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Strong Agreement (strong + agreement)
Selected AbstractsReliability of self-reported willingness-to-pay and annual income in patients treated for toenail onychomycosisBRITISH JOURNAL OF DERMATOLOGY, Issue 5 2007P.M.H. Cham Summary Background, Willingness-to-pay (WTP) is a health economics measure that has recently been used for skin diseases to evaluate patients' quality of life. However, the reliability of this measure has not been investigated in the dermatology literature and is essential in validating its use in health services research. Objectives, This study evaluated the test-retest reliability of self-reported annual income and WTP, a health economics measure of disease impact, in patients with toenail onychomycosis. Methods, Forty-six patients enrolled in a randomized clinical trial comparing two different dosing regimens of terbinafine completed a self-administered questionnaire at baseline and 1 month later. The questionnaire asked: (i) how much patients would be willing to pay for a theoretical treatment with a cure rate of 85% for their current onychomycosis (10 categories: $0,50, $51,100, to > $800); and (ii) annual income (10 categories: $0,10 000 to > $200 000). Results, Forty-four patients reported WTP at both visits, and 55% reported the same WTP. The quadratic-weighted (Fleiss,Cohen) , statistic indicated moderate agreement (, = 0·50, 95% confidence interval, CI 0·24,0·75, P < 0·01) as did the Spearman rank-order correlation coefficient (rs = 0·57, P < 0·01; median difference = 0, P = 0·50). Strong agreement was shown among the 42 patients who reported income at both visits; 71% reported the same annual income category (, = 0·72, 95% CI 0·47,0·96, P < 0·01; rs = 0·68, P < 0·01; median difference = 0, P = 0·77). Age, disease severity and duration, previous therapy, self-reported annual income, and medication side-effects were not statistically associated with the reliability of WTP. Conclusions, WTP and annual income demonstrated moderate and strong test-retest reliability, respectively. Self-reported WTP can serve as a reliable measure for future health economics research on onychomycosis. [source] A simple method to calculate the signal-to-noise ratio of a circular-shaped coil for MRICONCEPTS IN MAGNETIC RESONANCE, Issue 6 2006K. Ocegueda Abstract The introduction of the ultrafast imaging sequences has renewed the interest in development of RF coils. The theoretical frame of the SNR of MRI coils is a challenge because it requires a deep mathematical background to master the associated concepts. Here, a simpler method is proposed based on Legendre polynomials. This approximation method, together with a quasi-static approach, was used to derive a signal-to-noise ratio expression for a circular-shaped coil. Legendre polynomials were used instead of a weighting function to simplify the vector potential of the power loss, and an SNR formula was then derived. The simplified version of the SNR formula of a circular coil was compared with the weighting function-derived SNR expression using the quasi-static approach. SNR-vs.-depth plots were computed to theoretically compare both SNR formulas. Results showed a strong agreement between SNR values for the circular-shaped coil. This approach can be used as a tool to derive SNR expressions for more complex geometries. © 2006 Wiley Periodicals, Inc. Concepts Magn Reson Part A 28A: 422,429, 2006 [source] Nonlinear Flow in Karst FormationsGROUND WATER, Issue 5 2009David A. Chin The variation of effective hydraulic conductivity as a function of specific discharge in several 0.2-m and 0.3-m cubes of Key Largo Limestone was investigated. The experimental results closely match the Forchheimer equation. Defining the pore-size length scale in terms of Forchheimer parameters, it is demonstrated that significant deviations from Darcian flow will occur when the Reynolds number exceeds 0.11. A particular threshold model previously proposed for use in karstic formations does not show strong agreement with the data near the onset of nonlinear flow. [source] Ensuring Quality Information for Patients: development and preliminary validation of a new instrument to improve the quality of written health care informationHEALTH EXPECTATIONS, Issue 2 2004Beki Moult BA(Hons) MSc Abstract Background, Despite the recent focus on improving the quality of patient information, there is no rigorous method of assessing quality of written patient information that is applicable to all information types and that prescribes the action that is required following evaluation. Objective, The aims of this project were to develop a practical measure of the presentation quality for all types of written health care information and to provide preliminary validity and reliability of the measure in a paediatric setting. Methods, The Ensuring Quality Information for Patients (EQIP) tool was developed through a process of item generation, testing for concurrent validity, inter-rater reliability and utility. Patient information managers and health care professionals tested EQIP in three annual audits of health care leaflets produced by a children's hospital. Results, The final tool comprised 20 items. Kendall's , B rank correlation between EQIP and DISCERN was 0.56 (P = 0.001). There was strong agreement between intuitive rating and the EQIP score (Kendall's , B = 0.78, P = 0.009). Internal consistency using Cronbach's , was 0.80. There was good agreement between pairs of raters (mean , = 0.60; SD = 0.18) with no differences based on types of leaflets. Audits showed significant improvement in the number of leaflets achieving a higher quality EQIP rating over a 3-year period. Conclusions, EQIP demonstrated good preliminary validity, reliability and utility when used by patient information managers and healthcare professionals for a wide variety of written health care information. EQIP uniquely identifies actions to be taken as a result of the quality assessment. Use of EQIP improved the quality of written health care information in a children's hospital. Wider evaluation of EQIP with written information for other populations and settings is recommended. [source] Potential of low cost close-range photogrammetry system in soil microtopography quantificationHYDROLOGICAL PROCESSES, Issue 10 2009Mohamed A. M. Abd Elbasit Abstract Soil microtopography is a dynamic soil property which affects most soil-surface and water interaction processes. The importance of soil microtopography has been recognized for a long time, but only limited reports are available in the literature. In this study, the potential of using consumer-grade cameras and close-range photogrammetry procedures to quantify soil microtopography at plot-scale level (,1 m2) were assessed. Five fabricated gypsum surfaces with different degrees of roughness were used to simulate the soil surface conditions with different soil aggregates. The surfaces' digital elevation model (DEM) was generated using the photogrammetry system (PHM) involving a consumer-grade camera, and pin-microrelief meter (PM). The DEM generated using the PHM was assessed for accuracy, roughness indices (RI), depression area percentage (DA%), depression storage capacity (DSC), and micro-rills delineation in comparison with the PM. The accuracy was evaluated using the root mean square error (RMSE) in the x-, y-, and z-directions. Visual comparison between the 3D-visions of the DEM showed strong agreement between the DEM generated by the PHM and the PM, and between the PHM and the 2D images for the different gypsum surfaces. The average RMSE in the x-. y-, and z-direction were 2·08, 1·52, and 0·82 mm for the rough surface, and 4·42, 1·65, and 3·22 mm for the smooth surface. The RIs calculated from the two methods were highly correlated. The small discrepancy between the two methods was discussed. The micro-rills delineation was also similar for the two methods regarding the network density. The grid size did not effect the RI calculation, and has a strong influence on the DA%, DSC, and the delineated micro-rills orders. Results suggest that a consumer-grade camera and close-range photogrammetry have the potential to quantify the soil microtopography. Copyright © 2009 John Wiley & Sons, Ltd. [source] Self-ratings in Training Programs: An Examination of Level of Performance and the Effects of FeedbackINTERNATIONAL JOURNAL OF SELECTION AND ASSESSMENT, Issue 3 2001Sally A. Carless The level of agreement (mean differences and correlations) between self, peer and training staff ratings were examined in this study. The sample consisted of 545 participants who were undertaking a Royal Australian Airforce officer training program. Consistent with previous research there was strong agreement between training staff and peers and weak agreement between self-ratings and ratings by others (training staff and peers). Accuracy of ratings was examined by (a) comparing the mean ratings of outstanding, average and below-average performers; and (b) correlating difference scores with a measure of performance. The findings showed that below-average performers have a less accurate view of themselves compared to outstanding performers. Finally, we examined the effects of negative feedback on self-perceptions. The analyses indicated that after receiving negative feedback, average performers adjusted their self-ratings. Various explanations were proposed together with practical implications for training. [source] A Native American community's involvement and empowerment to guide their children's development in the school settingJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 4 2006Héctor H. Rivera This study provides an empirical description of the dimensions of community values, beliefs, and opinions through a survey conducted in the Pueblo Indian community of Zuni in New Mexico. The sample was composed of 200 randomly chosen community members ranging from 21 to 103 years old. A principal component factor analysis was conducted, as well as a multivariate analysis of variance, to explore gender, age, education, language, and socioeconomic (SES) differences on values, beliefs, and opinions from survey participants. Overall, the findings suggest a strong agreement by the community on the direction to be taken by their school district in their efforts to improve classroom instruction, as well as in their efforts to guide their children's development as Native Americans. © 2006 Wiley Periodicals, Inc. [source] Onion Cells After High Pressure and Thermal Processing: Comparison of Membrane Integrity Changes Using Different Analytical Methods and Impact on Tissue TextureJOURNAL OF FOOD SCIENCE, Issue 7 2010Maria E. Gonzalez Abstract:, Two different analytical methods were evaluated for their capacity to provide quantitative information on onion cell membrane permeability and integrity after high pressure and thermal processing and to study the impact of these processing treatments on cell compartmentalization and texture quality. To determine changes in cell membrane permeability and/or integrity the methodologies utilized were: (1) measurement of a biochemical product, pyruvate, formed as a result of membrane permeabilization followed by enzymatic activity and (2) leakage of electrolytes into solution. These results were compared to previously determined methods that quantified cell viability and 1H-NMR T2 of onions. These methods allowed for the monitoring of changes in the plasma and tonoplast membranes after high pressure or thermal processing. High pressure treatments consisted of 5 min holding times at 50, 100, 200, 300, or 600 MPa. Thermal treatments consisted of 30 min water bath exposure to 40, 50, 60, 70, or 90 °C. There was strong agreement between the methods in the determination of the ranges of high pressure and temperature that induce changes in the integrity of the plasma and tonoplast membranes. Membrane rupture could clearly be identified at 300 MPa and above in high pressure treatments and at 60 °C and above in the thermal treatments. Membrane destabilization effects could already be visualized following the 200 MPa and 50 °C treatments. The texture of onions was influenced by the state of the membranes and was abruptly modified once membrane integrity was lost. Practical Application:, In this study, we used chemical, biochemical, and histological techniques to obtain information on cell membrane permeability and onion tissue integrity after high pressure and thermal processing. Because there was strong agreement between the various methods used, it is possible to implement something relatively simple, such as ion leakage, into routine quality assurance measurements to determine the severity of preservation methods and the shelf life of processed vegetables. [source] Tree Basal Growth Response to Flooding in a Bottomland Hardwood Forest in Central Ohio,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 6 2008Christopher J. Anderson Abstract:, Tree basal growth in response to flooding regime was evaluated at a 5.2-ha bottomland forest along the Olentangy River in central Ohio. Tree-ring analysis was used to develop a 14-year basal area increment (BAI) (cm2/year) series for 42 canopy trees (representing 10 species) throughout the bottomland. Mean annual BAI was evaluated relative to the frequency and duration of bankfull (>70 m3/s) and high-flood (>154 m3/s) river discharge for a given water year (October 1-September 30) and growing season (April 1-September 30). A significant polynomial relationship was detected between the number of days of high-flood river discharge over a combined two-year period (Year i + Year i , 1) and mean annual BAI. No significant relationships were detected when only the concurrent-year or previous-year flood regimes were considered or when growing season was considered. A similar relationship was detected when duration of high-flood discharge days and BAI were both evaluated in two-year increments (Year i + Year i , 1). Mean annual BAI was most influenced by boxelder (Acer negundo) which was the dominant species and exhibited strong agreement with the overall BAI series. In each case, the resulting parabolic curve of tree basal growth in response to flooding suggests an optimal number of flooding days, a response to perturbation consistent with the subsidy-stress model. Dendrochronology may be a useful tool for managers looking to restore environmental flows to regulated rivers. [source] A structured communication adolescent guide (SCAG): assessment of reliability and validityMEDICAL EDUCATION, Issue 5 2005Kim Blake Purpose, To assess the reliability and validity of a Structured Communication Adolescent Guide (SCAG) in an undergraduate medical education setting using trained adolescent raters. Method, The SCAG is a 49-item, 6-section (A,F), protocol derived from the Calgary Cambridge Observation Guide that incorporates adolescent psychosocial data collection with the physician's communication skills. Four trained female adolescents scored 42 videotaped adolescent clinical encounters using the SCAG; a trained psychologist's rating for each videotape was used as the gold standard. Results, Agreement among adolescent raters was determined by calculating intraclass correlation coefficients (ICC). The individual SCAG item scores, combined with the global ratings for each section, resulted in an overall ICC value of 0.93, indicating very strong agreement among the 4 raters. The global rating scores for the sections (,initiating the session', ,initiating separation', ,once adolescent is alone , lifestyle' and ,closure') produced an ICC range of 0.58,0.93. However, the ICC values for the 2 remaining sections (,how was information collected' and ,gathering information') global rating scores were below 0.30, signifying low agreement. Overall agreement between the adolescent raters and the gold standard resulted in an ICC value of 0.78. This is evidence of the SCAG's criterion validity. Conclusion, The SCAG is a reasonably valid tool for use in guiding an encounter with an adolescent patient. However, 2 sections require modifications to improve their reliability and thus the SCAG's overall performance. Our results suggest that the SCAG shows promise as a potentially useful teaching resource in undergraduate medical education in adolescent medical interviewing. [source] Consultants' opinion on a new practice-based assessment programme for first-year residents in anaesthesiologyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2002C. Ringsted Background: Assessment in postgraduate education is moving towards using a broad spectrum of practice-based assessment methods. This approach was recently introduced in first-year residency in anaesthesiology in Denmark. The new assessment programme covers: clinical skills, communication skills, organizational skills and collaborative skills, scholarly proficiencies and professionalism. Eighteen out of a total of 21 assessment instruments were used for pass/fail decisions. The aim of this study was to survey consultants' opinions of the programme in terms of the representativeness of competencies tested, the suitability of the programme as a basis for pass/fail decisions and the relevance and sufficiency of the content of the different assessment instruments. Methods: A description of the assessment programme and a questionnaire were sent to all consultants of anaesthesiology in Denmark. The questionnaire consisted of items, to be answered on a five-point scale, asking the consultants' opinions about representativeness, suitability and content of the programme. Results: The response rate was 251/382 (66%). More than 75% of the respondents agreed that the assessment programme offered adequate coverage of the competencies of a first-year resident and was appropriate for making pass/fail decisions. There was strong agreement that the content of the 18 tests used for pass/fail decisions was relevant and sufficient for pass/fail decisions. Conclusion: Judging from the consultants' opinions, the assessment programme for first-year residency in anaesthesiology appears to be appropriate regarding the range of competencies assessed, the appropriateness as a basis for pass/fail decisions, and regarding the content of the tests used for pass/fail decisions. Further studies are needed to assess the feasibility and acceptability of the programme in practice. [source] ED Crowding Is Associated with Variable Perceptions of Care CompromiseACADEMIC EMERGENCY MEDICINE, Issue 12 2007Jesse M. Pines MD, MSCE Objectives The authors measured the association between emergency department (ED) crowding and patient and provider perceptions about whether patient care was compromised. Methods This was a cross-sectional study of patients admitted from the ED and their providers. Surveys of patients, nurses, and resident physicians were linked. The primary outcome was agreement or strong agreement on a five-item scale assessing whether ED crowding compromised care. Logistic regression was used to determine the association between the primary outcome and measures of ED crowding. Results Of 741 patients approached, 644 patients consented (87%); 703 resident physician surveys (95%) and 716 nursing surveys (97%) were completed. A total of 106 patients (16%), 86 residents (12%), and 173 nurses (24%) reported that care was compromised by ED crowding. In 252 cases (35%), one or more respondents reported that care was compromised. There was poor agreement over whose care was compromised. For patients, independent predictors of compromised care were waiting room time (odds ratio [OR], 1.05 for each additional 10-minute wait [95% confidence interval {CI} = 1.02 to 1.09]) and being surveyed in a hallway bed (OR, 2.02 [95% CI = 1.12 to 3.68]). Predictors of compromised care for nurses included waiting room time (OR, 1.05 for each additional 10-minute wait [95% CI = 1.01 to 1.08]), number of patients in the waiting room (OR, 1.05 for each additional patient waiting [95% CI = 1.02 to 1.07]), and number of admitted patients waiting for an inpatient bed (OR, 1.08 for each additional patient [95% CI = 1.03 to 1.12]). For residents, predictors of compromised care were patient/nurse ratio (OR, 1.39 for a one-unit increase [95% CI = 1.09 to 1.20]) and number of admitted patients waiting for an inpatient bed (OR, 1.14 for each additional patient [95% CI = 1.10 to 1.75]). Conclusions ED crowding is associated with perceptions of compromised emergency care. There is considerable variability among nurses, patients, and resident physicians over which factors are associated with compromised care, whose care was compromised, and how care was compromised. [source] Generation and propagation of gastric slow wavesCLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 4 2010Dirk F Van Helden Summary 1. Mechanisms underlying the generation and propagation of gastrointestinal slow wave depolarizations have long been controversial. The present review aims to collate present knowledge on this subject with specific reference to slow waves in gastric smooth muscle. 2. At present, there is strong agreement that interstitial cells of Cajal (ICC) are the pacemaker cells that generate slow waves. What has been less clear is the relative role of primary types of ICC, including the network in the myenteric plexus (ICC-MY) and the intramuscular network (ICC-IM). It is concluded that both ICC-MY and ICC-IM are likely to serve a major role in slow wave generation and propagation. 3. There has been long-standing controversy as to how slow waves ,propagate' circumferentially and down the gastrointestinal tract. Two mechanisms have been proposed, one being action potential (AP)-like conduction and the other phase wave-based ,propagation' resulting from an interaction of coupled oscillators. Studies made on single bundle gastric strips indicate that both mechanisms apply with relative dominance depending on conditions; the phase wave mechanism is dominant under circumstances of rhythmically generating slow waves and the AP-like propagation is dominant when the system is perturbed. 4. The phase wave mechanism (termed Ca2+ phase wave) uses cyclical Ca2+ release as the oscillator, with coupling between oscillators mediated by several factors, including: (i) store-induced depolarization; (ii) resultant electrical current flow/depolarization through the pacemaker cell network; and (iii) depolarization-induced increase in excitability of downstream Ca2+ stores. An analogy is provided by pendulums in an array coupled together by a network of springs. These, when randomly activated, entrain to swing at the same frequency but with a relative delay along the row giving the impression of a propagating wave. 5. The AP-like mechanism (termed voltage-accelerated Ca2+ wave) propagates sequentially like a conducting AP. However, it is different in that it depends on regenerative store Ca2+ release and resultant depolarization rather than regenerative activation of voltage-dependent channels in the cell membrane. 6. The applicability of these mechanisms to describing propagation in large intact gastrointestinal tissues, where voltage-dependent Ca2+ entry is also likely to be functional, is discussed. [source] | |||||||||||||