Quality of life instruments in studies of menorrhagia: a systematic review

BACKGROUND: The use of quality of life (QoL) instruments in menorrhagia research is increasing but there is concern that not enough emphasis is placed on patient-focus in these measurements, i.e. on issues which are of importance to patients and reflect their experiences and concerns (clinical face validity). The objective was to assess the quality of QoL instruments in studies of menorrhagia. STUDY DESIGN: A systematic review of published research. Papers were identified through MEDLINE (1966-April 2000), EMBASE (1980-April 2000), Science Citation Index (1981-April 2000), Social Science Citation Index (1981-April 2000), CINAHL (1982-1999) and PsychLIT (1966-1999), and by manual searching of bibliographies of known primary and review articles. Studies were selected if they assessed women with menorrhagia for life quality, either developing QoL instruments or applying them as an outcome measure. Selected studies were assessed for quality of their QoL instruments, using a 17 items checklist including 10 items for clinical face validity (issues of relevance to patients' expectations and concerns) and 7 items for measurement properties (such as reliability, responsiveness, etc.). RESULTS: A total of 19 articles, 8 on instrument development and 11 on application, were included in the review. The generic Short Form 36 Health Survey Questionnaire (SF36) was used in 12/19 (63%) studies. Only two studies developed new specific QoL instruments for menorrhagia but they complied with 7/17 (41%) and 10/17 (59%) of the quality criteria. Quality assessment showed that only 7/19 (37%) studies complied with more than half the criteria for face validity whereas 17/19 (90%) studies complied with more than half of the criteria for measurement properties (P = 0.0001). CONCLUSION: Among existing QoL instruments, there is good compliance with the quality criteria for measurement properties but not with those for clinical face validity. There is a need to develop methodologically sound disease specific QoL instruments in menorrhagia focussing both on face validity and measurement properties.

Quality of life instruments in studies of menorrhagia: a systematic review

BACKGROUND: The use of quality of life (QoL) instruments in menorrhagia research is increasing but there is concern that not enough emphasis is placed on patient-focus in these measurements, i.e. on issues which are of importance to patients and reflect their experiences and concerns (clinical face validity). The objective was to assess the quality of QoL instruments in studies of menorrhagia. STUDY DESIGN: A systematic review of published research. Papers were identified through MEDLINE (1966-April 2000), EMBASE (1980-April 2000), Science Citation Index (1981-April 2000), Social Science Citation Index (1981-April 2000), CINAHL (1982-1999) and PsychLIT (1966-1999), and by manual searching of bibliographies of known primary and review articles. Studies were selected if they assessed women with menorrhagia for life quality, either developing QoL instruments or applying them as an outcome measure. Selected studies were assessed for quality of their QoL instruments, using a 17 items checklist including 10 items for clinical face validity (issues of relevance to patients' expectations and concerns) and 7 items for measurement properties (such as reliability, responsiveness, etc.). RESULTS: A total of 19 articles, 8 on instrument development and 11 on application, were included in the review. The generic Short Form 36 Health Survey Questionnaire (SF36) was used in 12/19 (63%) studies. Only two studies developed new specific QoL instruments for menorrhagia but they complied with 7/17 (41%) and 10/17 (59%) of the quality criteria. Quality assessment showed that only 7/19 (37%) studies complied with more than half the criteria for face validity whereas 17/19 (90%) studies complied with more than half of the criteria for measurement properties (P = 0.0001). CONCLUSION: Among existing QoL instruments, there is good compliance with the quality criteria for measurement properties but not with those for clinical face validity. There is a need to develop methodologically sound disease specific QoL instruments in menorrhagia focussing both on face validity and measurement properties.

I don't see me like you see me, but is that a problem? Cultural influences on rating discrepancy in 360-degree feedback instruments

360-degree feedback from a variety of rater sources yields important information about leaders' styles, strengths and weaknesses for development. Results where observer ratings are discrepant (i.e., different) from self-ratings are often seen as indicators of problematic leadership relationships, skills, or lack of self-awareness. Yet research into the antecedents of such self-observer rating discrepancy suggests the presence of systematic influences, such as cultural values. The present study investigates the variation of rating discrepancies on three leadership skills (decision making, leading employees, and composure) in dependence of one exemplary culture dimension (power distance) on data from 31 countries using multilevel structural equation modelling. Results show that cultural values indeed predict self-observer rating discrepancies. Thus, systemic and contextual influences such as culture need to be taken into consideration when interpreting the importance and meaning of self-observer rating discrepancies in 360-degree instruments.

Pharmaceutical quality of ceftriaxone generic drug products compared with Rocephin (R)

The pharmaceutical qualities of 34 ceftriaxone generic products were compared with Rocephin as the reference standard. Quality standards specified in the European and US Pharmacopoeias were violated on 18 occasions, including those for sterility (4 products) and impurities (5 products). All 34 generics tested failed to meet Roche specifications for Rocephin, with 100 contraventions of the Roche Pharmaceutical standards. The most common failures amongst generic drug products were clarity of solution (30 products) and presence of thiotriazinone (33 products).

Generic experiments at the sump model "Zittauer Strömungswanne" (ZSW) for the behaviour of mineral wool in the sump and the reactor core

The investigation of insulation debris transport, sedimentation, penetration into the reactor core and head loss build up becomes important to reactor safety research for PWR and BWR, when considering the long-term behaviour of emergency core cooling systems during loss of coolant accidents. Research projects are being performed in cooperation between the University of Applied Sciences Zittau/Görlitz and the Helmholtz-Zentrum Dresden-Rossendorf. The projects include experimental investigations of different processes and phenomena of insulation debris in coolant flow and the development of CFD models. Generic complex experiments serve for building up a data base for the validation of models for single effects and their coupling in CFD codes. This paper includes the description of the experimental facility for complex generic experiments (ZSW), an overview about experimental boundary conditions and results for upstream and down-stream phenomena as well as for the long-time behaviour due to corrosive processes. © Carl Hanser Verlag, München.

Implementation of a generic autonomic framework

Based on insights from the implementation of commercial products for data-centre resource management, we identified key challenges in the development of cost-effective autonomic solutions, and best practices for overcoming these challenges. In a related paper, we proposed a generic autonomic framework that complies with these best practices, and suggested ways in which existing technologies could be used to realise this framework. In this paper, we describe the actual implementation of our autonomic framework as a service-oriented architecture, and we show how the universal policy engine at its core can be configured to manage the allocation of server capacity to services of different priorities. This case study demonstrates the effectiveness of our generic approach to autonomic solution development in an area of great interest for commercial data centres, research laboratories and application service providers.

Towards a generic autonomic architecture for legacy resource management

Half a decade has passed since the objectives and benefits of autonomic computing were stated, yet even the latest system designs and deployments exhibit only limited and isolated elements of autonomic functionality. From an autonomic computing standpoint, all computing systems – old, new or under development – are legacy systems, and will continue to be so for some time to come. In this paper, we propose a generic architecture for developing fully-fledged autonomic systems out of legacy, non-autonomic components, and we investigate how existing technologies can be used to implement this architecture.

A Generic model for the design and analysis of production systems

This dissertation studies the process of operations systems design within the context of the manufacturing organization. Using the DRAMA (Design Routine for Adopting Modular Assembly) model as developed by a team from the IDOM Research Unit at Aston University as a starting point, the research employed empirically based fieldwork and a survey to investigate the process of production systems design and implementation within four UK manufacturing industries: electronics assembly, electrical engineering, mechanical engineering and carpet manufacturing. The intention was to validate the basic DRAMA model as a framework for research enquiry within the electronics industry, where the initial IDOM work was conducted, and then to test its generic applicability, further developing the model where appropriate, within the other industries selected. The thesis contains a review of production systems design theory and practice prior to presenting thirteen industrial case studies of production systems design from the four industry sectors. The results and analysis of the postal survey into production systems design are then presented. The strategic decisions of manufacturing and their relationship to production systems design, and the detailed process of production systems design and operation are then discussed. These analyses are used to develop the generic model of production systems design entitled DRAMA II (Decision Rules for Analysing Manufacturing Activities). The model contains three main constituent parts: the basic DRAMA model, the extended DRAMA II model showing the imperatives and relationships within the design process, and a benchmark generic approach for the design and analysis of each component in the design process. DRAMA II is primarily intended for use by researchers as an analytical framework of enquiry, but is also seen as having application for manufacturing practitioners.

Reacting and responding in TESOL Quarterly:a generic analysis of procedure and purpose in intertextual critical exchanges

A key feature of ‘TESOL Quarterly’, a leading journal in the world of TESOL/applied linguistics, is its ‘Forum’ section which invites ‘responses and rebuttals’ from readers to any of its articles. These ‘responses or rebuttals’ form the focus of this research. In the interchanges between readers reacting to earlier research articles in TESOL Quarterly and authors responding to the said reaction I – examine the texts for evidence of genre-driven structure, whether shared between both ‘reaction’ and ‘response’ sections, or peculiar to each section, and attempt to determine the precise nature of the intended communicative purpose in particular and the implications for academic debate in general. The intended contribution of this thesis is to provide an analysis of how authors of research articles and their critics pursue their efforts beyond the research article which precipitated these exchanges in order to be recognized by their discourse community as, in the terminology of Swales (1981:51), ‘Primary Knowers’. Awareness of any principled generic process identified in this thesis may be of significance to practitioners in the applied linguistics community in their quest to establish academic reputation and in their pursuit of professional development. These findings may also be of use in triggering productive community discussion as a result of the questions they raise concerning the present nature of academic debate. Looking beyond the construction and status of the texts themselves, I inquire into the kind of ideational and social organization such exchanges keep in place and examine an alternative view of interaction. This study breaks new ground in two major ways. To the best of my knowledge, it is the first exploration of a bipartite, intertextual structure laying claim to genre status. Secondly, in its recourse to the comments of the writers’ themselves rather than relying exclusively on the evidence of their texts, as is the case with most studies of genre, this thesis offers an expanded opportunity to discuss perhaps the most interesting aspects of genre analysis – the light it throws on social ends and the role of genre in determining the nature of current academic debate as it here emerges.

Design methodology for the servo control of high speed multi-axis machinery (BL): decoupling and synchronisation of a generic machine by blockwise decentralised MIMO control

Traditional machinery for manufacturing processes are characterised by actuators powered and co-ordinated by mechanical linkages driven from a central drive. Increasingly, these linkages are replaced by independent electrical drives, each performs a different task and follows a different motion profile, co-ordinated by computers. A design methodology for the servo control of high speed multi-axis machinery is proposed, based on the concept of a highly adaptable generic machine model. In addition to the dynamics of the drives and the loads, the model includes the inherent interactions between the motion axes and thus provides a Multi-Input Multi-Output (MIMO) description. In general, inherent interactions such as structural couplings between groups of motion axes are undesirable and needed to be compensated. On the other hand, imposed interactions such as the synchronisation of different groups of axes are often required. It is recognised that a suitable MIMO controller can simultaneously achieve these objectives and reconciles their potential conflicts. Both analytical and numerical methods for the design of MIMO controllers are investigated. At present, it is not possible to implement high order MIMO controllers for practical reasons. Based on simulations of the generic machine model under full MIMO control, however, it is possible to determine a suitable topology for a blockwise decentralised control scheme. The Block Relative Gain array (BRG) is used to compare the relative strength of closed loop interactions between sub-systems. A number of approaches to the design of the smaller decentralised MIMO controllers for these sub-systems has been investigated. For the purpose of illustration, a benchmark problem based on a 3 axes test rig has been carried through the design cycle to demonstrate the working of the design methodology.