The Responsiveness, Content Validity, and Convergent Validity of the Measure Yourself Concerns and Wellbeing (MYCaW) Patient-Reported Outcome Measure

Objective Measure Yourself Concerns and Wellbeing (MYCaW) is a patient-centred questionnaire that allows cancer patients to identify and quantify the severity of their ‘Concerns’ and Wellbeing, as opposed to using a pre-determined list. MYCaW administration is brief and aids in prioritising treatment approaches. Our goal was to assess the convergent validity and responsiveness of MYCaW scores over time, the generalisability of the existing qualitative coding framework in different complementary and integrative healthcare settings and content validity. Methods Baseline and 6-week follow-up data (n=82) from MYCaW and FACIT-SpEx questionnaires were collected for a service evaluation of the ‘Living Well With The Impact of Cancer’ course at Penny Brohn Cancer Care. MYCaW construct validity was determined using Spearman's Rank Correlation test, and responsiveness indices assessed score changes over time. The existing qualitative coding framework was reviewed using a new dataset (n=158) and coverage of concern categories compared to items of existing outcome measures. Results Good correlation between MYCaW and FACIT-SpEx score changes were achieved (r= -0.57, p≥0.01). MYCaW Profile and Concern scores were highly responsive to change: SRM=1.02 and 1.08; effect size=1.26 and 1.22. MYCaW change scores showed the anticipated gradient of change according to clinically relevant degrees of change. Categories including ‘Spirituality’, ‘weight change’ and ‘practical concerns’ were added to the coding framework to improve generalisability. Conclusions MYCaW scores were highly responsive to change, allowing personalized patient outcomes to be quantified; the qualitative coding framework is generalisable across different oncology settings and has broader coverage of patient-identified concerns compared with existing cancer-related patient-reported outcome measures.

Differing methodologies to measure microbe dispersal during hand drying

Background: Having previously investigated the dispersal by different hand drying methods of a chemical indicator, fungi and bacteria on the hands of users, this new study assessed the potential for viral dispersal. Aims/Objectives: To determine differences between hand drying methods in their capacity to disperse viruses on the hands of users to other occupants of public washrooms and into the washroom environment. Method: A harmless virus was used to artificially contaminate the hands of participants prior to using three different hand drying devices (jet air dryer, warm air dryer, paper towel dispenser). Viral dispersal was assessed at different heights and distances from the hand drying devices and also at different times after use by means of an air sampler. Results: The jet air dryer was shown to produce significantly more dispersal of virus than the warm air dryer or paper towels. After use of the jet air dryer, high numbers of virus were detected at a range of heights with maximum numbers between 0.61 and 1.22 metres. Virus was also detected at distances of up to 3 metres from the jet air dryer and in the air for up to 15 minutes after its use. The warm air dryer and paper towel dispenser produced low or zero viral counts at different heights, different distances and times after use. Conclusion: Jet air dryers have a greater potential than other hand drying methods to disperse viruses on the hands and contaminate other occupants of a public washroom and the washroom environment.

Reduced-Reference Image Quality Assessment Based on Edge Preservation

Assessing the subjective quality of processed images through an objective quality metric is a key issue in multimedia processing and transmission. In some scenarios, it is also important to evaluate the quality of the received images with minimal reference to the transmitted ones. For instance, for closed-loop optimisation of image and video transmission, the quality measure can be evaluated at the receiver and provided as feedback information to the system controller. The original images - prior to compression and transmission - are not usually available at the receiver side, and it is important to rely at the receiver side on an objective quality metric that does not need reference or needs minimal reference to the original images. The observation that the human eye is very sensitive to edge and contour information of an image underpins the proposal of our reduced reference (RR) quality metric, which compares edge information between the distorted and the original image. Results highlight that the metric correlates well with subjective observations, also in comparison with commonly used full-reference metrics and with a state-of-the-art reduced reference metric. © 2012 ICST Institute for Computer Science, Social Informatics and Telecommunications Engineering.

Nutritional Evaluation and Optimisation in Neonates: a randomized, double-blind controlled trial of amino acid regimen and intravenous lipid composition in preterm parenteral nutrition

Background: Parenteral nutrition is central to the care of very immature infants. Current international recommendations favor higher amino acid intakes and fish oil–containing lipid emulsions. Objective: The aim of this trial was to compare 1) the effects of high [immediate recommended daily intake (Imm-RDI)] and low [incremental introduction of amino acids (Inc-AAs)] parenteral amino acid delivery within 24 h of birth on body composition and 2) the effect of a multicomponent lipid emulsion containing 30% soybean oil, 30% medium-chain triglycerides, 25% olive oil, and 15% fish oil (SMOF) with that of soybean oil (SO)-based lipid emulsion on intrahepatocellular lipid (IHCL) content. Design: We conducted a 2-by-2 factorial, double-blind, multicenter randomized controlled trial. Results: We randomly assigned 168 infants born at ,31 wk of gestation. We evaluated outcomes at term in 133 infants. There were no significant differences between Imm-RDI and Inc-AA groups for nonadipose mass [adjusted mean difference: 1.0 g (95% CI: 2108, 111 g; P = 0.98)] or between SMOF and SO groups for IHCL [adjusted mean SMOF:SO ratio: 1.1 (95% CI: 0.8, 1.6; P = 0.58]. SMOF does not affect IHCL content. There was a significant interaction (P = 0.05) between the 2 interventions for nonadipose mass. There were no significant interactions between group differences for either primary outcome measure after adjusting for additional confounders. Imm-RDI infants were more likely than Inc-AA infants to have blood urea nitrogen concentrations .7 mmol/L or .10 mmol/L, respectively (75% compared with 49%, P , 0.01; 49% compared with 18%, P , 0.01). Head circumference at term was smaller in the Imm-RDI group [mean difference: 20.8 cm (95% CI: 21.5, 20.1 cm; P = 0.02)]. There were no significant differences in any prespecified secondary outcomes, including adiposity, liver function tests, incidence of conjugated hyperbilirubinemia, weight, length, mortality, and brain volumes. Conclusion: Imm-RDI of parenteral amino acids does not benefit body composition or growth to term and may be harmful. This trial was registered at www.isrctn.com as ISRCTN29665319 and at eudract.ema.europa.eu as EudraCT 2009-016731-34.

A randomized trial to assess the potential of different beverages to affect hydration status: development of a beverage hydration index

Background: The identification of beverages that promote longer- term fluid retention and maintenance of fluid balance is of real clinical and practical benefit in situations in which free access to fluids is limited or when frequent breaks for urination are not desirable. The postingestion diuretic response is likely to be influenced by several beverage characteristics, including the volume ingested, energy den- sity, electrolyte content, and the presence of diuretic agents. Objective: This study investigated the effects of 13 different com- monly consumed drinks on urine output and fluid balance when ingested in a euhydrated state, with a view to establishing a beverage hydration index (BHI), i.e., the volume of urine produced after drinking expressed relative to a standard treatment (still water) for each beverage. Design: Each subject (n = 72, euhydrated and fasted male subjects) ingested 1 L still water or 1 of 3 other commercially available beverages over a period of 30 min. Urine output was then collected for the subsequent 4 h. The BHI was corrected for the water content of drinks and was calculated as the amount of water retained at 2 h after ingestion relative to that observed after the ingestion of still water. Results: Total urine masses (mean 6 SD) over 4 h were smaller than the still-water control (1337 6 330 g) after an oral rehydration solution (ORS) (1038 6 333 g, P , 0.001), full-fat milk (1052 6 267 g, P , 0.001), and skimmed milk (1049 6 334 g, P , 0.001). Cumulative urine output at 4 h after ingestion of cola, diet cola, hot tea, iced tea, coffee, lager, orange juice, sparkling water, and a sports drink were not different from the response to water ingestion. The mean BHI at 2 h was 1.54 6 0.74 for the ORS, 1.50 6 0.58 for full- fat milk, and 1.58 6 0.60 for skimmed milk. Conclusions: BHI may be a useful measure to identify the short- term hydration potential of different beverages when ingested in a euhydrated state.

Accessibility Instrument Survey

This chapter presents the main results of the Accessibility Instrument Survey (AIS), collecting basic information on each of the accessibility instruments reviewed in this report (for more detail on these Instruments see Chapter 3). The aim of the survey was to enable quick, objective and comparable overviews of each of the reviewed accessibility instruments. The information collected will enable the categorization of accessibility instruments present in this research, aiming to be a reference for future categorization of accessibility instruments for planning practice. These categories will support the analysis of the coverage of accessibility instruments in this research, i.e., identify how representative this research is across different accessibility instrument types. In addition, these will be used to analyse the characteristics and concerns which most frequently underlie the development of accessibility instruments. Finally, the survey also collects developer’s perceptions on the usefulness of their accessibility instruments in planning practice, enabling the first insight into the main research question of this COST Action, although limited to the developer’s point of view. In summary, the results of the survey will be used for four purposes: Development of an accessibility instrument sheet for each accessibility instrument summarizing its main characteristics (Appendix A); Identify the coverage of accessibility instrument types present in this research (Section 4.3.1) discussing the representativeness of this Action; Provide a glimpse on the characteristics and concerns which most frequently underlie the development of accessibility instruments (Section 4.3.2); Provide a first insight into the perceived usefulness of accessibility instruments in planning practice from the point of view of the developer (Section 4.3.2 and Section 4.3.3). The next section provides an overview of the Survey describing the information collected. This section also describes the development process of this survey including data collection, dates and means. The results of the survey are analysed in the third section starting with a discussion on the coverage of accessibility instruments reviewed by this research (Section 4.3.1), identifying accessibility measure types which are represented and which are absent. This discussion is accompanied by the presentation of the main categories of accessibility instruments from the perspective of the end user. These categories try to summarize the main concerns planning practitioners are expected to have when searching for an accessibility instrument and is built upon some of the information collected by the survey. Following, the third section also presents a general analysis of the results (Section 4.3.2), focussing on the dominant characteristics of the accessibility instruments reviewed and on the developer’s perception of the usefulness their instrument will have for end users. The section ends with a brief cross analysis of results (Section 4.3.3) trying to identify relationships between accessibility instrument characteristics and perceptions of usefulness by developers. The fourth and last section presents the main conclusions of this study.