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PubMed1986

Reliability and accuracy of visually analyzing graphed data from single-subject designs.

As the number of single-subject research reports in the occupational therapy literature increases, the reliability of clinical decisions made from single-subject data must be determined. This study examined the ability of occupational therapists to reliably and accurately analyze data from single-subject designs using visual inspection of graphed data. Forty-six therapists provided a rating on whether or not a clinically significant change in performance had occurred across the baseline and treatment phases for five graphs of hypothetical data. The results revealed that considerable disagreement existed in making visual judgments based on the five graphs. The data sets were also analyzed using a recently developed statistical procedure for use with single-subject data. The level of agreement between the quantitative analysis and the visual analysis was also poor, suggesting inconsistency in the ability to make accurate visual judgments of single-subject data. The advantages and limitations of graphic presentation and visual inspection of single-subject data are discussed and the argument is made that some form of quantitative analysis should generally be used in conjunction with the visual inspection of graphed data.

Data Collection↗
PubMedDate not supplied

Pressure ulcer incidence reporting.

AIM: To examine the accuracy of data collected on pressure ulcer incidence. A system for monitoring incidence has been in place since 1991 at a medium-sized hospital trust. The data collected are used to calculate resource requirements for specialist mattresses, to audit compliance with pressure ulcer guidelines and to identify staff training needs. METHOD: A convenience sample comprising 211 inpatients from the medical, surgical, rehabilitation and orthopaedic wards was assessed by the researcher over a 14-day period. Ward staff continued their usual routine of assessment and treatment. At the end of the study period, the researcher-generated data and ward staff-generated data were compared. RESULTS: A total of 343 assessments were carried out on 211 patients; 152 patients were found to have, or be at risk of having, pressure ulcers. The main finding after comparing both sets of data was that a significant number of patients at risk of, or with, pressure ulcers were not reported as such by ward staff (n = 86, 57 per cent; p < 0.0001). Twelve (14 per cent) of those not reported had pressure sores and were being cared for on specialist mattresses. Non-reporting was high from all wards. When reports were made of patients at risk of, or with, pressure ulcers, the reports were mostly accurate and complete. CONCLUSION: The data collection form is user-friendly and the assessment skills of nursing staff at the trust are adequate. However, the high incidence of under-reporting indicates that the current system may not be adequate for generating accurate data.

Humans↗
PubMed1999

An audit of the quality of operation notes in an otolaryngology unit.

Hand-written operation notes are often produced as evidence in medico-legal cases. Incomplete and illegible notes, along with the use of confusing abbreviations, are a common source of weakness in a surgeon's defence. An audit of 100 sets of operation notes was carried out in a single otolaryngology department. Notes were scrutinised for the accuracy of data, ward, department and name of surgeon, as well as for the inclusion of unacceptable abbreviations. Using an aide-memoire attached to the front of the operation sheet, the audit was repeated with identical criteria. The aide-memoire improved the standard of operation note with respect to all measured criteria. Clear identification of operating surgeon improved from 74% to 93%, and the avoidance of unacceptable abbreviations rose from 53% to 84%. We conclude that a simple aide-memoire attached to operation note sheets can significantly improve the quality of note-keeping and potentially avoid medico-legal problems.

Benchmarking↗
PubMed1999

Graphical analysis and simplified quantification of striatal and extrastriatal dopamine D2 receptor binding with [123I]epidepride SPECT.

UNLABELLED: The purpose of this study was to extend the graphical analysis of reversible tracer binding to account for labeled lipophilic metabolites (metabolites) in quantifying [123I]epidepride binding to striatal and extrastriatal D2 receptors and, additionally, to evaluate the feasibility of simplified analysis to measure the specific volume of distribution (V3') using single-sample blood data because the tissue ratio (RT) may be a less reliable measure of D2 binding in the presence of metabolites. METHODS: Multilinear regression analysis (MLRA) and graphical analysis (GA) using plasma parent (P) plus metabolite (M) activities as input and time activities of receptor-free (RF, cerebellum) and receptor-containing regions (RR, striatum and temporal cortex) derived V3' = (alpha(RR)(P) - alpha(RF)(P)), V3' = (1 + delta) (alpha(RR) - alpha(RF)) and RT = V3'/(V2P' + deltaV2M'), where alpha is a regression coefficient, delta is the equilibrium area ratio of M and P, and (V2P'/V2M') are the corresponding nondisplaceable distribution volumes. V3' by simplified analysis (SA) was calculated from RT determined without blood data and (V2P' + deltaV2M') with single-blood sample data. The accuracy of these three V3' values was assessed relative to the metabolite-accounted kinetic analysis (KA) for [123I]epidepride SPECT studies of 11 healthy volunteers, in which each participant had 27 scans and 30 plasma samples drawn during the 14 h after injection. RESULTS: All three V3' values (mL/g) significantly correlated with those by KA (r > or = 0.90) (striatum/temporal cortex: MLRA, 77.8 +/- 36.6/2.35 +/- 1.16; GA, 98.8 +/- 34.2/4.61 +/- 1.77; SA, 83.9 +/- 24.8/4.26 +/- 1.74; KA, 107.6 +/- 34.4/5.61 +/- 1.84). However, the correlation between RT and V3' was only moderate (r < or = 0.65) because of significant intersubject variability (23%) in (V2P' + deltaV2M'). CONCLUSION: The graphical analysis can be extended to account for metabolites in measuring D2 binding with [123I]epidepride SPECT for both high and low D2 density regions. Additionally, simplified V3' measurements with single blood sampling are feasible and may be a practical alternative to the tissue ratio RT because RT suffers as a measure of D2 binding from significant intersubject variability in the metabolite-contributed distribution volume of the nondisplaceable compartment.

Adult↗
PubMed1979

Biochemical changes in avian tissues during infection.

Major sources of error in studies of diet--infectious disease interactions relate to failure 1) to define the stage of a disease cycle; and 2) to determine the extent of disease involvement at time of sampling. The former can be determined from clinical and biochemical observations from time of inoculation to recovery or mortality; the latter can be calculated from indexes obtained from histological preparations, changes in body temperatures, and other clinical symptoms, including weight loss and efficiencies of feed utilization. Other significant errors are derived from the normal 24-hour dynamics of particular tissue constituents, which include oscillations and circadian rhythms. Experimental designs and accuracy of data are always helped by prior knowledge of 24-hour patterns of these normal fluctuations. For example, such patterns will reveal that enzyme and hormonal changes are far more dynamic than body water changes. Studies of nutrition--disease interactions are extremely complex and the researcher must be aware of and eliminate as many sources of experimental error as possible to avoid confounding the data.

Amino Acids↗
PubMed2001

The epidemiology of work and work-related disease in Rhode Island, 1876-2001.

Most Rhode Island workers now work in service industries, though many workers continue to be exposed to the risks of goods production in the workplace. Most reported occupational death is related to transportation and homicide, although in Rhode Island in 1999, exposure to harmful substances or environments was a significant cause of Rhode Island's few occupationally related deaths. How much occupational and environmental exposure contributes to Rhode Island's heart disease and cancer mortality rates in unknown. Musculoskeletal injuries are the predominant form of reported non-fatal occupational injuries, but there are questions about the completeness and accuracy of data on occupational injury and death.

History, 19th Century↗
PubMed2001

Completeness and accuracy of the birth registry data on congenital anomalies in Alberta, Canada.

Vital statistics and other administrative data are becoming an increasingly important source for epidemiologic research and surveillance. This study, the first in Canada, evaluated the usefulness of birth registry data on congenital anomalies in Alberta. We compared the number of birth defects recorded in the birth registry with the number collected through the Alberta Congenital Anomalies Surveillance System (ACASS) between 1985 and 1996. In addition, records of 3,881 (99.9 %) babies with (a) birth defect(s) from the ACASS during 1994--1996 were matched to the birth registry by deterministic linkage. Of these, 2,969 babies had single anomalies that were used for validity analysis. The anomalies were grouped by those within International Classification of Disease (ICD) ICD-9 Section XIV (ICD-9=740.0-759.9) and those outside the Section XIV. For those within Section XIV, 24 summary diagnostic categories were examined. As shown, the total case count from the birth registry was on average about 3 % lower than that from the ACASS between 1985 and 1996. The validity of diagnostic categories is high for the 24 categories examined, with an overall agreement of between 80 % and 100 %. The sensitivity, positive predictive value, and kappa are also high for all these anomalies combined during 1994 and 1996, showing 95.7 %, 99.8, and 0.81 respectively.

Alberta↗
PubMed2001

Overweight, stature, and socioeconomic status among women--cause or effect: Israel National Women's Health Interview Survey, 1998.

OBJECTIVE: To determine if short stature and overweight/obesity are predictors of low socioeconomic status (SES), measured by educational attainment. DESIGN: A cross-sectional study on a random sample carried out through telephone interviews over a period of five months (March through August 1998). SUBJECTS: A total of 1587 Jewish and Arab Israeli women--773 women age 20-44 years, and 814 women age 45-74 years. METHODS: Two cross-sectional telephone surveys were conducted; both times, telephone numbers were drawn from the population registry. Multiple logistic regression analysis was used to determine significant predictors of body mass index (BMI), while controlling for population group, parity, smoking, and physical activity. RESULTS: The level of one's education and one's stature were significantly, independently associated with BMI. Low stature and obesity were indicators of low educational attainment. LIMITATIONS: The subjects of the study reported their own weight and height. The tendency to overestimate one's height and underestimate one's weight places the accuracy of data under question. However, as there is no reason to believe that the biases in the reports would vary with educational status, the results of the study remain valid. CONCLUSIONS: Obesity/overweight is directly related to the level of education and inversely to stature. Together, one's level of education and stature may be determinants of low SES. Therefore, in subpopulations with high rates of obesity and short stature, comprehensive programs should include welfare in addition to dietary measures.

Adult↗
PubMed1975

The flammability limits of lean fuel-air mixtures: thermochemical and kinetic criteria for explosion hazards.

The present state of knowledge is reviewed concisely in terms of the experimental methods used, the effect of apparatus size, accuracy of data, methods of data presentation, and the sensitivity of the limits to initial temperature and pressure. The heat of combustion per mole of gas mixture at the lean limit is a reliable thermochemical criterion for the flammability of organic fuels with comparable reactivities. The limit calorific value for the heavy paraffins is 11.5 +/- 0.1 kcal mole -1. However, kinetic effects strongly influence this value. Highly reactive fuels (hydrogen, acetylene) require lower energy contents, whereas less reactive fuels (ammonia) require higher values. Hydrogen-starved fuels (carbon monoxide, cyanogen) show marked anomalies and are sensitive to impurities that can provide H-atom chain carriers. These kinetic effects are reflected in the experimentally measurable burning velocity of the fuel. This parameter is a key ingredient in the theory of flammable limits, which is briefly sketched. Five competing processes dissipate power from the combustion wave and quench it at some characteristic limit velocity. The prevalent consensus that the limits are controlled by natural convection is clearly demonstrated, and the complex interplay of kinetics and thermochemistry follows logically therefrom.

Accident Prevention↗
PubMed2002

[The significance of assessment of quality of life as a cancer treatment].

Now that cancer treatments have advanced and people are surviving longer, considerations of patient QOL are becoming more important. QOL questionnaires are lists of questions taken from more than two domains. The questions are roughly divided into the "general scale" type, which asks people, patients or not, about their level of general QOL, and the "disease specific scale" type, which investigates the level of QOL focusing on the effects of the disease or treatments. Questionnaires of QOL specific to patients suffering from cancer has the former as core questions, with the latter added for type of cancer, treatments, and symptoms. Two questionnaires, EORTC QLQ and FACT, are most often used in clinical research, and Japanese versions are also available. When investigating the change in the level of the QOL with time, the disease specific scale, which better reflects changes due to the disease, is useful. Moreover, using a questionnaire that is easy to complete will minimize deficit values, and raise the accuracy of data. Use of sample questionnaires available on the Internet will be useful in preliminary surveys. Any medical treatment has a detrimental effect on patients' mind and body. We hope that the results of the QOL research are utilized as evidence in deciding which medical treatments to give patients.

Anxiety↗
PubMed2002

Deficiencies of history taking among medical students.

OBJECTIVE: This study was designed to identify the deficiencies of the history taken by final medical students at the University of Bahr Elghazal, Khartoum, Sudan, during the academic year 2000 through to 2001. METHODS: Throughout the academic year the author observed the students while taking history. Each student was asked to give a fully written case history. I assessed the basic skills of history taking (questioning, facilitation, clarification, jargon use, initiation of interview and keeping to time limits). I also assessed the amount and accuracy of data obtained. The findings were rated on a 3-point scale (good, fair, poor). RESULTS: For the 45 students assessed, the deficiencies of history taking obtained included poor questioning (66.6%), poor facilitation (51.1%), poor clarification (40%), use or acceptance of jargons (42.2%), failure of proper initiation of interview (37.8%), failure of keeping to time limits (33.3%), failure of identification of major symptoms (33.3%), poor analysis of symptoms (53.3%), lack of control of the interview (31.1%), poor elucidation of previous events (48.9%) and poor coverage of social aspects (62.2%). CONCLUSION: The history obtained by our medical students is deficient and they generally lack the basic skills of interviewing. Many factors contribute to this, (namely deficient training, lack of staff and deficit of teaching hospitals). The author discussed possible solutions to remedy the history taking deficiencies.

Clinical Competence↗
PubMed2002

Erosion risk analysis by GIS in environmental impact assessments: a case study--Seyhan Köprü Dam construction.

Environmental Impact Assessment (EIA) is a systematically constructed procedure whereby environmental impacts caused by proposed projects are examined. Geographical Information Systems (GIS) are crucially efficient tools for impact assessment and their use is likely to dramatically increase in the near future. GIS have been applied to a wide range of different impact assessment projects and dams among them have been taken as the case work in this article. EIA Regulation in force in Turkey requires the analysis of steering natural processes that can be adversely affected by the proposed project, particularly in the section of the analysis of the areas with higher landscape value. At this point, the true potential value of GIS lies in its ability to analyze spatial data with accuracy. This study is an attempt to analyze by GIS the areas with higher landscape value in the impact assessment of dam constructions in the case of Seyhan-Köprü Hydroelectric Dam project proposal. A method needs to be defined before the overlapping step by GIS to analyze the areas with higher landscape value. In the case of Seyhan-Köprü Hydroelectric Dam project proposal of the present work, considering the geological conditions and the steep slopes of the area and the type of the project, the most important natural process is erosion. Therefore, the areas of higher erosion risk were considered as the Areas with Higher Landscape Value from the conservation demands points of view.

Conservation of Natural Resources↗
PubMed1976

Menu planning in the Nutrition Program for the Elderly. Modified Nutrient Standard Menu method.

A nutrient standard menu (NSM) planning method was developed for use in planning menus which provided one-third the Recommended Dietary Allowances for persons sixty years of age or older for nine indicator nutrients and calories, while restricting fat to less than 40 per cent of total calories. To eliminate manual calculations and make it easy for individuals untrained in dietetics or nutrition to use NSM planning, the nutrient composition of over a thousand commonly used menu items was listed in a menu planning manual in nutrient units which were one-tenth of the nutrient standard for the meal. Menus from third-party sources were monitored by selecting similar nutritionally analyzed menu items in the manual and adjusting the nutrient composition to conform to the portions actually served. Ten site managers of the Administration on Aging (AoA) evaluated the planning/monitoring method. The members of the group, on the average, were fifty-six years of age, had 1.6 years of education beyond high school, and had 4.6 years of foodservice experience. Approximately 83 per cent of the evaluators did not plan to monitor menus at their sites and had no formal training in dietetics or nutrition. Eighty-four per cent were able to plan menus satisfactorily after this brief introduction. The younger evaluators with more education grasped the concepts faster and were able to plan menus with greater accuracy. The data also indicated that previous experience in menu planning enhanced their ability to plan NSMs. Most felt the approach to be workable and applicable. Menu monitoring was more difficult for the evaluators. Seventy-five per cent were able to monitor menus satisfactorily, and all felt they could do so with more time. The data again showed that the younger individuals having more formal education were able to master the monitoring skills more easily.

Adult↗
PubMed1992

A preliminary experience with use of magnetic resonance angiography in assessment of failing lower extremity bypass grafts.

BACKGROUND: This study evaluates the ability of magnetic resonance angiography (MRA) to detect hemodynamic failure of lower extremity bypass grafts and questions whether conventional angiography is necessary for this purpose. METHODS: A prospective surveillance protocol with segmental plethysmography and color flow Doppler scanning has been used to detect hemodynamic graft failure in 110 patients with 120 lower extremity bypass grafts (90 vein, 30 polytetrafluoroethylene). Twenty (17%) bypass grafts fit the criteria for impending failure (drop in ankle/brachial index determination greater than or equal to 0.15; velocity less than 45 cm/sec; focal velocity two to three times mean graft flow). Intraarterial digital subtraction angiography and MRA studies were performed on all 20 grafts. RESULTS: Intraarterial digital subtraction angiograms showed graft occlusion in two grafts, severe native artery progression in three grafts, graft wall defects in six grafts, and anastomotic strictures in nine grafts. MRA results showed an exact correlation in 15 (75%) of 20 cases. False-positive tests occurred in four cases (20%), and false-negative tests occurred in one case (5%). Common reasons for interpretation error were metallic clips and field-of-view limitations. These problems are preventable. When MRA results were compared with color flow scan data, overall accuracy improved to 95%. CONCLUSIONS: Our studies suggest that MRA can be useful in graft surveillance and that the need for conventional angiography may be reduced in the future.

Anastomosis, Surgical↗
PubMed2004

Semantic generality, input frequency and the acquisition of syntax.

In many areas of language acquisition, researchers have suggested that semantic generality plays an important role in determining the order of acquisition of particular lexical forms. However, generality is typically confounded with the effects of input frequency and it is therefore unclear to what extent semantic generality or input frequency determines the early acquisition of particular lexical items. The present study evaluates the relative influence of semantic status and properties of the input on the acquisition of verbs and their argument structures in the early speech of 9 English-speaking children from 2;0 to 3;0. The children's early verb utterances are examined with respect to (1) the order of acquisition of particular verbs in three different constructions, (2) the syntactic diversity of use of individual verbs, (3) the relative proportional use of semantically general verbs as a function of total verb use, and (4) their grammatical accuracy. The data suggest that although measures of semantic generality correlate with various measures of early verb use, once the effects of verb use in the input are removed, semantic generality is not a significant predictor of early verb use. The implications of these results for semantic-based theories of verb argument structure acquisition are discussed.

Child Language↗
PubMed1992

Estimation of age from a tooth by means of racemization of an amino acid, especially aspartic acid--comparison of enamel and dentin.

In a study of age estimation from teeth by means of measuring racemization of aspartic acid (Asp), a representative amino acid, the accuracy of data from enamel and dentin in the same tooth was compared. The correlation of D/L ratio of aspartic acid with actual age gave the following parameters: r = 0.928, sigma = +/- 5.2, k = 4.47 x 10(-4) yr-1 in enamel and r = 0.995, sigma = +/- 1.4, k = 5.75 x 10(-4) yr-1. The difference in ages between one estimated by the D/L ratio and the actual one was within +/- 3 years in dentin, while in enamel an error of from 2 to 11 years was observed. Reaction rate constants of the racemization in a dry postmortem state (15 degrees C) were calculated as k = 9.70 x 10(-8) yr-1 in enamel, and k = 1.33 x 10(-7) yr-1 in dentin. Compared to rates determined from teeth recently extracted from living subjects, the rate was higher in dentin than in enamel. These data reconfirmed that dentin is superior to enamel in making exact age estimations from teeth.

Adult↗