A new instrument for measuring anticoagulation-related quality of life: development and preliminary validation.

BACKGROUND: Anticoagulation can reduce quality of life, and different models of anticoagulation management might have different impacts on satisfaction with this component of medical care. Yet, to our knowledge, there are no scales measuring quality of life and satisfaction with anticoagulation that can be generalized across different models of anticoagulation management. We describe the development and preliminary validation of such an instrument - the Duke Anticoagulation Satisfaction Scale (DASS). METHODS: The DASS is a 25-item scale addressing the (a) negative impacts of anticoagulation (limitations, hassles and burdens); and (b) positive impacts of anticoagulation (confidence, reassurance, satisfaction). Each item has 7 possible responses. The DASS was administered to 262 patients currently receiving oral anticoagulation. Scales measuring generic quality of life, satisfaction with medical care, and tendency to provide socially desirable responses were also administered. Statistical analysis included assessment of item variability, internal consistency (Cronbach's alpha), scale structure (factor analysis), and correlations between the DASS and demographic variables, clinical characteristics, and scores on the above scales. A follow-up study of 105 additional patients assessed test-retest reliability. RESULTS: 220 subjects answered all items. Ceiling and floor effects were modest, and 25 of the 27 proposed items grouped into 2 factors (positive impacts, negative impacts, this latter factor being potentially subdivided into limitations versus hassles and burdens). Each factor had a high degree of internal consistency (Cronbach's alpha 0.78-0.91). The limitations and hassles factors consistently correlated with the SF-36 scales measuring generic quality of life, while the positive psychological impact scale correlated with age and time on anticoagulation. The intra-class correlation coefficient for test-retest reliability was 0.80. CONCLUSIONS: The DASS has demonstrated reasonable psychometric properties to date. Further validation is ongoing. To the degree that dissatisfaction with anticoagulation leads to decreased adherence, poorer INR control, and poor clinical outcomes, the DASS has the potential to help identify reasons for dissatisfaction (and positive satisfaction), and thus help to develop interventions to break this cycle. As an instrument designed to be applicable across multiple models of anticoagulation management, the DASS could be crucial in the scientific comparison between those models of care.

A general framework for measuring inconsistency through minimal inconsistent sets

Hunter and Konieczny explored the relationships between measures of inconsistency for a belief base and the minimal inconsistent subsets of that belief base in several of their papers. In particular, an inconsistency value termed MIVC, defined from minimal inconsistent subsets, can be considered as a Shapley Inconsistency Value. Moreover, it can be axiomatized completely in terms of five simple axioms. MinInc, one of the five axioms, states that each minimal inconsistent set has the same amount of conflict. However, it conflicts with the intuition illustrated by the lottery paradox, which states that as the size of a minimal inconsistent belief base increases, the degree of inconsistency of that belief base becomes smaller. To address this, we present two kinds of revised inconsistency measures for a belief base from its minimal inconsistent subsets. Each of these measures considers the size of each minimal inconsistent subset as well as the number of minimal inconsistent subsets of a belief base. More specifically, we first present a vectorial measure to capture the inconsistency for a belief base, which is more discriminative than MIVC. Then we present a family of weighted inconsistency measures based on the vectorial inconsistency measure, which allow us to capture the inconsistency for a belief base in terms of a single numerical value as usual. We also show that each of the two kinds of revised inconsistency measures can be considered as a particular Shapley Inconsistency Value, and can be axiomatically characterized by the corresponding revised axioms presented in this paper.

Measuring inconsistency in network intrusion rules

In this preliminary case study, we investigate how inconsistency in a network intrusion detection rule set can be measured. To achieve this, we first examine the structure of these rules which incorporate regular expression (Regex) pattern matching. We then identify primitive elements in these rules in order to translate the rules into their (equivalent) logical forms and to establish connections between them. Additional rules from background knowledge are also introduced to make the correlations among rules more explicit. Finally, we measure the degree of inconsistency in formulae of such a rule set (using the Scoring function, Shapley inconsistency values and Blame measure for prioritized knowledge) and compare the informativeness of these measures. We conclude that such measures are useful for the network intrusion domain assuming that incorporating domain knowledge for correlation of rules is feasible.

Measuring Inconsistency in a Network Intrusion Detection Rule Set Based on Snort

In this preliminary study, we investigate how inconsistency in a network intrusion detection rule set can be measured. To achieve this, we first examine the structure of these rules which are based on Snort and incorporate regular expression (Regex) pattern matching. We then identify primitive elements in these rules in order to translate the rules into their (equivalent) logical forms and to establish connections between them. Additional rules from background knowledge are also introduced to make the correlations among rules more explicit. We measure the degree of inconsistency in formulae of such a rule set (using the Scoring function, Shapley inconsistency values and Blame measure for prioritized knowledge) and compare the informativeness of these measures. Finally, we propose a new measure of inconsistency for prioritized knowledge which incorporates the normalized number of atoms in a language involved in inconsistency to provide a deeper inspection of inconsistent formulae. We conclude that such measures are useful for the network intrusion domain assuming that introducing expert knowledge for correlation of rules is feasible.

How Do Trainees Rate the Impact of a Short Cognitive Behavioural Training Programme on their Knowledge and Skills?

Background: A strong evidence base for cognitive behavioural therapy has led to CBT models becoming available within mainstream mental health services. As the concept of stepped care develops, new less intensive mental health interventions such as guided self-help are emerging, delivered by staff not trained to the level of accredited Cognitive Behavioural Therapists. Aim: The aim of this study was to determine how mental health staff evaluated the usefulness of a short training programme in CBT concepts, models and techniques for routine clinical practice.
Method: A cohort of mental health staff (n = 102) completed pre- and posttraining self-report questionnaires measuring trainee perceptions of the impact of a short training programme on knowledge and skills. Mentors and managers were also asked to comment on perceived impact of the training.
Results: Trainees and mentors reported perceived gains in knowledge and skills posttraining and at 1-year follow-up. Managers and trainees reported perceived improvements in skills and practice. Conclusion: A short Cognitive Behavioural skills programme can enable mental health staff to integrate basic CB knowledge and skills into routine clinical practice.

A Characteristic Function Approach to Inconsistency Measures for Knowledge Bases.

Knowledge is an important component in many intelligent systems.
Since items of knowledge in a knowledge base can be conflicting, especially if
there are multiple sources contributing to the knowledge in this base, significant
research efforts have been made on developing inconsistency measures for
knowledge bases and on developing merging approaches. Most of these efforts
start with flat knowledge bases. However, in many real-world applications, items
of knowledge are not perceived with equal importance, rather, weights (which
can be used to indicate the importance or priority) are associated with items of
knowledge. Therefore, measuring the inconsistency of a knowledge base with
weighted formulae as well as their merging is an important but difficult task. In
this paper, we derive a numerical characteristic function from each knowledge
base with weighted formulae, based on the Dempster-Shafer theory of evidence.
Using these functions, we are able to measure the inconsistency of the knowledge
base in a convenient and rational way, and are able to merge multiple knowledge
bases with weighted formulae, even if knowledge in these bases may be
inconsistent. Furthermore, by examining whether multiple knowledge bases are
dependent or independent, they can be combined in different ways using their
characteristic functions, which cannot be handled (or at least have never been
considered) in classic knowledge based merging approaches in the literature.

Measuring non-use value of environmental goods using the contingent valuation method:problems of information and cognition and the application of cognitive questionnaire design methods

Much interest now focuses on the use of the contingent valuation method (CVM) to assess non-use value of environmental goods. The paper reviews recent literature and highlights particular problems of information provision and respondent knowledge, comprehension and cognition. These must be dealt with by economists in designing CVM surveys for eliciting non-use values. Cognitive questionnaire design methods are presented which invoke concepts from psychology and tools from cognitive survey design (focus groups and verbal reports) to reduce a complex environmnetal good into a meaningful commodity that can be valued by respondents in a contingent market. This process is illustrated with examples from the authors' own research valuing alternative afforestation programmes. -Authors

4.11(EC) Report new instrumentation and field measuring technology for tidal currents

One of the challenges the tidal power industry faces, is the requirement of cost effective, reliable but highly accurate acquisition of flow data. Different methods are required , applications range over different spatial and temporal scales. This report assembles in the first sections, theoretical background information on acoustic Doppler Velocimetry and RADAR measurements. The use of existing expertise in field tests of marine vehicles is discussed next, followed by a discussion of issues relating to recreating field conditions in laboratory environments. The last three sections present practical applications of various methods performed in field conditions. While progress has been made over the last years, this overview highlights the challenges in full scale field measurements and knowledge gaps in the industry.

Measuring healthcare integration: Operationalization of a framework for a systems evaluation of palliative care structures, processes, and outcomes

BACKGROUND: Healthcare integration is a priority in many countries, yet there remains little direction on how to systematically evaluate this construct to inform further development. The examination of community-based palliative care networks provides an ideal opportunity for the advancement of integration measures, in consideration of how fundamental provider cohesion is to effective care at end of life.

AIM: This article presents a variable-oriented analysis from a theory-based case study of a palliative care network to help bridge the knowledge gap in integration measurement.

DESIGN: Data from a mixed-methods case study were mapped to a conceptual framework for evaluating integrated palliative care and a visual array depicting the extent of key factors in the represented palliative care network was formulated.

SETTING/PARTICIPANTS: The study included data from 21 palliative care network administrators, 86 healthcare professionals, and 111 family caregivers, all from an established palliative care network in Ontario, Canada.

RESULTS: The framework used to guide this research proved useful in assessing qualities of integration and functioning in the palliative care network. The resulting visual array of elements illustrates that while this network performed relatively well at the multiple levels considered, room for improvement exists, particularly in terms of interventions that could facilitate the sharing of information.

CONCLUSION: This study, along with the other evaluative examples mentioned, represents important initial attempts at empirically and comprehensively examining network-integrated palliative care and healthcare integration in general.

From engagement to outcomes: measuring the impact of researcher training using the rugby team impact framework

This study addresses our approach to the difficult task of measuring the impact of an eLearning service, the Graduate Virtual Research Environment (GVRE), provided to doctoral students at a UK University since October 2009. The GVRE provides research students with access to a training needs analysis tool which is linked to a repository of video learning resources created by academics and experienced research students. This paper explores the use of the Rugby Team Impact Framework as a guide to measuring impact and our use of a number of techniques to gather evidence about the changes resulting from use of the GVRE. The framework gives four levels of evidence, starting with simple measures of provision, through attendance, interest and to outcomes. As with other research, we found the former easy to assess but the outcomes harder to define. We conclude with a critical evaluation of our research process and outcomes.

The World Health Organization Multi-Professional Patient Safety Curriculum : implementation of key modules and its impact on patient safety knowledge, skills, and attitudes of medical students at the University of Algarve

ABSTRACT - Objectives: We attempted to show how the implementation of the key elements of the World Health Organization Patient Safety Curriculum Guide Multi-professional Edition in an undergraduate curriculum affected the knowledge, skills, and attitudes towards patient safety in a graduate entry Portuguese Medical School. Methods: After receiving formal recognition by the WHO as a Complementary Test Site and approval of the organizational ethics committee , the validated pre-course questionnaires measuring the knowledge, skills, and attitudes to patient safety were administered to the 2nd and3rd year students pursuing a four-year course (N = 46). The key modules of the curriculum were implemented over the academic year by employing a variety of learning strategies including expert lecturers, small group problem-based teaching sessions, and Simulation Laboratory sessions. The identical questionnaires were then administered and the impact was measured. The Curriculum Guide was evaluated as a health education tool in this context. Results: A significant number of the respondents, 47 % (n = 22), reported having received some form of prior patient safety training. The effect on Patient Safety Knowledge was assessed by using the percentage of correct pre- and post-course answers to construct 2 × 2 contingency tables and by applying Fishers’ test (two-tailed). No significant differences were detected (p < 0.05). To assess the effect of the intervention on Patient Safety skills and attitudes, the mean and standard deviation were calculated for the pre and post-course responses, and independent samples were subjected to Mann-Whitney’s test. The attitudinal survey indicated a very high baseline incidence of desirable attitudes and skills toward patient safety. Significant changes were detected (p < 0.05) regarding what should happen if an error is made (p = 0.016), the role of healthcare organizations in error reporting (p = 0.006), and the extent of medical error (p = 0.005). Conclusions: The implementation of selected modules of the WHO Patient Safety Curriculum was associated with a number of positive changes regarding patient safety skills and attitudes, with a baseline incidence of highly desirable patient safety attitudes, but no measureable change on the patient safety knowledge, at the University of Algarve Medical School. The significance of these results is discussed along with implications and suggestions for future research.

Measuring the Maturity of Open Source Software for Digital Libraries: a Case Study of DSpace

The assessment of maturity of software is an important area in the general software sector. The field of OSS also applies various models to measure software maturity. However, measuring maturity of OSS being used for several applications in libraries is an area left with no research so far. This study has attempted to fill the research gap. Measuring maturity of software contributes knowledge on its sustainability over the long term. Maturity of software is one of the factors that positively influence adoption. The investigator measured the maturity of DSpace software using Woods and Guliani‟s Open Source Maturity Model-2005. The present study is significant as it addresses the aspects of maturity of OSS for libraries and fills the research gap on the area. In this sense the study opens new avenues to the field of library and information science by providing an additional tool for librarians in the selection and adoption of OSS. Measuring maturity brings in-depth knowledge on an OSS which will contribute towards the perceived usefulness and perceived ease of use as explained in the Technology Acceptance Model theory.

Methodology for measuring the impact of mobile technology change from 2nd to 3th generation percerved by users of smes in Barranquilla

This article presents the results of a research project undertaken to obtain a Masters inBusiness Administration from the Business School at the Universidad del Norte, whosepurpose was to identify and test a methodology to measure the impact exerted by thechange from 2nd to 3rd generation mobile tech, based on the perception of users belongingto Barranquilla SME, motivated by the influence of technological changes in behavior andthe knowledge creation among society members, and the importance it has taken to thesurvival of organizations the adoption of applications for process automation, web-basedapplications, voice, data and video that allow the development of competitive advantages,based on information and creativity for new and better products or services.