An item response analysis of the motor and behavioral subscales of the unified Huntington's disease rating scale in huntington disease gene expansion carriers

Although the Unified Huntington's Disease Rating Scale (UHDRS) is widely used in the assessment of Huntington disease (HD), the ability of individual items to discriminate individual differences in motor or behavioral manifestations has not been extensively studied in HD gene expansion carriers without a motor-defined clinical diagnosis (ie, prodromal-HD or prHD). To elucidate the relationship between scores on individual motor and behavioral UHDRS items and total score for each subscale, a nonparametric item response analysis was performed on retrospective data from 2 multicenter longitudinal studies. Motor and behavioral assessments were supplied for 737 prHD individuals with data from 2114 visits (PREDICT-HD) and 686 HD individuals with data from 1482 visits (REGISTRY). Option characteristic curves were generated for UHDRS subscale items in relation to their subscale score. In prHD, overall severity of motor signs was low, and participants had scores of 2 or above on very few items. In HD, motor items that assessed ocular pursuit, saccade initiation, finger tapping, tandem walking, and to a lesser extent, saccade velocity, dysarthria, tongue protrusion, pronation/supination, Luria, bradykinesia, choreas, gait, and balance on the retropulsion test were found to discriminate individual differences across a broad range of motor severity. In prHD, depressed mood, anxiety, and irritable behavior demonstrated good discriminative properties. In HD, depressed mood demonstrated a good relationship with the overall behavioral score. These data suggest that at least some UHDRS items appear to have utility across a broad range of severity, although many items demonstrate problematic features.

Health-related quality of life in Huntington’s Disease patients: a comparison of proxy assessment and patient self-rating using the disease-specific Huntington’s Disease health-related quality of life questionnaire (HDQoL)

Huntington’s disease (HD) is a fatal, neurodegenerative disease for which there is no known cure. Proxy evaluation is relevant for HD as its manifestation might limit the ability of persons to report their health-related quality of life (HrQoL). This study explored patient–proxy ratings of HrQoL of persons at different stages of HD, and examined factors that may affect proxy ratings. A total of 105 patient–proxy pairs completed the Huntington’s disease health-related quality of life questionnaire (HDQoL) and other established HrQoL measures (EQ-5D and SF-12v2). Proxy–patient agreement was assessed in terms of absolute level (mean ratings) and intraclass correlation. Proxies’ ratings were at a similar level to patients’ self-ratings on an overall Summary Score and on most of the six Specific Scales of the HDQoL. On the Specific Hopes and Worries Scale, proxies on average rated HrQoL as better than patients’ self-ratings, while on both the Specific Cognitive Scale and Specific Physical and Functional Scale proxies tended to rate HrQoL more poorly than patients themselves. The patient’s disease stage and mental wellbeing (SF-12 Mental Component scale) were the two factors that primarily affected proxy assessment. Proxy scores were strongly correlated with patients’ self-ratings of HrQoL, on the Summary Scale and all Specific Scales. The patient–proxy correlation was lower for patients at moderate stages of HD compared to patients at early and advanced stages. The proxy report version of the HDQoL is a useful complementary tool to self-assessment, and a promising alternative when individual patients with advanced HD are unable to self-report.

The information content of REIT credit rating actions and transparency

We examine the short-run and long-run price reaction of equity REIT shares following credit rating actions, testing the transparency of the REIT structure. Generally, the economic effect on the stock price is subdued for both upgrades and downgrades compared to prior literature examining the broader U.S. equity market. An examination of trading volume revealed a significant increase in trading in reaction to downgrade credit rating changes, with a more subdued response to upgrades. The findings support the notion that REITs are more publicly forthcoming about the expectation of positive news in comparison to negative news.

Can environmental performance rating programmes succeed in Africa?: an evaluation of Ghana’s AKOBEN project

The purpose of the article is to describe and analyse Ghana’s AKOBEN programme which is the first environmental performance rating and public disclosure programme in Africa. Furthermore, by means of a SWOT analysis, the article assesses the suitability of AKOBEN as a veritable tool for promoting good environmental governance in Ghana specifically and Africa in general.

Do online hotel rating schemes influence booking behaviours?

Travelers’ hotel booking behaviors increasingly depend on peers' opinions and online ratings. This study investigates the effects of online hotel ratings on travelers' attitudes toward the hotel and booking intentions, using a 2 × 2 experimental research design. The results suggest that online rating lists are more useful and credible when published by well-known online travel communities (e.g., TripAdvisor). More favorable attitudes toward a hotel and higher booking intentions emerge when the hotel appears in best hotels lists. Finally, for the entries on best hotels lists, better attitudes and higher booking intentions result if the list is published on a well-known online travel community (Tripadvisor), whereas for entries on a worst hotel list, attitudes and booking intentions decrease even further if the list appears on TripAdvisor.

Do online hotel rating schemes influence booking behaviors?

Travelers’ hotel booking behaviors increasingly depend on peers' opinions and online ratings. This study investigates the effects of online hotel ratings on travelers' attitudes toward the hotel and booking intentions, using a 2 × 2 experimental research design. The results suggest that online rating lists are more useful and credible when published by well-known online travel communities (e.g., TripAdvisor). More favorable attitudes toward a hotel and higher booking intentions emerge when the hotel appears in best hotels lists. Finally, for the entries on best hotels lists, better attitudes and higher booking intentions result if the list is published on a well-known online travel community (Tripadvisor), whereas for entries on a worst hotel list, attitudes and booking intentions decrease even further if the list appears on TripAdvisor.

A New Yardstick for Rating Dental Arch Relationship in Patients With Complete Bilateral Cleft Lip and Palate

Objective: To develop yardsticks for assessment of dental arch relationship in young individuals with repaired complete bilateral cleft lip and palate appropriate to different stages of dental development. Participants: Eleven cleft team orthodontists from five countries worked on the projects for 4 days. A total of 776 sets of standardized plaster models from 411 patients with operated complete bilateral cleft lip and palate were available for the exercise. Statistics: The interexaminer reliability was calculated using weighted kappa statistics. Results: The interrater weighted kappa scores were between .74 and .92, which is in the ""good"" to ""very good"" categories. Conclusions: Three bilateral cleft lip and palate yardsticks for different developmental stages of the dentition were made: one for the deciduous dentition (6-year-olds` yardstick), one for early mixed dentition (9-year-olds` yardstick), and one for early permanent dentition (12-year-olds` yardstick).

Remedies for unfair dismissal under the Workplace Relations Act 1996 - a fair go all round?

Background to unfair termination laws - remedies at common law - remedies for unfair termination under Federal Awards - overview of remedies under the Workplace Relations Act 1996 - compensation - reinstatement.

"Unfair" results and unfair doctrines : structuring the application of the equitable doctrines of undue influence and unconscionable dealing

Relevance of the substantive matter of an unfair result on the application of the doctrines of transactional fairness - undue influence and unconscionable dealing - need to keep considerations of transactional fairness and substantive fairness separate - case law involving undue influence and unconscionable conduct - relevance of an unfair result for future unconscionable dealing and undue influence cases.

Environmental design : incorporating a rating tool into the design of commercial buildings

Environmental performance assessment or green building rating tools for commercial buildings are one of the more recent responses to encourage green solutions for commercial buildings. This paper discusses the initial stages of a research project that looks at the impact of a rating tool, such as Green Star, on design. There are numerous ways in which an architect can design commercial buildings, but environmental design solutions have consistently failed to become accepted practice. Therefore, how will this tool be incorporated into the building design process? Developed to assist the designer can the inclusion of a rating tool such as Green Star provide an effective framework to encourage the inclusion of environmental design strategies in commercial buildings? A field study, recording the design process of a commercial building, anticipates that a whole building assessment approach towards design, as proposed through the Green Star Rating Tool, will provide an effective framework to set and monitor design targets in order to optimise the environmental design goals in commercial buildings.

Ecologically sustainable development and architecture: the impact of rating tools

The concept of Ecologically Sustainable Development (ESD) has become an important issue – albeit often scarcely applied – in the design of commercial buildings. To encourage the adoption of sustainable strategies in the practice of design and to address the environmental problems caused by these developments, governments and organisations of various countries have proposed the adoption of scorecard rating tools to inform designers of the impact of their decisions and to present a way of establishing project goals and objectives early in the design process. In Australia, the recent introduction of the Green Star Rating Tool (Office Design) is believed to provide the architects with a ‘whole-of-building’ assessment of the environmental impact of their design by creating a checklist against which to benchmark performance. This paper follows the design of a commercial building, evaluating the impact of Green Star in the overall process. The results of the study suggest the need to include the use of scorecard rating tools in a more integrated model, where ESD is considered at every stage of design and construction rather than being a separate component applied only to promote the ‘greenness’ of a building. Rating tools can be an asset to the design team, provided sustainable requirements are reinforced throughout the entire process.

Academic assessment of arts management journals: a multidimensional rating survey

The authors report the results of a journal rating survey assessing 14 publications dedicated to arts management and related topics. Establishing a rating scheme for journals is an important step in the professionalization of an academic field. The authors argue that the development of a rating system in arts management is in the best interests of the discipline. Academics used weighted multidimensional perceptual ratings to evaluate each journal’s prestige, contribution to theory, contribution to practice and contribution to teaching. Cluster analysis using these four criteria identified three classes of journals: A, B+ and B. The setting of standards serves to identify quality goals for academics and journal editors alike, thus enhancing the standing of arts management as a subdiscipline of management.