Development and interrater reliability testing of a telephone interview training programme for Australian nurse interviewers

Summary Background The final phase of a three phase study analysing the implementation and impact of the nurse practitioner role in Australia (the Australian Nurse Practitioner Project or AUSPRAC) was undertaken in 2009, requiring nurse telephone interviewers to gather information about health outcomes directly from patients and their treating nurse practitioners. A team of several registered nurses was recruited and trained as telephone interviewers. The aim of this paper is to report on development and evaluation of the training process for telephone interviewers. Methods The training process involved planning the content and methods to be used in the training session; delivering the session; testing skills and understanding of interviewers post-training; collecting and analysing data to determine the degree to which the training process was successful in meeting objectives and post-training follow-up. All aspects of the training process were informed by established educational principles. Results Interrater reliability between interviewers was high for well-validated sections of the survey instrument resulting in 100% agreement between interviewers. Other sections with unvalidated questions showed lower agreement (between 75% and 90%). Overall the agreement between interviewers was 92%. Each interviewer was also measured against a specifically developed master script or gold standard and for this each interviewer achieved a percentage of correct answers of 94.7% or better. This equated to a Kappa value of 0.92 or better. Conclusion The telephone interviewer training process was very effective and achieved high interrater reliability. We argue that the high reliability was due to the use of well validated instruments and the carefully planned programme based on established educational principles. There is limited published literature on how to successfully operationalise educational principles and tailor them for specific research studies; this report addresses this knowledge gap.

Development, reliability and validity of a tool, to measure emergency department clinicians' attitudes towards family presence (FP) during acute deterioration in adult patients.

Despite many studies of family presence during resuscitation, no validated tool exploring the attitudes and beliefs of healthcare staff towards family presence has been published. The aim of this paper is to describe the development of a tool to accurately measure the attitudes and beliefs of emergency department staff towards family presence in the deteriorating adult patient, present the results of validity and reliability testing, and present the final validated tool. Twenty-nine items were developed, informed by themes from the literature and unvalidated published tools related to family presence during resuscitation. The tool was piloted on a sample of 68 emergency nursing and medical staff. Content validity and face validity were established using feedback from participants. Reliability was established by unidimensionality, exploratory factor analysis and internal consistency. Sixteen items were deleted from the original tool due to low item-to-total correlations and low communalities. Exploratory factor analysis of the remaining items revealed four factors with acceptable correlation coefficients and appropriate explanation of variance. Cronbach's alpha for each factor was >0.7 indicating a high degree of internal consistency. The four factors were labelled and arranged in a logical order to form the final tool, the Emergency Department Family Presence Survey.

Development and reliability of a direct access sensor using flip chip on flex technology with anisotropic conductive adhesive

Technological developments in biomedical microsystems are opening up new opportunities to improve healthcare procedures. Swallowable diagnostic sensing capsules are an example of these. In none of the diagnostic sensing capsules, is the sensor’s first level packaging achieved via Flip Chip Over Hole (FCOH) method using Anisotropic Conductive Adhesive (ACA). In a capsule application with direct access sensor (DAS), ACA not only provides the electrical interconnection but simultaneously seals the interconnect area and the underlying electronics. The development showed that the ACA FCOH was a viable option for the DAS interconnection. Adequate adhesive formed a strong joint that withstood a shear stress of 120N/mm2 and a compressive stress of 6N required to secure the final sensor assembly in place before encapsulation. Electrical characterization of the ACA joint in a fluid environment showed that the ACA was saturated with moisture and that the ions in the solution actively contributed to the leakage current, characterized by the varying rate of change of conductance. Long term hygrothermal aging of the ACA joint showed that a thermal strain of 0.004 and a hygroscopic strain of 0.0052 were present and resulted in a fatigue like process. In-vitro tests showed that high temperature and acidity had a deleterious effect of the ACA and its joint. It also showed that the ACA contact joints positioned at around or over 1mm would survive the gastrointestinal (GI) fluids and would be able to provide a reliable contact during the entire 72hr of the GI transit time. A final capsule demonstrator was achieved by successfully integrating the DAS, the battery and the final foldable circuitry into a glycerine capsule. Final capsule soak tests suggested that the silicone encapsulated system could survive the 72hr gut transition.

Measuring factors that influence the utilisation of preventive care services provided by general practitioners in Australia

Background: Relatively little research attention has been given to the development of standardised and psychometrically sound scales for measuring influences relevant to the utilisation of health services. This study aims to describe the development, validation and internal reliability of some existing and new scales to measure factors that are likely to influence utilisation of preventive care services provided by general practitioners in Australia.----- Methods: Relevant domains of influence were first identified from a literature review and formative research. Items were then generated by using and adapting previously developed scales and published findings from these. The new items and scales were pre-tested and qualitative feedback was obtained from a convenience sample of citizens from the community and a panel of experts. Principal Components Analyses (PCA) and internal reliability testing (Cronbach's alpha) were then conducted for all of the newly adapted or developed scales utilising data collected from a self-administered mailed survey sent to a randomly selected population-based sample of 381 individuals (response rate 65.6 per cent).----- Results: The PCA identified five scales with acceptable levels of internal consistency were: (1) social support (ten items), alpha 0.86; (2) perceived interpersonal care (five items), alpha 0.87, (3) concerns about availability of health care and accessibility to health care (eight items), alpha 0.80, (4) value of good health (five items), alpha 0.79, and (5) attitudes towards health care (three items), alpha 0.75.----- Conclusion The five scales are suitable for further development and more widespread use in research aimed at understanding the determinants of preventive health services utilisation among adults in the general population.

Validation of the impact of Health Information Technology (I-HIT) scale : an international collaborative

In 2005, the Healthcare Information Management Systems Society (HIMSS) Nursing Informatics Community developed a survey to measure the impact of health information technology (HIT), the IHIT Scale, on the role of nurses and interdisciplinary communication in hospital settings. In 2007, nursing informatics colleagues from Australia, England, Finland, Ireland, New Zealand, Scotland and the United States formed a research collaborative to validate the IHIT across countries. All teams have completed construct and face validation in their countries. Five out of six teams have initiated reliability testing by practicing nurses. This paper reports the international collaborative’s validation of the IHIT Scale completed to date.

A validated self-administered female pelvic floor questionnaire

Introduction and hypothesis: The aim of this study was to validate a self-administered version of the already validated interviewer-administered Australian pelvic floor questionnaire. Methods: The questionnaire was completed by 163 women attending an urogynecological clinic. Face and convergent validity was assessed. Reliability testing and comparison with the interviewer-administered version was performed in a subset of 105 patients. Responsiveness was evaluated in a subset of 73 women. Results: Missing data did not exceed 4% for any question. Cronbach’s alpha coefficients were acceptable in all domains. Kappa coefficients for the test–retest analyses varied from 0.64–1.0. Prolapse symptoms correlated significantly with the pelvic organ prolapse quantification. Urodynamics confirmed the reported symptom stress incontinence in 70%. The self and interviewer administered questionnaires demonstrated equivalence. Effect sizes ranged from 0.6 to 1.4. Conclusions: This self-administered pelvic floor questionnaire assessed pelvic floor function in a reproducible and valid fashion and due to its responsiveness, can be used for routine clinical assessment and outcome research.

What factors influence nurses’ assessment practices? Development of the Barriers to Nurses’ use of Physical Assessment Scale

Aim To develop and psychometrically test the Barriers to Nurses’ use of Physical Assessment Scale. Background There is growing evidence of failure to recognise hospitalised patients at risk of clinical deterioration, in part due to inadequate physical assessment by nurses. Yet, little is known about the barriers to nurses’ use of physical assessment in the acute hospital setting and no validated scales have been published. Design Instrument development study. Method Scale development was based on a comprehensive literature review, focus groups, expert review and psychometric evaluation. The scale was administered to 434 acute care registered nurses working at a large Australian teaching hospital between June and July 2013. Psychometric analysis included factor analysis, model fit statistics and reliability testing. Results The final scale was reduced to 38 items representing seven factors, together accounting for 57.7% of the variance: (1) reliance on others and technology, (2) lack of time and interruptions, (3) ward culture, (4) lack of confidence, (5) lack of nursing role models, (6) lack of influence on patient care, and; (7) specialty area. Internal reliability ranged from .70 to .86. Conclusion Findings provide initial evidence for the validity and reliability of the Barriers to Nurses’ use of Physical Assessment Scale and point to the importance of understanding the organisational determinants of nurses’ assessment practices. The new scale has potential clinical and research applications to support nursing assessment in acute care settings.

Validation of the dietetic confidence scale

Dietitians have reported a lack of confidence in counselling clients with mental health issues. Standardised tools are needed to evaluate programs aiming to improve confidence. The Dietetic Confidence Scale (DCS) was developed to assess dietitians’perception of their capability about working with clients experiencing depression. Exploratory research revealed a 13-item, two-factor model. Dietetic confidence was associated with: 1) Confidence using the Nutrition Care Process; and 2) Confidence in Advocacy for Self-care and Client-care. This study aimed to validate the DCS using this two-factor model.The DCS was administered to 458 dietitians. Confirmatory factor analysis (CFA) assessed the scale’s psychometric validity. Reliability was measured using Cronbach’s alpha (α) co-efficient. CFA results supported the hypothesised two-factor, 13-item model. The Good Fit Index (GFI = 0.95) indicated a strong fit. Item-factor correlations ranged from r = 0.50 to 0.89. The overall scale and subscales showed good reliability (α = 0.93 to 0.76). This is the first study to validate an instrument that measures dietetic confidence about working with clients experiencing depression. The DCS can be used to measure changes in perceived confidence and identify where further training, mentoring or experience is needed. The findings also suggest that initiatives aimed at building dietitians' confidence about working with clients experiencing depression, should focus on improving client-focused nutrition care, foster advocacy, reflective practice, mentoring and encourage professional support networks. Avenues for future research include further validity and reliability testing to expand the generalisability of results; and modifying the scale for other disease or client populations.

A real-time software architecture for robotics and automation

This paper describes a software architecture for real-world robotic applications. We discuss issues of software reliability, testing and realistic off-line simulation that allows the majority of the automation system to be tested off-line in the laboratory before deployment in the field. A recent project, the automation of a very large mining machine is used to illustrate the discussion.

Use of objective psychomotor tests in health professionals

Evaluation of psychomotor skills is undertaken in a number of broad contexts. This includes testing of health professional populations as a measure of innate ability, to evaluate skill acquisition, or to compare professions. However, the use of psychomotor tests is frequently confounded by a lack of understanding of a particular tool's psychometric properties, strengths, and weaknesses. To identify and appraise the most commonly used tests on health professional populations, 86 articles were reviewed and the top nine tests identified. Few tests have had sufficient validity or reliability testing on health professionals. Based on the evidence available, use of the Grooved Pegboard Test, the Purdue Pegboard Test, or the Finger Tapping Test is recommended for the evaluation of dexterity in a health professional population; however, this choice may be dependent on the task(s) to which findings are generalised. More rigorous evaluation of validity and other psychometric properties is required.

Real-time temperature estimation for power MOSFETs considering thermal aging effects

This paper presents a novel real-time power-device temperature estimation method that monitors the power MOSFET's junction temperature shift arising from thermal aging effects and incorporates the updated electrothermal models of power modules into digital controllers. Currently, the real-time estimator is emerging as an important tool for active control of device junction temperature as well as online health monitoring for power electronic systems, but its thermal model fails to address the device's ongoing degradation. Because of a mismatch of coefficients of thermal expansion between layers of power devices, repetitive thermal cycling will cause cracks, voids, and even delamination within the device components, particularly in the solder and thermal grease layers. Consequently, the thermal resistance of power devices will increase, making it possible to use thermal resistance (and junction temperature) as key indicators for condition monitoring and control purposes. In this paper, the predicted device temperature via threshold voltage measurements is compared with the real-time estimated ones, and the difference is attributed to the aging of the device. The thermal models in digital controllers are frequently updated to correct the shift caused by thermal aging effects. Experimental results on three power MOSFETs confirm that the proposed methodologies are effective to incorporate the thermal aging effects in the power-device temperature estimator with good accuracy. The developed adaptive technologies can be applied to other power devices such as IGBTs and SiC MOSFETs, and have significant economic implications. 

FEA simulation of contact and wear between non-metallic materials for accelerated new product development

The conventional approach ie laboratory life testing to examine the reliability of products takes long time and involves tremendous cost as samples are tested till failures. The accelerated life test (ALT) has recently been used as an alternative method. Although ALT reduces the cost of reliability testing through applying more severe environmental conditions than the normal ones, it is no longer sufficient as it does not describe the process of products’ failure explicitly and it is still highly dependent on physical testing. Consequently, novel practices need to be developed for better understanding of the products’ reliability. A novel Finite Element Analysis (FEA) model incorporating mathematical wear equations is developed in the current work and applied to polymer materials. Wear rate, a key parameter, is calculated by using a combinatorial formula that combines a conventional linear equation with a recently published exponential equation. The local wear is firstly calculated and then integrated over the sliding distance. The FEA simulation works in a loop and performs a series of simulation with updated surface geometries. The simulation is in good agreement with the physical testing result.

A systematic review of how researchers characterize the school environment in determining its effect on student obesity

BACKGROUND: Obesity in early childhood is a robust predictor of obesity later in life. Schools provide unparalleled access to children and have subsequently become major intervention sites. However, empirical evidence supporting the effectiveness of school-based interventions against childhood obesity is of limited scope and unknown quality. The aim of this systematic review is to critically assess how researchers have characterized the school environment in determining its effect on childhood weight status in order to improve the quality and consistency of research in this area. We conducted a narrative review with a systematic search of the literature in line with PRISMA guidelines (2009). Original peer-reviewed research articles in English were searched from Medline, EMBASE, CENTRAL, CINAHL and PsycINFO databases from earliest record to January 2014. We included empirical research that reported at least one measure of the primary/elementary school environment and its relationship with at least one objective adiposity-related variable for students aged 4-12 years. Two authors independently extracted data on study design, school-level factors, student weight status, type of analysis and effect. RESULTS: Five studies met the inclusion criteria. Each study targeted different parts of the school environment and findings across the studies were not comparable. The instruments used to collect school-level data report no validity or reliability testing. CONCLUSIONS: Our review shows that researchers have used instruments of unknown quality to test if the school environment is a determinant of childhood obesity, which raises broader questions about the impact that schools can play in obesity prevention.

Diseño y simulación térmica de HB-LEDs con Autodesk y PCB para ensayos

Este PFC es un trabajo muy práctico, los objetivos fueron impuestos por el tutor, como parte del desarrollo de herramientas (software y hardware) que serán utilizados posteriormente a nivel de docencia e investigación. El PFC tiene dos áreas de trabajo, la principal y primera que se expone es la utilización de una herramienta de simulación térmica para caracterizar dispositivos semiconductores con disipador, la segunda es la expansión de una tarjeta de adquisición de datos con unas PCBs diseñadas, que no estaban disponibles comercialmente. Se ha probado y configurado “Autodesk 2013 Inventor Fusion” y “Autodesk 2013 Simulation and Multiphysics” para simulación térmica de dispositivos de alta potencia. Estas aplicaciones son respectivamente de diseño mecánico y simulación térmica, y la UPM dispone actualmente de licencia. En esta parte del proyecto se realizará un manual de utilización, para que se continúe con esta línea de trabajo en otros PFC. Además se han diseñado mecánicamente y simulado térmicamente diodos LED de alta potencia luminosa (High Brightness Lights Emitting Diodes, HB-LEDs), tanto blancos como del ultravioleta cercano (UVA). Las simulaciones térmicas son de varios tipos de LEDs que actualmente se están empleando y caracterizando térmicamente en Proyectos Fin de Carrera y una Tesis doctoral. En la segunda parte del PFC se diseñan y realizan unas placas de circuito impreso (PCB) cuya función es formar parte de sistemas de instrumentación de adquisición automática de datos basados en LabVIEW. Con esta instrumentación se pueden realizar ensayos de fiabilidad y de otro tipo a dispositivos y sistemas electrónicos. ABSTRACT. The PFC is a very practical work, the objectives were set by the tutor, as part of the development of tools (software and hardware) that will be used later at level of teaching and research. The PFC has two parts, the first one explains the use of a software tool about thermal simulation to characterize devices semiconductors with heatsink, and second one is the expansion of card data acquisition with a PCBs designed, which were not available commercially. It has been tested and configured "Autodesk 2013 Inventor Fusion" and "Autodesk 2013 Simulation Multiphysics” for thermal simulation of high power devices. These applications are respectively of mechanical design and thermal simulation, and the UPM has at present license. In this part of the project a manual of use will be realized, so that it is continued by this line of work in other PFC. Also they have been designed mechanically and simulated thermally LEDs light (High Brightness Lights Emitting Diodes , HB- LEDs) both white and ultraviolet. Thermal simulations are several types of LEDs are now being used in thermally characterizing in Thesis and PhD. In the second part of the PFC there are designed and realized circuit board (PCB) whose function is to be a part of instrumentation systems of automatic acquisition based on LabVIEW data. With this instrumentation can perform reliability testing and other electronic devices and systems.