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.

Variation in the type and frequency of postoperative invasive Staphylococcus aureus infections according to type of surgical procedure.

OBJECTIVE: To determine the epidemiological characteristics of postoperative invasive Staphylococcus aureus infection following 4 types of major surgical procedures.design. Retrospective cohort study. SETTING: Eleven hospitals (9 community hospitals and 2 tertiary care hospitals) in North Carolina and Virginia. PATIENTS: Adults undergoing orthopedic, neurosurgical, cardiothoracic, and plastic surgical procedures. METHODS: We used previously validated, prospectively collected surgical surveillance data for surgical site infection and microbiological data for bloodstream infection. The study period was 2003 through 2006. We defined invasive S. aureus infection as either nonsuperficial incisional surgical site infection or bloodstream infection. Nonparametric bootstrapping was used to generate 95% confidence intervals (CIs). P values were generated using the Pearson chi2 test, Student t test, or Wilcoxon rank-sum test, as appropriate. RESULTS: In total, 81,267 patients underwent 96,455 procedures during the study period. The overall incidence of invasive S. aureus infection was 0.47 infections per 100 procedures (95% CI, 0.43-0.52); 227 (51%) of 446 infections were due to methicillin-resistant S.aureus. Invasive S. aureus infection was more common after cardiothoracic procedures (incidence, 0.79 infections per 100 procedures [95%CI, 0.62-0.97]) than after orthopedic procedures (0.37 infections per 100 procedures [95% CI, 0.32-0.42]), neurosurgical procedures (0.62 infections per 100 procedures [95% CI, 0.53-0.72]), or plastic surgical procedures (0.32 infections per 100 procedures [95% CI, 0.17-0.47]) (P < .001). Similarly, S. aureus bloodstream infection was most common after cardiothoracic procedures (incidence, 0.57 infections per 100 procedures [95% CI, 0.43-0.72]; P < .001, compared with other procedure types), comprising almost three-quarters of the invasive S. aureus infections after these procedures. The highest rate of surgical site infection was observed after neurosurgical procedures (incidence, 0.50 infections per 100 procedures [95% CI, 0.42-0.59]; P < .001, compared with other procedure types), comprising 80% of invasive S.aureus infections after these procedures. CONCLUSION: The frequency and type of postoperative invasive S. aureus infection varied significantly across procedure types. The highest risk procedures, such as cardiothoracic procedures, should be targeted for ongoing preventative interventions.

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.

Surgical Neurology: Commentary

SCOPUS: no.j

Relating plankton assemblages to environmental variables using instruments towed by ships-of-opportunity

Undulating Oceanographic Recorders (UORs) and Continuous Plankton Recorders (CPRs) equipped with a suite of sensors were towed by merchant vessels in the North Sea between 1988 and 1991, recording a range of environmental variables. These were used to interpret the results of analyses of the plankton taken on CPR tows off the northeast coast of the UK in 1989 and in the Skagerrak and Kattegat in July 1988 and through 1989. Correlations were found between the biota and the environmental variables. The tidal front off the northeast coast of the UK and the front between the low salinity water in the Kattegat and the higher salinity water in the Skagerrak were dominant factors correlating with the distribution of the plankton assemblages. Discontinuities, defining the positions of the fronts, in the values of physical variables (temperature and, where measured, salinity and turbidity) were closely identified with geographical divisions between plankton assemblages. Measures of irradiance were found to be important on several occasions, presumably due to diel migrations of the zooplankton.

An Enactive Approach to the Design of New Tangible Musical Instruments

In this paper, we propose a theoretical framework for the design of tangible interfaces for musical expression. The main insight for the proposed approach is the importance and utility of familiar sensorimotor experiences for the creation of engaging and playable new musical instruments. In particular, we suggest exploiting the commonalities between different natural interactions by varying the auditory response or tactile details of the instrument within certain limits. Using this principle, devices for classes of sounds such as coarse grain collision interactions or friction interactions can be designed. The designs we propose retain the familiar tactile aspect of the interaction so that the performer can take advantage of tacit knowledge gained through experiences with such phenomena in the real world.

Alternative financing instruments for Spanish cooperative

The search for funding is an ongoing task of the company, which is exacerbated, particularly in times of economic crisis, affecting also to the cooperatives. Cooperative legislation available to these entities various instruments of external financing through the issuance of securities (bonds, equity securities, special shares), to them accounts are added in participation, but without much detail in the legal texts. At work we investigate their potential, by looking, especially in those last; We seek to clarify their legal status and contrast their potential as a technical instrument, alternative for funding in the area of cooperative societies. Finally, we also see the impact of the recent Law 5/2015, of promoting business financing in the cooperative sector and ended up proposing some policy adjustments.