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.

Age and gender influences on sensory perceptions of novel low cost nutrient-rich food products developed using traditional Ghanaian food ingredients

Background: A number of factors are known to influence food preferences and acceptability of new products. These include their sensory characteristics and strong, innate neural influences. In designing foods for any target group, it is important to consider intrinsic and extrinsic characteristics which may contribute to palatability, and acceptability of foods. Objective: To assess age and gender influences on sensory perceptions of novel low cost nutrient-rich food products developed using traditional Ghanaian food ingredients. Materials and Methods: In this study, a range of food products were developed from Ghanaian traditional food sources using the Food Multimix (FMM) concept. These products were subjected to sensory evaluation to assess the role of sensory perception on their acceptability among different target age groups across the life cycle (aged 11-68 years olds) and to ascertain any possible influences of gender on preference and choice. Variables including taste, odour, texture, flavour and appearance were tested and the results captured on a Likert scale and scores of likeness and acceptability analysed. Multivariate analyses were used to develop prediction models for targeted recipe development for different target groups. Multiple factor analysis of variance (ANOVA) and logistic linear regression were employed to test the strength of acceptability and to ascertain age and gender influences on product preference. Results: The results showed a positive trend in acceptability (r = 0.602) which tended towards statistical significance (p = 0.065) with very high product favourability rating (91% acceptability; P=0.005). However, age [odds ratios=1.44 (11-15 years old) odds ratios=2.01 (18-68 years old) and gender (P=0.000)] were major influences on product preference with children and females (irrespective of age) showing clear preferences or dislike of products containing certain particular ingredients. Conclusion: These findings are potentially useful in planning recipes for feeding interventions involving different vulnerable and target groups.

Microbial spatial variability: An example from the Celtic Sea

In July 2004, dominant populations of microbial ultraplankton (<5 μm), in the surface of the Celtic Sea (between UK and Eire), were repeatedly mapped using flow cytometry, at 1.5 km resolution over a region of diameter 100 km. The numerically dominant representatives of all basic functional types were enumerated including one group of phototrophic bacteria (Syn), two groups of phytoplankton (PP, NP), three groups of heterotrophic bacterioplankton (HB) and the regionally dominant group of heterotrophic protists (HP). The distributions of all organisms showed strong spatial variability with little relation to variability in physical fields such as salinity and temperature. Furthermore, there was little agreement between distributions of different organisms. The only linear correlation consistently explaining more than 50% of the variance between any pairing of the organism groups enumerated is between two different groups of HB. Specifically, no linear, or non-linear, relationship is found between any pairings of SYB, PP or HB groups with their protist predators HP. Looking for multiple dependencies, factor analysis reveals three groupings: Syn, PP and low nucleic acid content HB (LNA); high nucleic acid content HB (HNA); HP and NP. Even the manner in which the spatial variability of Syn, PP and HB abundance varies as a function of lengthscale (represented by a semivariogram) differs significantly from that for HP. In summary, although all microbial planktonic groups enumerated are present and numerically dominant throughout the region studied, at face value the relationships between them seem weak. Nevertheless, the behaviour of a simple, illustrative ecological model, with strongly interacting phototrophs and heterotrophs, with stochastic forcing, is shown to be consistent with the observed poor correlations and differences in how spatial variability varies with lengthscale. Thus, our study suggests that a comparison of microbial abundances alone may not discern strong underlying trophic interactions. Specific knowledge of these processes, in particular grazing, will be required to explain the causes of the observed microbial spatial variability and its resulting consequences for the functioning of the ecosystem.

The validity of the MacNew Quality of Life Questionnaire in heart disease.

Background A previous review suggested that the MacNew Quality of Life Questionnaire was the most appropriate disease-specific measure of health-related quality of life among people with ischaemic heart disease. However, there is ambiguity about the allocation of items to the three factors underlying the MacNew and the factor structure has not been confirmed previously among the people in the UK. Methods The MacNew Questionnaire and the SF-36 were administered to 117 newly admitted patients to a tertiary referral centre in Northern Ireland. All patients had been diagnosed with ischaemic heart disease. Results A confirmatory factor analysis was conducted on the factor structure of the MacNew and the model was found to be an inadequate fit of the data. A quantitative and qualitative analysis of the items suggested that a five factor solution was more appropriate and this was validated by confirmatory factor analysis. This new structure also displayed strong evidence of concurrent validity when compared to the SF-36. Conclusion We recommend that researchers should submit scores obtained from items on the MacNew to secondary analyses after being grouped according to the factor structure proposed in this paper, in order to explore further the most appropriate grouping of items.

Client's assessment of architects' performance in building delivery process: Evidence from Nigeria

The overall intent of this research is to provide architects with information that can be used to improve their performance so as to optimally satisfy the client's requirements and achieve high-quality overall project performance in Nigerian construction industry. Architect performance criteria were identified based on literature within the domain of architect responsibilities. The assessment of architects’ performance was carried out through a questionnaire survey of clients of recently completed building projects in Nigeria. Analysis of data includes comparison of criteria using importance–performance index analysis. Factor analysis was carried out on criteria where architects are falling below average, to group and explore the latent structure of the criteria in the data. The results showed that the architect needs to focus on management skills and ability, buildability, design quality, project communication, project integration and client focus. These results would encourage architects to perform better within their full responsibilities in the building delivery process and deliver high-quality projects within Nigerian construction industry.

Teacher attitudes and best practices with ICT faculty Adult Continuing Education in Andalusia

The present paper reports the results of a study aiming to describe the attitudes of teachers in adult continuous education in the Autonomous Community of Andalusia (Spain) towards the use and integration of information and communication technologies (ITC) in the educational centres they work in, while identifying those factors that favour the development of good practice. It is a mixed methods descriptive research, and information collection techniques include a questionnaire and in-depth interviews. A total number of 172 teachers were surveyed, as well as 18 head teachers and coordinators, in adult education. For questionnaire validation the expert judgment technique was used, as they were selected by the «expert competence coefficient» or «K coefficient» procedure. To improve its psychometric properties, construct validity was determined by means of Varimax factor analysis and maximum likelihood extraction (two factors were extracted). Confidence was set by Cronbach's alpha (0.88). The interview guide was also validated by this group of experts. Results point out, on one hand, that teachers hold positive attitudes towards ICT regarding both ICT's role in professional development and their ease of use and access. On the other hand, among the most important factors for ICT-supported good educational practices lies in ICT's capacity to favour personalized work.

Adaptation of a questionnaire to assess the epistemological beliefs of mathematics in secondary school teachers

The objective of the study is to determine the psychometric properties of the Epistemological Beliefs Questionnaire on Mathematics. 171 Secondary School Mathematics Teachers of the Central Region of Cuba participated. The results show acceptable internal consistency. The factorial structure of the scale revealed three major factors, consistent with the Model of the Three Constructs: beliefs about knowledge, about learning and teaching. Irregular levels in the development of the epistemological belief system about mathematics of these teachers were shown, with a tendency among naivety and sophistication poles. In conclusion, the questionnaire is useful for evaluating teacher’s beliefs about mathematics.

Predictors of attitudes toward inclusion of students with special educational needs in future education professionals

One of the main pillars in the development of inclusive schools is the initial teacher training. Before determining if it is necessary to make changes (and of what type) in training programs or curriculum guides related to the attention to diversity and inclusive education, the attitudes of future education professionals in this area should be analyzed. This includes the identification of the relevant predictors of inclusive attitudes. The research reported in this article pursued this objective, doing so with a quantitative survey methodology based on the use of cross-sectional structured data collection and statistical analyses related to the quality of the attitude questionnaire (factor analysis and Cronbach's alpha), descriptive statistics, correlations, hypothesis tests for difference of means, and regression analysis in order to predict attitudes towards inclusion in education. Firstly, the results show that the participants held very positive attitudes toward the inclusion of students with special educational needs. Particularly, older respondents, those with a longer training and, to a lesser extent, women and those who had been in touch with disabled people stood out within this attitude. Secondly, it is evidenced that self-transcendence values ​and, more weakly, contact, function as robust predictors of attitudes of future practitioners towards the inclusion of students with special needs. Some applications for the initial professionalization of educators are suggested in the discussion.

Video games in the classrooms: implications of a disruptive innovation to develop the Multiple Intelligences

The present study aims to identify the framework of personal, organizational and technical variables that contribute to the viability and successful of innovative educational practices with video games within the school context to enhance the multiple intelligences. For this purpose, advantage was taken on the information previously collected through a questionnaire about the views, thoughts and experiences of a group of teachers of childhood and primary education (N=25) who voluntarily participated in a blended training activity from Center of Teachers (CEFIRE) of Valencia, around a community of practice aimed at promoting and advising projects for implementing educational video games in the classroom. The mixed methodology adopted has allowed the following: a) describe the relationship between their degree of development and daily use made of ICT in the classroom, their level of familiarity with video games,  their previous experience to integrate them for educational purposes..., and their participation in projects that focus on game-based learning; b) conduct content analysis of the opinions and thoughts expressed in a forum for teachers on innovation on and methodological strategies adopted reflected in a virtual board; and c) develop a SWOT analysis: Strengths, Weaknesses, Opportunities and Threats inherent in the implementation of experience with video games in the classroom. Among the conclusions, it is highlighted that, even though most did not have specific training or enough technological resources and the planning and implementation of innovation required them a great investment of time, their personal interest, the support given by members of the online community of practice, helped to encourage their activity, along with receptivity, positive attitude and high motivation of students with the experience. These aspects have been crucial to promote successful innovative practices with video games.

Reliability and Validity of the Child Health QuestionnairePF-50 for European Children with Cerebral Palsy

Objective: To evaluate the psychometric performance of the Child Health Questionnaire (CHQ) in children with cerebral palsy (CP).
Method: 818 parents of children with CP, aged 8–12 from nine regions of Europe completed the CHQ (parent form 50 items). Functional abilities were classified using the five-level Gross Motor Function Classification Scheme (Levels I–III as ambulant; Level IV–V as nonambulant CP).
Results: Ceiling effects were observed for a number of subscales and summary scores across all Gross Motor Function Classification System levels, whilst floor effects occurred only in the physical functioning scale (Level V CP). Reliability was satisfactory overall. Confirmatory factor analysis (CFA) revealed a seven-factor structure for the total sample of children with CP but with different factor structures for ambulant and nonambulant children.
Conclusion: The CHQ has limited applicability in children with CP, although with judicious use of certain domains for ambulant and nonambulant children can provide useful and comparable data about child health status for descriptive purposes.

Species distribution and coordination of uranyl chloro complexes in acetonitrile

The complex formation of the uranyl ion, UO22+, with chloride ions in acetonitrile has been investigated by factor analysis of UV-vis absorption and U L-3 edge EXAFS (extended X-ray absorption fine structure) spectra. As a function of increasing [Cl-]/[UO22+] ratio, the five monomeric species [UO2(H2O)(5)](2+), [UO2Cl(H2O)(2)(MeCN)(2)](+), [UO2Cl2(H2O)(MeCN)(2)], [UO2Cl3(MeCN)(2)](-), and [UO2Cl4](2-) have been observed. The distances determined in the first coordination sphere are: U-O-ax = 1.77 angstrom, U-O-H2O = 2.43 angstrom, U-N-MeCN = 2.53 angstrom, and U-Cl = 2.68 angstrom. A crystalline material has been obtained from the intermediate solution with the [Cl-]/[UO22+] ratio of similar to 2, where [UO2Cl2(H2O)(MeCN)(2)] is the dominating species. The crystal structure analysis of this material revealed a tetrameric complex, [(UO2)(4)(mu(2)-Cl)(4)(mu(3)-O)(2)(H2O)(2)(CH3CN)(4)]center dot(CH3CN). The crystal data are: monoclinic, space group P2(1)/n, a 10.6388(5) angstrom, b = 14.8441(5) angstrom, c = 10.8521(5) angstrom, beta = 109.164(5)degrees, and Z = 2. The U(VI) coordination of the solution species [UO2Cl2(H2O)(MeCN)(2)] changes during the crystallization by replacing one MeCN molecule with a bridging mu(3)-O atom in the tetramer.

Finding the magic number

Paul Wilson and Colin Cooper investigate methods used to extract the number of factors in a factor analysis

Surveying nursing students on their sources of stress: A validation study

This study tested the psychometric properties of a questionnaire that measured sources of distress and eustress, or good stress, in nursing students. The Transactional model of stress construes stress in these different ways and is frequently used to understand sources of stress, coping and stress responses. Limited research has attempted to measure sources of distress and eustress or sources that can potentially enhance performance and well-being. A volunteer sample of final year nursing students (n = 120) was surveyed in the United Kingdom in 2007. The questionnaire measured sources of stress and measures of psychological well-being were taken to test construct validity. This was tested through an exploratory factor analysis. This reduced the questionnaire from 49 to 29 items and suggested three factors: learning and teaching, placement related and course organization; second, it was analysed by testing the assumptions of the Transactional model, the model on which the questionnaire was based. In line with the assumptions of the model, measures of distress related to adverse well-being, and measures of eustress related to healthier well-being responses. The test–retest reliability estimate was 0.8. While certain programme issues were associated with distress, placement-related experiences were the most important source of eustress.

Recognising the co-occurance of domestic and child abuse: a comparison of community and hospital-based midwives

This study aimed to compare and contrast how midwives working in either hospital or community settings are currently responding to the cooccurrence of domestic and child abuse (CA), their perceived role and willingness to identify abuse, record keeping, reporting of suspected or definite cases of CA and training received. A survey questionnaire was sent to 861 hospital and community midwives throughout Northern Ireland which resulted in 488 midwives completing the questionnaire, leading to a 57% response rate. Comparisons were made using descriptive statistics and cross-tabulation, and the questionnaire was validated using exploratory factor analysis. Community midwives reported receiving more training on domestic and CA. Although a high percent of both hospital and community midwives acknowledged a link between domestic violence (DV) and CA, it was the community midwives who encountered more suspected and definite (P <0.001) cases of CA. More community midwives reported to be aware of the mechanisms for reporting CA. However, an important finding is that although 12% of community midwives encountered a definite case of CA, only 2% reported the abuse, leaving a 10% gap between reporting and identifying definite cases of CA. Findings suggest that lack of education and training was a problem as only a quarter of hospital-based midwives reported to have received training on DV and 40% on CA. This was significantly less than that received by community midwives, as 57% received training on DV, and 62% on CA. The study suggests that midwives need training on how to interact with abused mothers using non-coercive, supportive and empowering mechanisms. Many women may not spontaneously disclose the issues of child or domestic abuse in their lives, but often respond honestly to a sensitively asked question. This issue is important as only 13% of the sample actually asked a woman a direct question about DV.

Factors That Impact Technology Innovation Adoption Among Irish Professional Service Sector SMEs

This paper disseminates the findings from a study into the factors impacting technological innovation adoption and diffusion specific to the deployment of electronic-commerce strategies within professional service sector SMEs in Ireland. Confirmatory factor analysis was performed and seven factors relating to a firm's external/internal environment were found to underpin adoption. These are: electronic-commerce capability; willingness to change/rate of response to new technologies; technological opportunity recognition; customer orientation; sensitivity to competitive/customer environments; perceptions of technology feasibility; and e-skills development mechanisms. t-tests revealed differences between adopters and non-adopters, and forward stepwise logistic regression is used to assess the extent to which these seven factors actually predict electronic-commerce adoption. It was found that electronic-commerce capability and the willingness to change/rate of response to new technologies are the two most important factors affecting adoption behaviours. © Imperial College Press.