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Results for “Reality Testing”

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At least 1,459 records · Page 81Linked to original sources
PubMed2003

Comparison of a rational and an empirical standard setting procedure for an OSCE. Objective structured clinical examinations.

PURPOSE: Earlier studies of absolute standard setting procedures for objective structured clinical examinations (OSCEs) show inconsistent results. This study compared a rational and an empirical standard setting procedure. Reliability and credibility were examined first. The impact of a reality check was then established. METHODS: The OSCE included 16 stations and was taken by trainees in their final year of postgraduate training in general practice and experienced general practitioners. A modified Angoff (independent judgements, no group discussion) with and without a reality check was used as a rational procedure. A method related to the borderline group procedure, the borderline regression (BR) method, was used as an empirical procedure. Reliability was assessed using generalisability theory. Credibility was assessed by comparing pass rates and by relating the passing scores to test difficulty. RESULTS: The passing scores were 73.4% for the Angoff procedure without reality check (Angoff I), 66.0% for the Angoff procedure with reality check (Angoff II) and 57.6% for the BR method. The reliabilities (expressed as root mean square errors) were 2.1% for Angoffs I and II, and 0.6% for the BR method. The pass rates of the trainees and GPs were 19% and 9% for Angoff I, 66% and 46% for Angoff II, and 95% and 80% for the BR method, respectively. The correlation between test difficulty and passing score was 0.69 for Angoff I, 0.88 for Angoff II and 0.86 for the BR method. CONCLUSION: The BR method provides a more credible and reliable standard for an OSCE than a modified Angoff procedure. A reality check improves the credibility of the Angoff procedure but does not improve its reliability.

Clinical Competence↗
PubMed2006

Hair analysis for drug detection.

Given the limitations of self-reports on drug use, testing for drugs of abuse is important for most clinical and forensic toxicological situations, both for assessing the reality of the intoxication and for evaluation of the level of drug impairment. It is generally accepted that chemical testing of biological fluids is the most objective means of diagnosis of drug use. The presence of a drug analyte in a biological specimen can be used to document exposure. The standard in drug testing is the immunoassay screen, followed by the gas chromatographic-mass spectrometric confirmation conducted on a urine sample. In recent years, remarkable advances in sensitive analytical techniques have enabled the analysis of drugs in unconventional biological specimens such as hair. The advantages of this sample over traditional media, like urine and blood, are obvious: collection is noninvasive, relatively easy to perform, and in forensic situations it may be achieved under close supervision of law enforcement officers to prevent adulteration or substitution. The window of drug detection is dramatically extended to weeks, months or even years when testing hair. It seems that the value of alternative specimen analysis for the identification of drug users is steadily gaining recognition. This can be seen from its growing use in preemployment screening, in forensic sciences, in clinical applications and for doping control. Hair analysis may be a useful adjunct to conventional drug testing in urine. Methods for evading urinalysis do not affect hair analysis. The aim of this review is to document toxicological applications of hair analysis in drug detection.

Alcoholism↗
PubMed2006

[Rating scales based on the phenomenological and structural approach].

A current tendency of research in clinical psychology consists in using an integrated quantitative and qualitative methodology. This approach is especially suited to the study of the therapeutic intervention where the researcher is himself part of the situation he is investigating. As to the tools of research, the combination of the semi-structured clinical interview, of psychometric scales and projective tests has proved to be pertinent to describe the multidimensional and fluctuating reality of the therapeutic relationship and the changes induced by it in the two partners. In arts therapeutic research the investigation of the artistic production or of the free expression of people may complete the psychometric and projective tools. The concept of "expressive test" is currently being used to characterise this method. In this context, the development of rating scales, based on the phenomenological and structural or holistic approach allows us making the link between qualitative analysis and quantification, leading to the use of inferential statistics, providing that we remain at the nominal or ordinal level of measurement. We are explaining the principle of construction of these rating scales and we are illustrating our practice with some examples drawn from studies we realized in clinical psychology.

Biometry↗
PubMed2006

A randomized, controlled, prospective study validating the acquisition of percutaneous renal collecting system access skills using a computer based hybrid virtual reality surgical simulator: phase I.

PURPOSE: The need to develop new methods of surgical training combined with advances in computing has led to the development of sophisticated virtual reality surgical simulators. The PERC Mentortrade mark is designed to train the user in percutaneous renal collecting system access puncture. We evaluated and established face, content and construct validation of the simulator in this task. MATERIALS AND METHODS: A total of 63 trainees underwent baseline testing on the simulator, consisting of percutaneous renal puncture followed by the introduction of a guidewire into the collecting system. Subjects were then randomized to an intervention arm, in which they underwent 2, 30-minute training sessions on the simulator, and a control arm, in which no further training was given, followed by repeat testing. Performance was assessed using a global rating scale and by virtual reality derived parameters. RESULTS: There were no significant differences between the 2 groups with respect to baseline measures. Subjects who underwent training with the simulator demonstrated significant improvement in objective and subjective parameters compared to their baseline performance and compared to the untrained control group. Spearman rank correlations demonstrated a significant relationship between multiple parameters of the objective and subjective data. CONCLUSIONS: Training on the simulator improves virtual reality skills. It may allow trainees to develop the basic skills necessary to perform percutaneous renal collecting system access. Face and content validity were demonstrated and construct validity was supported by establishing convergent validity.

Computer Simulation↗
PubMed2005

Cognitive abilities, androgen levels, and body mass index in 5-year-old children.

This study explores the potential relationship between a series of cognitive abilities and testosterone, dehydroepiandrosterone (DHEA), androstenedione, and body mass index (BMI) measurements in 5-year-old children. 60 boys and 69 girls were administered a test (K-BIT) which provided measurements of fluid intelligence (Matrices subtest), crystallized intelligence (Vocabulary subtest), and IQ composite (the combination of the two subtests); a sub-sample of 48 boys and 61 girls was also subjected to diverse tests related to theory of mind (affective labeling, appearance-reality distinction, display rules, and false belief). Testosterone, DHEA, and androstenedione levels were measured using an enzyme immunoassay technique in saliva samples. An analysis of variance failed to reveal any significant differences between boys and girls in any of the cognitive abilities assessed. The correlation analysis revealed a positive relationship between fluid intelligence and testosterone levels in boys, a negative relationship between crystallized intelligence and androstenedione levels in girls, and between affective labeling and androstenedione levels in boys. A multiple regression analysis indicated that androstenedione and BMI were the best predictors for some of the cognitive abilities assessed.

Affect↗
PubMed1996

"Routine" preoperative studies. Which studies in which patients?

The utility of mass screening of preoperative patients has never been demonstrated for the majority of tests. Although screening patients to uncover occult disease appears logical, in reality it has resulted in excessive expenditure of our health care dollars with limited benefit. More than $30 billion is spent annually on preoperative examinations, 60% of which are unnecessary. In addition, iatrogenic injury has resulted from the further evaluation and treatment of false-positive results. A selective utilization of routine examinations can accurately supplement the clinician's evaluation, providing the patient with a complete preoperative assessment. The benefits of selective testing must be balanced against the possible omission of warranted examinations, highlighting the need for a more reliable system for test ordering.

Adult↗
PubMed1978

Skin testing for allergic diseases: techniques, indications and interpretations.

Despite significant strides in serologic methodologies, the skin test, when properly done, has remained the single most sensitive and practical assay for specific dermal-bound reaginic antibody. Its value could further be enhanced if and when characterization and standardization of the allergen extracts become a reality. While the technique is simple, the indications and interpretations of allergy skin tests required the expertise of well-trained allergists. A positive skin reaction is no more than a mere supportive laboratory aid in the diagnosis of allergic disease, which is arrived at through a carefully taken detailed history and a meticulously done physical examination.

Allergens↗
PubMed2005

Comparison of the sensitivity of physical and virtual laparoscopic surgical training simulators to the user's level of experience.

BACKGROUND: The recent focus on quality of care and patient safety has been accompanied by increased interest in standardizing the training for laparoscopic surgeons. Studies have shown that laparoscopic simulators can be used to train surgical skills. Therefore, we designed an experiment to compare the effectiveness of two popular training systems. One system was based on a physical model, whereas the other used a virtual reality model. METHODS: A total of 32 medical students and residents were tested on both simulators. Time required for task completion and number of errors committed were recorded and compared. RESULTS: The physical training system differentiated among experience levels on three of the five tasks when time was used as a measure and four of five tasks when score was used, whereas the virtual reality system yielded statistically significant results in eight of 13 tasks for time and in five of 13 tasks for score. CONCLUSION: The physical model is more sensitive than the virtual reality one in detecting differences in levels of laparoscopic surgical experience.

Computer Simulation↗
PubMed2002

Virtual reality exposure therapy for the treatment of fear of flying: a controlled investigation.

Forty-five participants who refused to fly during a screening test and who also met Diagnostic and Statistical Manual of Mental Disorders criteria for specific phobia, agoraphobia, or panic disorder with agoraphobia were randomly assigned to 5 sessions of either virtual reality exposure (VRE) or attention-placebo group treatment (GT). At posttreatment, 65% of VRE participants and 57% of GT participants flew during a test flight. Both groups showed significant improvement following treatment on standardized self-report measures of flight anxiety, with a better outcome for the VRE group on 4 of 5 of these measures. At 6-month follow-up, however, most group differences had disappeared; VRE resulted in a better outcome on only 1 of 5 standardized flight anxiety measures.

Adult↗
PubMed2004

Hereditary non-syndromic sensorineural hearing loss: transforming silence to sound.

Tremendous progress has been made in our understanding of the molecular basis of hearing and hearing loss. Through recent advances, we have begun to understand the fascinating biology of the auditory system and unveiled new molecular mechanisms of hearing impairment. Changes in the diagnostic impact of genetic testing have occurred, as well as exciting developments in therapeutic options. Molecular diagnosis, which is already a reality for several hearing-associated genes, will doubtlessly continue to increase in the near future, both in terms of the number of mutations tested and the spectrum of genes. Genetic analysis for hearing loss is mostly used for diagnosis and treatment, and relatively rarely for reproductive decisions, in contrast to other inherited disorders. Inherited hearing loss, however, is characterized by impressive genetic heterogeneity. An abundance of genes carry a large number of mutations, but specific mutations in a single gene may lead to syndromic or non-syndromic hearing loss. Some mutations predominate in individual ethnic groups. For clinical and laboratory diagnosticians, it is challenging to keep abreast of the unfolding discoveries. This review aims to provide the framework pertinent to diagnosticians and a practical approach to mutation analysis in the hearing impaired.

Connexins↗
PubMed1994

Capabilities of compact analyzers for decentralized testing of lipids and lipoproteins.

Advances in compact analyzer technology have provided the capability to move laboratory testing to the patient, the bedside, the physician office, wellness sites and even into the home. The future has arrived in the sense that lipid testing can be performed in a simple manner similar to blood pressure testing with results immediately available to facilitate treatment decisions. The realities of access and utilization as well as the rate of future technology developments will be determined to a large degree by government regulatory and reimbursement decisions.

Blood Chemical Analysis↗
PubMed1996

[Can successful reading acquirements be predicted?].

BACKGROUND: This research aims to register predictive tests of reading by way of a first intention test usually proposed in children with school difficulties: the WISC-R. POPULATION AND METHODS: Thirty-one children aged from 3.9 to 8.3 years, consulting in a psychiatry service for school difficulties, were tested twice. Twenty-one children aged less than 5.9 years (age for beginning to read), consulting for anticipated schooling, were also included in the study. These fifty-two children passed twice WISC-R for the elder and WPPSI for those who were younger. RESULTS: Three subtests, similitude test, understanding test and test of Kohs 'blocks seemed to be good predictive markers of ability to read. Predictive score for fiability with these three tests was 87%. CONCLUSIONS: These tests that bring the ability of generalizing into question, as reality and space adjustment, show well the necessary qualities for a child who must begin to read.

Child↗
PubMed2005

The United States Department of Energy's Regional Carbon Sequestration Partnerships program: a collaborative approach to carbon management.

This paper reviews the Regional Carbon Sequestration Partnerships (RCSP) concept, which is a first attempt to bring the U.S. Department of Energy's (DOE) carbon sequestration program activities into the "real world" by using a geographically-disposed-system type approach for the U.S. Each regional partnership is unique and covers a unique section of the U.S. and is tasked with determining how the research and development activities of DOE's carbon sequestration program can best be implemented in their region of the country. Although there is no universal agreement on the cause, it is generally understood that global warming is occurring, and many climate scientists believe that this is due, in part, to the buildup of carbon dioxide (CO(2)) in the atmosphere. This is evident from the finding presented in the National Academy of Science Report to the President on Climate Change which stated "Greenhouse gases are accumulating in Earth's atmosphere as a result of human activities, causing surface air temperatures and subsurface ocean temperatures to rise. Temperatures are, in fact, rising. The changes observed over the last several decades are likely mostly due to human activities, ...". In the United States, emissions of CO(2) originate mainly from the combustion of fossil fuels for energy production, transportation, and other industrial processes. Roughly one third of U.S. anthropogenic CO(2) emissions come from power plants. Reduction of CO(2) emissions through sequestration of carbon either in geologic formations or in terrestrial ecosystems can be part of the solution to the problem of global warming. However, a number of steps must be accomplished before sequestration can become a reality. Cost effective capture and separation technology must be developed, tested, and demonstrated; a database of potential sequestration sites must be established; and techniques must be developed to measure, monitor, and verify the sequestered CO(2). Geographical differences in fossil fuel use, the industries present, and potential sequestration sinks across the United States dictate the use of a regional approach to address the sequestration of CO(2). To accommodate these differences, the DOE has created a nationwide network of seven Regional Carbon Sequestration Partnerships (RCSP) to help determine and implement the carbon sequestration technologies, infrastructure, and regulations most appropriate to promote CO(2) sequestration in different regions of the nation. These partnerships currently represent 40 states, three Indian Nations, four Canadian Provinces, and over 200 organizations, including academic institutions, research institutions, coal companies, utilities, equipment manufacturers, forestry and agricultural representatives, state and local governments, non-governmental organizations, and national laboratories. These partnerships are dedicated to developing the necessary infrastructure and validating the carbon sequestration technologies that have emerged from DOE's core R&D and other programs to mitigate emissions of CO(2), a potent greenhouse gas. The partnerships provide a critical link to DOE's plans for FutureGen, a highly efficient and technologically sophisticated coal-fired power plant that will produce both hydrogen and electricity with near-zero emissions. Though limited to the situation in the U.S., the paper describes for the international scientific community the approach being taken by the U.S. to prepare for carbon sequestration, should that become necessary.

Air Pollution↗
PubMed1993

Gastrointestinal pacing.

Gastrointestinal pacing has been used to alter motor function and is effective in animal models in modulating gastric emptying, intestinal transit, and absorption. Application of gastrointestinal pacing to disorders of the human stomach and small bowel is an attractive treatment option that may some day become a clinical reality. Several technical problems must be overcome before further clinical testing can proceed.

Animals↗
PubMedDate not supplied

Control of virtual environments for young people with learning difficulties.

PURPOSE: The objective of this research is to identify the requirements for the selection or development of usable virtual environment (VE) interface devices for young people with learning disabilities. METHOD: A user-centred design methodology was employed, to produce a design specification for usable VE interface devices. Details of the users' cognitive, physical and perceptual abilities were obtained through observation and normative assessment tests. CONCLUSIONS: A review of computer interface technology, including virtual reality and assistive devices, was conducted. As there were no devices identified that met all the requirements of the design specification, it was concluded that there is a need for the design and development of new concepts. Future research will involve concept and prototype development and user-based evaluation of the prototypes.

Adolescent↗
PubMed1996

The uses and abuses of meta-analysis.

Meta-analysis is a quantitative process of summary and interpretation which involves pooling information from independent studies concerning a single theme in order to draw conclusions. Greatly increased employment of meta-analysis is currently being advocated for clinical and policy decision making. However, the prestige of meta-analysis is based upon a false model of scientific practice. Interpreting empirical research is an extremely complex activity requiring clinical and scientific knowledge of the field in question; and teams of professional 'meta-analysts' with a primary skill base in information technology and biostatistics cannot take over this role. Meta-analysis is not a hypothesis-testing activity, and cannot legitimately be used to establish the reality of a putative hazard or therapy. The proper use of meta-analysis is to increase the precision of quantitative estimates of health states in populations. If used to estimate an effect, the reality of that effect should have been established by previous scientific studies. But the summary estimate from a meta-analysis can only be directly applied to a target population when the 'meta-protocol' and 'meta-population' match the target situation in all relevant particulars. These constraints can rarely be satisfied in practice, so the results of meta-analysis typically require adjustment--which is a complex, assumption-laden process that negates many of the statistical power advantages of a meta-analysis. Lacking any understanding or acknowledgement of the need for adjustment, most meta-analyses must be regarded as abuses of the technique.

Clinical Trials as Topic↗
PubMedDate not supplied

Facilitating critical thinking.

Supporting staff to think effectively is essential to improve clinical systems, decrease errors and sentinel events, and engage staff involvement to refine patient care systems in readiness for new care-delivery models that truly reflect the valued role of the RN. The authors explore practical methods, based on current research and national consulting experience, to facilitate the development of mature critical thinking skills. Assessment tools, a sample agenda for formal presentations, and teaching strategies using behavioral examples that make the important and necessary link of theory to reality are discussed in the form of a critical thinking test as well as a conceptual model for application in problem solving.

Clinical Competence↗