Development of an instrument measuring the quality of residential care facilities for older people

Aims. To validate the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM). The instrument’s items measure environmental elements important for supporting the needs of older people, and conceptualized within eight domains. Methods. Item relevance was assessed by a group of experts and measured using content validity index (CVI). Test-retest and inter-rater reliability tests were performed.  The domain structure was assessed by the inter-rater agreement of a second group of experts, and measured using Fleiss kappa. Results. All items attained a CVI above 0.78, the suggested criteria for excellent content validity. Test-retest reliability showed high stability (96% and 95% for two independent raters respectively), and inter-rater reliability demonstrated high levels of agreement (95% and 94% on two separate rating occasions). Kappa values were very good for test-retest (κ = 0.903 and 0.869) and inter-rater reliability (κ = 0.851 and 0.832). Domain structure was good,  Fleiss’ kappa was 0.63 (range 0.45 to 0.75).    Conclusion. The S-SCEAM of 210 items and eight domains showed good content validity and construct validity. The instrument is suggested for use in measuring of the quality of the physical environment in residential care facilities for older persons.

Influence of hardwood, softwoodand fractionated pulp in a stratifiedthree-layered fine paper : Lövved, barrved och fraktionerad massa ochdess inverkan på ett treskiktat finpapper

Four different trials of stratified three-layered fine paper, of sulphate pulp, were performed to investigate if stratified fine fraction or fibres from birch can improve the properties of a paper compared to a reference sheet. All trials had five different scenarios and each scenario was calendered with different linear load. All sheets had a grammage of 80 g/m2.In the first trial, the paper contained birch, pine and filler of calciumcarbonate (marble), and was manufactured with the pilot paper machine XPM and the stratified headbox Formator at RCF (Stora Enso Research Center in Falun). The furnish consisted of 75% birch and 25% pine.The second trial contained coated sheets with paper from trial one as the base paper. The coating slip contained calciumcarbonate and clay and the amount was approximately 10-12 g/m2.The third trial, also with birch and pine but without filler, was performed at STFI (Skogsindustrins Tekniska Forskningsinstitut in Stockholm) with the laboratory scaled paper machine StratEx and the stratified headbox AQ-vanes. The furnish consisted of 75% birch and 25% pine, except for one scenario which contained of 75% pine and 25% birch.The last trial contained fractionated pulp of birch and pine and was performed at STFI. 50% was fine fraction and 50% was coarse fraction.This test does not show any clear benefits of making stratified sheets of birch and pine when it comes to properties such as bending stiffness, tensile index and surface smoothness. The retention can be improved with birch in the surface plies. It is possible that the formation can be improved with birch in the surface plies and pine in the middle ply. It is also possible that fine fraction in the surface plies and coarse fraction in the middle ply can improve both surface smoothness and bending stiffness. The results in this test are shown with confidence intervals which points out the difficulties of analysing sheets manufactured with a pilot paper machine or a laboratory scaled paper machine.

Science is Primary - Children Thinking and Learning in theChemistry Laboratory

The goal of primary science education is to foster children’s interest, develop positive science attitudes and promote science process skills development. Learning by playing and discovering provides several opportunities for children to inquiry and understand science based on the first–hand experience. The current research was conducted in the children’s laboratory in Heureka, the Finnish science centre. Young children (aged 7 years) which came from 4 international schools did a set of chemistry experiments in the laboratory. From the results of the cognitive test, the pre-test, the post-test, supported by observation and interview, we could make the conclusion that children enjoyed studying in the laboratory. Chemistry science was interesting and fascinating for young children; no major gender differences were found between boys and girls learning in the science laboratory. Lab work not only encouraged children to explore and investigate science, but also stimulated children’s cognitive development.

Comparison of learning between Digital gallery and Hands-on Laboratory

This thesis has been done in ROM (Royal Ontario Museum) located in Toronto Canada. It focuses on learning in two parts of the museum. It tries to find out how much each part is effective in terms of learning. Studies have been done in the Digital gallery, which has been equipped with digital video projector and workstation that allows visitors to interact with the collections in 2 or 3 dimensional spaces while they are watching the presenting film. The rest of the study was in Hands-on laboratory, which allows students to examine artifacts and discuss their findings .The method was used in this research is Concept mapping .In Digital gallery, 24 schools surveys in the form of pre-post- test by help of the concept mapping method has been done. In Hands-on laboratory, 12 schools have been studied by using the combination of interviewing and written pre post-test of concept mapping.

Print quality study of a laboratory offset press

PAPRO operates within the Forest Research company and their mission is to develop value-addingindustry solutions. At present there are no good ways for mills to easily test the printing quality on newsprintpaper. There is a great need for a fast way to do this on different paper qualities; with a laboratory-offset press this can be both a time and money saving method. At PAPRO Forest Research, NewZealand, a laboratory offset press has been developed and designed, during the past seven years, concerningthis issue. Earlier projects were made concerning the press, e.g. to establish the optimal settings.The mission with this project was to partly determine the present variability of the print quality andto evaluate if the fountain solution, distilled water and 2% Diol green concentrate, used at the momentmixed with different percentages of Isopropanol could decrease the variability and contribute to morestabile results. Throughout the whole project the print quality showed a high variation and was evenmore variable when the Isopropanol was added. All in all 50 print rounds times twelve printed paperstrips was carried out through the project divided into three parts. To analyse the print quality, amicroscope with an image capture camera has been used. Data from the taken images was analysedand inserted into charts to see the variations.The conclusions of the whole project are not satisfying because no final evaluations were possible tomake. Main conclusions are that the additive of Isopropanol to the ordinary fountain solution, used atpresent, only contributed to more unstable results of the print quality. And it seems to be difficult toget some stable results from the lab press as long as the room where it is placed is not fully conditionedas required for the process of offset printing. And the fact that the airbrush which applies theamount of fountain solution is also variable, as shown in earlier projects, which contributes to unstableresults as well. For further work more exact parameters as a conditioned room are required and thepossibility to further design the laboratory press to use waterless offset printing instead.

Quality management for vital forest tree seedlings : Final report, Project no: P33854-1

The work concerns development of a prototype molecular tests to identify vitality status of conifer seedlings. The work is done by NSure, Holland, Dalarna University and SUAS. In case for spruce, a successful validation experiment has been performed to validate the identified frost tolerance and vitality genes. Multiple indicators were identified that can be used to either reinforce the existing ColdnSure test, but also for development of a vitality test. The identified frost tolerance and vitality genes for pine still need to be validated. NSure together with Dalarna University aim to perform a validation next season. Multiple LN indicators were identified in spruce that can be used to determine the effectiveness of a LN treatment, but they are not yet validated. In spruce and pine hardly any scientific research is performed to study the effect of a LN treatment, particularly not at molecular level. Therefore NSure together with Dalarna Research Station want to apply for a project. Within this project, we would be able to develop the tests further.

Mobile systems for monitoring Parkinson's disease

A challenge for the clinical management of Parkinson's disease (PD) is the large within- and between-patient variability in symptom profiles as well as the emergence of motor complications which represent a significant source of disability in patients. This thesis deals with the development and evaluation of methods and systems for supporting the management of PD by using repeated measures, consisting of subjective assessments of symptoms and objective assessments of motor function through fine motor tests (spirography and tapping), collected by means of a telemetry touch screen device. One aim of the thesis was to develop methods for objective quantification and analysis of the severity of motor impairments being represented in spiral drawings and tapping results. This was accomplished by first quantifying the digitized movement data with time series analysis and then using them in data-driven modelling for automating the process of assessment of symptom severity. The objective measures were then analysed with respect to subjective assessments of motor conditions. Another aim was to develop a method for providing comparable information content as clinical rating scales by combining subjective and objective measures into composite scores, using time series analysis and data-driven methods. The scores represent six symptom dimensions and an overall test score for reflecting the global health condition of the patient. In addition, the thesis presents the development of a web-based system for providing a visual representation of symptoms over time allowing clinicians to remotely monitor the symptom profiles of their patients. The quality of the methods was assessed by reporting different metrics of validity, reliability and sensitivity to treatment interventions and natural PD progression over time. Results from two studies demonstrated that the methods developed for the fine motor tests had good metrics indicating that they are appropriate to quantitatively and objectively assess the severity of motor impairments of PD patients. The fine motor tests captured different symptoms; spiral drawing impairment and tapping accuracy related to dyskinesias (involuntary movements) whereas tapping speed related to bradykinesia (slowness of movements). A longitudinal data analysis indicated that the six symptom dimensions and the overall test score contained important elements of information of the clinical scales and can be used to measure effects of PD treatment interventions and disease progression. A usability evaluation of the web-based system showed that the information presented in the system was comparable to qualitative clinical observations and the system was recognized as a tool that will assist in the management of patients.

Digital spiral analysis for objective assessment of fine motor timing variability in Parkinson's disease

OBJECTIVES: To develop a method for objective assessment of fine motor timing variability in Parkinson’s disease (PD) patients, using digital spiral data gathered by a touch screen device. BACKGROUND: A retrospective analysis was conducted on data from 105 subjects including65 patients with advanced PD (group A), 15 intermediate patients experiencing motor fluctuations (group I), 15 early stage patients (group S), and 10 healthy elderly subjects (HE) were examined. The subjects were asked to perform repeated upper limb motor tasks by tracing a pre-drawn Archimedes spiral as shown on the screen of the device. The spiral tracing test was performed using an ergonomic pen stylus, using dominant hand. The test was repeated three times per test occasion and the subjects were instructed to complete it within 10 seconds. Digital spiral data including stylus position (x-ycoordinates) and timestamps (milliseconds) were collected and used in subsequent analysis. The total number of observations with the test battery were as follows: Swedish group (n=10079), Italian I group (n=822), Italian S group (n = 811), and HE (n=299). METHODS: The raw spiral data were processed with three data processing methods. To quantify motor timing variability during spiral drawing tasks Approximate Entropy (APEN) method was applied on digitized spiral data. APEN is designed to capture the amount of irregularity or complexity in time series. APEN requires determination of two parameters, namely, the window size and similarity measure. In our work and after experimentation, window size was set to 4 and similarity measure to 0.2 (20% of the standard deviation of the time series). The final score obtained by APEN was normalized by total drawing completion time and used in subsequent analysis. The score generated by this method is hence on denoted APEN. In addition, two more methods were applied on digital spiral data and their scores were used in subsequent analysis. The first method was based on Digital Wavelet Transform and Principal Component Analysis and generated a score representing spiral drawing impairment. The score generated by this method is hence on denoted WAV. The second method was based on standard deviation of frequency filtered drawing velocity. The score generated by this method is hence on denoted SDDV. Linear mixed-effects (LME) models were used to evaluate mean differences of the spiral scores of the three methods across the four subject groups. Test-retest reliability of the three scores was assessed after taking mean of the three possible correlations (Spearman’s rank coefficients) between the three test trials. Internal consistency of the methods was assessed by calculating correlations between their scores. RESULTS: When comparing mean spiral scores between the four subject groups, the APEN scores were different between HE subjects and three patient groups (P=0.626 for S group with 9.9% mean value difference, P=0.089 for I group with 30.2%, and P=0.0019 for A group with 44.1%). However, there were no significant differences in mean scores of the other two methods, except for the WAV between the HE and A groups (P<0.001). WAV and SDDV were highly and significantly correlated to each other with a coefficient of 0.69. However, APEN was not correlated to neither WAV nor SDDV with coefficients of 0.11 and 0.12, respectively. Test-retest reliability coefficients of the three scores were as follows: APEN (0.9), WAV(0.83) and SD-DV (0.55). CONCLUSIONS: The results show that the digital spiral analysis-based objective APEN measure is able to significantly differentiate the healthy subjects from patients at advanced level. In contrast to the other two methods (WAV and SDDV) that are designed to quantify dyskinesias (over-medications), this method can be useful for characterizing Off symptoms in PD. The APEN was not correlated to none of the other two methods indicating that it measures a different construct of upper limb motor function in PD patients than WAV and SDDV. The APEN also had a better test-retest reliability indicating that it is more stable and consistent over time than WAV and SDDV.

Test av patientenkät riktad till personer med levercirros i uppföljning vid leversjuksköterskemottagning: : En pilotstudie med mixad metod

Syfte: Att testa den patientenkät som används i utvärdering av en leversjuksköterskemottagning på patienter med dekompenserad levercirros för att undersöka upplevelsen av att besvara frågorna samt frågornas relevans till patientens situation. Metod: Pilotstudiens metod var mixad. Resultat: Spridningen av deltagarnas upplevelse av oro/obehag av enkäten var stor (VAS 6-100 millimeter). Vid få sjukdomssymtom väcktes oro om framtida sjukdomsutveckling men vid längre tids sjukdom kändes samtliga symtom igen, tankar om tidigare beteende uppstod vid alkoholsorsakad sjukdom. En mindre spridning (VAS 66-92 millimeter) sågs gällande hur viktiga/väsentliga frågorna upplevdes. Frågor om bemötande ansågs viktiga och påverkade upplevelsen av rätten till vård. Kompletterande frågor om individuellt anpassad information samt upplevelsen av delaktighet vid information efterfrågades. Deltagarna visade hög uppskattning (VAS 73-95 millimeter) till att sjukdomen/situation uppmärksammades genom enkäten. Besöken till sjuksköterskan skiljde sig från läkarbesök. Sjuksköterskan fokuserade på egenvård och mer tid fanns för information. För en informant innebar försöksverksamheten ökade antal sjukhusbesök, samordning innebar för- och nackdelar. Vid symtom på fatigue och nedsatt koncentrationsförmåga upplevdes enkäten lång, tvådelad enkät efterfrågades. Vid lindrig sjukdom upplevdes enkäten inte ansträngande. Språket var enkelt att förstå och innehållet upplevdes relevant. De öppna frågeställningarna tillförde inte något för de tre informanterna.