431 resultados para routine outcome measurement


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To date, a wide range of methods has been used to measure physical activity in children and adolescents. These include self-report methods such as questionnaires, activity logs, and diaries as well as objective measures of physical activity such as direct observation, doubly labeled water, heart rate monitoring, accelerometers, and pedometers. The purpose of this review is to overview the methods currently being used to measure physical activity in children and adolescents. For each measurement approach, new developments and/or innovations are identified and discussed. Particular attention is given to the use of accelerometers and the calibration of accelerometer output to units of energy expenditure to developing children.

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Background Few cancers pose greater challenges than head and neck (H&N) cancer. Residual effects following treatment include body image changes, pain, fatigue and difficulties with appetite, swallowing and speech. Depression is a common comorbidity. There is limited evidence about ways to assist patients to achieve optimal adjustment after completion of treatment. In this study, we aim to examine the effectiveness and feasibility of a model of survivorship care to improve the quality of life of patients who have completed treatment for H&N cancer. Methods This is a preliminary study in which 120 patients will be recruited. A prospective randomised controlled trial of the H&N Cancer Survivor Self-management Care Plan (HNCP) involving pre- and post-intervention assessments will be used. Consecutive patients who have completed a defined treatment protocol for H&N cancer will be recruited from two large cancer services and randomly allocated to one of three study arms: (1) usual care, (2) information in the form of a written resource or (3) the HNCP delivered by an oncology nurse who has participated in manual-based training and skill development in patient self-management support. The trained nurses will meet patients in a face-to-face interview lasting up to 60 minutes to develop an individualised HNCP, based on principles of chronic disease self-management. Participants will be assessed at baseline, 3 and 6 months. The primary outcome measure is quality of life. The secondary outcome measures include mood, self-efficacy and health-care utilisation. The feasibility of implementing this intervention in routine clinical care will be assessed through semistructured interviews with participating nurses, managers and administrators. Interviews with patients who received the HNCP will explore their perceptions of the HNCP, including factors that assisted them in achieving behavioural change. Discussion In this study, we aim to improve the quality of life of a patient population with unique needs by means of a tailored self-management care plan developed upon completion of treatment. Delivery of the intervention by trained oncology nurses is likely to be acceptable to patients and, if successful, will be a model of care that can be implemented for diverse patient populations.

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Although accelerometers are extensively used for assessing gait, limited research has evaluated the concurrent validity of these devices on less predictable walking surfaces or the comparability of different methods used for gravitational acceleration compensation. This study evaluated the concurrent validity of trunk accelerations derived from a tri-axial inertial measurement unit while walking on firm, compliant and uneven surfaces and contrasted two methods used to remove gravitational accelerations: i) subtraction of the best linear fit from the data (detrending), and; ii) use of orientation information (quaternions) from the inertial measurement unit. Twelve older and twelve younger adults walked at their preferred speed along firm, compliant and uneven walkways. Accelerations were evaluated for the thoracic spine (T12) using a tri-axial inertial measurement unit and an eleven-camera Vicon system. The findings demonstrated excellent agreement between accelerations derived from the inertial measurement unit and motion analysis system, including while walking on uneven surfaces that better approximate a real-world setting (all differences <0.16 m.s−2). Detrending produced slightly better agreement between the inertial measurement unit and Vicon system on firm surfaces (delta range: −0.05 to 0.06 vs. 0.00 to 0.14 m.s−2), whereas the quaternion method performed better when walking on compliant and uneven walkways (delta range: −0.16 to −0.02 vs. −0.07 to 0.07 m.s−2). The technique used to compensate for gravitational accelerations requires consideration in future research, particularly when walking on compliant and uneven surfaces. These findings demonstrate trunk accelerations can be accurately measured using a wireless inertial measurement unit and are appropriate for research that evaluates healthy populations in complex environments.

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Second-generation activity monitors have revolutionized the way in which we measure youth physical activity. Use of the monitors avoids the problems associated with self-report methods and allows for the estimation of physical activity patterns over time. This article examines important methodological issues related to the use of activity monitors in children and adolescents.

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Background Promoting participation physical activity (PA) is an important means of promoting healthy growth and development in children with cerebral palsy (CP). The ActiGraph is a uniaxial accelerometer that provides a realtime measure of PA intensity, duration and frequency. Its small, light weight design makes it a promising measure of activity in children with CP. To date no study has validated the use of accelerometry as a measure of PA in ambulant adolescents with CP. Objectives To evaluate the validity of the ActiGraph accelerometer for measuring PA intensity in adolescents with CP, using oxygen consumption (VO2), measured using portable indirect calorimetry (Cosmed K4b2), as the criterion measure. Design Validation Study Participants/Setting: Ambulant adolescents with CP aged 10–16 years, GMFCS rating of I-III. The recruitment target is 30 (10 in each GMFCS level). Materials/Methods Participants wore the ActiGraph (counts/min) and a Cosmed K4b2 indirect calorimeter (mL/kg/min) during six activity trials: quiet sitting (QS), comfortable paced walking (CPW), brisk paced walking (BPW), fast paced walking (FPW), a ball-kicking protocol (KP) and a ball-throwing protocol (TP). MET levels (multiples of resting metabolism) for each activity were predicted from ActiGraph counts using the Freedson age-specific equation (Freedson et al. 2005) and compared with actual MET levels measured by the Cosmed. Predicted and measured METs for each activity trial were classified as light (> 1.5 METs and <4.6 METs) or moderate to vigorous intensity (≥ 4.6 METs). Results To date 36 bouts of activity have been completed (6 participants x 6 activities). Mean VO2 increased linearly as the intensity of the walking activity increased (CPW=9.47±2.16, BPW=14.06±4.38, FPW=19.21±5.68 ml/kg/min) and ActiGraph counts reflected this pattern (CPW=1099±574, BPW=2233±797 FPW=4707±1013 counts/min). The throwing protocol recording the lowest VO2 (TP=7.50±3.86 ml/kg/min) and lowest overall counts/min (TP=31±27 counts/min). When each of the 36 bouts were classified as either light or moderate to vigorous intensity using measured VO2 as the criterion measure, the Freedson equation correctly classified 28 from 36 bouts (78%). Conclusion/Clinical Implications These preliminary findings suggest that there is a relationship between the intensity of PA and direct measure of oxygen consumption and that therefore the ActiGraph may be a promising tool for accurately measuring free living PA in the community. Further data collection of the complete sample will enable secondary analysis of the relationship between PA and severity of CP (GMFCS level).

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This thesis developed a practical, cost effective, easy-to-use method for measuring the vertical displacements of bridges using fiber Bragg grating (FBG) sensors, which includes the curvature and inclination approaches. These approaches were validated by the numerical simulation tests on a full scale bridge and the laboratory-based tests. In doing so, a novel frictionless FBG inclination sensor with extremely high sensitivity and resolution has also been developed and validated.

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The 1967 Protocol Relating to the Status of Refugees has been described as an unnecessary addendum to the 1951 Convention Relating to the Status of Refugees. However, if the 1967 Protocol was superfluous, why did the United Nations High Commissioner for Refugees in the early 1960s insist on its development? This article seeks to establish that the 1967 Protocol was originally intended to encompass the broader concerns of African and Asian states concerning refugee populations in their region. However, the political influence upon the development of international refugee law radically altered the UNHCR's endeavour to make the 1951 Convention universally accessible.

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This thesis is a comparative investigation of the methodology applied to human skin temperature measurement. The findings of this thesis suggest that clinical and significant differences exist between conductive and infrared devices which are commonly employed in the assessment of human skin temperature. These significant differences could potentially influence the interpretation of results, diagnosis and therefore treatment outcomes for health, clinical and exercise science applications.

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We have demonstrated the nonlinear absorption at 532 nm wavelength in an Au semi-continuous film (SF) resulting from smearing of the Fermi distribution and diffusion of conduction electrons into the substrate. The Au SF was irradiated by a pulsed laser with 8 ns pulse width at 532 nm in near resonance with the interband transition of the Au. We determined the temperature increase in the SF for different intensities by electrical measurement. We calculated the temperature increase by using a 1D heat transport equation; comparing the results of the calculation with measured values for the temperature increase, revealed the nonlinear absorption in the Au SF. We employed this deviation from linear behaviour to determine the nonlinear absorption coefficient.

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Firm-customer digital connectedness for effective sensing and responding is a strategic imperative for contemporary competitive firms. This research-in-progress paper conceptualizes and operationalizes the firm-customer mobile digital connectedness of a smart-mobile customer. The empirical investigation focuses on mobile app users and the impact of mobile apps on customer expectations. Based on pilot data collected from 127 customers, we tested hypotheses pertaining to firm-customer mobile digital connectedness and customer expectations. Our test analysis using linear and non-linear postulations reveals those customers raise their expectations as they increase their digital interactions with a firm.

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Monitoring gases for environmental, industrial and agricultural fields is a demanding task that requires long periods of observation, large quantity of sensors, data management, high temporal and spatial resolution, long term stability, recalibration procedures, computational resources, and energy availability. Wireless Sensor Networks (WSNs) and Unmanned Aerial Vehicles (UAVs) are currently representing the best alternative to monitor large, remote, and difficult access areas, as these technologies have the possibility of carrying specialised gas sensing systems, and offer the possibility of geo-located and time stamp samples. However, these technologies are not fully functional for scientific and commercial applications as their development and availability is limited by a number of factors: the cost of sensors required to cover large areas, their stability over long periods, their power consumption, and the weight of the system to be used on small UAVs. Energy availability is a serious challenge when WSN are deployed in remote areas with difficult access to the grid, while small UAVs are limited by the energy in their reservoir tank or batteries. Another important challenge is the management of data produced by the sensor nodes, requiring large amount of resources to be stored, analysed and displayed after long periods of operation. In response to these challenges, this research proposes the following solutions aiming to improve the availability and development of these technologies for gas sensing monitoring: first, the integration of WSNs and UAVs for environmental gas sensing in order to monitor large volumes at ground and aerial levels with a minimum of sensor nodes for an effective 3D monitoring; second, the use of solar energy as a main power source to allow continuous monitoring; and lastly, the creation of a data management platform to store, analyse and share the information with operators and external users. The principal outcomes of this research are the creation of a gas sensing system suitable for monitoring any kind of gas, which has been installed and tested on CH4 and CO2 in a sensor network (WSN) and on a UAV. The use of the same gas sensing system in a WSN and a UAV reduces significantly the complexity and cost of the application as it allows: a) the standardisation of the signal acquisition and data processing, thereby reducing the required computational resources; b) the standardisation of calibration and operational procedures, reducing systematic errors and complexity; c) the reduction of the weight and energy consumption, leading to an improved power management and weight balance in the case of UAVs; d) the simplification of the sensor node architecture, which is easily replicated in all the nodes. I evaluated two different sensor modules by laboratory, bench, and field tests: a non-dispersive infrared module (NDIR) and a metal-oxide resistive nano-sensor module (MOX nano-sensor). The tests revealed advantages and disadvantages of the two modules when used for static nodes at the ground level and mobile nodes on-board a UAV. Commercial NDIR modules for CO2 have been successfully tested and evaluated in the WSN and on board of the UAV. Their advantage is the precision and stability, but their application is limited to a few gases. The advantages of the MOX nano-sensors are the small size, low weight, low power consumption and their sensitivity to a broad range of gases. However, selectivity is still a concern that needs to be addressed with further studies. An electronic board to interface sensors in a large range of resistivity was successfully designed, created and adapted to operate on ground nodes and on-board UAV. The WSN and UAV created were powered with solar energy in order to facilitate outdoor deployment, data collection and continuous monitoring over large and remote volumes. The gas sensing, solar power, transmission and data management systems of the WSN and UAV were fully evaluated by laboratory, bench and field testing. The methodology created to design, developed, integrate and test these systems was extensively described and experimentally validated. The sampling and transmission capabilities of the WSN and UAV were successfully tested in an emulated mission involving the detection and measurement of CO2 concentrations in a field coming from a contaminant source; the data collected during the mission was transmitted in real time to a central node for data analysis and 3D mapping of the target gas. The major outcome of this research is the accomplishment of the first flight mission, never reported before in the literature, of a solar powered UAV equipped with a CO2 sensing system in conjunction with a network of ground sensor nodes for an effective 3D monitoring of the target gas. A data management platform was created using an external internet server, which manages, stores, and shares the data collected in two web pages, showing statistics and static graph images for internal and external users as requested. The system was bench tested with real data produced by the sensor nodes and the architecture of the platform was widely described and illustrated in order to provide guidance and support on how to replicate the system. In conclusion, the overall results of the project provide guidance on how to create a gas sensing system integrating WSNs and UAVs, how to power the system with solar energy and manage the data produced by the sensor nodes. This system can be used in a wide range of outdoor applications, especially in agriculture, bushfires, mining studies, zoology, and botanical studies opening the way to an ubiquitous low cost environmental monitoring, which may help to decrease our carbon footprint and to improve the health of the planet.

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Combustion sources are well-known sources of electrical ions (Howard, J.B. et al. 1973). Motor vehicles emissions are one of the main sources of ions in urban environments. The presence of charged particles in motor vehicle emissions has been known for many years (Kittelson, 1986; Yu et al, 2004; Jung and Kittelson, 2005). Although these particles are probably charged by the attachment of air ions, there is very little information on the nature, sign and magnitude of the small ions (diameter < 1.6 nm) emitted by motor vehicles and/or present by the sides of roads.

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Indians tend to have lower lean body mass than other ethnic groups which increases the risk of chronic diseases. Three complementary studies included in this thesis advanced knowledge on determinants of lean body mass in Indians and the techniques to measure it. The first study examined the determinants of lean body mass in young Indian adults and highlighted the importance of diet and physical activity for development of lean body mass. This study has important implications for policy on prevention of chronic diseases in India. The other two studies helped refinement of the techniques of lean body mass measurement and are expected to facilitate future research in this area. The thesis is presented in the form of publications in high ranking journals.

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Superhydrophobicity is directly related to the wettability of the surfaces. Cassie-Baxter state relating to geometrical configuration of solid surfaces is vital to achieving the Superhydrophobicity and to achieve Cassie-Baxter state the following two criteria need to be met: 1) Contact line forces overcome body forces of unsupported droplet weight and 2) The microstructures are tall enough to prevent the liquid that bridges microstructures from touching the base of the microstructures [1]. In this paper we discuss different measurements used to characterise/determine the superhydrophobic surfaces.

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Background Research has identified associations between serum 25(OH)D and a range of clinical outcomes in chronic kidney disease and wider populations. The present study aimed to investigate vitamin D deficiency/insufficiency in dialysis patients and the relationship with vitamin D intake and sun exposure. Methods A cross-sectional study was used. Participants included 30 peritoneal dialysis (PD) (43.3% male; 56.87 ± 16.16 years) and 26 haemodialysis (HD) (80.8% male; 63.58 ± 15.09 years) patients attending a department of renal medicine. Explanatory variables were usual vitamin D intake from diet/supplements (IU day−1) and sun exposure (min day−1). Vitamin D intake, sun exposure and ethnic background were assessed by questionnaire. Weight, malnutrition status and routine biochemistry were also assessed. Data were collected during usual department visits. The main outcome measure was serum 25(OH)D (nm). Results Prevalence of inadequate/insufficient vitamin D intake differed between dialysis modality, with 31% and 43% found to be insufficient (<50 nm) and 4% and 33% found to be deficient (<25 nm) in HD and PD patients, respectively (P < 0.001). In HD patients, there was a correlation between diet and supplemental vitamin D intake and 25(OH)D (ρ = 0.84, P < 0.001) and average sun exposure and 25(OH)D (ρ = 0.50, P < 0.02). There were no associations in PD patients. The results remained significant for vitamin D intake after multiple regression, adjusting for age, gender and sun exposure. Conclusions The results highlight a strong association between vitamin D intake and 25(OH)D in HD but not PD patients, with implications for replacement recommendations. The findings indicate that, even in a sunny climate, many dialysis patients are vitamin D deficient, highlighting the need for exploration of determinants and consequences.