Item and task difficulty in a B2 reading examination: perceptions of test-takers and CEFR alignment experts compared with psychometric measurements

The article presents a study of a CEFR B2-level reading subtest that is part of the Slovenian national secondary school leaving examination in English as a foreign language, and compares the test-taker actual performance (objective difficulty) with the test-taker and expert perceptions of item difficulty (subjective difficulty). The study also analyses the test-takers’ comments on item difficulty obtained from a while-reading questionnaire. The results are discussed in the framework of the existing research in the fields of (the assessment of) reading comprehension, and are addressed with regard to their implications for item-writing, FL teaching and curriculum development.

Response process and test-retest reliability of the Context Assessment for Community Health tool in Vietnam

BACKGROUND: The recently developed Context Assessment for Community Health (COACH) tool aims to measure aspects of the local healthcare context perceived to influence knowledge translation in low- and middle-income countries. The tool measures eight dimensions (organizational resources, community engagement, monitoring services for action, sources of knowledge, commitment to work, work culture, leadership, and informal payment) through 49 items. OBJECTIVE: The study aimed to explore the understanding and stability of the COACH tool among health providers in Vietnam. DESIGNS: To investigate the response process, think-aloud interviews were undertaken with five community health workers, six nurses and midwives, and five physicians. Identified problems were classified according to Conrad and Blair's taxonomy and grouped according to an estimation of the magnitude of the problem's effect on the response data. Further, the stability of the tool was examined using a test-retest survey among 77 respondents. The reliability was analyzed for items (intraclass correlation coefficient (ICC) and percent agreement) and dimensions (ICC and Bland-Altman plots). RESULTS: In general, the think-aloud interviews revealed that the COACH tool was perceived as clear, well organized, and easy to answer. Most items were understood as intended. However, seven prominent problems in the items were identified and the content of three dimensions was perceived to be of a sensitive nature. In the test-retest survey, two-thirds of the items and seven of eight dimensions were found to have an ICC agreement ranging from moderate to substantial (0.5-0.7), demonstrating that the instrument has an acceptable level of stability. CONCLUSIONS: This study provides evidence that the Vietnamese translation of the COACH tool is generally perceived to be clear and easy to understand and has acceptable stability. There is, however, a need to rephrase and add generic examples to clarify some items and to further review items with low ICC.

New tools for cognitive and motor rehabilitation: development and clinical validation

Nervous system disorders are associated with cognitive and motor deficits, and are responsible for the highest disability rates and global burden of disease. Their recovery paths are vulnerable and dependent on the effective combination of plastic brain tissue properties, with complex, lengthy and expensive neurorehabilitation programs. This work explores two lines of research, envisioning sustainable solutions to improve treatment of cognitive and motor deficits. Both projects were developed in parallel and shared a new sensible approach, where low-cost technologies were integrated with common clinical operative procedures. The aim was to achieve more intensive treatments under specialized monitoring, improve clinical decision-making and increase access to healthcare. The first project (articles I – III) concerned the development and evaluation of a web-based cognitive training platform (COGWEB), suitable for intensive use, either at home or at institutions, and across a wide spectrum of ages and diseases that impair cognitive functioning. It was tested for usability in a memory clinic setting and implemented in a collaborative network, comprising 41 centers and 60 professionals. An adherence and intensity study revealed a compliance of 82.8% at six months and an average of six hours/week of continued online cognitive training activities. The second project (articles IV – VI) was designed to create and validate an intelligent rehabilitation device to administer proprioceptive stimuli on the hemiparetic side of stroke patients while performing ambulatory movement characterization (SWORD). Targeted vibratory stimulation was found to be well tolerated and an automatic motor characterization system retrieved results comparable to the first items of the Wolf Motor Function Test. The global system was tested in a randomized placebo controlled trial to assess its impact on a common motor rehabilitation task in a relevant clinical environment (early post-stroke). The number of correct movements on a hand-to-mouth task was increased by an average of 7.2/minute while the probability to perform an error decreased from 1:3 to 1:9. Neurorehabilitation and neuroplasticity are shifting to more neuroscience driven approaches. Simultaneously, their final utility for patients and society is largely dependent on the development of more effective technologies that facilitate the dissemination of knowledge produced during the process. The results attained through this work represent a step forward in that direction. Their impact on the quality of rehabilitation services and public health is discussed according to clinical, technological and organizational perspectives. Such a process of thinking and oriented speculation has led to the debate of subsequent hypotheses, already being explored in novel research paths.

Understanding and validating accelerometry as a measure of physical activity in children with intellectual disabilities

Background Physical activity in children with intellectual disabilities is a neglected area of study, which is most apparent in relation to physical activity measurement research. Although objective measures, specifically accelerometers, are widely used in research involving children with intellectual disabilities, existing research is based on measurement methods and data interpretation techniques generalised from typically developing children. However, due to physiological and biomechanical differences between these populations, questions have been raised in the existing literature on the validity of generalising data interpretation techniques from typically developing children to children with intellectual disabilities. Therefore, there is a need to conduct population-specific measurement research for children with intellectual disabilities and develop valid methods to interpret accelerometer data, which will increase our understanding of physical activity in this population. Methods Study 1: A systematic review was initially conducted to increase the knowledge base on how accelerometers were used within existing physical activity research involving children with intellectual disabilities and to identify important areas for future research. A systematic search strategy was used to identify relevant articles which used accelerometry-based monitors to quantify activity levels in ambulatory children with intellectual disabilities. Based on best practice guidelines, a novel form was developed to extract data based on 17 research components of accelerometer use. Accelerometer use in relation to best practice guidelines was calculated using percentage scores on a study-by-study and component-by-component basis. Study 2: To investigate the effect of data interpretation methods on the estimation of physical activity intensity in children with intellectual disabilities, a secondary data analysis was conducted. Nine existing sets of child-specific ActiGraph intensity cut points were applied to accelerometer data collected from 10 children with intellectual disabilities during an activity session. Four one-way repeated measures ANOVAs were used to examine differences in estimated time spent in sedentary, moderate, vigorous, and moderate to vigorous intensity activity. Post-hoc pairwise comparisons with Bonferroni adjustments were additionally used to identify where significant differences occurred. Study 3: The feasibility on a laboratory-based calibration protocol developed for typically developing children was investigated in children with intellectual disabilities. Specifically, the feasibility of activities, measurements, and recruitment was investigated. Five children with intellectual disabilities and five typically developing children participated in 14 treadmill-based and free-living activities. In addition, resting energy expenditure was measured and a treadmill-based graded exercise test was used to assess cardiorespiratory fitness. Breath-by-breath respiratory gas exchange and accelerometry were continually measured during all activities. Feasibility was assessed using observations, activity completion rates, and respiratory data. Study 4: Thirty-six children with intellectual disabilities participated in a semi-structured school-based physical activity session to calibrate accelerometry for the estimation of physical activity intensity. Participants wore a hip-mounted ActiGraph wGT3X+ accelerometer, with direct observation (SOFIT) used as the criterion measure. Receiver operating characteristic curve analyses were conducted to determine the optimal accelerometer cut points for sedentary, moderate, and vigorous intensity physical activity. Study 5: To cross-validate the calibrated cut points and compare classification accuracy with existing cut points developed in typically developing children, a sub-sample of 14 children with intellectual disabilities who participated in the school-based sessions, as described in Study 4, were included in this study. To examine the validity, classification agreement was investigated between the criterion measure of SOFIT and each set of cut points using sensitivity, specificity, total agreement, and Cohen’s kappa scores. Results Study 1: Ten full text articles were included in this review. The percentage of review criteria met ranged from 12%−47%. Various methods of accelerometer use were reported, with most use decisions not based on population-specific research. A lack of measurement research, specifically the calibration/validation of accelerometers for children with intellectual disabilities, is limiting the ability of researchers to make appropriate and valid accelerometer use decisions. Study 2: The choice of cut points had significant and clinically meaningful effects on the estimation of physical activity intensity and sedentary behaviour. For the 71-minute session, estimations for time spent in each intensity between cut points ranged from: sedentary = 9.50 (± 4.97) to 31.90 (± 6.77) minutes; moderate = 8.10 (± 4.07) to 40.40 (± 5.74) minutes; vigorous = 0.00 (± .00) to 17.40 (± 6.54) minutes; and moderate to vigorous = 8.80 (± 4.64) to 46.50 (± 6.02) minutes. Study 3: All typically developing participants and one participant with intellectual disabilities completed the protocol. No participant met the maximal criteria for the graded exercise test or attained a steady state during the resting measurements. Limitations were identified with the usability of respiratory gas exchange equipment and the validity of measurements. The school-based recruitment strategy was not effective, with a participation rate of 6%. Therefore, a laboratory-based calibration protocol was not feasible for children with intellectual disabilities. Study 4: The optimal vertical axis cut points (cpm) were ≤ 507 (sedentary), 1008−2300 (moderate), and ≥ 2301 (vigorous). Sensitivity scores ranged from 81−88%, specificity 81−85%, and AUC .87−.94. The optimal vector magnitude cut points (cpm) were ≤ 1863 (sedentary), ≥ 2610 (moderate) and ≥ 4215 (vigorous). Sensitivity scores ranged from 80−86%, specificity 77−82%, and AUC .86−.92. Therefore, the vertical axis cut points provide a higher level of accuracy in comparison to the vector magnitude cut points. Study 5: Substantial to excellent classification agreement was found for the calibrated cut points. The calibrated sedentary cut point (ĸ =.66) provided comparable classification agreement with existing cut points (ĸ =.55−.67). However, the existing moderate and vigorous cut points demonstrated low sensitivity (0.33−33.33% and 1.33−53.00%, respectively) and disproportionately high specificity (75.44−.98.12% and 94.61−100.00%, respectively), indicating that cut points developed in typically developing children are too high to accurately classify physical activity intensity in children with intellectual disabilities. Conclusions The studies reported in this thesis are the first to calibrate and validate accelerometry for the estimation of physical activity intensity in children with intellectual disabilities. In comparison with typically developing children, children with intellectual disabilities require lower cut points for the classification of moderate and vigorous intensity activity. Therefore, generalising existing cut points to children with intellectual disabilities will underestimate physical activity and introduce systematic measurement error, which could be a contributing factor to the low levels of physical activity reported for children with intellectual disabilities in previous research.

Refolding of omega conotoxin peptide derived from marine snail, Conus magus, to evaluate its analgesic effects

Oxidative refolding is one of the key challenges hampering the development of peptide based compounds as therapeutics. The correct refolding for three disulfide peptide like w-Conotoxi n MVIIA is difficult and crucial for biological activity. This work advanced knowledge of chemical and biological for improve oxidative refolding of synthetic w-Conotoxi n MVIIA in base of Conus magus venom. The present study aimed to set up an appropriate and effective protocols for refolding of disulfide-rich w-Conotoxin MVIIA. In this study, the crude peptide was protected with Acm group, according to the right amino acid sequences (Synthesized by Australian Company). The crude peptide was purified by H PLC. To prepare the peptide to refolding, innovative deprotection applied molar ratio (AMR) method was performed based on mercury. Accuracy of deprotection was approved by reverse phase chromatography. The deprotected target peptide (omega-conotoxin) was determined by SDS-PAGE. Then the Oxidative refolding of target peptide was performed in six protocol based on Guanidinium chloride and oxidized and reduced Glutathione. Analgesic effect of refolded peptide was surveyed with formalin test in mice Balb/c. Non neurotoxic effects of target peptides were survey with ICV injection in mice model (C57/BL6). The innovative deprotection protocol performed based on the best ratio of mercury/2-mercaptoethanol adjusted to 1mg/10p1 in 90 minute. The results showed the yield and purity of omega-conotoxin MVIIA as 93 and 95%, respectively. Refolding of 40 mg omega Conotoxin with GSSG and GSH on ratio of 10:1 and 20 mM ammonium acetate showed the best analgesic effect compared with the other methods. The result showed 95.5% yield and 98% purity of omega-conotoxin MVIIA in this refolding method. Related refolding method reduced 85% pain in experimented mice using 7 ng of the peptide. That was 71.5 fold stronger than morphine and 2 times than standard Prialt®. And it was not neurotoxic in mice. In this study, refolding method for omega-conotoxin MVIIA was optimized in the fourth factor including: reducing the time, amount and number of reagent and increase the efficiency. We introduced new method for deprotection of omega-conotoxin MVIIA. Effective, economic and applied refolding and deprotecti on method was performed in this research may al so be applied to similar omega conotoxin peptides.

The development and field test of a Mealtime Interaction Clinical Observation Tool: a pilot study and clinical research portfolio

Objective: The purpose of this study was to develop and test psychometric properties of a Mealtime Interaction Clinical Observation Tool (MICOT) that could be used to facilitate assessment and behavioural intervention in childhood feeding difficulties. Methods: Thematic analysis of four focus groups with feeding and behaviour experts identified the content and structure of the MICOT. Following refinement, inter-rater reliability was tested between three healthcare professionals. Results: Six themes were identified for the MICOT, which utilises a traffic-light system to identify areas of strength and areas for intervention. Despite poor inter-rater reliability, for which a number of reasons are postulated, some correlation between psychologists’ ratings was evident. Healthcare professionals liked the tool and reported that it could have good clinical utility. Conclusion: The study provides a promising first version of a clinical observation tool that facilitates assessment and behavioural intervention in childhood feeding difficulties.

Accumulation of six metals in the mangrove crab Ucides cordatus (Crustacea: Ucididae) and its food source, the red mangrove Rhizophora mangle (Angiosperma: Rhizophoraceae)

The crab Ucides cordatus and the red mangrove Rhizophora mangle are endemic mangrove species and potential bio-accumulators of metals. This study quantified the accumulation of six metals (Cd, Cr, Cu, Hg, Mn and Pb) in different organs (claw muscle, hepatopancreas and gills) of U. cordatus, as well as in different maturation stages of the leaves (buds, green mature, and pre-abscission senescent) of R. mangle. Samples were collected from mangrove areas in Cubatao, state of São Paulo, a heavily polluted region in Brazil. Data for metal contents in leaves were evaluated by one-way ANOVA; while for crabs a factorial ANOVA was used to investigate the effect of different tissues, animal size and the interactions between them. Means were compared by Tukey test at five percent, and the association between the metal concentrations in each crab organ, depending on the size, was evaluated by Pearson's linear correlation coefficient (r). Concentrations of Pb and Hg were undetectable for the different leaf stages and crab tissues, while Cd concentrations were undetectable in the leaf stages. In general, the highest accumulation of metals in R. mangle leaves occurred in pre-abscission senescent and green mature leaves, except for Cu, which was found in the highest concentrations in buds and green mature leaves. For the crab, Cd, Cu, Cr and Mn were present in concentrations above the detection limit, with the highest accumulation in the hepatopancreas, followed by the gills. Cu was accumulated mostly in the gills. Patterns of bioaccumulation between the crab and the mangrove tree differed for each metal, probably due to the specific requirements of each organism for essential metals. However, there was a close and direct relationship between metal accumulation in the mangrove trees and in the crabs feeding on them. Tissues of R. mangle leaves and U. cordatus proved effective for monitoring metals, acting as important bioindicators of mangrove areas contaminated by various metals. (C) 2012 Elsevier B.V. All rights reserved.

CERVIXCHECK: A SPIRITUALLY-BASED SMS TEXT MESSAGING PILOT INTERVENTION TO INCREASE CERVICAL CANCER AWARENESS AND PAP TEST SCREENING INTENTION AMONG AFRICAN AMERICAN WOMEN

African American women account for a disproportionate burden of cervical cancer incidence and mortality rate when compared to non-Hispanic White women. Cervical cancer is one of the most preventable types of cancer, and women can be screened for it with a routine Pap test. Given that religion occupies an essential place in African American lives, framing health messages with important spiritual themes and delivering them through a popular communication delivery channel may allow for a more culturally-relevant and accessible technology-based approach to promoting cervical cancer educational content to African American women. Using community-engaged research as a framework, the purpose of this multiple methods study was to develop, pilot test, and evaluate the feasibility, acceptability, and initial efficacy of a spiritually-based SMS text messaging intervention to increase cervical cancer awareness and Pap test screening intention among African American women. The study recruited church-attending African American women ages 21-65 and was conducted in three phases. Phases 1 and 2 consisted of a series of focus group discussions (n=15), cognitive response interviews (n=8), and initial usability testing that were conducted to inform the intervention development and modifications. Phase 3 utilized a non-experimental one-group pretest-posttest design to pilot test the 16-day text messaging intervention (n=52). Of the individuals enrolled, forty-six completed the posttest (retention rate=88%). Findings provided evidence for the early feasibility, high acceptability, and some initial efficacy of the CervixCheck intervention. There were significant pre-post increases observed for knowledge about cervical cancer and the Pap test (p = .001) and subjective norms (p = .006). Additionally, results post-intervention revealed that 83% of participants reported being either “satisfied” or “very satisfied” with the program and 85% found the text messages either “useful” or “very useful”. 85% of the participants also indicated that they would “likely” or “very likely” share the information they learned from the intervention with the women around them, with 39% indicating that they had already shared some of the information they received with others they knew. A spiritually-based SMS text messaging intervention could be a culturally appropriate and cost-effective method of promoting cervical cancer early detection information to African American women.

Testing the random walk hypothesis with variance ratio statistics

Mestrado em Finanças

Equine exercise electrocardiogram : standardized lungeing test

Dissertação de Mestrado Integrado em Medicina Veterinária

Apparent digestibility of dry matter, crude protein, and amino acids of six rendered by-products in juvenile Litopenaeus vannamei

Apparent digestibility coefficients (ADC) of dry matter, crude protein (CP), and amino acids (AA) were evaluated in diets with six rendered by-products used to feed juvenile Pacific white shrimp: two poultry meals (poultry meal 1, 69% CP; poultry meal 2, 72% CP), two feather meals (89% CP), one blood meal (96% CP), and one pork meal (57% CP). Experimental diets were formulated with 30% of the test ingredient and 70% of a commercial diet supplemented with 1% of chromium oxide as inert marker. AA contents in ingredients, diets, leached diets, and feces were determined by high performance liquid chromatography. Preprandial AA losses attributed to leaching were higher in the blood meal diet (15%) and pork meal diet (10%). Poultry meal diets 1 and 2 showed mean AA losses of 3% and 5%, respectively, while the reference diet had a mean AA leaching of 6%. The AA that had the highest leaching rates were lysine (21%), methionine (15%), and histidine (12%). The ADC of dry matter was higher for poultry meals 1 (70%) and 2 (73%), followed by pork meal (69%), feather meals (61%), and blood meal (57%). The digestibility of CP was higher for poultry meals (78–80%), followed by pork meal (76%), and blood meal and feather meals (65–67%). The digestibility of CP in the reference diet (83%) was higher than that observed for all the animal by-product meals except the poultry meals. The ADC of the sum of AA adjusted for nutrient leaching fluctuated from 65% for blood meal to 80% for poultry meals.

Descriptive analysis of the test of everyday attention for children in a Spanish normative sample

Introduction. Test of Everyday Attention for Children (TEA-Ch) has been validated in different countries demonstrating that it is an instrument with a correct balance between reliability and duration. Given the shortage of trustworthy instruments of evaluation in our language for infantile population we decide to explore the Spanish version of the TEA-Ch. Methods. We administered TEA-Ch (version A) to a sample control of 133 Spanish children from 6 to 11 years enrolled in school in the Community of Madrid. Four children were selected at random by course of Primary Education, distributing the sex of equivalent form. Descriptive analysis and comparison by ages and sex in each of the TEA-Ch's subtests were conducted to establish a profile of the sample. In order to analyze the effect of the age, subjects were grouped in six sub-samples: 6, 7, 8, 9, 10 and 11 years-old. Results. This first descriptive analysis demonstrates age exerted a significant effect on each measure, due to an important "jump" in children's performance between 6 and 7 years-old. The effect of sex was significant only in two visual attention measures (Sky Search & Map) and interaction age and sex exerted a significant effect only in the dual task (Score DT). Conclusions. The results suggest that the Spanish version of the TEA-Ch (A) might be a useful instrument to evaluate attentional processes in Spanish child population.

Double blind test series

Braille is a communication tool in decline, in America by 80% since 1950, and in the UK to the extent that only 1% of blind people are now thought to read Braille.1, 2 There are a variety of causal factors, including the phasing out of Braille instruction due to the educational mainstreaming of blind children and the resistance to learning Braille by those who lose sight later in life.3Braille is a writing system of raised dots that allows blind people to read and write tactilely. Each Braille character comprises a cell of six potentially raised dots, two dots across and three dots down. It is designed only to communicate the message and does not convey the tonality provided by visual fonts.However, in his book Design Meets Disability, Graham Pullin, observes that: “Braille is interesting and beautiful, as abstract visual and tactile decoration, intriguing and indecipherable to the nonreader ” and continues; “…braille could be decorative for sighted people.”4I assert that the increasing abandonment of Braille frees it from its restrictive constraints, opening it to exploration and experimentation, and that this may result in Braille becoming dynamic expression for the sighted, as well as the partially sighted and blind.Printmaking is well suited for this exploration. Printmaking processes and techniques can result in prints aesthetically compelling to both senses of sight and touch. Established approaches, such as flocking, varnishes, puff-ink, embossing and die cut, combined with experiments in new techniques in laser cutting and 3D printing, create visually and texturally vibrant prints.In this paper I will detail my systematic investigation of sensually expressive printmaking concentrating on the issues surrounding Braille as a printmaking design element paying particular attention to the approaches and techniques used not only in producing its visual style but to those techniques used to keep it integrally tactile.

Test de step y capacidad de trabajo en jugadoras de voleibol: la paradoja de un mejor rendimiento en las jugadoras mayores

El objetivo del presente estudio fue comparar dos pruebas submáximas de capacidad aeróbica, el YMCA step test y la prueba de capacidad de trabajo físico a 170 ppm (P170) de frecuencia cardíaca (FC), en jugadoras de voleibol femenino. Se analizaron en 152 participantes variables antropométricas, el rendimiento, la frecuencia cardiaca final (Stepend) y la frecuencia cardiaca en el primer minuto de recuperación (Steprec) en la prueba YMCA step test, la P170 fue analizada expresando los resultados en valores absolutos (P170,abs, W) y relativos (P170,rel, W.kg-1). Además, un subgrupo (n=14) fue analizado otra vez después de un año. Los resultados mostraron como el YMCA step test correlacionó altamente (Steprec) y muy altamente (Stepend) con la P170 rel (r = –0.58 and r = –0.76, p < 0.001, respectively), y con la P170,abs (r = –0.54 and r = –0.68, p < 0.001, respectively). No se encontraron correlaciones entre los porcentajes de cambio en los test de capacidad aeróbica después de un año (p>0.05). La edad presentó una correlación baja a moderada con todos los índices de capacidad aeróbica (0.23 ≤ ŇrŇ ≤ 0.45, p<0.05), viendo como las mayores edades tenían una mejor capacidad aeróbica. Basándonos en estos resultados podemos concluir que la prueba YMCA step test (especialmente el parámetro Stepend) y la P170 podrian ser utilizadas indistintamente por entrenadores y preparadores físicos para monitorizar la capacidad aeróbica de jugadoras de voleibol. El paradójico incremento de la capacidad aeróbica con la edad puede ser atribuido a los métodos de evaluación utilizados que están basados en la FC y al descenso de la FC máxima con la edad. Por lo tanto, estos test deberían ser utilizados solo con edades inferiores.

Review of Program Integrity Operations At Six Managed Care Organizations Delivering Medicaid Services under a Contract with the South Carolina Department of Health & Human Services

The State contracted with six managed care organizations to deliver Medicaid managed care at an annual cost of $2.7 billion, representing 10% of the State’s annual budget, to 750,000 Medicaid beneficiaries in South Carolina. This review’s scope and objectives were: Test the six MCOs’ compliance and effective execution of the SCDHHS’s managed care contract “Section 11 - Program Integrity” focusing on the operational components of pre-payment review and post-payment review. Identify opportunities to improve SCDHHS’s biennial managed care contract, contract monitoring, and MCO compliance and effective execution of the contract.