Dr. Dave McCarthy

Professor McCarthy lecturing in one of the Thistle lecture halls.

Regurgitating Nature: On a Celebrated Anecdote by Karel van Mander about Pieter Bruegel the Elder

The curious anecdote in Karel van Mander’s biography of Bruegel, where the artist is said to have swallowed all the mountains and rocks during his crossing of the Alps and spat them out again onto canvas and panels upon returning home, has been quoted by almost every Bruegel scholar. Yet it has never been given a full explanation. In this study, it is proposed that the passage, echoing on one level Bruegel’s frequent depiction of overindulging peasants, disguises a highly cultivated reference to the theory of imitation as a digestive process, or innutrition theory, which was widely used by humanist writers of the time to champion vernacular expression.

Some Awkward Questions about Supervision - Dave Green

Slides from Workshop Dave Green 2012

Are we wasting our money on food supplements in elder care wards?

Background. It is reported that undernutrition in older hospitalized patients is commonly found, but estimates of its prevalence vary. It is also not clear which treatment approaches are best because poor methodology prevents comparison of outcomes between different studies. Rationale. The rationale of this observational study was to look at typical elder care wards in order to determine what food supplements were being prescribed. We wished to determine whether serum albumin and/or body mass index (BMI) were appropriately related to the prescription of sip feeds and also to determine the palatability of supplements provided. Method. We monitored the wastage of sip feeds over a 24-hour period and extrapolated an estimated cost. Ninety-six patients were studied, including 23 patients with a BMI of less than 20, of whom 30% were on supplementary feeds. Results. Seventy percentage of prescribed sip feeds were being given to people with a BMI of 20 or more. The mean wastage in this 24-hour period was 63% (pound79.56) in four wards containing 96 older patients. Conclusion. We concluded that there was no relationship between the numbers of patients with a low albumin and BMI and the prescription of sip feeds. We found compliance to be low (37%) because of poor palatability, with a large number of patients who appeared to require sip feeds not being prescribed them and those who received them wasting more than they drank.

Translating and testing the Alberta Context Tool for use among nurses in Swedish elder care

Background. There is emerging evidence that context is important for successful transfer of research knowledge into health care practice. The Alberta Context Tool (ACT) is a Canadian developed research-based instrument that assesses 10 modifiable concepts of organizational context considered important for health care professionals’ use of evidence. Swedish and Canadian health care have similarities in terms of organisational and professional aspects, suggesting that the ACT could be used for measuring context in Sweden. This paper reports on the translation of the ACT to Swedish and a testing of preliminary aspects of its validity, acceptability and reliability in Swedish elder care. Methods. The ACT was translated into Swedish and back-translated into English before being pilot tested in ten elder care facilities for response processes validity, acceptability and reliability (Cronbach’s alpha). Subsequently, further modification was performed. Results. In the pilot test, the nurses found the questions easy to respond to (52%) and relevant (65%), yet the questions’ clarity were mainly considered ‘neither clear nor unclear’ (52%). Missing data varied between 0 (0%) and 19 (12%) per item, the most common being 1 missing case per item (15 items). Internal consistency (Cronbach’s Alpha > .70) was reached for 5 out of 8 contextual concepts. Translation and back translation identified 21 linguistic- and semantic related issues and 3 context related deviations, resolved by developers and translators. Conclusion. Modifying an instrument is a detailed process, requiring time and consideration of the linguistic and semantic aspects of the instrument, and understanding of the context where the instrument was developed and where it is to be applied. A team, including the instrument’s developers, translators, and researchers is necessary to ensure a valid translation. This study suggests preliminary validity, reliability and acceptability evidence for the ACT when used with nurses in Swedish elder care.

Adaptação transcultural para o Português/Brasil do instrumento vulnerability to abuse screening scale (VASS)

Esse trabalho objetivou promover a adaptação transcultural para o Brasil da VASS. Os passos para adaptação transcultural seguirão a proposta de operacionalização alicerçado na apreciação de diferentes tipos de equivalência: a conceitual e de itens, a semântica e a de mensuração. Para alcançar as duas primeiras etapas utilizou-se as técnicas de tradução e retrotradução associada ao procedimento intitulado Painel de Especialistas. Para o pré-teste e verificação de equivalência de mensuração, aplicou-se o questionário com uma população de 30 e 66 idosos, respectivamente. Para as análises dos resultados foi utilizada a estatística descritiva e inferencial, em especial o KR-20, teste T de student, correlação de Pearson e ANOVA univariada, bem como o método kappa de Fleiss para verificação do índice de confiabilidade. Verificou-se que o conceito utilizado para construção do instrumento, bem como seus itens se mostram adequados à investigação do fenômeno. Evidenciou-se boa equivalência semântica entre os itens das retrotraduções e do instrumento original, especialmente quanto aos resultados de T1 R1. Os juízes optaram pelo uso de 11 itens de T1 à versão-síntese. A equivalência operacional mostrou-se satisfatória. Em geral, os resultados apresentados mostraram-se aceitáveis. Quanto à etapa da equivalência de mensuração, verificou-se que a idade dos participantes variou entre 60 a 84 anos, prevalecendo respondentes idosas (n = 38), representando 57,6% da amostra estudada. O valor do KR-20 para o escore geral do instrumento foi de 0,688 (IC95%: 0,670). Os valores encontrados para as quatro dimensões propostas pelos autores do estudo inicial do instrumento foram 0,528, 0,289, 0,552 e 0,303, respectivamente. Apenas os valores de consistência interna das subescalas Vulnerabilidade e Coerção mostraram-se aproximados aos encontrados no estudo original, a saber, 0,550 e 0,390, respectivamente. Verificou-se que com a retirada dos itens nº 04, nº 06 e nº 10, houve aumento do índice de consistência interna da escala total. Já quanto aos valores da consistência interna das subescalas, percebeu-se que apenas com a retirada dos itens nº 09, referente à escala que dimensiona o Desânimo, e nº 12, item da subescala Coerção, é que houve acréscimo nesses valores. Destaca-se que esses são resultados preliminares, uma vez que após a verificação da adequabilidade e de padrões psicométricos iniciais acerca do uso do instrumento para a população idosa, ainda há de se dar continuidade à etapa concernente à verificação de propriedades psicométricas robustas do instrumento, que indiquem, por exemplo, evidências de fidedignidade em situação de teste-reteste, validade de constructo e de critério, se possível e aplicável. A principal limitação do estudo é a falta de um instrumento padrão-ouro para testar a fidedignidade, sensibilidade e especificidade do instrumento em questão. Apesar desta limitação, a adaptação transcultural e a verificação de propriedades psicométricas preliminares do instrumento de uma medida de autorrelato que afere indicativo de violência doméstica contra o idoso tem sua relevância e foi satisfatória

Narrow-band search of continuous gravitational-wave signals from Crab and Vela pulsars in Virgo VSR4 data

In this paper we present the results of a coherent narrow-band search for continuous gravitational-wave signals from the Crab and Vela pulsars conducted on Virgo VSR4 data. In order to take into account a possible small mismatch between the gravitational-wave frequency and two times the star rotation frequency, inferred from measurement of the electromagnetic pulse rate, a range of 0.02 Hz around two times the star rotational frequency has been searched for both the pulsars. No evidence for a signal has been found and 95% confidence level upper limits have been computed assuming both that polarization parameters are completely unknown and that they are known with some uncertainty, as derived from x-ray observations of the pulsar wind torii. For Vela the upper limits are comparable to the spin-down limit, computed assuming that all the observed spin-down is due to the emission of gravitational waves. For Crab the upper limits are about a factor of 2 below the spin-down limit, and represent a significant improvement with respect to past analysis. This is the first time the spin-down limit is significantly overcome in a narrow-band search.

Directed search for gravitational waves from Scorpius X-1 with initial LIGO data

We present results of a search for continuously emitted gravitational radiation, directed at the brightest low-mass x-ray binary, Scorpius X-1. Our semicoherent analysis covers 10 days of LIGO S5 data ranging from 50-550 Hz, and performs an incoherent sum of coherent F-statistic power distributed amongst frequency-modulated orbital sidebands. All candidates not removed at the veto stage were found to be consistent with noise at a 1% false alarm rate. We present Bayesian 95% confidence upper limits on gravitational-wave strain amplitude using two different prior distributions: a standard one, with no a priori assumptions about the orientation of Scorpius X-1; and an angle-restricted one, using a prior derived from electromagnetic observations. Median strain upper limits of 1.3 x 10(-24) and 8 x 10(-25) are reported at 150 Hz for the standard and angle-restricted searches respectively. This proof-of-principle analysis was limited to a short observation time by unknown effects of accretion on the intrinsic spin frequency of the neutron star, but improves upon previous upper limits by factors of similar to 1.4 for the standard, and 2.3 for the angle-restricted search at the sensitive region of the detector.