7-point Subjective Global Assessment is more time sensitive than conventional Subjective Global Assessment in detecting nutrition changes

Background: It is important for nutrition intervention in malnourished patients to be guided by accurate evaluation and detection of small changes in the patient’s nutrition status over time. However, the current Subjective Global Assessment (SGA) is not able to detect changes in a short period of time. The aim of the study was to determine whether 7-point SGA is more time sensitive to nutrition changes than the conventional SGA. Methods: In this prospective study, 67 adult inpatients assessed as malnourished using both the 7-point SGA and conventional SGA were recruited. Each patient received nutrition intervention and was followed up post-discharge. Patients were reassessed using both tools at 1, 3 and 5 months from baseline assessment. Results: It took significantly shorter time to see a one-point change using 7-point SGA compared to conventional SGA (median: 1 month vs. 3 months, p = 0.002). The likelihood of at least a one-point change is 6.74 times greater in 7-point SGA compared to conventional SGA after controlling for age, gender and medical specialties (odds ratio = 6.74, 95% CI 2.88-15.80, p<0.001). Fifty-six percent of patients who had no change in SGA score had changes detected using 7-point SGA. The level of agreement was 100% (k = 1, p < 0.001) between 7-point SGA and 3-point SGA and 83% (k=0.726, p<0.001) between two blinded assessors for 7-point SGA. Conclusion: The 7-point SGA is more time sensitive in its response to nutrition changes than conventional SGA. It can be used to guide nutrition intervention for patients.

Non-parametric consistency test for multiple-sensing-modality data fusion

Fusing data from multiple sensing modalities, e.g. laser and radar, is a promising approach to achieve resilient perception in challenging environmental conditions. However, this may lead to \emph{catastrophic fusion} in the presence of inconsistent data, i.e. when the sensors do not detect the same target due to distinct attenuation properties. It is often difficult to discriminate consistent from inconsistent data across sensing modalities using local spatial information alone. In this paper we present a novel consistency test based on the log marginal likelihood of a Gaussian process model that evaluates data from range sensors in a relative manner. A new data point is deemed to be consistent if the model statistically improves as a result of its fusion. This approach avoids the need for absolute spatial distance threshold parameters as required by previous work. We report results from object reconstruction with both synthetic and experimental data that demonstrate an improvement in reconstruction quality, particularly in cases where data points are inconsistent yet spatially proximal.

Modality as portrayed in upper secondary school textbooks : A corpus-based approach

Tämän pro gradu -lopputyön aiheena on englannin kielen modaalisten apuverbien ns. ydinjoukko: will, would, can, could, shall, should, may, might ja must. Semantiikan kannalta nämä apuverbit ovat erityisen kompleksisia: niiden tulkinnassa on usein huomattavaa monivivahteisuutta, vaikka perinteiset kieliopit antavat ymmärtää niillä olevan kaksi tai kolme toisistaan selkeästi erillään olevaa merkitystä. Ne asettavatkin vieraan kielen oppimisympäristössä erityisiä haasteita. Viimeaikainen kehitys korpuslingvistiikan metodeissa on tuottanut entistä tarkempia kuvauksia siitä, miten modaalisia apuverbejä nykyenglannissa käytetään ja mihin suuntaan niiden kehitys on lyhyenkin ajan sisällä kulkenut. Tämän tutkielman tavoitteena on ollut verrata näiden uusien tutkimusten tuloksia siihen todellisuuteen, jonka englannin kielen lukiotasoinen oppimateriaali Suomessa opiskelijalle tarjoaa. Lähdin siitä, että opetussuunnitelman vaatima autenttisuus ja kommunikaativisuus kieltenopetuksessa tulisi näkyä tasapuolisena modaalisten apuverbien kohteluna. Alkuperäinen hypoteesini kuitenkin oli, että siinä miten modaalisuus ilmenee autenttisessa ympäristössä ja siinä miten se esitetään oppikirjoissa, on poikkeavuuksia. Lähestymistapani tähän tutkielmaan oli korpuslähtöinen. Valitsin kahdesta lukion kirjasarjasta ne kirjat, joissa modaaliset apuverbit mainittiin eksplisiittisesti. Skannasin jokaisen neljästä eri kirjasta löytyvän (kokonaisen) tekstin ja rakensin näistä aineksista pienen korpuksen. Tästä korpuksesta hain korpusanalyyseihin tarkoitetulla ohjelmalla kaikki lauseet, joissa esiintyi modaalisia apuverbejä. Tämän jälkeen analysoin jokaisen modaalisen apuverbin semanttisesti lauseyhteydessään. Tämän analyysin tuloksena pystyin rakentamaan taulukoita ja vertailemaan tuloksia uusimpien tutkimusten tuloksiin. Tämän tutkielman perusteella poikkeavuuksia on olemassa. Yleisesti ottaen modaalisten apuverbien keskinäinen frekvenssi oli oikean suuntainen: mitään apuverbiä ei ollut käytetty merkittävästi enemmän tai vähemmän kuin mitä viimeaikaisen tutkimuksen valossa olisi suotavaa. Sen sijaan apuverbien semanttisessa jakaumassa oli paikoin suuriakin eroja siinä, mitkä merkitykset oppikirjoissa painottuivat ja mitkä taas nykyenglannissa vaikuttaisivat olevan frekvensseiltään suurempia. Erityisesti can ja must erottuivat joukosta siinä, että oppikirjojen tarjoama kuva niiden käytöstä on päinvastainen kuin mitä voisi odottaa: can-verbin käyttö painottui selvästi tarkoittamaan ’kykyä’ eikä ’mahdollisuutta’, joka nykytutkimuksen valossa on sen pääasiallinen käyttötapa. Toisaalta must tarkoitti aineistossa ylikorostuneesti ’pakkoa’, kun se useimmiten nykyään tarkoittaa yhtä usein ’johtopäätöstä’ kuin ’pakkoa’. Lisäksi ’lupaa’ pyydettiin aineistossa merkillisen harvoin. Tulosten perusteella esitän, että oppikirjojen tekijät yleisellä tasolla luopuisivat kielioppikirjojen luutuneista käsityksistä ja uskaltaisivat altistaa opiskelijat koko modaalisten apuverbien merkityskirjolle.

A head-mounted display as a personal viewing device: Dimensions of subjective experiences

The use of head-mounted displays (HMDs) can produce both positive and negative experiences. In an effort increase positive experiences and avoid negative ones, researchers have identified a number of variables that may cause sickness and eyestrain, although the exact nature of the relationship to HMDs may vary, depending on the tasks and the environments. Other non-sickness-related aspects of HMDs, such as users opinions and future decisions associated with task enjoyment and interest, have attracted little attention in the research community. In this thesis, user experiences associated with the use of monocular and bi-ocular HMDs were studied. These include eyestrain and sickness caused by current HMDs, the advantages and disadvantages of adjustable HMDs, HMDs as accessories for small multimedia devices, and the impact of individual characteristics and evaluated experiences on reported outcomes and opinions. The results indicate that today s commercial HMDs do not induce serious sickness or eyestrain. Reported adverse symptoms have some influence on HMD-related opinions, but the nature of the impact depends on the tasks and the devices used. As an accessory to handheld devices and as a personal viewing device, HMDs may increase use duration and enable users to perform tasks not suitable for small screens. Well-designed and functional, adjustable HMDs, especially monocular HMDs, increase viewing comfort and usability, which in turn may have a positive effect on product-related satisfaction. The role of individual characteristics in understanding HMD-related experiences has not changed significantly. Explaining other HMD-related experiences, especially forward-looking interests, also requires understanding more stable individual traits and motivations.

The influence of a novel simulated learning environment upon student clinical subjective refraction performance: A pilot study

Background: Optometry students are taught the process of subjective refraction through lectures and laboratory based practicals before progressing to supervised clinical practice. Simulated learning environments (SLEs) are an emerging technology that are used in a range of health disciplines, however, there is limited evidence regarding the effectiveness of clinical simulators as an educational tool. Methods: Forty optometry students (20 fourth year and 20 fifth year) were assessed twice by a qualified optometrist (two examinations separated by 4-8 weeks) while completing a monocular non-cycloplegic subjective refraction on the same patient with an unknown refractive error simulated using contact lenses. Half of the students were granted access to an online SLE, The Brien Holden Vision Institute (BHVI®) Virtual Refractor, and the remaining students formed a control group. The primary outcome measures at each visit were; accuracy of the clinical refraction compared to a qualified optometrist and relative to the Optometry Council of Australia and New Zealand (OCANZ) subjective refraction examination criteria. Secondary measures of interest included descriptors of student SLE engagement, student self-reported confidence levels and correlations between performance in the simulated and real world clinical environment. Results: Eighty percent of students in the intervention group interacted with the SLE (for an average of 100 minutes); however, there was no correlation between measures of student engagement with the BHVI® Virtual Refractor and speed or accuracy of clinical subjective refractions. Fifth year students were typically more confident and refracted more accurately and quickly than fourth year students. A year group by experimental group interaction (p = 0.03) was observed for accuracy of the spherical component of refraction, and post hoc analysis revealed that less experienced students exhibited greater gains in clinical accuracy following exposure to the SLE intervention. Conclusions: Short-term exposure to a SLE can positively influence clinical subjective refraction outcomes for less experienced optometry students and may be of benefit in increasing the skills of novice refractionists to levels appropriate for commencing supervised clinical interactions.

Career adaptability predicts subjective career success above and beyond personality traits and core self-evaluations

The Career Adapt-Abilities Scale (CAAS) measures career adaptability as a higher-order construct that integrates four psychosocial resources of employees for managing their career development: concern, control, curiosity, and confidence. The goal of the present study was to investigate the validity of the CAAS with regard to its effects on two indicators of subjective career success (career satisfaction and self-rated career performance) above and beyond the effects of employees' Big Five personality traits and core self-evaluations. Data came from a large and heterogeneous sample of employees in Australia (N=1723). Results showed that overall career adaptability positively predicted career satisfaction and self-rated career performance above and beyond the Big Five personality traits and core self-evaluations. In addition, concern and confidence positively predicted the two indicators of subjective career success. The findings provide further support for the incremental validity of the CAAS.

Instrument for simultaneous assessment of tear film surface quality and subjective vision

To develop and test a custom-built instrument to simultaneously assess tear film surface quality (TFSQ) and subjective vision score (SVS).

Which patients with chronic kidney disease have the greatest symptom burden? A comparative study of advanced CKD stage and dialysis modality

Background Chronic kidney disease (CKD) leads to a range of symptoms, which are often under-recognised and little is known about the multidimensional symptom experience in advanced CKD. Objectives To examine (1) symptom burden at CKD stages 4 and 5, and dialysis modalities, and (2) demographic and renal history correlates of symptom burden. Methods Using a cross-sectional design, a convenience sample of 436 people with CKD was recruited from three hospitals. The CKD Symptom Burden Index (CKD-SBI) was used to measure the prevalence, severity, distress and frequency of 32 symptoms. Demographic and renal history data were also collected. Results Of the sample, 75.5 % were receiving dialysis (haemodialysis, n = 287; peritoneal dialysis, n = 42) and 24.5 % were not undergoing dialysis (stage 4, n = 69; stage 5, n = 38). Participants reported an average of 13.01 ± 7.67 symptoms. Fatigue and pain were common and burdensome across all symptom dimensions. While approximately one-third experienced sexual symptoms, when reported these symptoms were frequent, severe and distressing. Haemodialysis, older age and being female were independently associated with greater symptom burden. Conclusions In CKD, symptom burden is better understood when capturing the multidimensional aspects of a range of physical and psychological symptoms. Fatigue, pain and sexual dysfunction are key contributors to symptom burden, and these symptoms are often under-recognised and warrant routine assessment. The CKD-SBI offers a valuable tool for renal clinicians to assess symptom burden, leading to the commencement of timely and appropriate interventions.

Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF) is a valid screening tool in chemotherapy outpatients

Purpose In the oncology population where malnutrition prevalence is high, more descriptive screening tools can provide further information to assist triaging and capture acute change. The Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF) is a component of a nutritional assessment tool which could be used for descriptive nutrition screening. The purpose of this study was to conduct a secondary analysis of nutrition screening and assessment data to identify the most relevant information contributing to the PG-SGA SF to identify malnutrition risk with high sensitivity and specificity. Methods This was an observational, cross-sectional study of 300 consecutive adult patients receiving ambulatory anti-cancer treatment at an Australian tertiary hospital. Anthropometric and patient descriptive data were collected. The scored PG-SGA generated a score for nutritional risk (PG-SGA SF) and a global rating for nutrition status. Receiver operating characteristic curves (ROC) were generated to determine optimal cut-off scores for combinations of the PG-SGA SF boxes with the greatest sensitivity and specificity for predicting malnutrition according to scored PG-SGA global rating. Results The additive scores of boxes 1–3 had the highest sensitivity (90.2 %) while maintaining satisfactory specificity (67.5 %) and demonstrating high diagnostic value (AUC = 0.85, 95 % CI = 0.81–0.89). The inclusion of box 4 (PG-SGA SF) did not add further value as a screening tool (AUC = 0.85, 95 % CI = 0.80–0.89; sensitivity 80.4 %; specificity 72.3 %). Conclusions The validity of the PG-SGA SF in chemotherapy outpatients was confirmed. The present study however demonstrated that the functional capacity question (box 4) does not improve the overall discriminatory value of the PG-SGA SF.

Physiological and subjective thermal response from Indians

A controlled laboratory experiment was carried out on forty Indian male college students for evaluating the effect of indoor thermal environment on occupants' response and thermal comfort. During experiment, indoor temperature varied from 21 degrees C to 33 degrees C, and the variables like relative humidity, airflow, air temperature and radiant temperature were recorded along with skin (T-sk) and oral temperature (T-core) from the subjects. From T-sk and T-c, body temperature (T-b) was evaluated. Subjective Thermal Sensation Vote (TSV) was recorded using ASHRAE 7-point scale. In PMV model, Fanger's T-sk equation was used to accommodate adaptive response. Stepwise regression analysis result showed T-b was better predictor of TSV than T-sk and T-core. Regional skin temperature response, lower sweat threshold temperature with no dipping sweat and higher cutaneous sweating threshold temperature were observed as thermal adaptive responses. Using PMV model, thermal comfort zone was evaluated as (22.46-25.41) degrees C with neutral temperature of 23.91 degrees C, whereas using TSV response, wider comfort zone was estimated as (23.25-2632) degrees C with neutral temperature at 24.83 degrees C. It was observed that PMV-model overestimated the actual thermal response. Interestingly, these subjects were found to be less sensitive to hot but more sensitive to cold. A new TSV-PPD relation (PPDnew) was obtained with an asymmetric distribution of hot-cold thermal sensation response in Indians. (C) 2013 Elsevier Ltd. All rights reserved.

PMV model is insufficient to capture subjective thermal response from Indians

A controlled laboratory experiment was carried out on forty Indian male college students for evaluating the effect of indoor thermal environment on occupants' response and thermal comfort. During experiment, indoor temperature varied from 21 degrees C to 33 degrees C, and the variables like relative humidity, airflow, air temperature and radiant temperature were recorded along with subject's physiological parameters (skin (T-sk) and oral temperature (T-c)) and subjective thermal sensation responses (TSV). From T-sk and T-c, body temperature (T-b) was evaluated. Subjective Thermal Sensation Vote (TSV) was recorded using ASHRAE 7-point scale. In PMV model, Fanger's T-sk equation was used to accommodate adaptive response. Step-wise regression analysis result showed T-b was better predictor of TSV than T-sk and T-c. Regional skin temperature response, suppressed sweating without dipping, lower sweating threshold temperature and higher cutaneous threshold for sweating were observed as thermal adaptive responses. These adaptive responses cannot be considered in PMV model. To incorporate subjective adaptive response, mean skin temperature (T-sk) is considered in dry heat loss calculation. Along with these, PMV-model and other two methodologies are adopted to calculate PMV values and results are compared. However, recent literature is limited to measure the sweat rate in Indians and consideration of constant Ersw in PMV model needs to be corrected. Using measured T-sk in PMV model (Method(1)), thermal comfort zone corresponding to 0.5 <= PMV <= 0.5 was evaluated as (22.46-25.41) degrees C with neutral temperature of 23.91 degrees C, similarly while using TSV response, wider comfort zone was estimated as (23.25-26.32) degrees C with neutral temperature at 24.83 degrees C, which was further increased to with TSV-PPDnew, relation. It was observed that PMV-model overestimated the actual thermal response. Interestingly, these subjects were found to be less sensitive to hot but more sensitive to cold. A new TSV-PPD relation (PPDnew) was obtained from the population distribution of TSV response with an asymmetric distribution of hot-cold thermal sensation response from Indians. The calculations of human thermal stress according to steady state energy balance models used on PMV model seem to be inadequate to evaluate human thermal sensation of Indians. Relevance to industry: The purpose of this paper is to estimate thermal comfort zone and optimum temperature for Indians. It also highlights that PMV model seems to be inadequate to evaluate subjective thermal perception in Indians. These results can be used in feedback control of HVAC systems in residential and industrial buildings. (C) 2014 Elsevier B.V. All rights reserved.

Validation of polyvinylidene fluoride nasal sensor to assess nasal obstruction in comparison with subjective technique

Objective: The aim of this study is to validate the applicability of the PolyVinyliDene Fluoride (PVDF) nasal sensor to assess the nasal airflow, in healthy subjects and patients with nasal obstruction and to correlate the results with the score of Visual Analogue Scale (VAS). Methods: PVDF nasal sensor and VAS measurements were carried out in 50 subjects (25-healthy subjects and 25 patients). The VAS score of nasal obstruction and peak-to-peak amplitude (Vp-p) of nasal cycle measured by PVDF nasal sensors were analyzed for right nostril (RN) and left nostril (LN) in both the groups. Spearman's rho correlation was calculated. The relationship between PVDF nasal sensor measurements and severity of nasal obstruction (VAS score) were assessed by ANOVA. Results: In healthy group, the measurement of nasal airflow by PVDF nasal sensor for RN and LN were found to be 51.14 +/- 5.87% and 48.85 +/- 5.87%, respectively. In patient group, PVDF nasal sensor indicated lesser nasal airflow in the blocked nostrils (RN: 23.33 +/- 10.54% and LN: 32.24 +/- 11.54%). Moderate correlation was observed in healthy group (r = 0.710, p < 0.001 for RN and r = 0.651, p < 0.001 for LN), and moderate to strong correlation in patient group (r = 0.751, p < 0.01 for RN and r = 0.885, p < 0.0001 for LN). Conclusion: PVDF nasal sensor method is a newly developed technique for measuring the nasal airflow. Moderate to strong correlation was observed between PVDF nasal sensor data and VAS scores for nasal obstruction. In our present study, PVDF nasal sensor technique successfully differentiated between healthy subjects and patients with nasal obstruction. Additionally, it can also assess severity of nasal obstruction in comparison with VAS. Thus, we propose that the PVDF nasal sensor technique could be used as a new diagnostic method to evaluate nasal obstruction in routine clinical practice. (C) 2015 Elsevier Inc. All rights reserved.