Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SCALE”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 973 records · Page 54Linked to original sources

Scaling of maximum net force output by motors used for locomotion.

Biological and engineered motors are surprisingly similar in their adherence to two or possibly three fundamental regimes for the mass scaling of maximum force output (Fmax). One scaling regime (Group 1: myosin, kinesin, dynein and RNA polymerase molecules; muscle cells; whole muscles; winches; linear actuators) comprises motors that create slow translational motion with force outputs limited by the axial stress capacity of the motor, which results in Fmax scaling as motor mass0.67 (M0.67). Another scaling regime (Group 2: flying birds, bats and insects; swimming fish; running animals; piston engines; electric motors; jets) comprises motors that cycle rapidly, with significant internal and external accelerations, and for whom inertia and fatigue life appear to be important constraints. The scaling of inertial loads and fatigue life both appear to enforce Fmax scaling as M1.0 in these motors. Despite great differences in materials and mechanisms, the mass specific Fmax of Group 2 motors clusters tightly around a mean of 57 N kg(-1), a region of specific force loading where there appears to be a common transition from high- to low-cycle fatigue. For motors subject to multi-axial stresses, the steepness of the load-life curve in the neighborhood of 50-100 N kg(-1) may overwhelm other material and mechanistic factors, thereby homogenizing the mass specific Fmax of grossly dissimilar animals and machines. Rockets scale with Group 1 motors but for different mechanistic reasons; they are free from fatigue constraints and their thrust is determined by mass flow rates that depend on cross sectional area of the exit nozzle. There is possibly a third scaling regime of Fmax for small motors (bacterial and spermatazoan flagella; a protozoan spring) where viscosity dominates over inertia. Data for force output of viscous regime motors are scarce, but the few data available suggest a gradually increasing scaling slope that converges with the Group 2 scaling relationship at a Reynolds number of about 10(2). The Group 1 and Group 2 scaling relationships intersect at a motor mass of 4400 kg, which restricts the force output and design of Group 2 motors greater than this mass. Above 4400 kg, all motors are limited by stress and have Fmax that scales as M0.67; this results in a gradual decline in mass specific Fmax at motor mass greater than 4400 kg. Because of declining mass specific Fmax, there is little or no potential for biological or engineered motors or rockets larger than those already in use.

Animals↗

Reliability, validity, and responsiveness of four knee outcome scales for athletic patients.

BACKGROUND: Many patient-based knee-rating scales are available for the evaluation of athletic patients. However, there is little information on the measurement properties of these instruments and therefore no evidence to support the use of one questionnaire rather than another. The goal of the present study was to determine the reliability, validity, and responsiveness of four knee-rating scales commonly used for the evaluation of athletic patients: the Lysholm scale, the subjective components of the Cincinnati knee-rating system, the American Academy of Orthopaedic Surgeons sports knee-rating scale, and the Activities of Daily Living scale of the Knee Outcome Survey. METHODS: All patients in the study had a disorder of the knee and were active in sports (a Tegner score of 4 points). Forty-one patients who had a knee disorder that had stabilized and who were not receiving treatment were administered all four questionnaires at baseline and again at a mean of 5.2 days (range, two to fourteen days) later to test reliability. Forty-two patients were administered the scales at baseline and at a minimum of three months after treatment to test responsiveness. The responses of 133 patients at baseline were studied to test construct validity. RESULTS: The reliability was high for all scales, with the intraclass correlation coefficient ranging from 0.88 to 0.95. As for construct validity, the correlations among the knee scales ranged from 0.70 to 0.85 and those between the knee scales and the physical component scale of the Short Form-36 (SF-36) and the patient and clinician severity ratings ranged from 0.59 to 0.77. Responsiveness, measured with the standardized response mean, ranged from 0.8 for the Cincinnati knee-rating system to 1.1 for the Activities of Daily Living scale. CONCLUSIONS: All four scales satisfied our criteria for reliability, validity, and responsiveness, and all are acceptable for use in clinical research.

Adolescent↗

[Suicidal Risk Scale].

Assessment of para-suicidal patients is one of the main tasks for the practitioner in an emergency unit. There are now any characteristics known as suicide risk factors, like drug or alcohol abuse, past history of suicides in the family, or psychiatric disorder. However though these characteristics are useful to define high-risk populations, they are not always relevant in personal assessment. The more relevant variables in this case are psychological. Unfortunately, there are very few assessment scales in this area, since scales are usually related to the prediction of suicide or para-suicide before the act. The only existing tool for assessment after the act is the Beck Suicidal Intent Scale (SIS, 1974), which assesses the wish to die. Therefore we propose a new scale for a global assessment of parasuicide: it is an eleven-items scale, divided in four sections. Each section assesses: (1) the parasuicide itself, with the wish to die, the way to die and precautions against intervention; (2) the patient himself, with the premeditation level, an affective disorder existing before the act, the means of future, and environment effect (in a sense of protection or risk); (3) the global impression after the psychiatric interview: the emotionalism level, and the trust in the patient attitude; (4) the patient history: alcohol or drug abuse, personal past-parasuicide. The scale construction was empirical, from clinical practice, but it encompasses the nine high-risk variables found by Motto and Bostrom (1990) in an analysis of prospective data from 3,005 psychiatric patients at risk for suicide, focusing on 38 persons who committed suicide within 60 days of evaluation. Our study has been conducted on a 77 sample of para-suicidal patients in the psychiatrist emergency unit of the Avignon Hospital. For each patient, the score from our scale was calculated by psychiatric nurses after their own interview, before psychiatric examination, about 12 or 24 hours after the entrance in the emergency unit. Then, patients were classified in four groups according to the psychiatrist decision and orientation: exit (n = 7), consultation (n = 34), hospitalization (n = 24), hospitalization under constraint (n = 12). These groups mean theoretically an increasing global gravity: it is possible for example to hospitalize a parasuicidal patient because he wants to die, even without depression. Or in an other case, if he has a very serious psychiatric disorder (for example affective or psychotic), with a low-lethality para-suicide. Moreover, for a 22 sub-sample patients, the score from Beck-SIS was also calculated. The scale scores comparison in the four groups were made by analysis of variance: there was a statistically significant difference between groups as whole and individually (p < 0.001). In the second analysis, we defined two subsamples: the first one contains the hospitalized patients (n = 36) and the second one, the non-hospitalized (n = 41) patients. Statistically, from the scale scores, it was possible to define a threshold above which all the patients were hospitalized, and an other one under which all patients were not hospitalized. Third, there was a good correlation between lethality scores in our scale (first section) and the Beck SIS scores (r = 0.91). In conclusion, our scale seems to be well correlated with global gravity meant by parasuicide, to assess correctly suicidal intent, and to provide reliable indicators for hospitalization. However, some aspects are still missing in this study: we did not compare any sub-score with other well-known scales, assessing depression or hopelessness. On the other hand, we couldn't obtain prospective data on all the patients after their parasuicide. The following steps will be to carry on with these studies, as well as with the replication of our results on larger samples.

Emergency Service, Hospital↗

[French validation of the revised Piper Fatigue Scale].

The need for a valid and reliable multi-dimensional instrument in French to enable nurses and clinicians to assess intensity and changes in cancer-related fatigue (CRF) and evaluate efficacy of intervention stratégies on patient outcome, prompted us to translate the Piper Fatigue Scale (PFS) and assess its psychometric properties in a French speaking population. The revised PFS is a 22 item self-report instrument with four sub-scales: behavioural/severity, affective, sensory and cognitive/mood. The PFS was translated using a procédure of translation and back translation and tested on 20 bilingual subjects. Correlation coefficients were measured between the item scores of the English and French version of the PFS. The French version of the PFS was adjusted and then completed by 229 adult cancer patients with solid tumours under-going treatment by chemo-, radio-, hormono- or immunotherapy. A factorial analysis and a multi-traits analysis were used to assess the reliability and the dimensional structure of the translated version of the PFS. Cronbach's alpha correlations ranged between 0.85 and 0.92 for the various sub-scales, thus indicating good sub-scale reliability. Item internal consistency was good with 100% of item-scale correlations greater than or equal to 0.4. Item discriminant validity checking showed 3 items to be insufficiently discriminating. Item-scale correlations greater than the correlation of the item with other sub-scales were 98%. The Cognitive/Mood dimension appeared to group 2 separate dimensions. Convergent validity, tested by correlating the PFS with a Visual Analogue Scale measuring fatigue and with the OMS Physical Performance Status Scale, revealed significant relationships. A five sub-scale model of the PFS is proposed containing 22 items to increase performance of the French version of the PFS comparatively to the 4 sub-scale model of the original PFS. Translation of 2 items has been slightly modified to reduce ambiguity. The overall results of this preliminary study are satisfactory. We expect results to be further improved by the modifications proposed and testing is now underway in homogenous populations to evaluate the sensitivity of the instrument to changes over time. This will enable us to ascertain the definitive French version of the Piper Fatigue Scale.

Activities of Daily Living↗

The Functional Pain Scale: reliability, validity, and responsiveness in an elderly population.

OBJECTIVES: Because of difficulty experienced in assessing pain in frail older patients and the lack of pain assessment tools with standardization in the elderly, the Functional Pain Scale (FPS), an instrument incorporating both subjective and objective components to assess pain, was developed and evaluated. DESIGN, SETTING, PARTICIPANTS, AND MEASURES: One hundred subjects more than 65 years old participated in the validity, reliability, and responsiveness (the clinical sensitivity of the instrument to change) testing of the Functional Pain Scale. Subjects were recruited from a geriatrics inpatient setting, a geriatrics outpatient setting, and a local hospice (residing in their homes). Ninety-four of the subjects completed all phases of testing. Reliability was tested using a test-retest format and a correlation matrix. Criterion-related validity was established as compared with the Visual Analog Scale (VAS), the Present Pain Intensity (PPI), the McGill Short Form Questionnaire (MPQ-SF), and the Numeric Pain Scale (NPS) instruments. Responsiveness for the FPS, the VAS, the PPI, the MPQ-SF, and the NPS instruments was determined using five previously described techniques: effect size, standardized response means, relative efficiency, direct comparison of t test scores, and direct comparison of P values. A cumulative index was developed to rank each scale. Cumulative responsiveness index scores were based on individual scale performance for each separate responsiveness test. The lowest score in the cumulative responsiveness index indicated the most responsive scale. RESULTS: Interrater reliability for instruments tested exceeded 0.95 for all instruments tested. Validity testing showed high correlations as well (r = 0.62, r = 0.85, r = 0.80, r = 0.90 for the VAS, the PPI, the MPQ-SF, and the NPS respectively). Responsiveness evaluated overall by the responsiveness index was best for the Functional Pain Scale (7) followed by the Visual Analog Scale (12), the Present Pain Intensity (13), the McGill Pain Questionnaire-Short Form (19), and the Numerical Pain Questionnaire (24). CONCLUSIONS: The Functional Pain Scale was determined to be reliable, valid, and responsive. The responsiveness of the Functional Pain Scale was superior to the other instruments tested. The Functional Pain Scale is an acceptable instrument for assessing pain in older adults and may reflect changes in pain better than other instruments tested. Further testing in other populations is warranted.

Journal Article↗

Scale development in fish: a review, with description of sonic hedgehog (shh) expression in the zebrafish (Danio rerio).

In the first part of this paper we review current knowledge regarding fish scales, focusing on elasmoid scales, the only type found in two model species, the zebrafish and the medaka. After reviewing the structure of scales and their evolutionary origin, we describe the formation of the squamation pattern. The regularity of this process suggests a pre-patterning of the skin before scale initiation. We then summarise the dynamics of scale development on the basis of morphological observations. In the absence of molecular data, these observations support the existence of genetic cascades involved in the control of scale development. In the second part of this paper, we illustrate the potential that scale development offers as a model to study organogenesis mediated by epithelial-mesenchymal interactions. Using the zebrafish (Danio rerio), we have combined alizarin red staining, light and transmission electron microscopy and in situ hybridisation using an anti-sense RNA probe for the sonic hedgehog (shh) gene. Scales develop late in ontogeny (30 days post-fertilisation) and close to the epidermal cover. Only cells of the basal epidermal layer express shh. Transcripts are first detected after the scale papillae have formed. Thus, shh is not involved in the mechanisms controlling squamation patterning and scale initiation. As the scales enlarge, shh expression is progressively restricted to a subset of basal epidermal cells located in the region that overlies their posterior field. This pattern of expression suggests that shh may be involved in the control of scale morphogenesis and differentiation in relationship with the formation of the epidermal fold in the posterior region.

Animals↗

Preliminary evaluation of a visual analog function scale for use in rheumatoid arthritis.

OBJECTIVE: Key outcomes in rheumatoid arthritis (RA) are evaluated with multi-item ratings scales such as the Health Assessment Questionnaire (HAQ) and visual analog scales (VAS) such as pain and patient and physician global. As VAS scales are easy to use and particularly effective in research and patient care, we studied the characteristics, association, and psychometric properties of a VAS function scale (VAS-F) to determine if it could be used in RA studies and clinical practice. METHODS: A total of 394 patients with RA completed the HAQ, the HAQ-II, and a VAS functional scale. In addition, they completed standard assessments of pain, global, fatigue, sleep problems, joint count, and the Medical Outcome Study Short-Form 36 (SF-36) physical component summary score (PCS) and vitality and total pain scores. RESULTS: The HAQ-II was correlated with VAS-F at 0.76, but distributional characteristics of the HAQ and VAS-F differed, as the VAS-F scale results contained more higher scores as well as more lower scores compared with the HAQ-II and HAQ. Kendall's tau concordance analyses indicated that VAS scales were more concordant with other VAS than with non-VAS scales. Concordance of VAS-F was greatest with VAS global and was similar overall with VAS pain, sleep disturbance, fatigue, and quality of life. By contrast, the PCS, a multi-item scale, was more concordant with HAQ-II and HAQ. There was little to no difference between the VAS-F and the 2 HAQ with regard to concordance with the multi-item joint count, SF-36 vitality, and SF-36 total pain. CONCLUSION: The distribution differences between HAQ and HAQ-II and the VAS-F suggest that patients do not see minor limitations as problematic, but rate major limitations as being particularly limiting and worthy of high ratings. A VAS functional scale represents a patient-weighted functional assessment in which additional interpretation is given to the meaning of the limitations by the patient. VAS-F scales may be suitable for use in the clinic and in research. However, studies to assess sensitivity to change are required to determine the appropriate role of this scale.

Activities of Daily Living↗

[Evaluation of a revised "Ikigai" scale and the relationship between motivation for achievement of a purpose and mental health in senior high school students].

The term "ikigai" describes the state in which people have a positive purpose, a sense of being full and social support. In order to measure this condition and its effects on mental and physical health, an Ikigai scale was constructed. In this study, the Ikigai scale was revised by altering the number of choices for each item, and the revised scale was applied to a group of senior high school students. The purpose of the present study is to discuss the revised scale by comparing its results with those from the original scale. In addition, the relationship between motivation for achievement of a purpose and depression which is an index of mental health is studied. The results of this study are summarized as follows: 1) The revised Ikigai scale was more reliable than the original scale. 2) The correlation between the Ikigai scale and Self-rating Depression Scale (SDS) demonstrated that our revised scale had greater validity than the original. 3) Male students who had strong motivation for achievement of a purpose were significantly less depressed than those who had no motivation. From these results, it is concluded that the revised Ikigai scale is better than the original scale and in male students, motivation for achievement of a purpose correlates to mental health.

Achievement↗

Comparing acculturation scales and their relationship to cancer screening among older Mexican-American women.

BACKGROUND: Hispanic women in the United States are less likely to participate in breast and cervical cancer screening than women of other racial and ethnic groups. To plan appropriate interventions requires an understanding of the barriers to participation, including those of acculturation and assimilation. Few studies have examined the effects of acculturation and assimilation on the cancer-screening behavior of Mexican-American women. PURPOSE: Because of the extensive use of the Cuellar acculturation scale and the more recent use of the Hazuda scale, we explore the utility of these two measures to predict Pap smear and mammography screening. Using a population-based sample of Mexican-American women aged 40 years and older, we compare the two scales with each other and describe their relationship to sociodemographic factors and to participation in cancer screening. METHODS: The data are from baseline surveys in El Paso and Houston, Tex., conducted before the implementation of community interventions to improve Pap smear and mammography screening in low-income Mexican-American women. Study subjects were 923 randomly selected Mexican-American women aged 40 years and older living in 16 El Paso census tracts and seven Houston census tracts. Personal interviews solicited information on age, martial and employment status, household annual income and size, education, health insurance coverage, Pap smear and mammogram history, and a series of acculturation dimensions. Acculturation was measured using the abbreviated version of the Cuellar scale developed for the Hispanic Health and Nutrition Examination Survey, 1982-1984, and the Hazuda scale developed for the San Antonio Heart Study. The eight-item Cuellar acculturation scale assessed the extent to which Spanish and English were spoken, preferred, read, and written; the ethnic identification of the respondent and her parents; and generational status in the United States. The Hazuda scale assessed the following dimensions of acculturation: adult proficiency in English, adult pattern of English versus Spanish language usage, value placed on preserving Mexican cultural origin, attitude toward traditional family structure and sex-role organization, and adult interaction with members of mainstream society. RESULTS: The Cuellar scale was highly correlated with Hazuda's two language dimension. The Hazuda scale dimensions, Mexican cultural values and traditional family attitudes, correlated the least with Cuellar's scale. All the acculturation dimensions, Cuellar's and Hazuda's, were strongly associated with education and health insurance coverage. With the use of multiple logistic regression to adjust for education, health insurance, and other variables, English proficiency was a predictor of both a recent Pap smear and a recent mammogram. No other language-based acculturation dimension was associated with a recent screening with adjustment for education, health insurance, and other variables. However, in controlling for these factors, we found that a woman's attitude toward traditional family structure was related inversely to mammogram screening. That is, women who held the strongest traditional Mexican family attitudes were more likely to participate in mammography screening. CONCLUSION: This study shows the importance of separating the effects of acculturation on cancer screening from those due to social and economic conditions. Results suggest that the Hazuda scale provides a more multidimensional approach than the Cuellar scale and is a superior measure of the acculturation process. Traditional Mexican family attitudes positively influence mammogram-screening behavior, and this finding has implications for cancer control interventions in this population.

Acculturation↗

The Brown Assessment of Beliefs Scale: reliability and validity.

OBJECTIVE: The authors developed and evaluated the reliability and validity of the Brown Assessment of Beliefs Scale, a clinician-administered seven-item scale designed to assess delusions across a wide range of psychiatric disorders. METHOD: The authors developed the scale after reviewing the literature on the assessment of delusions. Four raters administered the scale to 20 patients with obsessive-compulsive disorder (OCD), 20 patients with body dysmorphic disorder, and 10 patients with mood disorder with psychotic features. Audiotaped interviews of scale administration conducted by one rater were independently scored by the other raters to evaluate interrater reliability. The scale was administered to 27 patients twice to determine test-retest reliability. Other insight instruments as well as scales that assess symptom severity were administered to assess convergent and discriminant validity. Sensitivity to change was assessed in a multicenter treatment study of sertraline for OCD. RESULTS: Interrater and test-retest reliability for the total score and individual item scores was excellent, with a high degree of internal consistency. One factor was obtained that accounted for 56% of the variance. Scores on the Brown Assessment of Beliefs Scale were not correlated with symptom severity but were correlated with other measures of insight. The scale was sensitive to change in insight in OCD but was not identical to improvement in severity. CONCLUSIONS: The Brown Assessment of Beliefs Scale is a reliable and valid instrument for assessing delusionality in a number of psychiatric disorders. This scale may help clarify whether delusional and nondelusional variants of disorders constitute the same disorder as well as whether delusionality affects treatment outcome and prognosis.

1-Naphthylamine↗

Concurrent validity of the clinical symptom syndrome scales of the Millon Clinical Multiaxial Inventory.

This study examined relationships between the clinical symptom syndrome scales of the Millon Clinical Multiaxial Inventory (MCMI) and the various clinically meaningful mood or symptom states measured by the six Profile of Mood States (POMS) scales (N = 243). The MCMI symptom scale--POMS symptom/mood scale relationships found in this study were compared with MCMI symptom scale--MMPI and SCL-90 symptom/mood scale relationships reported in the MCMI manual (Millon, 1983). Results of the present investigation, when combined with results of the previous analyses reported in the MCMI manual, reveal a number of consistent associations of moderate strength between MCMI symptom scales and selected mood or symptom scales from the MMPI and Symptom Checklist-90 as well as from the POMS. Although most relationships between the MCMI symptom scales and the symptom/mood scales of the POMS, MMPI and SCL-90 were consistent with expectation, the Anxiety, Dysthymia and Psychotic Depression scales of the MCMI show limited ability to discriminate appropriately between anxiety and depression in several of the concurrent validity analyses considered herein.

Adult↗

A new rating scale for dementia syndromes.

A new scale, the GBS-scale, is constructed for rating dementia syndromes. The scale is divided into four subscales measuring motor, intellectual and emotional functions and different symptoms characteristic for dementia. The scale can be used by physicians, psychologists and registered nurses. The reliability of the scale is tested by rating 100 patients in somatic and psychogeriatric long-term care. The raters worked independently of each other and were recommended to confer with the staff about the status of the patient. The agreement between the raters was good. The validity of the scale was tested by comparing it with another geriatric rating scale. High correlations between the two scales were seen and indicated that the new scale measures dementia syndromes. The new scale measures degree of dementia and profiles of dementia syndromes. It is constructed in such a way that it can measure changes in dementia symptoms over a certain amount of time. Thus, it can be used in evaluating effect of treatment. It is not, however, meant to be a diagnostic scale.

Aged↗

Prediction of long-term outcome in schizophrenia by prognostic scales.

The predictive validity of four prognostic scales described in the literature (Gittelman-Klein Scale, Goldstein Scale, Phillips Scale, Strauss-Carpenter Scale) and of four newly developed prognostic scores was tested in two long-term followup studies on schizophrenic patients. Among the prognostic scales of the literature, the Strauss-Carpenter Scale showed the best results; it reached a level that was attained by only three of the newly developed scales. The three other scales of the literature could also prove their predictive validity. It may be concluded from the results that a scale has a comparatively high predictive value when certain dimensions and aspects are considered but that a certain maximum cannot, in general, be exceeded--even if more items are added to the prognostic scale. A higher number of items may be able to guarantee a better stability of predictive power in different samples.

Adult↗

The Bedford Alzheimer Nursing Severity scale for the severely demented: validation study.

We evaluated the floor effect and convergent, discriminant, and known-group validity of the Bedford Alzheimer Nursing Severity scale (BANS-s), a rating scale comprising cognitive and functional items recently developed for grading severe dementia. Ninety-nine demented patients (81 females and 18 males aged 55-100 years) in two nursing homes were assessed with the BANS-s, established cognitive and functional scales [Mini Mental State Examination, the extended version of the Clinical Dementia Rating (CDR), Katz's basic activities of daily living, Tinetti balance and gait, and Crichton scales], a behavioral scale (UCLA Neuropsychiatric Inventory), and indicators of malnutrition (Prognostic Nutritional Index). A relevant proportion (40%) of patients scored close to the floor of all scales except BANS-s and CDR, which showed a more uniform distribution of scores throughout the possible range. Convergent validity of BANS-s with the other cognitive and functional scales was good, with Pearson's r ranging from 0.62 to 0.79. Discriminant validity analysis of BANS-s versus the UCLA Neuropsychiatric Inventory showed that the two scales measure different domains (Pearson's r = 0.36). To test known-group validity, all patients were divided into two groups of different severity as defined by the Prognostic Nutritional Index. BANS-s and CDR were the scales with the best ability to discriminate malnourished from nonmalnourished patients. As a further validity test, the 37 patients reaching the floor on other cognitive and functional scales were divided into two subgroups of different dementia severity as defined by the Tinetti scale. BANS-s but not CDR was able to differentiate the two groups.

Aged↗

Vigilance scoring in children with acquired brain injury: Vienna Vigilance Score in comparison with usual coma scales.

An instrument in neurologic rehabilitation for the assessment of a person's clarity of consciousness must fulfill the need to provide the rehabilitation team with some information regarding the structuring of the rehabilitation process. The Vienna Vigilance Score is oriented toward cooperation within the rehabilitation team with the specific advantage of focus on the subject status of the patient on the basis of the dialogue. It does not use painful stimuli and is oriented toward the next developmental step of the rehabilitation process. The first extensive application of the Vienna Vigilance Score was carried out in a 3-year study of 38 children and adolescents. We report the comparison with other coma scales (Glasgow Coma Scale, Children's Coma Score, and Modified Glasgow Coma Scale) on 24 children and adolescents (1.4-16.8 years of age). The results showed satisfying statistical parameters: measuring range comparable with other scales; a Kendall tau correlation of .59 on both the Modified Glasgow Coma Scale and the Children's Coma Scale and of .66 on the Glasgow Coma Scale; a Spearman's rank order correlation of .70 to both the Modified Glasgow Coma Scale and the Children's Coma Scale and of .78 on the Glasgow Coma Scale. By accepting the Glasgow Coma Scale as a gold standard for classification of the level of coma, we can confirm satisfactory measuring qualities for the Vienna Vigilance Score.

Adolescent↗

Is loss of attachment due to root planning and scaling in sites with minimal probing depths a statistical or real occurrence?

BACKGROUND: Following root planing and scaling many studies have implied an association between a loss of clinical attachment at sites with initially shallow pockets (1 to 3 mm) and gains in attachment level for deeper probing depths. However, these effects are also consistent with a statistical phenomenon referred to as regression towards the mean. This principle suggests that extreme values will moderate the next time they are recorded. The purpose of this report was to estimate the effect that regression towards the mean has on perceived changes in attachment level after root planing and scaling. METHODS: During the initial examination, 2 different investigators conducted 2 full-mouth probings. Two quadrants were randomly selected to be root planed and scaled until the root surfaces were smooth by tactile touch of an explorer. The 2 remaining quadrants were not treated. At 4 to 6 weeks after treatment, another full mouth probing was done. An examiner who was blind to the quadrants that had been scaled measured attachment level and probing depth after therapy. This study design provided periodontal measurements before and after root planing and scaling, measurements before and after a period of 4 to 6 weeks of no therapy, and duplicate measurements at the beginning of the study. RESULTS: Using the repeat examination when no true change could occur, shallow sites (< or =3 mm of probing depth) showed average negative differences between repeat attachment level measurements (-0.23 mm), which mimicked loss of periodontal attachment. Deep sites, (>6 mm) showed average positive values (0.40) mimicking gain in attachment level. These results suggest that regression towards the mean is a significant effect in this data set. Both shallow non-scaled and scaled sites had similar differences in repeat measures (-0.28 mm, -0.25 mm) which were also similar to and not statistically different from changes after therapy for both non-scaled (-0.21 mm) and scaled sites (-0.08 mm). Thus not only does this data set exhibit regression towards the mean, but it explains the majority of perceived loss of periodontal attachment after scaling at sites that have minimal probing depth. CONCLUSIONS: These results suggest that the majority of perceived loss of attachment due to scaling at sites of minimal probing depth that have been reported in many studies may be due a statistical phenomenon called regression towards the mean.

Dental Scaling↗

[Are all sedation scales equally useful for nursing assessment?].

The usefulness of three clinical scales for monitoring sedation in intensive care units was compared. The Ramsay scale, Cook modification of the Glasgow scale, and combined Ramsay-Cook scale were evaluated. Thirty-five patients with continuous intravenous sedation were monitored using all three clinical scales. The scores were collected simultaneosly with a two-observer method carried out by the nurse in charge of the patient and a second observer (nurse or physician). The three scales were considered valid and reproductible, with "good" agreement for the Ramsay scale and "very good" agreement for the Cook modified coma scale and the combined Ramsay-Cook scale. In conclusion, since the Cook modified Glasgow scale was the most reproducible, it is preferred for use in research and daily practice. The Ramsay scale is more subjective, but may be useful for daily nursing activities.

Adult↗

Assessing attention-deficit/hyperactivity disorder in adults: focus on rating scales.

The diagnosis of attention-deficit/hyperactivity disorder (ADHD) in adults can be a challenging process because it includes making judgments based on clinical interviews, rating scale results, informant ratings, and objective supporting evidence. The patient evaluation should gather information on the severity and frequency of symptoms, the establishment of childhood onset of symptoms, the chronicity and pervasiveness of symptoms, and the impact of symptoms on major life activities. Some of the rating scales being used in the adult population are the Conners' Adult ADHD Rating Scales, the Brown Attention-Deficit Disorder Scale for Adults, the Wender Utah Rating Scale, the ADHD Rating Scale and ADHD Rating Scale-IV, the Current Symptoms Scale, and the recently-developed Adult ADHD Self-Report Scale-v1.1 Symptom Checklist. More research is needed to establish the usefulness of self-administered rating scales compared with investigator-administered scales in the assessment and diagnosis of adult ADHD.

Activities of Daily Living↗