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PubMed2004

Predicting bicycle helmet stage-of-change among middle school, high school, and college cyclists from demographic, cognitive, and motivational variables.

OBJECTIVES: To apply Prochaska's Transtheoretical model of behavior change to bicycle helmet use among middle school, high school, and college students. STUDY DESIGN: A battery of questionnaires was administered to cyclists in the seventh and ninth grades and to college students in Phoenix, Arizona (N=797). The battery included: (1) a question to determine respondent's stage of behavior change in Prochaska's Transtheoretical model; (2) items assessing the perceived pros and cons of helmet use; (3) a bicycle safety knowledge test; and (4) demographic information. RESULTS: Forty-three percent of the students were in "Precontemplation," 17% were in either "Contemplation" or "Preparation," 16% were in either "Action" or "Maintenance," and 24% were in the "Relapse" stage of change. Grade, Sex, Knowledge, Pros, and Cons, and the Grade by sex and the Grade by knowledge interactions were significant predictors of helmet use stages. Compared with students in Precontemplation, students in the Contemplation stage were disproportionately younger and had higher Pro scores, lower Con scores, and more knowledge (except in the ninth grade). CONCLUSIONS: The Transtheoretical model of behavior change is a viable theoretical framework for designing interventions aimed at increasing bicycle helmet use in children and adolescents.

Adolescent↗
PubMed1993

Age differences in memory-span errors: speed or inhibitory mechanisms?

This study investigated age differences in errors on the digit-span task. Protocols of 119 men and women, aged 18-99 years, were scored for the occurrence of three types of errors derived from the speed-of-processing and inhibition-deficit frameworks: omission errors, intrusion errors, and transposition errors. The types of errors made on the digit-span task varied with span size. At larger span sizes, participants were more likely to omit digits or introduce nonstimulus digits than to transpose those in storage. No age differences in intrusion errors were found, however, old-old women (75+ years) were significantly more likely than young (18-25 years) and old (60-70 years) adults of either sex to exhibit transposition errors. Consequently, old-old women were significantly less likely to exhibit omission errors. The results indicate that the digit-span task may involve two parallel processes: digit storage/recall and serial/position storage-recall. Age differences in the serial-processing component, rather than in the digit storage/recall component, may be age sensitive. These results are discussed within an inhibition-deficit framework of cognitive aging.

Adolescent↗
PubMed1984

The permanence of otoplasty in the rabbit ear: a comparison of techniques.

Otoplasty should restructure the cartilage framework of the ear with permanent results. Major techniques include the placement of permanent sutures, with or without concomitant cartilage scoring, and cartilage abrasion alone. Our study evaluates the durability of the results of each method. Fifteen New Zealand white rabbits were divided into two groups. In 10 rabbits, the posterior surface of the right ear cartilage was abraded, and the ear was folded forward and secured with nylon stitches. A similar procedure was performed on the left ear, omitting the cartilage abrasion. In 4 rabbits, both ears were abraded transversely on the posterior cartilaginous surface and no sutures were placed. In 1 rabbit only the posterior skin was undermined on both ears. For one week dressings maintained a right-angle fold at the operative site. Rabbit ears reshaped with abrasion only failed to maintain the desired conformation. Ears with suture and abrasion did not maintain the full 90-degree angle created at surgery, although they did not fully straighten. Ears reshaped with suture alone maintained a folded angle close to the original right angle. Three months after operation the sutures within the cartilage were removed to approximate the clinical situation of late suture disruption from trauma to the operated ear and the shape was assessed.

Animals↗
PubMed2001

Validity evidence for using a general critical thinking test to measure nursing students' critical thinking.

This study examined validity evidence for using a general test of critical-thinking skills and dispositions to measure nursing students' critical-thinking abilities. Content evidence indicated strong support for the theoretical framework underlying the test but less support for the way in which the critical-thinking constructs were specifically measured. Scores related to critical-thinking skills demonstrated significant but low correlations with grade point averages, were moderately correlated with SAT scores, and were uncorrelated with scores related to critical-thinking dispositions. The evidence suggests that nursing programs may need to reconsider how critical thinking should be measured and evaluated.

Adult↗
PubMedDate not supplied

Assessing antipsychotic effectiveness in dementia with the factor structure of the Psychogeriatric Dependency Rating Scale (PGDRS).

OBJECTIVE: Behavioral and psychological symptoms of dementia (BPSD) impact patient functioning, caregiver burden, and transition to structured living environments. The purpose of this study was to use the derived factor structure of the Psychogeriatric Dependency Rating Scale (PGDRS) to retrospectively assess short-term antipsychotic effectiveness. SETTING AND MEASUREMENT: A principal components factor analysis was conducted with PGDRS admission ratings for a large national sample of hospitalized dementia patients (N = 2747). Changes in calculated factor scores (admission to discharge) were used to compare effectiveness for a subset of patients treated with one of three antipsychotic agents: haloperidol, olanzapine, or risperidone. RESULTS: A four-factor solution accounted for almost 60% of rating variance. Factors were interpreted as disruptive overactivity, thought/communication disorder, interpersonal aggressiveness, and destructiveness. Medication effects (adjusting for group differences) were found for only the Interpersonal Aggressiveness factor. Improvement in this factor score was significantly greater in the olanzapine group. CONCLUSIONS: Findings suggest that these four PGDRS factors can provide a useful framework for symptom assessment and for targeted treatment.

Aged↗
PubMed2006

Integral invariants for shape matching.

For shapes represented as closed planar contours, we introduce a class of functionals which are invariant with respect to the Euclidean group and which are obtained by performing integral operations. While such integral invariants enjoy some of the desirable properties of their differential counterparts, such as locality of computation (which allows matching under occlusions) and uniqueness of representation (asymptotically), they do not exhibit the noise sensitivity associated with differential quantities and, therefore, do not require presmoothing of the input shape. Our formulation allows the analysis of shapes at multiple scales. Based on integral invariants, we define a notion of distance between shapes. The proposed distance measure can be computed efficiently and allows warping the shape boundaries onto each other; its computation results in optimal point correspondence as an intermediate step. Numerical results on shape matching demonstrate that this framework can match shapes despite the deformation of subparts, missing parts and noise. As a quantitative analysis, we report matching scores for shape retrieval from a database.

Algorithms↗
PubMed1999

A class of permutation tests for stratified survival data.

We propose a class of permutation tests for stratified survival data. The tests are derived using the framework of Fay and Shih (1998, Journal of the American Statistical Association 93, 387-396), which creates tests by permuting scores based on a functional of estimated distribution functions. Here the estimated distribution function for each possibly right-, left-, or interval-censored observation is based on a shrinkage estimator similar to the nonparametric empirical estimator of Ghosh, Lahiri, and Tiwari (1989, Communications in Statistics--Theory and Methods 18, 121-146), and permutation is carried out within strata. The proposed test with a weighted Mann-Whitney functional is similar to the permutation form of the stratified log-rank test when there is a large strata effect or the sample size in each stratum is large and is similar to the permutation form of the ordinary log-rank test when there is little strata effect. Thus, the proposed test unifies the advantages of both the stratified and ordinary log-rank tests. By changing the functional, we may obtain a stratified Prentice-Wilcoxon test or a difference in means test with similar unifying properties. We show through simulations the advantage of the proposed test over existing tests for uncensored and right-censored data.

AIDS-Related Opportunistic Infections↗
PubMed2005

Review article: drug-induced microscopic colitis - proposal for a scoring system and review of the literature.

The pathophysiology of microscopic colitis is unknown, although it is thought to be because of an abnormal immune reaction to luminal antigens in predisposed hosts. Specific antigens have not been proved, although various infectious triggers and drugs have been proposed. The responsibility of several drugs has been questioned, some with strong clinical and/or histological evidence suggesting causality. The issue of drug-induced microscopic colitis is important because of the burden of this disease. Thus, any case that can be cured by withdrawal of a drug must be identified. In this report, we propose a scoring system for drug-induced microscopic colitis, adapting existing criteria of drug causality, and review the literature using this framework. Based on this review, several drugs are identified with intermediate or high likelihood of inducing microscopic colitis. Finally, we suggest how to treat individual patients suspected of having drug-induced colitis according to the level of evidence for that particular drug.

Colitis, Microscopic↗
PubMed2006

Nursing assistants' behaviour during morning care: effects of the implementation of snoezelen, integrated in 24-hour dementia care.

AIM: This paper reports an investigation of the effects of the implementation of snoezelen, or multisensory stimulation, on the quality of nursing assistants' behaviour during morning care. BACKGROUND: Nursing assistants in long-term dementia care are often unaware of the impact of their behaviour on patient functioning. Snoezelen is a psychosocial intervention that might improve the quality of caregiver behaviour by combining a person-centred approach with the integration of sensory stimuli. METHODS: A quasi-experimental pre- and post-test design was implemented in 12 wards for older mentally infirm patients at six nursing homes. The experimental group intervention was a 4-day in-house 'snoezelen' training, stimulus preference screening and supervision meetings. The control group received usual nursing home care. The effectiveness of the intervention was studied by analysing 250 video recordings, which were assessed by independent observers using a 4-point measurement scale developed for this study and based on Kitwood's Dialectical Framework. RESULTS: The results showed a statistically significant increase in 'Positive Person Work' and decrease in 'Malignant Social Psychology' (total scores) after the implementation of snoezelen. Nursing assistants in the experimental group also improved by statistically significant amounts on all subitems of 'Positive Person Work'. The mean number of sensory stimuli, offered explicitly, increased. CONCLUSION: The implementation of snoezelen succeeded in effecting a change to a more person-centred approach during morning care. The results indicate that nursing assistants' behaviour can be positively changed provided that the new care model has been successfully implemented.

Adult↗
PubMed2001

Users in the driving seat or sitting alongside map-reading?

The government agenda is clear. At the highest level users are involved in policy making. We as service providers need to show evidence that users views are elicited and used to improve the quality of care. The tool bag of techniques used to elicit users views will be explored--questionnaires, structured interviews, focus groups and innovative cognitive techniques such as perception score cards. We explore the continuum of user-led qualitative techniques to provider-led quantitative approaches. Building a framework of techniques which cover the diverse needs of people using a speech and language therapy (SLT) service is a challenge. A greater challenge is using the views of users to bring about meaningful change.

Humans↗
PubMed1993

[The relation of ideal self to perception of self and others].

One hundred and twelve (112) junior high school students made ratings of their ideal and actual selves, and of other persons of same sex whom they liked or disliked, using uni-polar scales of 42 positive and 42 negative traits words. Positive and negative ideal-self rating scores correlated with those for actual-self and others. At the same time, rating scores on important traits for each subject which gained the highest score in ideal-self rating differed among the actual self and the liked other and disliked other--the liked other was rated more positively than the disliked other, though self-esteem affected relative positiveness of actual self to liked or disliked others. However, no such differences were found on unimportant traits which gained lower scores in ideal-self rating. These results seem to indicate that both positive and negative ideal selves provide cognitive framework for perception of self and others.

Adolescent↗
PubMed1992

Preoperative cardiac risk assessment for patients having peripheral vascular surgery.

PURPOSE: To review the methods used for preoperative cardiac risk stratification of patients having peripheral vascular surgery. DATA SOURCES: Relevant studies published before August 1991 were identified using a MEDLINE search of the English-language literature, followed by a manual search of the references of all identified articles. STUDY SELECTION: All clinical studies evaluating methods used for preoperative cardiac risk stratification of patients having peripheral vascular surgery. DATA EXTRACTION: The key data extracted from each article included the inclusion and exclusion criteria of the study patients, the techniques used for testing and the corresponding definitions of positive test results, and the clinical outcomes of the tested patients. Data were analyzed using a Bayesian conceptual framework, and pretest probabilities were converted to post-test probabilities using calculation of likelihood ratios. RESULTS: Patients with high scores on clinical cardiac risk indexes (Goldman index greater than 12 or Detsky index greater than 15), or more than three of the criteria identified by Eagle (age greater than 70 years, diabetes, angina, Q waves on electrocardiogram, or ventricular arrhythmias) are likely to be at higher risk for cardiac death and myocardial infarction after vascular surgery. Those with both low scores and none of Eagle's criteria may be at lower risk, but this result has not been reproduced by independent studies. Neither group of patients would benefit from further investigation for cardiac risk stratification. Patients with one or two of these criteria may be at intermediate risk and would benefit most from further testing for the purposes of risk stratification. Most of the published evidence shows that the absence of redistribution on dipyridamole-thallium scanning identifies a low risk for postoperative cardiac complications, whereas the presence of redistribution predicts a high risk. Preliminary reports suggest that preoperative monitoring for silent myocardial ischemia may also be useful in identifying a high-risk subset of patients. CONCLUSIONS: Patients identified clinically to be at either very low or high risk for cardiac complications after peripheral vascular surgery are unlikely to benefit from further risk stratification. Dipyridamole-thallium scanning is the test of choice for further evaluation of patients at intermediate clinical risk because studies have shown that it is sensitive enough to rule out a high-risk status for patients who do not have redistribution.

Bayes Theorem↗
PubMedDate not supplied

The FLACC: a behavioral scale for scoring postoperative pain in young children.

PURPOSE: To evaluate the reliability and validity of the FLACC Pain Assessment Tool which incorporates five categories of pain behaviors: facial expression; leg movement; activity; cry; and consolability. METHOD: Eighty-nine children aged 2 months to 7 years, (3.0 +/- 2.0 yrs.) who had undergone a variety of surgical procedures, were observed in the Post Anesthesia Care Unit (PACU). The study consisted of: 1) measuring interrater reliability; 2) testing validity by measuring changes in FLACC scores in response to administration of analgesics; and 3) comparing FLACC scores to other pain ratings. FINDINGS: The FLACC tool was found to have high interrater reliability. Preliminary evidence of validity was provided by the significant decrease in FLACC scores related to administration of analgesics. Validity was also supported by the correlation with scores assigned by the Objective Pain Scale (OPS) and nurses' global ratings of pain. CONCLUSIONS: The FLACC provides a simple framework for quantifying pain behaviors in children who may not be able to verbalize the presence or severity of pain. Our preliminary data indicates the FLACC pain assessment tool is valid and reliable.

Child↗
PubMed2006

Does a higher 'quality points' score mean better care in stroke? An audit of general practice medical records.

BACKGROUND: The Royal College of Physicians (RCP) have produced guidelines for stroke management in primary care; this guidance is taken to be the gold standard for the care of people with stroke. UK general practitioners now have a quality-based contract which includes a Quality and Outcomes Framework (QOF). This consists of financially remunerated 'quality points' for specific disease areas, including stroke. Achievement of these quality points is measured by extracting a limited list of computer codes from practice computer systems. OBJECTIVES: To investigate whether a high stroke quality score is associated with adherence to RCP guidelines. DESIGN: Examination of computer and written medical records of all patients with a diagnosis of stroke. SETTING: Two general practices, one in southwest London, one in Surrey, with a combined practice population of over 20 000. Both practices had a similar age-sex profile and prevalence of stroke. RESULTS: One practice scored 93.5% (29/31) of the available stroke quality points. The other practice achieved 73.4% (22.75/31), and only did better in one stroke quality target. However, the practice scoring fewer quality points had much better adherence to RCP guidance: 96% of patients were assessed in secondary care compared with 79% (P=0.001); 64% of stroke patients were seen the same day, compared with 44%; 56% received rehabilitation compared with 37%. CONCLUSIONS: Higher quality points did not reflect better adherence to RCP guidance. This audit highlights a gap between relatively simplistic measures of quality in the QOF, dependent on the recording of a narrow range of computer codes, and the actual standard of care being delivered. Research is needed to see whether this finding is generalisable and how the Quality and Outcomes Framework might be better aligned with delivering best practice.

Adolescent↗
PubMed2025

Unicorn: enhancing single-cell Hi-C data with blind super-resolution for 3D genome structure reconstruction.

MOTIVATION: Single-cell Hi-C (scHi-C) data provide critical insights into chromatin interactions at individual cell levels, uncovering unique genomic 3D structures. However, scHi-C datasets are characterized by sparsity and noise, complicating efforts to accurately reconstruct high-resolution chromosomal structures. In this study, we present ScUnicorn, a novel blind super-resolution framework for scHi-C data enhancement. ScUnicorn uses an iterative degradation kernel optimization process, unlike traditional super-resolution approaches, which rely on downsampling, predefined degradation ratios, or constant assumptions about the input data to reconstruct high-resolution interaction matrices. Hence, our approach more reliably preserves critical biological patterns and minimizes noise. Additionally, we propose 3DUnicorn, a maximum likelihood algorithm that leverages the enhanced scHi-C data to infer precise 3D chromosomal structures. RESULTS: Our evaluation demonstrates that ScUnicorn achieves superior performance over the state-of-the-art methods in terms of Peak Signal-to-Noise Ratio, Structural Similarity Index Measure, and GenomeDisco scores. Moreover, 3DUnicorn's reconstructed structures align closely with experimental 3D-FISH data, underscoring its biological relevance. Together, ScUnicorn and 3DUnicorn provide a robust framework for advancing genomic research by enhancing scHi-C data fidelity and enabling accurate 3D genome structure reconstruction. AVAILABILITY AND IMPLEMENTATION: Unicorn implementation is publicly accessible at https://github.com/OluwadareLab/Unicorn.

Single-Cell Analysis↗
PubMed2005

Dietary quality-adherence to the dietary guidelines in Tehranian adolescents: Tehran Lipid and Glucose Study.

The aim of this study was to determine the Healthy Eating Index (HEI) score and its relation take of nutrients and the number of servings from each food group consumed by adolescents residing in district 13 of Tehran. This study, conducted within the framework of Tehran Lipid and Glucose Study (TLGS), was a part of a dietary intake assessment carried out in 443 families, including 465 adolescents, aged 10-18 years, according to the Food Guide Pyramid and dietary guidelines on individuals residing in district 13 of Tehran. In this study, dietary intake was assessed with two-day 24-hour recalls. HEI was calculated based on nine components. The score range of each component was 0 to 10, the sum score of this index therefore being 90. The HEI score was categorized into three groups: less than 45 (poor diet), between 45-72 (needs improvement) and more than 72 (good diet). The mean score of HEI was 64.9 +/- 9.6 in boys and 64.8 +/- 9.4 in girls. The results showed that the number of servings of food groups in those with good diet was significantly higher than the two other groups (p < 0.05). In contrast the percent of saturated fat intake and cholesterol consumption in those with HEI > or = 72 was lower than the other groups (p < 0.05). The approximate number of food items consumed and the total nutrient intake by adolescents with HEI score > or = 72 was significantly higher than the others (p < 0.05). There was a significant positive correlation between the number of servings of grains group (r = 0.1), vegetables (r = 0.4), fruits (r = 0.4), dairy (r = 0.3), meat (r = 0.1), and HEI (p < 0.001). There was a significant negative correlation between fat intake (r = -0.2, p < 0.001), percent of saturated fatty acids (r = -0.2, p < 0.05), cholesterol consumption (r = -0.4, p < 0.05), and the ratio of polyunsaturated fatty acids/saturated fatty acids (P/S) in diet (r = 0.2, p < 0.05), and HEI score. Seventy-four, 23, and 3% of diets were categorized into "needs improvement", "good", and "poor", respectively. In conclusion, the diets of most Tehranian adolescents need improvement, demonstrating the need for nutrition education in this age group.

Adolescent↗
PubMed2000

Sequence analysis by additive scales: DNA structure for sequences and repeats of all lengths.

MOTIVATION: DNA structure plays an important role in a variety of biological processes. Different di- and tri-nucleotide scales have been proposed to capture various aspects of DNA structure including base stacking energy, propeller twist angle, protein deformability, bendability, and position preference. Yet, a general framework for the computational analysis and prediction of DNA structure is still lacking. Such a framework should in particular address the following issues: (1) construction of sequences with extremal properties; (2) quantitative evaluation of sequences with respect to a given genomic background; (3) automatic extraction of extremal sequences and profiles from genomic databases; (4) distribution and asymptotic behavior as the length N of the sequences increases; and (5) complete analysis of correlations between scales. RESULTS: We develop a general framework for sequence analysis based on additive scales, structural or other, that addresses all these issues. We show how to construct extremal sequences and calibrate scores for automatic genomic and database extraction. We show that distributions rapidly converge to normality as Nincreases. Pairwise correlations between scales depend both on background distribution and sequence length and rapidly converge to an analytically predictable asymptotic value. For di- and tri-nucleotide scales, normal behavior and asymptotic correlation values are attained over a characteristic window length of about 10-15 bp. With a uniform background distribution, pairwise correlations between empirically-derived scales remain relatively small and roughly constant at all lengths, except for propeller twist and protein deformability which are positively correlated. There is a positive (resp. negative) correlation between dinucleotide base stacking (resp. propeller twist and protein deformability) and AT-content that increases in magnitude with length. The framework is applied to the analysis of various DNA tandem repeats. We derive exact expressions for counting the number of repeat unit classes at all lengths. Tandem repeats are likely to result from a variety of different mechanisms, a fraction of which is likely to depend on profiles characterized by extreme structural features.

Animals↗
PubMed2006

Study protocol: delayed intervention randomised controlled trial within the Medical Research Council (MRC) Framework to assess the effectiveness of a new palliative care service.

BACKGROUND: Palliative care has been proposed to help meet the needs of patients who suffer progressive non-cancer conditions but there have been few evaluations of service development initiatives. We report here a novel protocol for the evaluation of a new palliative care service in this context. METHODS/DESIGN: Using the MRC Framework for the Evaluation of Complex Interventions we modelled a new palliative care and neurology service for patients severely affected by Multiple Sclerosis (MS). We conducted qualitative interviews with patients, families and staff, plus a literature review to model and pilot the service. Then we designed a delayed intervention randomised controlled trial to test its effectiveness as part of phase II of the MRC framework. Inclusion criteria for the trial were patients identified by referring clinicians as having unresolved symptoms or psychological concerns. Referrers were advised to use a score of greater than 8 on the Expanded Disability Scale was a benchmark. Consenting patients newly referred to the new service were randomised to either receive the palliative care service immediately (fast-track) or after a 12-week wait (standard best practice). Face to face interviews were conducted at baseline (before intervention), and at 4-6, 10-12 (before intervention for the standard-practice group), 16-18 and 22-24 weeks with patients and their carers using standard questionnaires to assess symptoms, palliative care outcomes, function, service use and open comments. Ethics committee approval was granted separately for the qualitative phase and then for the trial. DISCUSSION: We publish the protocol trial here, to allow methods to be reviewed in advance of publication of the results. The MRC Framework for the Evaluation of Complex Interventions was helpful in both the design of the service, methods for evaluation in convincing staff and the ethics committee to accept the trial. The research will provide valuable information on the effects of palliative care among non-cancer patients and a method to evaluate palliative care in this context.

Journal Article↗