Patient-based outcome assessment instruments in acupuncture research.

BACKGROUND: Outcome assessment can support the therapeutic process by providing a way to track symptoms and functionality over time, providing insights to clinicians and patients, as well as offering a common language to discuss patient behavior/functioning. OBJECTIVES: In this article, we examine the patient-based outcome assessment (PBOA) instruments that have been used to determine outcomes in acupuncture clinical research and highlight measures that are feasible, practical, economical, reliable, valid, and responsive to clinical change. The aims of this review were to assess and identify the commonly available PBOA measures, describe a framework for identifying appropriate sets of measures, and address the challenges associated with these measures and acupuncture. Instruments were evaluated in terms of feasibility, practicality, economy, reliability, validity, and responsiveness to clinical change. METHODS: This study was a systematic review. A total of 582 abstracts were reviewed using PubMed (from inception through April 2009). RESULTS: A total of 582 citations were identified. After screening of title/abstract, 212 articles were excluded. From the remaining 370 citations, 258 manuscripts identified explicit PBOA; 112 abstracts did not include any PBOA. The five most common PBOA instruments identified were the Visual Analog Scale, Symptom Diary, Numerical Pain Rating Scales, SF-36, and depression scales such as the Beck Depression Inventory. CONCLUSIONS: The way a questionnaire or scale is administered can have an effect on the outcome. Also, developing and validating outcome measures can be costly and difficult. Therefore, reviewing the literature on existing measures before creating or modifying PBOA instruments can significantly reduce the burden of developing a new measure.

Physical activity in US Blacks: a systematic review and critical examination of self-report instruments.

BACKGROUND: Physical activity self-report instruments in the US have largely been developed for and validated in White samples. Despite calls to validate existing instruments in more diverse samples, relatively few instruments have been validated in US Blacks. Emerging evidence suggests that these instruments may have differential validity in Black populations. PURPOSE: This report reviews and evaluates the validity and reliability of self-reported measures of physical activity in Blacks and makes recommendations for future directions. METHODS: A systematic literature review was conducted to identify published reports with construct or criterion validity evaluated in samples that included Blacks. Studies that reported results separately for Blacks were examined. RESULTS: The review identified 10 instruments validated in nine manuscripts. Criterion validity correlations tended to be low to moderate. No study has compared the validity of multiple instruments in a single sample of Blacks. CONCLUSION: There is a need for efforts validating self-report physical activity instruments in Blacks, particularly those evaluating the relative validity of instruments in a single sample.

Heat balances and thermally driven lagoon-ocean exchangeson a tropical coral reef system (Moorea, French Polynesia)

© 2015. American Geophysical Union. All Rights Reserved.The role of surface and advective heat fluxes on buoyancy-driven circulation was examined within a tropical coral reef system. Measurements of local meteorological conditions as well as water temperature and velocity were made at six lagoon locations for 2 months during the austral summer. We found that temperature rather than salinity dominated buoyancy in this system. The data were used to calculate diurnally phase-averaged thermal balances. A one-dimensional momentum balance developed for a portion of the lagoon indicates that the diurnal heating pattern and consistent spatial gradients in surface heat fluxes create a baroclinic pressure gradient that is dynamically important in driving the observed circulation. The baroclinic and barotropic pressure gradients make up 90% of the momentum budget in part of the system; thus, when the baroclinic pressure gradient decreases 20% during the day due to changes in temperature gradient, this substantially changes the circulation, with different flow patterns occurring during night and day. Thermal balances computed across the entire lagoon show that the spatial heating patterns and resulting buoyancy-driven circulation are important in maintaining a persistent advective export of heat from the lagoon and for enhancing ocean-lagoon exchange.