Patient classification system: An integrated method for measuring nursing intensity and optimizing resource allocation

A patient classification system was developed integrating a patient acuity instrument with a computerized nursing distribution method based on a linear programming model. The system was designed for real-time measurement of patient acuity (workload) and allocation of nursing personnel to optimize the utilization of resources.^ The acuity instrument was a prototype tool with eight categories of patients defined by patient severity and nursing intensity parameters. From this tool, the demand for nursing care was defined in patient points with one point equal to one hour of RN time. Validity and reliability of the instrument was determined as follows: (1) Content validity by a panel of expert nurses; (2) predictive validity through a paired t-test analysis of preshift and postshift categorization of patients; (3) initial reliability by a one month pilot of the instrument in a practice setting; and (4) interrater reliability by the Kappa statistic.^ The nursing distribution system was a linear programming model using a branch and bound technique for obtaining integer solutions. The objective function was to minimize the total number of nursing personnel used by optimally assigning the staff to meet the acuity needs of the units. A penalty weight was used as a coefficient of the objective function variables to define priorities for allocation of staff.^ The demand constraints were requirements to meet the total acuity points needed for each unit and to have a minimum number of RNs on each unit. Supply constraints were: (1) total availability of each type of staff and the value of that staff member (value was determined relative to that type of staff's ability to perform the job function of an RN (i.e., value for eight hours RN = 8 points, LVN = 6 points); (2) number of personnel available for floating between units.^ The capability of the model to assign staff quantitatively and qualitatively equal to the manual method was established by a thirty day comparison. Sensitivity testing demonstrated appropriate adjustment of the optimal solution to changes in penalty coefficients in the objective function and to acuity totals in the demand constraints.^ Further investigation of the model documented: correct adjustment of assignments in response to staff value changes; and cost minimization by an addition of a dollar coefficient to the objective function. ^

Two Decades of Measuring Environmental Attitudes: An Analysis of the ISSP Environmental Modules 1993, 2000, and 2010

This paper analyzes the development of environmental concern by using the three waves of the environmental modules of the International Social Survey Programme (ISSP). First, we discuss the measurement of environmental concern and construct a ranking of countries according to the new 2010 ISSP results. Second, we analyze the determinants of environmental concern by employing multilevel models that take individual as well as context effects into account. Third, we explore the impact of attitudes on environmental behavior and support of environmental policies. The results show that environmental concern is closely correlated with the wealth of nations. However, environmental concern decreased in OECD as well as non-OECD nations slightly during the last two decades. The decline was lower in countries with improving economic conditions suggesting that economic growth helps to maintain higher levels of environmental concern. Furthermore, attitudes have a stronger impact on support of environmental policies as compared to everyday environmental behavior.

PREPARATION AND CHARACTERIZATION OF COVALENTLY LINKED ENZYME-ANTIBODY CONJUGATES AND THEIR USE IN MEASURING MINUTE QUANTITIES OF PROTEIN ANTIGENS

The discovery and characterization of oncofetal proteins have led to significant advances in early cancer diagnosis and therapeutic monitoring of patients undergoing cancer chemotherapy. These tumor-associated antigens are presently measured by sensitive, specific immunoassay techniques based on the detection of minute amounts of labeled antigen or antibody incorporated into immune complexes, which must be isolated from free antigen and antibody.^ Since there are several disadvantages with using radioisotopes, the most common immunolabel, one major objective was to prepare covalently coupled enzyme-antibody conjugates and evaluate their use as a practical alternative to radiolabeled immune reagents. An improved technique for the production of enzyme-antibody conjugates was developed that involves oxidizing the carbohydrate moieties on a glycoprotein enzyme, then introducing antibody in the presence of polyethylene glycol (PEG). Covalent enzyme-antibody conjugates involving alkaline phosphatase and amyloglucosidase were produced and characterized.^ In order to increase the sensitivity of detecting the amyloglucosidase-antibody conjugate, an enzyme cycling assay was developed that measures glucose, the product of maltose cleavage by amyloglucosidase, in the picomole range. The increased sensitivity obtained by combined usage of the amyloglucosidase-antibody conjugate and enzyme cycling assay was then compared to that of conventional enzyme immunoassay (EIA).^ For immune complex isolation, polystyrene tubes and protein A-bearing Staphylococcus aureus were evaluated as solid phase matrices, upon which antibodies can be immobilized. A sandwich-type EIA, using antibody-coated S. aureus, was developed that measures human albumin (HSA) in the nanogram range. The assay, using an alkaline phosphatase-anti-HSA conjugate, was applied to the determination of HSA in human urine and evaluated extensively for its clinical applicability.^ Finally, in view of the clinical significance of alpha-fetoprotein (AFP) as an oncofetal antigen and the difficulty with its purification for use as an immunogen and assay standard, a chemical purification protocol was developed that resulted in a high yield of immunochemically pure AFP. ^

Measuring gbar with AEgIS, progress and perspectives

AEgIS experiment’s main goal is to measure the local gravitational acceleration of antihydrogen¯g and thus perform a direct test of the weak equivalence principle with antimatter. In the first phase of the experiment the aim is to measure ¯g with 1% relative precision. This paper presents the antihydrogen production method and a description of some components of the experiment, which are necessary for the gravity measurement. Current status of the AE¯gIS experimental apparatus is presented and recent commissioning results with antiprotons are outlined. In conclusion we discuss the short-term goals of the AE¯gIS collaboration that will pave the way for the first gravity measurement in the near future.

Religious Diversity and Religious Vitality: New Measuring Strategies and Empirical Evidence

Quantitative studies of the conditions and consequences of religious diversity are based mostly on indices that measure the variety of religious membership in a particular region. However, this line of research has become stagnant, and the question of whether diversity affects religious vitality remains unanswered. This article attempts to shed new light on the discussion by measuring religious diversity differently and capturing religious vitality independently of membership figures. In particular, it contrasts the Herfindahl-Hirschman Index based on membership proportions with a second measure of diversity: an index of organizational diversity. Conversely, the dependent variable religious vitality is measured not by using rates of participation in religious organizations but via the Centrality of Religion Scale. Based on ecological and individual level data of forty-three local regions in Finland, Germany, and Slovenia and using multilevel analysis, our results suggest that religious diversity is related to religious vitality. However, the nature of this association differs across subgroups.

Measuring citizens' implicit and explicit attitudes towards the European Union

Studies assessing citizens’ attitudes towards Europe have mostly used explicit concepts and measures. However, psychologists have shown that human behaviour is not only determined by explicit attitudes which can be assessed via self-report, but also by implicit attitudes which require indirect measurement. We combine a self-report questionnaire with an implicit Affective Misattribution Procedure for the first time in an online environment to estimate the reliability, validity and predictive power of this implicit measure for the explanation of European Union-skeptical behaviour. Based on a survey with a sample representative for Germany, we found evidence for good reliability and validity of the implicit measure. In addition, the implicit attitude had a significant incremental impact beyond explicit attitudes on citizens’ proneness to engage in EU-skeptical information and voting behaviour.

How comparable are parallel corpora? Measuring the distribution of general vocabulary and connectives

In this paper, we question the homogeneity of a large parallel corpus by measuring the similarity between various sub-parts. We compare results obtained using a general measure of lexical similarity based on χ2 and by counting the number of discourse connectives. We argue that discourse connectives provide a more sensitive measure, revealing differences that are not visible with the general measure. We also provide evidence for the existence of specific characteristics defining translated texts as opposed to non-translated ones, due to a universal tendency for explicitation.