [source] Diagnostic role of 99mTc hexamethyl-propyleneamine oxime brain single photon emission computed tomography in Sydenham's choreaPEDIATRICS INTERNATIONAL, Issue 4 2004Kaan Demirören AbstractBackground:,The objective of this study was to determine whether technetium-99m hexamethyl-propyleneamine oxime (HMPAO) brain single photon emission computed tomography (SPECT) imaging is capable of detecting perfusional abnormalities in Sydenham's chorea (SC) patients and contributing to diagnosis of SC. Methods:,In this study, 17 SC patients were evaluated. HMPAO SPECT was performed on all patients at the acute phase and six of them at the recovery phase. Magnetic resonance imaging (MRI) of the brain was performed to 13 patients. SPECT images of basal ganglia and thalamus were evaluated both visually and by measuring the radioactivity uptakes. Ten subjects constituted the control group. Results:,HMPAO SPECT was visually evaluated as indicating hyperperfusion in the basal ganglia and thalamus in 16 patients, and evaluated as normal in one patient at the acute phase. The radioactivity uptakes of basal ganglia and thalamus of the patients at the acute phase were found statistically higher than those of the patients at the recovery phase, and also higher than those of the control group (P < 0.05). A significant difference between the radioactivity uptake of the patients at the recovery phase and those of the control group was not found (P > 0.05). Only one patient did not show any abnormality in both acute and recovery phases. MRI study did not show any abnormality in the basal ganglia and thalamus. Conclusion:,It is suggested that brain SPECT can contribute to the diagnosis of SC as an objective tool. Resolving of the hyperperfusion at the recovery phase provides further support for the diagnosis of SC. [source] Effects of rivastigmine on the quantitative EEG in demented Parkinsonian patientsACTA NEUROLOGICA SCANDINAVICA, Issue 4 2003N. Fogelson Objectives, , Quantitative electroencephalogram (qEEG) can be used to measure the effects of drugs on the brain. We studied the effects of rivastigmine on the qEEG in Parkinson's disease (PD) patients with dementia. Subjects and methods, , Demented PD patients (n=19) were treated with rivastigmine in an open label study. Recordings were obtained prior to and following 12 weeks of treatment. Results were analyzed using two-way ANOVA with repeated measures. Results, , A significant increase in the relative alpha (P < 0.05) activity was observed after treatment with rivastigmine. This was general rather than localized to specific brain surface areas. An increase in beta activity and decrease in the slower frequencies (delta and theta) were also observed; however, these were not statistically significant. Conclusion, , qEEG may serve as an objective tool to monitor the effects of antidementia drug therapy. The changes characterized by increased faster frequencies and decreased slower frequencies that were observed may indicate increased arousal or improvement in the cognitive state of the patients as a consequence of the treatment with rivastigmine. [source] Recent advances of genetic ancestry testing in biomedical research and direct to consumer testingCLINICAL GENETICS, Issue 3 2009M Via In the post-Human Genome Project era, the debate on the concept of race/ethnicity and its implications for biomedical research are dependent on two critical issues: whether and how to classify individuals and whether biological factors play a role in health disparities. The advent of reliable estimates of genetic (or biogeographic) ancestry has provided this debate with a quantitative and more objective tool. The estimation of genetic ancestry allows investigators to control for population stratification in association studies and helps to detect biological causation behind population-specific differences in disease and drug response. New techniques such as admixture mapping can specifically detect population-specific risk alleles for a disease in admixed populations. However, researchers have to be mindful of the correlation between genetic ancestry and socioeconomic and environmental factors that could underlie these differences. More importantly, researchers must avoid the stigmatization of individuals based on perceived or real genetic risks. The latter point will become increasingly sensitive as several ,for profit companies' are offering ancestry and genetic testing directly to consumers and the consequences of the spread of the services of these companies are still unforeseeable. [source] A new index for rating aesthetics of implant-supported single crowns and adjacent soft tissues , the Implant Crown Aesthetic IndexCLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2005A pilot study on validation of a new index Abstract Objectives: The important item of aesthetics is rarely included in evaluation studies. The aim of this study was to develop and validate an index for rating aesthetics of implant-supported single crowns and adjacent soft tissues. Material and methods: Nine items were selected, which have an influence on the aesthetic result. The items are based on the anatomic form, colour and surface characteristics of the crown and on the anatomic form, colour and surface characteristics of the peri-implant soft tissues. Two oral-maxillofacial surgeons and two prosthodontists rated 24 implant-supported single-tooth restorations and adjacent soft tissues on a form with the nine items of the rating index. The rating was carried out twice by each of the examiners. Weighted Cohen's , was calculated to express the intra- and interobserver agreement. Results: Intraobserver results indicated that the agreement between the first and second rating of both the prosthodontists was good (both 0.7) and that the agreement of the oral-maxillofacial surgeons was moderate (0.49 and 0.56). The best interobserver agreement was found between the two prosthodontists (0.61, good agreement). Conclusions: The Implant Crown Aesthetic Index is an objective tool in rating aesthetics of implant-supported single crowns and adjacent soft tissues. The rating is best be carried out by one prosthodontist to have the highest reliability. Résumé L'aspect important qu'est l'esthétique est rarement inclus dans les études d'évaluation. Le but de cette étude était de développer et de valider un index pour évaluer l'esthétique d'implants avec une couronne unique et les tissus mous adjacents. Neuf points ayant une influence sur le résultat esthétique ont été sélectionnés. Ces points sont basés sur une forme anatomique, des caractéristiques de surface et de couleur de la couronne et de la forme anatomique, la couleur et les caractéristiques de surface des tissus mous paroïmplantaires. Deux chirurgiens maxillo-faciaux et deux spécialistes en prothèse ont évalué 24 restaurations de dents uniques sur implants et leurs tissus mous adjacents dans un formulaire avec les neuf points de l'indice d'évaluation. L'évaluation a été effectuée deux fois par chacun des examinateurs. Le kappa de Cohen a été calculé pour exprimer l'accord intra- et inter-observateurs. Les résultats intra-observateurs ont indiqué que l'accord entre la première et la deuxième évaluation étaient bonnes pour les spécialistes en prothèse (les deux 0,70) et l'accord pour les chirurgiens était moyen (0,49 et 0,56). Le meilleur accord inter-observateurs était trouvé entre les deux spécialistes de prothèse (0,61, bon accord). L'indice d'esthétique de la couronne sur implant est un outil objectif dans l'évaluation de l'esthétique des couronnes uniques sur implant et les tissus mous adjacents. L'évaluation est mieux effectuée par un spécialiste en prothèse pour obtenir la plus haute précision. Zusammenfassung Ziele: Der wichtige Faktor Aesthetik wird kaum in Untersuchungen miteinbezogen. Das Ziel dieser Studie war, einen Index zur Wertung der Aesthetik von implantatgetragenen Einzelkronen und der angrenzenden Weichgewebe zu entwickeln und zu werten. Material und Methoden: Neun Punkte wurden ausgewählt, welche einen Einfluss auf das Ästhetische Resultat haben. Die Punkte basierten auf der anatomischen Form, Farb- und Oberflächencharakteristiken der Krone und auf der anatomischen Form, Farb- und Formcharakteristiken der peri-implantären Weichgewebe. Zwei Kieferchirurgen und zwei Prothetikspezialisten bewerteten 24 implantatgetragene Einzelkronen und die angrenzenden Weichgewebe auf einem Formular mit 9 Punkten des Wertungsindex. Die Bewertung wurde von jedem Untersucher zweimal durchgeführt. Es wurden gewichtete Cohen`s Kappa berechnet, um die Uebereinstimmung innerhalb der Untersucher und zwischen den verschiednen Untersuchern auszudrücken. Resutate: Die Resultate innerhalb der Untersucher zeigten, dass die Uebereinstimmung zwischen der ersten und der zweiten Bewertung bei beiden Prothetikern gut war (beide 0.7) und dass die Uebereinstimmung bei den Kieferchirurgen mässig ausfiel (0.49 und 0.56). Die beste Uebereinstimmung zwischen zwei verschiedenen Untersuchern wurde zwischen den beiden Prothetikern gefunden (0.61, gut Uebereinstimmung). Schlussfolgerung: Der Implantat Kronen Aesthetik Index stellt ein objektives Werkzeug zur Bewertung der Aesthetik von implantatgetragenen Einzelkronen und der angrenzenden Weichgewebe dar. Die Bewertung wird am besten durch einen Prothetikspezialisten durchgeführt, um die höchste Zuverlässigkeit zu erhalten. Resumen Objetivos: El punto importante de la estética raramente se incluye en estudios de evaluación. La intención del presente estudio fue desarrollar y validar un índice para valorar la estética de las coronas unitarias implantosoportadas y los tejidos blandos adyacentes. Material y métodos: Se seleccionaron nueve puntos, que tienen influencia en el resultado estético. Los puntos se basan en la forma anatómica, color y características de la superficie de la corona y en la forma anatómica, color y características de la superficie de los tejidos blandos periimplantarios. Dos cirujanos maxilofaciales y dos prostodoncistas valoraron 24 restauraciones unitarias implantosoportadas y los tejidos blandos adyacentes en un formulario con nueve puntos del índice de valoración. La valoración se llevó a cabo dos veces por cada examinador. Se calculó el weighted kappa de Cohen para expresar la concordancia intra- e interobservador. Resultados: Los resultados intraobservador indicaron que el acuerdo entre la primera y la segunda valoración de ambos prostodoncistas fue buena (ambos 0.70) y que el acuerdo de los cirujanos maxilofaciales fue moderada (0.49 y 0.56). El mejor acuerdo interobservador se encontró entre los dos prostodoncistas (0.61, buen acuerdo). Conclusión: El Índice de Estética de Coronas de Implantes es una herramienta objetiva en la valoración de la estética de las coronas unitarias implantosoportadas y los tejidos blandos adyacentes. La valoración se llevó mejor a cabo por un prostodoncista que tuvo la mayor fiabilidad. [source] How we do it: Diagrammatic recording of tympanomastoid proceduresCLINICAL OTOLARYNGOLOGY, Issue 6 2006J.D. Wasson Keypoints ,,Accurate documentation of the operative findings of tympanomastoid procedures is essential for effective patient management and to satisfy the growing demands of clinical audit. ,,Due to the three-dimensional complexity of the middle ear, it is difficult to represent graphically. ,,Consequently, most surgeons only describe subjectively their operative, otological findings. ,We present for the first time a simple middle ear template which provides an objective tool to improve the recording of tympanomastoid procedures. [source] Risk assessment and management: A community forensic mental health practice modelINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 4 2002Teresa Kelly ABSTRACT: In Victoria, the Crimes (Mental Impairment and Unfitness to be Tried) Act (1997) reformed legal practice in relation to the detention, management and release of persons found by a court to be not guilty on the grounds of insanity or unfit to be tried. This Act provides a legal structure for such ,forensic patients' to move from secure inpatient facilities into the community. This new legislative landscape has generated challenges for all stakeholders and has provided the impetus for the development of a risk assessment and management model. The key components of the model are the risk profile, assessment and management plan. The discussion comprises theory, legislation, practice implications and limitations of the model. Practice implications concern the provision of objective tools, which identify risk and document strategic interventions to support clinical management. Some of the practice limitations include the model's applicability to risk assessment and management and its dependence on a mercurial multi-service interface in after-hours crisis situations. In addition to this, the paper articulates human limitations implicit in the therapeutic relationship that necessarily underpins the model. The paper concludes with an exploration of the importance of evaluative processes as well as the need for formal support and education for clinicians. [source] STANDARD SCALES FOR CRISPNESS, CRACKLINESS AND CRUNCHINESS IN DRY AND WET FOODS: RELATIONSHIP WITH ACOUSTICAL DETERMINATIONSJOURNAL OF TEXTURE STUDIES, Issue 4 2008MAITE A. CHAUVIN ABSTRACT A trained panel developed rating scales for crispness, crunchiness and crackliness for dry and wet foods based on the auditory perception of selected foods. The newly developed scales were then evaluated by 40 untrained panelists and the sound perception of standard foods was assessed through the analysis of the root mean square (RMS) of the 5-s audio waveforms and multidimensional scaling (MDS). The RMS was highly correlated to auditory sensory perception of crispness (r = 0.83 and 0.96), crunchiness (r = 0.99 and 0.99) and crackliness (r = 0.88 and 0.96) for dry and wet foods, respectively. MDS technique applied for the 40 untrained panelists was instructive in assessing auditory textural differences of naïve panelists and a useful statistical instrument to graphically validate selected scales. Auditory perception of the selected foods were rated similarly using standard auditory texture scales for crispness, crunchiness and crackliness developed by the trained panel (oral evaluation) and MDS results from the untrained panel (recordings). PRACTICAL APPLICATIONS Crispness, crunchiness and crackliness are not only important and useful descriptors of food texture, but are also desirable textural qualities in many foods. The lack of consistency in the procedures used for the evaluation of crunchy, crispy and crackly in sensory studies often results in confusion when training expert panels. Research will benefit textural studies through an improvement of consistent textural definitions and development of standard scales and evaluation techniques. The crispness, crunchiness and crackliness scales developed and applied in the current study represent a new potential standard frame of reference that may be used for training panelists in texture parameters related to food auditory perception. The scales may be considered illustrations demonstrating full and practical ranges for each texture attribute with regard to analyzing auditory parameters of foods and effective objective tools for assessing panelists in descriptive analysis. [source] | |||||||||||||