411 resultados para local validation


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Background Spanish is one of the five most spoken languages in the world. There is currently no published Spanish version of the Örebro Musculoskeletal Pain Questionnaire (OMPQ). The aim of the present study is to describe the process of translating the OMPQ into Spanish and to perform an analysis of reliability, internal structure, internal consistency and concurrent criterion-related validity. Methods Design: Translation and psychometric testing. Procedure: Two independent translators translated the OMPQ into Spanish. From both translations a consensus version was achieved. A backward translation was made to verify and resolve any semantic or conceptual problems. A total of 104 patients (67 men/37 women) with a mean age of 53.48 (±11.63), suffering from chronic musculoskeletal disorders, twice completed a Spanish version of the OMPQ. Statistical analysis was performed to evaluate the reliability, the internal structure, internal consistency and concurrent criterion-related validity with reference to the gold standard questionnaire SF-12v2. Results All variables except “Coping” showed a rate above 0.85 on reliability. The internal structure calculation through exploratory factor analysis indicated that 75.2% of the variance can be explained with six components with an eigenvalue higher than 1 and 52.1% with only three components higher than 10% of variance explained. In the concurrent criterion-related validity, several significant correlations were seen close to 0.6, exceeding that value in the correlation between general health and total value of the OMPQ. Conclusions The Spanish version of the screening questionnaire OMPQ can be used to identify Spanish patients with musculoskeletal pain at risk of developing a chronic disability.

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Objectives To externally evaluate the accuracy of the new Vancouver Chest Pain Rule and to assess the diagnostic accuracy using either sensitive or highly sensitive troponin assays. Methods Prospectively collected data from 2 emergency departments (EDs) in Australia and New Zealand were analysed. Based on the new Vancouver Chest Pain Rule, low-risk patients were identified using electrocardiogram results, cardiac history, nitrate use, age, pain characteristics and troponin results at 2 hours after presentation. The primary outcome was 30-day diagnosis of acute coronary syndrome (ACS), including acute myocardial infarction, and unstable angina. Sensitivity, specificity, positive predictive values and negative predictive values were calculated to assess the accuracy of the new Vancouver Chest Pain Rule using either sensitive or highly sensitive troponin assay results. Results Of the 1635 patients, 20.4% had an ACS diagnosis at 30 days. Using the highly sensitive troponin assay, 212 (13.0%) patients were eligible for early discharge with 3 patients (1.4%) diagnosed with ACS. Sensitivity was 99.1% (95% CI 97.4-99.7), specificity was 16.1 (95% CI 14.2-18.2), positive predictive values was 23.3 (95% CI 21.1-25.5) and negative predictive values was 98.6 (95% CI 95.9-99.5). The diagnostic accuracy of the rule was similar using the sensitive troponin assay. Conclusions The new Vancouver Chest Pain Rule should be used for the identification of low risk patients presenting to EDs with symptoms of possible ACS, and will reduce the proportion of patients requiring lengthy assessment; however we recommend further outpatient investigation for coronary artery disease in patients identified as low risk.

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Objective: The aim of this study was to develop a model capable of predicting variability in the mental workload experienced by frontline operators under routine and nonroutine conditions. Background: Excess workload is a risk that needs to be managed in safety-critical industries. Predictive models are needed to manage this risk effectively yet are difficult to develop. Much of the difficulty stems from the fact that workload prediction is a multilevel problem. Method: A multilevel workload model was developed in Study 1 with data collected from an en route air traffic management center. Dynamic density metrics were used to predict variability in workload within and between work units while controlling for variability among raters. The model was cross-validated in Studies 2 and 3 with the use of a high-fidelity simulator. Results: Reported workload generally remained within the bounds of the 90% prediction interval in Studies 2 and 3. Workload crossed the upper bound of the prediction interval only under nonroutine conditions. Qualitative analyses suggest that nonroutine events caused workload to cross the upper bound of the prediction interval because the controllers could not manage their workload strategically. Conclusion: The model performed well under both routine and nonroutine conditions and over different patterns of workload variation. Application: Workload prediction models can be used to support both strategic and tactical workload management. Strategic uses include the analysis of historical and projected workflows and the assessment of staffing needs. Tactical uses include the dynamic reallocation of resources to meet changes in demand.

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Background The Spine Functional Index (SFI) is a recently published, robust and clinimetrically valid patient reported outcome measure. Objectives The purpose of this study was the adaptation and validation of a Spanish-version (SFI-Sp) with cultural and linguistic equivalence. Methods A two stage observational study was conducted. The SFI was cross-culturally adapted to Spanish through double forward and backward translation then validated for its psychometric characteristics. Participants (n = 226) with various spine conditions of >12 weeks duration completed the SFI-Sp and a region specific measure: for the back, the Roland Morris Questionnaire (RMQ) and Backache Index (BADIX); for the neck, the Neck Disability Index (NDI); for general health the EQ-5D and SF-12. The full sample was employed to determine internal consistency, concurrent criterion validity by region and health, construct validity and factor structure. A subgroup (n = 51) was used to determine reliability at seven days. Results The SFI-Sp demonstrated high internal consistency (α = 0.85) and reliability (r = 0.96). The factor structure was one-dimensional and supported construct validity. Criterion specific validity for function was high with the RMQ (r = 0.79), moderate with the BADIX (r = 0.59) and low with the NDI (r = 0.46). For general health it was low with the EQ-5D and inversely correlated (r = −0.42) and fair with the Physical and Mental Components of the SF-12 and inversely correlated (r = −0.56 and r = −0.48), respectively. The study limitations included the lack of longitudinal data regarding other psychometric properties, specifically responsiveness. Conclusions The SFI-Sp was demonstrated as a valid and reliable spine-regional outcome measure. The psychometric properties were comparable to and supported those of the English-version, however further longitudinal investigations are required.

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Measurements of particle concentrations and distributions in terms of number, surface area, and mass were performed simultaneously at eight sampling points within a symmetric street canyon of an Italian city. The aim was to obtain a useful benchmark for validation of wind tunnel experiments and numerical schemes: to this purpose, the influence of wind directions and speeds was considered. Particle number concentrations (PNCs) were higher on the leeward side than the windward side of the street canyon due to the wind vortex effect. Different vertical PNC profiles were observed between the two canyon sides depending on the wind direction and speed at roof level. A decrease in particle concentrations was observed with increasing rooftop wind speed, except for the coarse fraction indicating a possible particle resuspension due to the traffic and wind motion. This study confirms that particle concentration fields in urban street canyons are strongly influenced by traffic emissions and meteorological parameters, especially wind direction and speed.

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Background Spatial analysis is increasingly important for identifying modifiable geographic risk factors for disease. However, spatial health data from surveys are often incomplete, ranging from missing data for only a few variables, to missing data for many variables. For spatial analyses of health outcomes, selection of an appropriate imputation method is critical in order to produce the most accurate inferences. Methods We present a cross-validation approach to select between three imputation methods for health survey data with correlated lifestyle covariates, using as a case study, type II diabetes mellitus (DM II) risk across 71 Queensland Local Government Areas (LGAs). We compare the accuracy of mean imputation to imputation using multivariate normal and conditional autoregressive prior distributions. Results Choice of imputation method depends upon the application and is not necessarily the most complex method. Mean imputation was selected as the most accurate method in this application. Conclusions Selecting an appropriate imputation method for health survey data, after accounting for spatial correlation and correlation between covariates, allows more complete analysis of geographic risk factors for disease with more confidence in the results to inform public policy decision-making.

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Objective Risk scores and accelerated diagnostic protocols can identify chest pain patients with low risk of major adverse cardiac event who could be discharged early from the ED, saving time and costs. We aimed to derive and validate a chest pain score and accelerated diagnostic protocol (ADP) that could safely increase the proportion of patients suitable for early discharge. Methods Logistic regression identified statistical predictors for major adverse cardiac events in a derivation cohort. Statistical coefficients were converted to whole numbers to create a score. Clinician feedback was used to improve the clinical plausibility and the usability of the final score (Emergency Department Assessment of Chest pain Score [EDACS]). EDACS was combined with electrocardiogram results and troponin results at 0 and 2 h to develop an ADP (EDACS-ADP). The score and EDACS-ADP were validated and tested for reproducibility in separate cohorts of patients. Results In the derivation (n = 1974) and validation (n = 608) cohorts, the EDACS-ADP classified 42.2% (sensitivity 99.0%, specificity 49.9%) and 51.3% (sensitivity 100.0%, specificity 59.0%) as low risk of major adverse cardiac events, respectively. The intra-class correlation coefficient for categorisation of patients as low risk was 0.87. Conclusion The EDACS-ADP identified approximately half of the patients presenting to the ED with possible cardiac chest pain as having low risk of short-term major adverse cardiac events, with high sensitivity. This is a significant improvement on similar, previously reported protocols. The EDACS-ADP is reproducible and has the potential to make considerable cost reductions to health systems.

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Uncertainty assessments of herbicide losses from rice paddies in Japan associated with local meteorological conditions and water management practices were performed using a pesticide fate and transport model, PCPF-1, under the Monte Carlo (MC) simulation scheme. First, MC simulations were conducted for five different cities with a prescribed water management scenario and a 10-year meteorological dataset of each city. The effectiveness of water management was observed regarding the reduction of pesticide runoff. However, a greater potential of pesticide runoff remained in Western Japan. Secondly, an extended analysis was attempted to evaluate the effects of local water management and meteorological conditions between the Chikugo River basin and the Sakura River basin using uncertainty inputs processed from observed water management data. The results showed that because of more severe rainfall events, significant pesticide runoff occurred in the Chikugo River basin even when appropriate irrigation practices were implemented. © Pesticide Science Society of Japan.

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Educating responsive graduates. Graduate competencies include reliability, communication skills and ability to work in teams. Students using Collaborative technologies adapt to a new working environment, working in teams and using collaborative technologies for learning. Collaborative Technologies were used not simply for delivery of learning but innovatively to supplement and enrich research-based learning, providing a space for active engagement and interaction with resources and team. This promotes the development of responsive ‘intellectual producers’, able to effectively communicate, collaborate and negotiate in complex work environments. Exploiting technologies. Students use ‘new’ technologies to work collaboratively, allowing them to experience the reality of distributed workplaces incorporating both flexibility and ‘real’ time responsiveness. Students are responsible and accountable for individual and group work contributions in a highly transparent and readily accessible workspace. This experience provides a model of an effective learning tool. Navigating uncertainty and complexity. Collaborative technologies allows students to develop critical thinking and reflective skills as they develop a group product. In this forum students build resilience by taking ownership and managing group work, and navigating the uncertainties and complexities of group dynamics as they constructively and professionally engage in team dialogue and learn to focus on the goal of the team task.

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Background Domestic violence against women is a major public health problem and violations of women’s human rights. Health professionals could play an important role in screening for the victims. From the evidence to date, it is unclear whether health professionals do play an active role in identification of the victims. Objectives To develop a reliable and valid instrument to measure health professionals’ attitude to identifying female victims of domestic violence. Methods A primary questionnaire was constructed in accordance with established guidelines using the Theory of Planned Behaviour Ajzen (1975) to develop an instrument to measure health professionals’ attitudes in identifying female victim of DV. An expert panel was used to establish content validity. Focus groups amongst a group of health professionals (N = 5) of the target population were performed to confirm face validity. A pilot study (N = 30 nurses and doctors) was undertaken to elicit the feasibility and reliability of the questionnaire. The questionnaire was also administered a second time after one week to check the stability of the tests. Results Feedbacks of the expert panel’s and group discussion confirmed that the questionnaire had the content and face validity. Cronbach’s alpha values for all the items were greater than 0.7. Strong correlations between the direct and indirect measures confirmed that the indirect measures were well constructed. High test-retest correlations confirmed that the measures were reliable in the sense of temporal stability. Significance This tool has the potential to be used by researchers in expanding the knowledge base in this important area.

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In some of the countries where there has been a rapid increase in the use of online music distribution technologies, analysts have reported about declining sales of local music repertoire (e.g. Nordgård, 2013). The analysts are concerned about such tendencies since local music repertoire accounts for a sizable share of an average country’s total recorded music sales (e.g. IFPI, 2012). This paper searches for empirical evidence that may confirm these reports in a number of music markets in North America, Europe and Australasia. The paper makes a contribution to the literature on the digital transformation of the music industry since it combines and analyses data sources that previously have not been used in this context and gives a new perspective on changing user consumption practices in the music industry. The paper also examines the variation of geographic diversity over time among international acts that become commercially successful in the countries covered by the study.

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Objective: To develop bioelectrical impedance analysis (BIA) equations to predict total body water (TBW) and fat-free mass (FFM) of Sri Lankan children. Subjects/Methods: Data were collected from 5- to 15-year-old healthy children. They were randomly assigned to validation (M/F: 105/83) and cross-validation (M/F: 53/41) groups. Height, weight and BIA were measured. TBW was assessed using isotope dilution method (D2 O). Multiple regression analysis was used to develop preliminary equations and cross-validated on an independent group. Final prediction equation was constructed combining the two groups and validated by PRESS (prediction of sum of squares) statistics. Impedance index (height2/impedance; cm2/Ω), weight and sex code (male = 1; female = 0) were used as variables. Results: Independent variables of the final prediction equation for TBW were able to predict 86.3% of variance with root means-squared error (RMSE) of 2.1l. PRESS statistics was 2.1l with press residuals of 1.2l. Independent variables were able to predict 86.9% of variance of FFM with RMSE of 2.7 kg. PRESS statistics was 2.8 kg with press residuals of 1.4 kg. Bland Altman technique showed that the majority of the residuals were within mean bias±1.96 s.d. Conclusions: Results of this study provide BIA equation for the prediction of TBW and FFM in Sri Lankan children. To the best of our knowledge there are no published BIA prediction equations validated on South Asian populations. Results of this study need to be affirmed by more studies on other closely related populations by using multi-component body composition assessment.

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Sob o rótulo da globalização, as ciências humanas e sociais têm sido forçadas a rever seu pensamento para encontrar novas maneiras de falar sobre as situações de mudança ao nosso redor e para reorientar-se conceitualmente em um aparente ‘mundo sem fronteiras’. Este artigo analisa algumas dessas formas, sugerindo que a pesquisa em currículo transnacional como tarefa, como talvez inclusiva de algo para além dos estudos curriculares como subárea, tem preocupações, pontos de entrada e horizontes de promulgação amplos, inconstantes, imprevisíveis, que levantam uma série de questões e considerações éticas que exigem maior compromisso nos espaços em que as fronteiras percebidas forem transgredidas no ato da investigação. Usando os relatórios sobre os resultados do PISA como disparador intelectual, este artigo discute quatro questões que surgem no ato investigativo em currículo transnacional: a comparação como princípio de produção de conhecimento; as estratégias de agrupamento onto-teo-filosóficas e a delimitação da ética; o retorno do sujeito centrado, humanista, racional e as críticas a esse sujeito inspirado no Iluminismo; as questões relativas à causalidade, ou seja, como os processos de atribuição são forjados e que tipos de ‘legitimação via procedimento’ operam na crítica social. Em vez de sugerir uma nova ordem, este artigo busca um questionamento mais profundo dos repetitivos pressupostos ocidentalistas.

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The scanning tunneling microscope (STM) has evolved continually since its invention, as scientists have expanded its use to encompass atomic-scale manipulation, momentum-resolved electronic characterization, localized chemical reactions (bond breaking and bond making) in adsorbed molecules, and even chain reactions at surfaces. This burgeoning field has recently expanded to include the use of the STM to inject hot electrons into substrate surface states; the injected electrons can travel laterally and induce changes in chemical structure in molecules located up to 100 nm from the STM tip. We describe several key demonstrations of this phenomenon, including one appearing in this issue of ACS Nano by Chen et al. Possible applications for this technique are also discussed, including characterizing the dispersion of molecule−substrate interface states and the controlled patterning of molecular overlayers.

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Recent calls in Australia have addressed the need for better integration of planning processes. The consequent effort made by government has been, and still is, reshaping the way urban and regional planning and sustainability are managed. Focusing on planning practices at the local and regional levels, we investigate how environmental sustainability is pursued from an institutional perspective. Specifically, we analyse the way that planning in Australian cities aims to achieve sustainable strategies and reflect on the relationship with ‘Strategic Environmental Assessment’. This paper has four goals. First, sustainable planning practices at the local and regional levels are analysed considering the legislative and organizational frameworks of each state. The goal is to identify through an analysis of planning documents how much discretion is given to local councils to address sustainable strategies. Second, we focus on two regional and four cities in Queensland, to outline strengths and weaknesses of current legislative and practical frameworks. We use analytical criteria from the SEA literature to investigate these plans in more detail. Third, we examine the relationship between strategic and statutory plans, to see how sustainability is actually implemented. Finally we compare emerging issues about sustainable planning in Australia with countries overseas with different planning and SEA traditions. Considering that SEA is evolving and there are considerable international experiences, we offer recommendations on how Australia might achieve a more integrated and sustainable approach to planning.