Factor analysis of the North American Spine Society outcome assessment instrument: a study based on a spine registry of patients treated with lumbar and cervical disc arthroplasty.

BACKGROUND CONTEXT: Studies involving factor analysis (FA) of the items in the North American Spine Society (NASS) outcome assessment instrument have revealed inconsistent factor structures for the individual items. PURPOSE: This study examined whether the factor structure of the NASS varied in relation to the severity of the back/neck problem and differed from that originally recommended by the developers of the questionnaire, by analyzing data before and after surgery in a large series of patients undergoing lumbar or cervical disc arthroplasty. STUDY DESIGN/SETTING: Prospective multicenter observational case series. PATIENT SAMPLE: Three hundred ninety-one patients with low back pain and 553 patients with neck pain completed questionnaires preoperatively and again at 3 to 6 and 12 months follow-ups (FUs), in connection with the SWISSspine disc arthroplasty registry. OUTCOME MEASURES: North American Spine Society outcome assessment instrument. METHODS: First, an exploratory FA without a priori assumptions and subsequently a confirmatory FA were performed on the 17 items of the NASS-lumbar and 19 items of the NASS-cervical collected at each assessment time point. The item-loading invariance was tested in the German version of the questionnaire for baseline and FU. RESULTS: Both NASS-lumbar and NASS-cervical factor structures differed between baseline and postoperative data sets. The confirmatory analysis and item-loading invariance showed better fit for a three-factor (3F) structure for NASS-lumbar, containing items on "disability," "back pain," and "radiating pain, numbness, and weakness (leg/foot)" and for a 5F structure for NASS-cervical including disability, "neck pain," "radiating pain and numbness (arm/hand)," "weakness (arm/hand)," and "motor deficit (legs)." CONCLUSIONS: The best-fitting factor structure at both baseline and FU was selected for both the lumbar- and cervical-NASS questionnaires. It differed from that proposed by the originators of the NASS instruments. Although the NASS questionnaire represents a valid outcome measure for degenerative spine diseases, it is able to distinguish among all major symptom domains (factors) in patients undergoing lumbar and cervical disc arthroplasty; overall, the item structure could be improved. Any potential revision of the NASS should consider its factorial structure; factorial invariance over time should be aimed for, to allow for more precise interpretations of treatment success.

Factor analysis of the North American Spine Society outcome assessment instrument: a study based on a spine registry of patients treated with lumbar and cervical disc arthroplasty.

Background context Studies involving factor analysis (FA) of the items in the North American Spine Society (NASS) outcome assessment instrument have revealed inconsistent factor structures for the individual items. Purpose This study examined whether the factor structure of the NASS varied in relation to the severity of the back/neck problem and differed from that originally recommended by the developers of the questionnaire, by analyzing data before and after surgery in a large series of patients undergoing lumbar or cervical disc arthroplasty. Study design/setting Prospective multicenter observational case series. Patient sample Three hundred ninety-one patients with low back pain and 553 patients with neck pain completed questionnaires preoperatively and again at 3 to 6 and 12 months follow-ups (FUs), in connection with the SWISSspine disc arthroplasty registry. Outcome measures North American Spine Society outcome assessment instrument. Methods First, an exploratory FA without a priori assumptions and subsequently a confirmatory FA were performed on the 17 items of the NASS-lumbar and 19 items of the NASS-cervical collected at each assessment time point. The item-loading invariance was tested in the German version of the questionnaire for baseline and FU. Results Both NASS-lumbar and NASS-cervical factor structures differed between baseline and postoperative data sets. The confirmatory analysis and item-loading invariance showed better fit for a three-factor (3F) structure for NASS-lumbar, containing items on “disability,” “back pain,” and “radiating pain, numbness, and weakness (leg/foot)” and for a 5F structure for NASS-cervical including disability, “neck pain,” “radiating pain and numbness (arm/hand),” “weakness (arm/hand),” and “motor deficit (legs).” Conclusions The best-fitting factor structure at both baseline and FU was selected for both the lumbar- and cervical-NASS questionnaires. It differed from that proposed by the originators of the NASS instruments. Although the NASS questionnaire represents a valid outcome measure for degenerative spine diseases, it is able to distinguish among all major symptom domains (factors) in patients undergoing lumbar and cervical disc arthroplasty; overall, the item structure could be improved. Any potential revision of the NASS should consider its factorial structure; factorial invariance over time should be aimed for, to allow for more precise interpretations of treatment success.

Lake restoration, protection, and management : proceedings of the second annual conference, North American Lake Management Society, October 26-29, 1982, Vancouver, British Columbia.

"Office of Water Regulations and Standards"--Cover.

Biometrical Clinic on Entomological Problems, New York City, December 13, 1948. Proceedings of a joint meeting of the American Association of Economic Entomologists and the Biometric Society, Eastern North American Region.

Mode of access: Internet.

Historical notices of the missions of the Church of England in the North American colonies, previous to the independence of the United States: chiefly from the ms. documents of the Society for the Propagation of the Gospel in Foreign Parts.

Previously published in part in the British Magazine.

The constitution of the North-Western branch of the American Society for Educating Pious Youth for the Gospel Ministry : with instructions for beneficiaries, directions for agents, and an address to the Christian publick.

Cover title.

Genetic differentiation between Australian and North American populations of the monarch butterfly Danaus plexippus (L.) (Lepidoptera : Nymphalidae): an exploration using allozyme electrophoresis

Allozyme analysis was used to address the question of the source of the Australian populations of the monarch butterfly Danaus plexippus (L.). The study had three major aims: (1) To compare the levels of diversity of Australian and Hawaiian populations with potential source populations. (2) To determine whether eastern and western North American populations were sufficiently divergent for the Australian populations to be aligned to a source population. (3) To compare the differentiation among regions in Australia and North America to test the prediction of greater genetic structure in Australia, as a consequence of reduced migratory behaviour. The reverse was found, with F-ST values an order of magnitude lower in Australia than in North America. Predictably, Australian and Hawaiian populations had lower allelic diversity, but unexpected higher heterozygosity values than North American populations. It was not possible to assign the Australian populations to a definitive source, although the high levels of similarity of Australian populations to each other suggest a single colonization event. The possibility that the Australian populations have not been here long enough to reach equilibrium is discussed. (C) 2002 The Linnean Society of London, Biological Journal of the Linnean Society, 2002, 75, 437-452.

The relationship between the North American summer monsoon, the Rocky Mountains and the North Pacific subtropical anticyclone in HadAM3

In this study the relationship between the North American monsoon, the Californian sea surface temperature (SST) cold pool, the Rocky Mountains and the North Pacific subtropical anticyclone is investigated using the Hadley Centre's atmospheric climate model, HadAM3. In 1996 Hoskins hypothesized that heating in the North American monsoon might be important for the maintenance of the summertime North Pacific subtropical anticyclone, since the monsoon heating may induce descent to the north-west of the monsoon in the descending eastern flank of the subtropical anticyclone. This descent is further enhanced by radiative cooling and is associated with equatorward surface winds parallel to the western coast of North America. These equatorward winds induce oceanic upwelling of cold water and contribute to the formation of the Californian SST cold pool, which may feed back on the anticyclone by further suppressing convection and inducing descent. More recently, Rodwell and Hoskins also investigated the global summer monsoon–subtropical anticyclone relationship. They examined the role that mountains play in impeding the progress of the low-level mid-latitude westerlies, either deflecting the westerlies northwards where they ascend along the sloping mid-latitude isentropes or deflecting them southwards forcing them to descend along the isentropes. In particular, the introduction of the Rockies into a primitive-equation model adiabatically induces descent in the eastern descending flank of the North Pacific subtropical anticyclone. These hypothesized mechanisms have been investigated using HadAM3, focusing on the possible suppression of convection by the Californian SST cold pool, the response of the North Pacific subtropical anticyclone to the strength of the North American monsoon and the ‘blocking’ of the mid-latitude westerlies by the Rocky Mountains. The role of the Rockies is examined by integrating the model with modified orography for the Rocky Mountains. Changing the height of the Rockies alters the circulation in a way consistent with the mechanism outlined above. Higher Rocky mountains force the westerlies southwards, inducing descent in the eastern flank of the subtropical anticyclone as the air descends along the sloping isentropes. The relationship between the North American monsoon and the North Pacific subtropical anticyclone is investigated by suppressing the monsoon in HadAM3. The suppression of the monsoon is accomplished by increasing the surface albedo over Mexico, which induces anomalous ascent on the eastward flank of the subtropical anticyclone and anomalous polewards surface winds along the western coast of the North American continent, also providing support for the above hypothesis. The removal of the Californian SST cold pool, however, has a statistically insignificant effect on the model, suggesting that in this model the feedback of the SST cold pool on the eastern flank of the anticyclone is weak.

Typification of four North American club-chollas: the names of four Engelmannian species from Mexico and Southwestern United States

The names Opuntia bulbispina, O. clavata, O. emoryi and O. grahamii, originally proposed by George Engelmann between 1848 and 1856, are reviewed and typified after new findings of previously unknown voucher specimens. Original materials collected by some of the collaborators employed by Engelmann during the Mexican Boundary Survey were discovered in a loan from the Torrey Herbarium at the New York Botanical Garden (NY). Many of the materials include fragments of stems and fruits, and others include only sectioned flowers and some seeds. Particularly good descriptions of the species here concerned were published in Engelmann’s “Synopsis of the Cactaceae” in 1857, and exceptional illustrations were produced by Paulus Roetter and printed in “Cactaceae of the Boundary” in 1859. The problems surrounding some previous typifications of these names range from typification of joint lectotypes to illegitimate typifications of illustrations when original material was known to exist. The materials selected for typification were collected by the Mexican Boundary Survey and are lodged at the herbaria of the Missouri Botanical Garden (MO) and the New York Botanical Garden (NY); some are illustrations published by Engelmann.

North American Indian musical styles /

Mode of access: Internet.

The North American bees of the genus Osmia (Hymenoptera: Apoidea) /

Descriptive letterpress on versos of plates.

United States, from the discovery of the North American Continent to the present time /

Index: v. 9, p. 323-410.