Response shift, recall bias and their effect on measuring change in health-related quality of life amongst older hospital patients

Background: Assessments of change in subjective patient reported outcomes such as health-related quality of life (HRQoL) are a key component of many clinical and research evaluations. However, conventional longitudinal evaluation of change may not agree with patient perceived change if patients' understanding of the subjective construct under evaluation changes over time (response shift) or if patients' have inaccurate recollection (recall bias). This study examined whether older adults' perception of change is in agreement with conventional longitudinal evaluation of change in their HRQoL over the duration of their hospital stay. It also investigated this level of agreement after adjusting patient perceived change for recall bias that patients may have experienced. Methods: A prospective longitudinal cohort design nested within a larger randomised controlled trial was implemented. 103 hospitalised older adults participated in this investigation at a tertiary hospital facility. The EQ-5D utility and Visual Analogue Scale (VAS) scores were used to evaluate HRQoL. Participants completed EQ-5D reports as soon as they were medically stable (within three days of admission) then again immediately prior to discharge. Three methods of change score calculation were used (conventional change, patient perceived change and patient perceived change adjusted for recall bias). Agreement was primarily investigated using intraclass correlation coefficients (ICC) and limits of agreement. Results: Overall 101 (98%) participants completed both admission and discharge assessments. The mean (SD) age was 73.3 (11.2). The median (IQR) length of stay was 38 (20-60) days. For agreement between conventional longitudinal change and patient perceived change: ICCs were 0.34 and 0.40 for EQ-5D utility and VAS respectively. For agreement between conventional longitudinal change and patient perceived change adjusted for recall bias: ICCs were 0.98 and 0.90 respectively. Discrepancy between conventional longitudinal change and patient perceived change was considered clinically meaningful for 84 (83.2%) of participants, after adjusting for recall bias this reduced to 8 (7.9%). Conclusions: Agreement between conventional change and patient perceived change was not strong. A large proportion of this disagreement could be attributed to recall bias. To overcome the invalidating effect of response shift (on conventional change) and recall bias (on patient perceived change) a method of adjusting patient perceived change for recall bias has been described.

Developments in measuring the “creative” workforce

This article outlines the contribution the ARC Centre of Excellence for Creative Industries and Innovation has made to the project to improve statistical parameters for defining the “creative” workforce. This is one approach which addresses the imprecision of official statistics in grasping the emergent nature of the creative industries. The article discusses the policy implications of the differences between emphasizing industry and occupation or workforce. It provides qualitative case studies that provide further perspectives on quantitative analysis of the creative workforce. It also outlines debates about the implications for the cultural disciplines of an evidence-based account of creative labour. The “creative trident” methodology is summarized: it is the total of creative occupations within the core creative industries (specialists), plus the creative occupations employed in other industries (embedded) plus the business and support occupations employed in creative industries who are often responsible for managing, accounting for and technically supporting creative activity (support). The method is applied to the arts workforce in Australia. An industry-facing spin-off from the centre's mapping work, Creative Business Benchmarker, is discussed. The implications of this approach to the creative workforce is raised and exemplified in case studies of design and of the health industry.

Measuring neighbourhood sustainability performance: an indexing model for Gold Coast City, Australia

The aim of this research is to develop an indexing model to evaluate sutainability performance of urban settings, in order to assess environmental impacts of urban development and to provide planning agencies an indexing model as a decision support tool to be used in curbing negative impacts of urban development. Indicator-based sustainability assessment is embraced as the method. Neigbourhood-level urban form and transport related indicators are derived from the literature by conducting a content analysis and finalised via a focus group meeting. The model is piloted on three suburbs of Gold Coast City, Australia. Final neighbourhood level sustainability index score was calculated by employing equal weighting schema. The results of the study show that indexing modelling is a reasonably practical method to measure and visualise local sustainability performance, which can be employed as an effective communication and decision making tool.

Technical note : a technique for measuring the surface area of articular cartilage in acetabular fractures

The aim of this study was to develop a reliable technique for measuring the area of a curved surface from an axial computed tomography (CT) scan and to apply this clinically in the measurement of articular cartilage surface area in acetabular fractures. The method used was a triangulation algorithm. In order to determine the accuracy of the technique, areas of hemispheres of known size were measured to give the percentage error in area measurement. Seven such hemispheres were machined into a Perspex block and their area measured geometrically, and also from CT scans by means of the triangulation algorithm. Scans of 1, 2 and 4 mm slice thickness and separation were used. The error varied with slice thickness and hemisphere diameter. It was shown that the 2 mm slice thickness provides the most accurate area measurement, while 1 mm cuts overestimate and 4 mm cuts underestimate the area. For a hemisphere diameter of 5 cm, which is of similar size to the acetabulum, the error was -11.2% for 4 mm cuts, +4.2% for 2 mm cuts and + 5.1% for 1 mm cuts. As expected, area measurement was more accurate for larger hemispheres. This method can be applied clinically to quantify acetabular fractures by measuring the percentage area of intact articular cartilage. In the case of both column fractures, the percentage area of secondary congruence can be determined. This technique of quantifying acetabular fractures has a potential clinical application as a prognostic factor and an indication for surgery in the long term.

Measuring complexity for building projects : a Delphi study

Purpose---The aim of this study is to identify complexity measures for building projects in the People’s Republic of China (PRC). Design/Methodology/Approach---A three-round of Delphi questionnaire survey was conducted to identify the key parameters that measure the degree of project complexity. A complexity index (CI) was developed based on the identified measures and their relative importance. Findings---Six key measures of project complexity have been identified, which include, namely (1) building structure & function; (2) construction method; (3) the urgency of the project schedule; (4) project size/scale; (5) geological condition; and (6) neighboring environment. Practical implications---These complexity measures help stakeholders assess degrees of project complexity and better manage the potential risks that might be induced to different levels of project complexity. Originality/Value---The findings provide insightful perspectives to define and understand project complexity. For stakeholders, understanding and addressing the complexity help to improve project planning and implementation.

Measuring bitrate and quality trade-off in a fast region-of-interest based video coding

Prevailing video adaptation solutions change the quality of the video uniformly throughout the whole frame in the bitrate adjustment process; while region-of-interest (ROI)-based solutions selectively retains the quality in the areas of the frame where the viewers are more likely to pay more attention to. ROI-based coding can improve perceptual quality and viewer satisfaction while trading off some bandwidth. However, there has been no comprehensive study to measure the bitrate vs. perceptual quality trade-off so far. The paper proposes an ROI detection scheme for videos, which is characterized with low computational complexity and robustness, and measures the bitrate vs. quality trade-off for ROI-based encoding using a state-of-the-art H.264/AVC encoder to justify the viability of this type of encoding method. The results from the subjective quality test reveal that ROI-based encoding achieves a significant perceptual quality improvement over the encoding with uniform quality at the cost of slightly more bits. Based on the bitrate measurements and subjective quality assessments, the bitrate and the perceptual quality estimation models for non-scalable ROI-based video coding (AVC) are developed, which are found to be similar to the models for scalable video coding (SVC).

CARDIAC-ARIA: Measuring the Accessibility to Cardiovascular Services in Rural and Remote Australia Via Applied Geographical Spatial Technology (GIS)

Background/aims: Cardiovascular disease (CVD) continues to impose a heavy burden in terms of cost, disability and death in Australia. Recent evidence suggests that increasing remoteness, where cardiac services are scarce, is linked to an increased risk of dying from CVD. Fatal CVD events are reported to be between 20% and 50% higher in rural areas compared to major cities. Method: This project, with its extensive use of Geographic Information Systems (GIS) technology, will rank 11,338 rural and remote population centres to identify geographical ‘hotspots’ where there is likely to be a mismatch between the demand for and actual provision of cardiovascular services. It will, therefore, guide more equitable provision of services to rural and remote communities. Outcomes: The CARDIAC-ARIA project is designed to; map the type and location of cardiovascular services currently available in Australia, relative to the distribution of individuals who currently have symptomatic CVD; determine, by expert panel, what are the minimal requirements for comprehensive cardiovascular health support in metropolitan and rural communities and derive a rating classification based on the Accessibility and Remoteness Index of Australia (ARIA) for each of Australia's 11,338 rural and remote population centres. Conclusion: This unique, innovative and highly collaborative project has the potential to deliver a powerful tool to highlight and combat the burden imposed by cardiovascular disease (CVD) in Australia.

Measuring the effect of motorcycle rider training on psychosocial influences for risk taking

Aim: Whilst motorcycle rider training is commonly incorporated into licensing programs in many developed nations, little empirical support has been found in previous research to prescribe it as an effective road safety countermeasure. It has been posited that the lack of effect of motorcycle rider training on crash reduction may, in part, be due to the predominant focus on skills-based training with little attention devoted to addressing attitudes and motives that influence subsequent risky riding. However, little past research has actually endeavoured to measure attitudinal and motivational factors as a function of rider training. Accordingly, this study was undertaken to assess the effect of a commercial motorcycle rider training program on psychosocial factors that have been shown to influence risk taking by motorcyclists. Method: Four hundred and thirty-eight motorcycle riders attending a competency-based licence training course in Brisbane, Australia, voluntarily participated in the study. A self-report questionnaire adapted from the Rider Risk Assessment Measure (RRAM) was administered to participants at the commencement of training, then again at the conclusion of training. Participants were informed of the independent nature of the research and that their responses would in no way effect their chance of obtaining a licence. To minimise potential demand characteristics, participants were instructed to seal completed questionnaires in envelopes and place them in a sealed box accessible only by the research team (i.e. not able to be viewed by instructors). Results: Significant reductions in the propensity for thrill seeking and intentions to engage in risky riding in the next 12 months were found at the end of training. In addition, a significant increase in attitudes to safety was found. Conclusions: These findings indicate that rider training may have a positive short-term influence on riders’ propensity for risk taking. However, such findings must be interpreted with caution in regard to the subsequent safety of riders as these factors may be subject to further influence once riders are licensed and actively engage with peers during on-road riding. This highlights a challenge for road safety education / training programs in regard to the adoption of safety practices and the need for behavioural follow-up over time to ascertain long-term effects. This study was the initial phase of an ongoing program of research into rider training and risk taking framed around Theory of Planned Behaviour concepts. A subsequent 12 month follow-up of the study participants has been undertaken with data analysis pending.

A decision table method for randomness measurement

Data quality has become a major concern for organisations. The rapid growth in the size and technology of a databases and data warehouses has brought significant advantages in accessing, storing, and retrieving information. At the same time, great challenges arise with rapid data throughput and heterogeneous accesses in terms of maintaining high data quality. Yet, despite the importance of data quality, literature has usually condensed data quality into detecting and correcting poor data such as outliers, incomplete or inaccurate values. As a result, organisations are unable to efficiently and effectively assess data quality. Having an accurate and proper data quality assessment method will enable users to benchmark their systems and monitor their improvement. This paper introduces a granules mining for measuring the random degree of error data which will enable decision makers to conduct accurate quality assessment and allocate the most severe data, thereby providing an accurate estimation of human and financial resources for conducting quality improvement tasks.

Measuring reef complexity and rugosity from monocular video bathymetric reconstruction

Topographic structural complexity of a reef is highly correlated to coral growth rates, coral cover and overall levels of biodiversity, and is therefore integral in determining ecological processes. Modeling these processes commonly includes measures of rugosity obtained from a wide range of different survey techniques that often fail to capture rugosity at different spatial scales. Here we show that accurate estimates of rugosity can be obtained from video footage captured using underwater video cameras (i.e., monocular video). To demonstrate the accuracy of our method, we compared the results to in situ measurements of a 2m x 20m area of forereef from Glovers Reef atoll in Belize. Sequential pairs of images were used to compute fine scale bathymetric reconstructions of the reef substrate from which precise measurements of rugosity and reef topographic structural complexity can be derived across multiple spatial scales. To achieve accurate bathymetric reconstructions from uncalibrated monocular video, the position of the camera for each image in the video sequence and the intrinsic parameters (e.g., focal length) must be computed simultaneously. We show that these parameters can be often determined when the data exhibits parallax-type motion, and that rugosity and reef complexity can be accurately computed from existing video sequences taken from any type of underwater camera from any reef habitat or location. This technique provides an infinite array of possibilities for future coral reef research by providing a cost-effective and automated method of determining structural complexity and rugosity in both new and historical video surveys of coral reefs.

Traffic and climate change impacts on water quality : measuring build-up and wash-off of heavy metals and petroleum hydrocarbons

Understanding the impacts of traffic and climate change on water quality helps decision makers to develop better policy and plans for dealing with unsustainable urban and transport development. This chapter presents detailed methodologies developed for sample collection and testing for heavy metals and total petroleum hydrocarbons, as part of a research study to investigate the impacts of climate change and changes to urban traffic characteristics on pollutant build-up and wash-off from urban road surfaces. Cadmium, chromium, nickel, copper, lead, iron, aluminium, manganese and zinc were the target heavy metals, and selected gasoline and diesel range organics were the target total petroleum hydrocarbons for this study. The study sites were selected to encompass the urban traffic characteristics of the Gold Coast region, Australia. An improved sample collection method referred to as ‘the wet and dry vacuum system’ for the pollutant build-up, and an effective wash-off plan to incorporate predicted changes to rainfall characteristics due to climate change, were implemented. The novel approach to sample collection for pollutant build-up helped to maintain the integrity of collection efficiency. The wash-off plan helped to incorporate the predicted impacts of climate change in the Gold Coast region. The robust experimental methods developed will help in field sample collection and chemical testing of different stormwater pollutants in build-up and wash-off.

Measuring neighbourhood sustainability : a comparative analysis of residential types in Malaysia

The expansion of city-regions, the increase in the standard of living and changing lifestyles have collectively led to an increase in housing demand. New residential areas are encroaching onto the city fringes including suburban and green field areas. Large and small developers are actively building houses ranging from a few blocks to master-planned style projects. These residential developments, particularly in major urban areas, represent a large portion of urban land use in Malaysia, and, thus, have become a major contributor to overall urban sustainability. There are three main types that comprise the mainstream, and form integral parts to contemporary urban residential developments, namely, subdivision developments, piecemeal developments, and master-planned developments. Many new master-planned developments market themselves as environmentally friendly, and provide layouts that encompass sustainable design and development. To date, however, there have been limited studies conducted to examine such claims or to ascertain which of these three residential development layouts is more sustainable. To fill this gap, this research was undertaken to develop a framework for assessing the level of sustainability of residential developments, focusing on their layouts at the neighbourhood level. The development of this framework adopted a mixed method research strategy and embedded research design to achieve the study aim and objectives. Data were collected from two main sources, where quantitative data were gathered from a three-round Delphi survey and spatial data from a layout plan. Sample respondents for surveys were selected from among experts in the field of the built environment, both from Malaysia and internationally. As for spatial data, three case studies – master-planned, piecemeal and subdivision developments representing different types of neighbourhood developments in Malaysia have been selected. Prior to application on the case studies, the appropriate framework was subjected to validation to ascertain its robustness for application in Malaysia. Following the application of the framework on the three case studies the results revealed that master-planned development scored a better level of sustainability compared to piecemeal and subdivision developments. The results generated from this framework are expected to provide evidence to the policy makers and development agencies as well as provide an awareness of the level of sustainability and the necessary collective efforts required for developing sustainable neighbourhoods. Continuous assessment can facilitate a comparison of sustainability over time for neighbourhoods as a means to monitor changes in the level of sustainability. In addition, the framework is able to identify any particular indicator (issue) that causes a significant impact on sustainability.

A new framework of measuring national nutrients balance for international and global comparison

Nutrients balance such as nitrogen and phosphorus balance are increasingly used as an indicator of the environmental performance of agricultural sector in international and global context. However there still is a lack of harmony in the use of methods for estimating the nutrients balance among countries. This is because of the disagreement regarding the accuracy and uncertainty of different accounting methods. The lack of harmony in the methods used in different countries further increases the uncertainty in the context of the international comparisons. This paper provides a new framework for nutrients balance calculation using the farm-gate accounting method. The calculation under this new framework takes advantage of availability of data from FAO and other reliable national and international sources. Due to this, the proposed framework is highly adaptable in many countries, making the global comparison feasible. The paper also proposes three criteria including adaptability, accuracy and interpretability to assess the appropriateness of nutrients accounting method. Based on these criteria, the paper provides a comprehensive comparison of the farm-gate and soil-surface methods in accounting country-level nutrients balance of agricultural production. The paper identifies some shortcomings of the soil-surface balance and shows that the farm-gate method has a greater potential of providing a more accurate and meaningful estimation of national nutrients balance.

Investigation of the airborne submicrometer particles emitted by dredging vessels using a plume capture method

This paper presents a method for investigating ship emissions, the plume capture and analysis system (PCAS), and its application in measuring airborne pollutant emission factors (EFs) and particle size distributions. The current investigation was conducted in situ, aboard two dredgers (Amity: a cutter suction dredger and Brisbane: a hopper suction dredger) but the PCAS is also capable of performing such measurements remotely at a distant point within the plume. EFs were measured relative to the fuel consumption using the fuel combustion derived plume CO2. All plume measurements were corrected by subtracting background concentrations sampled regularly from upwind of the stacks. Each measurement typically took 6 minutes to complete and during one day, 40 to 50 measurements were possible. The relationship between the EFs and plume sample dilution was examined to determine the plume dilution range over which the technique could deliver consistent results when measuring EFs for particle number (PN), NOx, SO2, and PM2.5 within a targeted dilution factor range of 50-1000 suitable for remote sampling. The EFs for NOx, SO2, and PM2.5 were found to be independent of dilution, for dilution factors within that range. The EF measurement for PN was corrected for coagulation losses by applying a time dependant particle loss correction to the particle number concentration data. For the Amity, the EF ranges were PN: 2.2 - 9.6 × 1015 (kg-fuel)-1; NOx: 35-72 g(NO2).(kg-fuel)-1, SO2 0.6 - 1.1 g(SO2).(kg-fuel)-1and PM2.5: 0.7 – 6.1 g(PM2.5).(kg-fuel)-1. For the Brisbane they were PN: 1.0 – 1.5 x 1016 (kg-fuel)-1, NOx: 3.4 – 8.0 g(NO2).(kg-fuel)-1, SO2: 1.3 – 1.7 g(SO2).(kg-fuel)-1 and PM2.5: 1.2 – 5.6 g(PM2.5).(kg-fuel)-1. The results are discussed in terms of the operating conditions of the vessels’ engines. Particle number emission factors as a function of size as well as the count median diameter (CMD), and geometric standard deviation of the size distributions are provided. The size distributions were found to be consistently uni-modal in the range below 500 nm, and this mode was within the accumulation mode range for both vessels. The representative CMDs for the various activities performed by the dredgers ranged from 94-131 nm in the case of the Amity, and 58-80 nm for the Brisbane. A strong inverse relationship between CMD and EF(PN) was observed.

Measuring mechanical properties of tendon in vivo

Introduction: Understanding the mechanical properties of tendon is an important step to guiding the process of improving athletic performance, predicting injury and treating tendinopathies. The speed of sound in a medium is governed by the bulk modulus and density for fluids and isotropic materials. However, for tendon,which is a structural composite of fluid and collagen, there is some anisotropy requiring an adjustment for Poisson’s ratio. In this paper, these relationships are explored and modelled using data collected, in vivo, on human Achilles tendon. Estimates for elastic modulus and hysteresis based on speed of sound data are then compared against published values from in vitro mechanical tests. Methods: Measurements using clinical ultrasound imaging, inverse dynamics and acoustic transmission techniques were used to determine dimensions, loading conditions and longitudinal speed of sound for the Achilles tendon during a series of isometric plantar flexion exercises against body weight. Upper and lower bounds for speed of sound versus tensile stress in the tendon were then modelled and estimates derived for elastic modulus and hysteresis. Results: Axial speed of sound varied between 1850 to 2090 m.s−1 with a non-linear, asymptotic dependency on the level of tensile stress in the tendon 5–35 MPa. Estimates derived for the elastic modulus ranged between 1–2 GPa. Hysteresis derived from models of the stress-strain relationship, ranged from 3–11%. These values agree closely with those previously reported from direct measurements obtained via in vitro mechanical tensile tests on major weight bearing tendons. Discussion: There is sufficiently good agreement between these indirect (speed of sound derived) and direct (mechanical tensile test derived) measures of tendon mechanical properties to validate the use of this non-invasive acoustic transmission technique. This non-invasive method is suitable for monitoring changes in tendon properties as predictors of athletic performance, injury or therapeutic progression.