Combining qualitative and quantitative methods to analyze serious games outcomes: A pilot study for a new cognitive screening tool

Computer games for a serious purpose - so called serious games can provide additional information for the screening and diagnosis of cognitive impairment. Moreover, they have the advantage of being an ecological tool by involving daily living tasks. However, there is a need for better comprehensive designs regarding the acceptance of this technology, as the target population is older adults that are not used to interact with novel technologies. Moreover given the complexity of the diagnosis and the need for precise assessment, an evaluation of the best approach to analyze the performance data is required. The present study examines the usability of a new screening tool and proposes several new outlines for data analysis.

An Assessment of the Risk of Bias in Randomized Controlled Trial Reports Published in Prosthodontic and Implant Dentistry Journals

PURPOSE The objective of this study was to assess the risk of bias of randomized controlled trials (RCTs) published in prosthodontic and implant dentistry journals. MATERIALS AND METHODS The last 30 issues of 9 journals in the field of prosthodontic and implant dentistry (Clinical Implant Dentistry and Related Research, Clinical Oral Implants Research, Implant Dentistry, International Journal of Oral & Maxillofacial Implants, International Journal of Periodontics and Restorative Dentistry, International Journal of Prosthodontics, Journal of Dentistry, Journal of Oral Rehabilitation, and Journal of Prosthetic Dentistry) were hand-searched for RCTs. Risk of bias was assessed using the Cochrane Collaboration's risk of bias tool and analyzed descriptively. RESULTS From the 3,667 articles screened, a total of 147 RCTs were identified and included. The number of published RCTs increased with time. The overall distribution of a high risk of bias assessment varied across the domains of the Cochrane risk of bias tool: 8% for random sequence generation, 18% for allocation concealment, 41% for masking, 47% for blinding of outcome assessment, 7% for incomplete outcome data, 12% for selective reporting, and 41% for other biases. CONCLUSION The distribution of high risk of bias for RCTs published in the selected prosthodontic and implant dentistry journals varied among journals and ranged from 8% to 47%, which can be considered as substantial.

Use of quality assessment tools in systematic reviews was varied and inconsistent

OBJECTIVES To assess the use of quality assessment tools among a cross-section of systematic reviews (SRs) and to further evaluate whether quality was used as a parameter in the decision to include primary studies within subsequent meta-analysis. STUDY DESIGN AND SETTING We searched PubMed for SRs (interventional, observational, and diagnostic) published in Core Clinical Journals between January 1 and March 31, 2014. RESULTS Three hundred nine SRs were identified. Quality assessment was undertaken in 222 (71.8%) with isolated use of the Cochrane risk of bias tool (26.1%, n = 58) and the Newcastle-Ottawa Scale (15.3%, n = 34) most common. A threshold level of primary study quality for subsequent meta-analysis was used in 12.9% (40 of 309) of reviews. Overall, fifty-four combinations of quality assessment tools were identified with a similar preponderance of tools used among observational and interventional reviews. Multiple tools were used in 11.7% (n = 36) of SRs overall. CONCLUSION We found that quality assessment tools were used in a majority of SRs; however, a threshold level of quality for meta-analysis was stipulated in just 12.9% (n = 40). This cross-sectional analysis provides further evidence of the need for more active or intuitive editorial processes to enhance the reporting of SRs.

Air Force web-based preventive health assessement alcohol screening effectiveness using the Alcohol Use Disorders Identification Tool (AUDIT)

Alcohol consumption has a long-standing tradition in the United States Air Force (USAF). From squadron bars to officers and enlisted clubs, alcohol has been used in social settings to increase morale and also as a way to help decrease the stress of military operations. Surveys have demonstrated that the USAF has more than double the percentage of heavy drinkers than the US population. More than one-third of the Air Force reports binge drinking in the last month while only six percent of the nation reports the same consumption pattern.^ However, alcohol has a significant harmful health effect if consumed in excess. As part of an overall prevention and treatment program aimed at curbing the harmful effects of alcohol consumption, the USAF uses the Alcohol Use Disorder Identification Test (AUDIT) to screen for high-risk alcohol consumption patterns before alcohol disorder and disability occur. All Air Force active-duty members are required to complete a yearly Preventive Health Assessment questionnaire. Various health topics are included in this questionnaire including nutrition, exercise, tobacco use, family history, mental health and alcohol use. While this questionnaire has been available in a web-based format for several years, mandatory use was not implemented until 2009.^ Although the AUDIT was selected due to its effectiveness in assessing high-risk alcohol consumption in other populations, its effectiveness in the Air Force population had not been studied previously. In order to assess the sensitivity, specificity, and positive predictive value of this screening tool, the Air Force Web-based Preventive Health Assessment alcohol screening results were compared to whether any alcohol-related diagnosis was made from January 1, 2009 to March 31, 2010.^ While the AUDIT has previously been shown to have a high sensitivity and specificity, the Air Force screening values were 27.9% and 93.0% respectively. Positive predictive value was only 4.9%. With the screening statistics found, less than one-third of those having an alcohol disorder will be found with this screening tool and only 1 out of 20 Airmen who require further evaluation actually have an alcohol-related diagnosis.^

Air Force Web Preventive Health Assessment (AF WEBPHA) mental health screening effectiveness

The U.S. Air Force assesses Active Duty Air Force (ADAF) health annually using the Air Force Web-based Preventative Health Assessment (AF WebPHA). The assessment is based on a self-administered survey used to determine the overall Air Force health and readiness, as well as, the individual health of each airman. Individual survey responses as well as groups of responses generate further computer generated assessment and result in a classification of 'Critical', 'Priority', or 'Routine', depending on the need and urgency for further evaluation by a health care provider. The importance of the 'Priority' and 'Critical' classifications is to provide timely intervention to prevent or limit unfavorable outcomes that may threaten an airman. Though the USAF has been transitioning from a paper form to the online WebPHA survey for the last three years it was not made mandatory for all airmen until 2009. The survey covers many health aspects including family history, tobacco use, exercise, alcohol use, and mental health. ^ Military stressors such as deployment, change of station, and the trauma of war can aggravate and intensify the common baseline worries experienced by the general population and place airmen at additional risks for mental health concerns and illness. This study assesses the effectiveness of the AF WebPHA mental health screening questions in predicting a mental health disorder diagnosis according to International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes generated by physicians or their surrogates. In order to assess the sensitivity, specificity, and positive predictive value of the AF WebPHA as a screening tool for mental health, survey results were compared to ascertain if they generated any mental health disorder related diagnosis for the period from January 1, 2009 to March 31, 2010. ^ Statistical analysis of the AF WebPHA mental health responses when compared with matching ICD-9-CM codes found that the sensitivity for 'Critical' or 'Priority' responses was only 3.4% and that it would correctly predict those who had the selected mental health diagnosis 9% of the time.^

Assessment of occupational exposures to organic chemicals in a plastics manufacturing facility

The objective of this dissertation was to design and implement strategies for assessment of exposures to organic chemicals used in the production of a styrene-butadiene polymer at the Texas Plastics Company (TPC). Linear statistical retrospective exposure models, univariate and multivariate, were developed based on the validation of historical industrial hygiene monitoring data collected by industrial hygienists at TPC, and additional current industrial hygiene monitoring data collected for the purposes of this study. The current monitoring data served several purposes. First, it provided information on current exposure data, in the form of unbiased estimates of mean exposure to organic chemicals for each job title included. Second, it provided information on homogeneity of exposure within each job title, through the use of a carefully designed sampling scheme which addressed variability of exposure both between and within job titles. Third, it permitted the investigation of how well current exposure data can serve as an evaluation tool for retrospective exposure estimation. Finally, this dissertation investigated the simultaneous evaluation of exposure to several chemicals, as well as the use of values below detection limits in a multivariate linear statistical model of exposures. ^

Q method factor analysis of stakeholder social perspectives of the effectiveness of Environmental Impact Assessment public participation in the Western Cape, South Africa

Public participation is an integral part of Environmental Impact Assessment (EIA), and as such, has been incorporated into regulatory norms. Assessment of the effectiveness of public participation has remained elusive however. This is partly due to the difficulty in identifying appropriate effectiveness criteria. This research uses Q methodology to discover and analyze stakeholder's social perspectives of the effectiveness of EIAs in the Western Cape, South Africa. It considers two case studies (Main Road and Saldanha Bay EIAs) for contextual participant perspectives of the effectiveness based on their experience. It further considers the more general opinion of provincial consent regulator staff at the Department of Environmental Affairs and the Department of Planning (DEA&DP). Two main themes of investigation are drawn from the South African National Environmental Management Act imperative for effectiveness: firstly, the participation procedure, and secondly, the stakeholder capabilities necessary for effective participation. Four theoretical frameworks drawn from planning, politics and EIA theory are adapted to public participation and used to triangulate the analysis and discussion of the revealed social perspectives. They consider citizen power in deliberation, Habermas' preconditions for the Ideal Speech Situation (ISS), a Foucauldian perspective of knowledge, power and politics, and a Capabilities Approach to public participation effectiveness. The empirical evidence from this research shows that the capacity and contextual constraints faced by participants demand the legislative imperatives for effective participation set out in the NEMA. The implementation of effective public participation has been shown to be a complex, dynamic and sometimes nebulous practice. The functional level of participant understanding of the process was found to be significantly wide-ranging with consequences of unequal and dissatisfied stakeholder engagements. Furthermore, the considerable variance of stakeholder capabilities in the South African social context, resulted in inequalities in deliberation. The social perspectives revealed significant differences in participant experience in terms of citizen power in deliberation. The ISS preconditions are highly contested in both the Saldanha EIA case study and the DEA&DP social perspectives. Only one Main Road EIA case study social perspective considered Foucault's notion of governmentality as a reality in EIA public participation. The freedom of control of ones environment, based on a Capabilities approach, is a highly contested notion. Although agreed with in principle, all of the social perspectives indicate that contextual and capacity realities constrain its realisation. This research has shown that Q method can be applied to EIA public participation in South Africa and, with the appropriate research or monitoring applications it could serve as a useful feedback tool to inform best practice public participation.

Estudio de la variación del contenido de humedad en el Pinus pinaster Ait. por medio de la técnica no destructiva del georradar / Assessment of the variation of the moisture content in the Pinus pinaster Ait using the non destructive gpr technique

La variación en el contenido de humedad (CH) tiene una influencia significativa tanto en las propiedades físico- químicas de la madera, como en sus propiedades electromagnéticas y por tanto afecta a las características de la propagación de las ondas. En concreto, en este trabajo se estudia la capacidad del georradar (GR) empleando una antena de 1.6GHz de frecuencia central para registrar las variaciones que se producen en la velocidad y en la amplitud de las ondas electromagnéticas cuando se propagan en unas viguetas de madera de Pinus pinaster Ait de uso estructural cuyo CH va disminuyendo. Se ha comprobado como cuando el CH descendía la velocidad de propagación y las amplitudes, tanto de la onda directa como de la reflejada aumentaba. Los altos factores de correlación encontrados demuestran que el GR es una técnica capaz de evaluar, de forma no destructiva, el CH de la madera de uso estructural. The moisture content variations in wood have a significant influence in wood?s physicochemical properties, as well as in its electromagnetic properties and to specific effects upon waves? characteristics. In particular, this paper focuses on the analysis of the Ground-penetrating Radar?s (GPR) using an antenna of 1.6 GHz central frequency capacity to register the velocity and the amplitude of the electromagnetic waves? variation during the drying process of Pinus pinaster Ait timber joists. The results showed that when timber MC descended, the propagation velocity and amplitude of both the direct and the reflected wave increased. The high correlation found between the variables studied demonstrates GPR efficiency and the innovative application of this technique as a non-destructive evaluation tool for timber structures, particularly when studying its moisture content.

Approach to the use of indicators for the assessment of the environmental level of construction products

The European construction industry is supposed to consume the 40% of the natural European resources and to generate the 40% of the European solid waste. Conscious of the great damage being suffered by the environment because of construction activity, this work tries to provide the building actors with a new tool to improve the current situation. The tool proposed is a model for the comprehensive evaluation of construction products by determining their environmental level. In this research, the environmental level of a construction product has been defined as its quality of accomplishing the construction requirements needed by causing the minimum ecological impact in its surrounding environment. This information allows building actors to choose suitable materials for building needs and also for the environment, mainly in the project stage or on the building site, contributing to improve the relationship between buildings and environment. For the assessment of the environmental level of construction products, five indicators have been identified regarding their global environmental impact through the product life cycle: CO2 emissions provoked during their production, volume and toxicity of waste generated on the building site, durability and recycling capacity after their useful life. Therefore, the less environmental impact one construction product produces, the higher environmental level performs. The model has been tested in 30 construction products that include environmental criteria in their description. The results obtained will be discussed in this article. Furthermore, this model can lay down guidelines for the selection of ecoefficient construction products and the design of new eco-competitive and eco-committed ones

Reflectance anisotropy spectroscopy assessment of the MOVPE nucleation of GaInP on Germanium (100)

This work summarizes the observations made on the variation and time evolution of the reflectanceanisotropy signal during the MOVPE growth of GaInPnucleation layers on Germanium substrates. This in situ monitoring tool is used to assess the impact of different nucleation routines and reactor conditions on the quality of the layers grown. This comparison is carried out by establishing a correlation between reflectanceanisotropy signature at 2.1 eV and the morphology of the epilayers evaluated by atomic force microscopy (AFM). This paper outlines the potential of reflectanceanisotropy to predict, explore, and therefore optimize, the best growth conditions that lead to a high quality III–V epilayer on a Ge substrate

Consequences of different meteorological scenarios in the environmental impact assessment of tritium in air

The environmental impact of systems managing large (kg) tritium amount represents a public scrutiny issue for the next coming fusion facilities as ITER and DEMO. Furthermore, potentially new dose limits imposed by international regulations (ICRP) shall impact next coming devices designs and the overall costs of fusion technology deployment. Refined environmental tritium dose impact assessment schemes are then overwhelming. Detailed assessments can be procured from the knowledge of the real boundary conditions of the primary tritium discharge phase into atmosphere (low levels) and into soils. Lagrangian dispersion models using real-time meteorological and topographic data provide a strong refinement. Advance simulation tools are being developed in this sense. The tool integrates a numerical model output records from European Centre for Medium range Weather Forecast (ECMWF) with a lagrangian atmospheric dispersion model (FLEXPART). The composite model ECMWF/FLEXTRA results can be coupled with tritium dose secondary phase pathway assessment tools. Nominal tritium discharge operational reference and selected incidental ITER-like plant systems tritium form source terms have been assumed. The realtime daily data and mesh-refined records together with lagrangian dispersion model approach provide accurate results for doses to population by inhalation or ingestion in the secondary phase

Atmospheric modelling of tritium forms transport: review of capabilities and R&D needs for the assessment of fusion facilities environmental impact

One of the key scrutiny issues of new coming energy era would be the environmental impact of fusion facilities managing one kg of tritium. The potential change of committed dose regulatory limits together with the implementation of nuclear design principles (As Low as Reasonably achievable - ALARA -, Defense in Depth -D-i-D-) for fusion facilities could strongly impact on the cost of deployment of coming fusion technology. Accurate modeling of environmental tritium transport forms (HT, HTO) for the assessment of fusion facility dosimetric impact in Accidental case appears as of major interest. This paper considers different short-term releases of tritium forms (HT and HTO) to the atmosphere from a potential fusion reactor located in the Mediterranean Basin. This work models in detail the dispersion of tritium forms and dosimetric impact of selected environmental patterns both inland and in-sea using real topography and forecast meteorological data-fields (ECMWF/FLEXPART). We explore specific values of this ratio in different levels and we examine the influence of meteorological conditions in the HTO behavior for 24 hours. For this purpose we have used a tool which consists on a coupled Lagrangian ECMWF/FLEXPART model useful to follow real time releases of tritium at 10, 30 and 60 meters together with hourly observations of wind (and in some cases precipitations) to provide a short-range approximation of tritium cloud behavior. We have assessed inhalation doses. And also HTO/HT ratios in a representative set of cases during winter 2010 and spring 2011 for the 3 air levels.

Decarbonization of toll plazas: impact assessment of toll collection system management

Transport climate change impacts have become a worldwide concern. The use of Intelligent Transport Systems (ITS) could contribute to a more effective use of resources in toll road networks. Management of toll plazas is central to the reduction of greenhouse gas (GHG) emissions, as it is there that bottlenecks and congestion occur. This study focuses on management strategies aimed at reducing climate change impacts of toll plazas by managing toll collection systems. These strategies are based on the use of different collection system technologies – Electronic Toll Collection (ETC) and Open Road Tolling (ORT) – and on queue management. The carbon footprint of various toll plazas is determined by a proposed integrated methodology which estimates the carbon dioxide (CO2) emissions of the different operational stages at toll plazas (deceleration, service time, acceleration, and queuing) for the different toll collection systems. To validate the methodology, two main-line toll plazas of a Spanish toll highway were evaluated. The findings reveal that the application of new technologies to toll collection systems is an effective management strategy from an environmental point of view. The case studies revealed that ORT systems lead to savings of up to 70% of CO2 emissions at toll plazas, while ETC systems save 20% comparing to the manual ones. Furthermore, queue management can offer a 16% emissions savings when queue time is reduced by 116 seconds. The integrated methodology provides an efficient environmental management tool for toll plazas. The use of new technologies is the future of the decarbonization of toll plazas.

Assessment of "mobile mapping system": A GIS-based support methodology

In this article, the authors examine the current status of different elements that integrate the landscape of the municipality of Olias del Rey in Toledo (Spain). A methodology for the study of rural roads, activity farming and local hunting management. We used Geographic Information Technologies (GIT) in order to optimize spatial information including the design of a Geographic Information System (GIS). In the acquisition of field data we have used vehicle "mobile mapping" instrumentation equipped with GNSS, LiDAR, digital cameras and odometer. The main objective is the integration of geoinformation and geovisualization of the information to provide a fundamental tool for rural planning and management.

Seismic Risk Scenarios in Puerto Principe (Haiti). A Tool for Reconstruction and Emergency Planning

The 12 January 2010, an earthquake hit the city of Port-au-Prince, capital of Haiti. The earthquake reached a magnitude Mw 7.0 and the epicenter was located near the town of Léogâne, approximately 25 km west of the capital. The earthquake occurred in the boundary region separating the Caribbean plate and the North American plate. This plate boundary is dominated by left-lateral strike slip motion and compression, and accommodates about 20 mm/y slip, with the Caribbean plate moving eastward with respect to the North American plate (DeMets et al., 2000). Initially the location and focal mechanism of the earthquake seemed to involve straightforward accommodation of oblique relative motion between the Caribbean and North American plates along the Enriquillo-Plantain Garden fault system (EPGFZ), however Hayes et al., (2010) combined seismological observations, geologic field data and space geodetic measurements to show that, instead, the rupture process involved slip on multiple faults. Besides, the authors showed that remaining shallow shear strain will be released in future surface-rupturing earthquakes on the EPGFZ. In December 2010, a Spanish cooperation project financed by the Politechnical University of Madrid started with a clear objective: Evaluation of seismic hazard and risk in Haiti and its application to the seismic design, urban planning, emergency and resource management. One of the tasks of the project was devoted to vulnerability assessment of the current building stock and the estimation of seismic risk scenarios. The study was carried out by following the capacity spectrum method as implemented in the software SELENA (Molina et al., 2010). The method requires a detailed classification of the building stock in predominant building typologies (according to the materials in the structure and walls, number of stories and age of construction) and the use of the building (residential, commercial, etc.). Later, the knowledge of the soil characteristics of the city and the simulation of a scenario earthquake will provide the seismic risk scenarios (damaged buildings). The initial results of the study show that one of the highest sources of uncertainties comes from the difficulty of achieving a precise building typologies classification due to the craft construction without any regulations. Also it is observed that although the occurrence of big earthquakes usually helps to decrease the vulnerability of the cities due to the collapse of low quality buildings and the reconstruction of seismically designed buildings, in the case of Port-au-Prince the seismic risk in most of the districts remains high, showing very vulnerable areas. Therefore the local authorities have to drive their efforts towards the quality control of the new buildings, the reinforcement of the existing building stock, the establishment of seismic normatives and the development of emergency planning also through the education of the population.