Psychometric characteristics of the Spanish version of instruments to measure neck pain disability

Background: The NDI, COM and NPQ are evaluation instruments for disability due to NP. There was no Spanish version of NDI or COM for which psychometric characteristics were known. The objectives of this study were to translate and culturally adapt the Spanish version of the Neck Disability Index Questionnaire (NDI), and the Core Outcome Measure (COM), to validate its use in Spanish speaking patients with non-specific neck pain (NP), and to compare their psychometric characteristics with those of the Spanish version of the Northwick Pain Questionnaire (NPQ).Methods: Translation/re-translation of the English versions of the NDI and the COM was done blindly and independently by a multidisciplinary team. The study was done in 9 primary care Centers and 12 specialty services from 9 regions in Spain, with 221 acute, subacute and chronic patients who visited their physician for NP: 54 in the pilot phase and 167 in the validation phase. Neck pain (VAS), referred pain (VAS), disability (NDI, COM and NPQ), catastrophizing (CSQ) and quality of life (SF-12) were measured on their first visit and 14 days later. Patients' self-assessment was used as the external criterion for pain and disability. In the pilot phase, patients' understanding of each item in the NDI and COM was assessed, and on day 1 test-retest reliability was estimated by giving a second NDI and COM in which the name of the questionnaires and the order of the items had been changed.Results: Comprehensibility of NDI and COM were good. Minutes needed to fill out the questionnaires [median, (P25, P75)]: NDI. 4 (2.2, 10.0), COM: 2.1 (1.0, 4.9). Reliability: [ICC, (95%CI)]: NDI: 0.88 (0.80, 0.93). COM: 0.85 (0.75,0.91). Sensitivity to change: Effect size for patients having worsened, not changed and improved between days 1 and 15, according to the external criterion for disability: NDI: -0.24, 0.15, 0.66; NPQ: -0.14, 0.06, 0.67; COM: 0.05, 0.19, 0.92. Validity: Results of NDI, NPQ and COM were consistent with the external criterion for disability, whereas only those from NDI were consistent with the one for pain. Correlations with VAS, CSQ and SF-12 were similar for NDI and NPQ (absolute values between 0.36 and 0.50 on day 1, between 0.38 and 0.70 on day 15), and slightly lower for COM (between 0.36 and 0.48 on day 1, and between 0.33 and 0.61 on day 15). Correlation between NDI and NPQ: r = 0.84 on day 1, r = 0.91 on day 15. Correlation between COM and NPQ: r = 0.63 on day 1, r = 0.71 on day 15.Conclusion: Although most psychometric characteristics of NDI, NPQ and COM are similar, those from the latter one are worse and its use may lead to patients' evolution seeming more positive than it actually is. NDI seems to be the best instrument for measuring NP-related disability, since its results are the most consistent with patient's assessment of their own clinical status and evolution. It takes two more minutes to answer the NDI than to answer the COM, but it can be reliably filled out by the patient without assistance.

Development of an instrument to measure the degree of critical patient's satisfaction with nursing care: research protocol

Aim: To investigate and understand patient's satisfaction with nursing care in the intensive care unit to identify the dimensions of the concept of"satisfaction" from the patient's point of view. To design and validate a questionnaire that measures satisfaction levels in critical patients. Background: There are many instruments capable of measuring satisfaction with nursing care; however, they do not address the reality for critical patients nor are they applicable in our context. Design: A dual approach study comprising: a qualitative phase employing Grounded Theory and a quantitative and descriptive phase to prepare and validate the questionnaire. Methods: Data collection in the qualitative phase will consist of: in-depth interview after theoretical sampling, on-site diary and expert discussion group. The sample size will depend on the expected theoretical saturation n = 27-36. Analysis will be based on Grounded Theory. For the quantitative phase, the sampling will be based on convenience (n = 200). A questionnaire will be designed on the basis of qualitative data. Descriptive and inferential statistics will be used. The validation will be developed on the basis of the validity of the content, the criteria of the construct and reliability of the instrument by the Cronbach's alpha and test-retest approach. Approval date for this protocol was November 2010. Discussion: Self-perceptions, beliefs, experiences, demographic, socio-cultural epistemological and political factors are determinants for satisfaction, and these should be taken into account when compiling a questionnaire on satisfaction with nursing care among critical patients.

A Methodology to measure shareholder value orientation and shareholder value creation aimed at providing a research basis to investigate the link between both magnitudes

Does shareholder value orientation lead to shareholder value creation? This article proposes methods to quantify both, shareholder value orientation and shareholder value creation. Through the application of these models it is possible to quantify both dimensions and examine statistically in how far shareholder value orientation explains shareholder value creation. The scoring model developed in this paper allows quantifying the orientation of managers towards the objective to maximize wealth of shareholders. The method evaluates information that comes from the companies and scores the value orientation in a scale from 0 to 10 points. Analytically the variable value orientation is operationalized expressing it as the general attitude of managers toward the objective of value creation, investment policy and behavior, flexibility and further eight value drivers. The value creation model works with market data such as stock prices and dividend payments. Both methods where applied to a sample of 38 blue chip companies: 32 firms belonged to the share index IBEX 35 on July 1st, 1999, one company represents the “new economy” listed in the Spanish New Market as per July 1st, 2001, and 5 European multinational groups formed part of the EuroStoxx 50 index also on July 1st, 2001. The research period comprised the financial years 1998, 1999, and 2000. A regression analysis showed that between 15.9% and 23.4% of shareholder value creation can be explained by shareholder value orientation.

A doubling measure on R(d) can charge a rectifiable curve

"Vegeu el resum a l'inici del document del fitxer adjunt"

Hausdorff measure of quasicircles

"Vegeu el resum a l'inici del document del fitxer adjunt."

Detecció i localització d'impactes a estructures aeroespacials

Projecte de recerca elaborat a partir d’una estada a la Universidad Politécnica de Madrid, Espanya, entre setembre i o desembre del 2007. Actualment la indústria aeroespacial i aeronàutica té com prioritat millorar la fiabilitat de las seves estructures a través del desenvolupament de nous sistemes per a la monitorització i detecció d’impactes. Hi ha diverses tècniques potencialment útils, i la seva aplicabilitat en una situació particular depèn críticament de la mida del defecte que permet l’estructura. Qualsevol defecte canviarà la resposta vibratòria de l’element estructural, així com el transitori de l’ona que es propaga per l’estructura elàstica. Correlacionar aquests canvis, que poden ser detectats experimentalment amb l’ocurrència del defecte, la seva localització i quantificació, és un problema molt complex. Aquest treball explora l’ús de l'Anàlisis de Components Principals (Principal Component Analysis - PCA-) basat en la formulació dels estadístics T2 i Q per tal de detectar i distingir els defectes a l'estructura, tot correlacionant els seus canvis a la resposta vibratòria. L’estructura utilitzada per l’estudi és l’ala d’una turbina d’un avió comercial. Aquesta ala s’excita en un extrem utilitzant un vibrador, i a la qual s'han adherit set sensors PZT a la superfície. S'aplica un senyal conegut i s'analitzen les respostes. Es construeix un model PCA utilitzant dades de l’estructura sense defecte. Per tal de provar el model, s'adhereix un tros d’alumini en quatre posicions diferents. Les dades dels assajos de l'estructura amb defecte es projecten sobre el model. Les components principals i les distàncies de Q-residual i T2-Hotelling s'utilitzaran per a l'anàlisi de les incidències. Q-residual indica com de bé s'adiu cadascuna de les mostres al model PCA, ja que és una mesura de la diferència, o residu, entre la mostra i la seva projecció sobre les components principals retingudes en el model. La distància T2-Hotelling és una mesura de la variació de cada mostra dins del model PCA, o el que vindria a ser el mateix, la distància al centre del model PCA.

Neither dashboard nor 'mashup' indices: an empirical wealth approach as a pathway to a comprehensive measure of development

The article is composed of two sections. The first one is a critical review of the three main alternative indices to GDP which were proposed in the last decades – the Human Development Index (HDI), the Genuine Progress Indicator (GPI), and the Happy Planet Index (HPI) – which is made on the basis of conceptual foundations, rather than looking at issues of statistical consistency or mathematical refinement as most of the literature does. The pars construens aims to propose an alternative measure, the composite wealth index, consistent with an approach to development based on the notion of composite wealth, which is in turn derived from an empirical common sense criterion. Arguably, this approach is suitable to be conveyed into an easily understandable and coherent indicator, and thus appropriate to track development in its various dimensions: simple in its formulation, the wealth approach can incorporate social and ecological goals without significant alterations in conceptual foundations, while reducing to a minimum arbitrary weighting.

Inter-rater agreement and reliability of the COSMIN (COnsensus-based Standards for the selection of health status Measurement Instruments) Checklist

Background: The COSMIN checklist is a tool for evaluating the methodological quality of studies on measurement properties of health-related patient-reported outcomes. The aim of this study is to determine the inter-rater agreement and reliability of each item score of the COSMIN checklist (n = 114). Methods: 75 articles evaluating measurement properties were randomly selected from the bibliographic database compiled by the Patient-Reported Outcome Measurement Group, Oxford, UK. Raters were asked to assess the methodological quality of three articles, using the COSMIN checklist. In a one-way design, percentage agreement and intraclass kappa coefficients or quadratic-weighted kappa coefficients were calculated for each item. Results: 88 raters participated. Of the 75 selected articles, 26 articles were rated by four to six participants, and 49 by two or three participants. Overall, percentage agreement was appropriate (68% was above 80% agreement), and the kappa coefficients for the COSMIN items were low (61% was below 0.40, 6% was above 0.75). Reasons for low inter-rater agreement were need for subjective judgement, and accustom to different standards, terminology and definitions.Conclusions: Results indicated that raters often choose the same response option, but that it is difficult on item level to distinguish between articles. When using the COSMIN checklist in a systematic review, we recommend getting some training and experience, completing it by two independent raters, and reaching consensus on one final rating. Instructions for using the checklist are improved.

Non-invasive monitoring of diaphragmatic timing by means of surface contact sensors: an experimental study in dogs

Background: Non-invasive monitoring of respiratory muscle function is an area of increasing research interest, resulting in the appearance of new monitoring devices, one of these being piezoelectric contact sensors. The present study was designed to test whether the use of piezoelectric contact (non-invasive) sensors could be useful in respiratory monitoring, in particular in measuring the timing of diaphragmatic contraction.Methods: Experiments were performed in an animal model: three pentobarbital anesthetized mongrel dogs. The motion of the thoracic cage was acquired by means of a piezoelectric contact sensor placed on the costal wall. This signal is compared with direct measurements of the diaphragmatic muscle length, made by sonomicrometry. Furthermore, to assess the diaphragmatic function other respiratory signals were acquired: respiratory airflow and transdiaphragmatic pressure. Diaphragm contraction time was estimated with these four signals. Using diaphragm length signal as reference, contraction times estimated with the other three signals were compared with the contraction time estimated with diaphragm length signal.Results: The contraction time estimated with the TM signal tends to give a reading 0.06 seconds lower than the measure made with the DL signal (-0.21 and 0.00 for FL and DP signals, respectively), with a standard deviation of 0.05 seconds (0.08 and 0.06 for FL and DP signals, respectively). Correlation coefficients indicated a close link between time contraction estimated with TM signal and contraction time estimated with DL signal (a Pearson correlation coefficient of 0.98, a reliability coefficient of 0.95, a slope of 1.01 and a Spearman's rank-order coefficient of 0.98). In general, correlation coefficients and mean and standard deviation of the difference were better in the inspiratory load respiratory test than in spontaneous ventilation tests.Conclusion: The technique presented in this work provides a non-invasive method to assess the timing of diaphragmatic contraction in canines, using a piezoelectric contact sensor placed on the costal wall.

A measure of rationality and welfare

There is evidence showing that individual behavior often deviates fromthe classical principle of maximization. This evidence raises at least two importantquestions: (i) how severe the deviations are and (ii) which method is the best forextracting relevant information from choice behavior for the purposes of welfare analysis.In this paper we address these two questions by identifying from a foundationalanalysis a new measure of the rationality of individuals that enables the analysis ofindividual welfare in potentially inconsistent subjects, all based on standard revealedpreference data. We call such measure minimal index.

A Note on Shapley's convex measure games

L. S. Shapley, in his paper 'Cores of Convex Games', introduces Convex Measure Games, those that are induced by a convex function on R, acting over a measure on the coalitions. But in a note he states that if this function is a function of several variables, then convexity for the function does not imply convexity of the game or even superadditivity. We prove that if the function is directionally convex, the game is convex, and conversely, any convex game can be induced by a directionally convex function acting over measures on the coalitions, with as many measures as players

A Note on Shapley's convex measure games

L. S. Shapley, in his paper 'Cores of Convex Games', introduces Convex Measure Games, those that are induced by a convex function on R, acting over a measure on the coalitions. But in a note he states that if this function is a function of several variables, then convexity for the function does not imply convexity of the game or even superadditivity. We prove that if the function is directionally convex, the game is convex, and conversely, any convex game can be induced by a directionally convex function acting over measures on the coalitions, with as many measures as players