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We propose a new summary measure of population health (SMPH), the well-being-adjusted health expectancy (WAHE). WAHE belongs to a subgroup of health-adjusted life expectancy indicators and gives the number of life years equivalent to full health. WAHE combines health and mortality information into a single indicator with weights that quantify the reduction in well-being associated with decreased health. WAHE's advantage over other SMPHs lies in its ability to differentiate between the consequences of health limitations at various levels of severity and its transparent, simple valuation function. Following the guidelines of a Committee on Summary Measures of Population Health, we discuss WAHE's validity, universality, feasibility sensitivity and ensure its reproducibility. We evaluate WAHE's performance compared to life expectancy, the most commonly used indicators of health expectancy (HE) and disability-adjusted life expectancy (DALE) in an empirical application for 29 European countries. Data on health and well-being are taken from the 2018 EU-SILC, and the life tables are from Eurostat. DALE is taken from the database of the Global Burden of Disease Programme. WAHE's sensitivity to univariate and multivariate state specifications is studied using the three Minimum European Health Module health dimensions: chronic morbidity, limitations in activities of daily living, and self-rated health. The empirical tests of the indicators' correspondence reveal that WAHE has the strongest correlation with the other SMPHs. Moreover, WAHE estimates are in agreement with all other SMPHs. Additionally, WAHE and all other SMPHs form a group of reliable indicators for studying population health in European countries. Finally, WAHE estimates are robust, regardless of whether health is defined across one or multiple simultaneous dimensions of health. We conclude that WAHE is a useful and reliable indicator of population health and performs at least as well as other commonly used SMPHs.The online version contains supplementary material available at 10.1007/s10680-022-09628-1.

Introduction Life expectancy is a public health metric used to assess mortality. We describe life expectancy calculations for US counties and present methodologic considerations compared with years of potential life lost before age 75 (YPLL-75) and premature age-adjusted mortality (PAAM), 2 commonly used length-of-life metrics. Methods We used death data from the National Center for Health Statistics for 2015-2017 and other health measures from the 2019 County Health Rankings & Roadmaps. We calculated life expectancy from birth at the county level using an abridged life table and the Chiang method of variance. Studentized residuals identified counties with discordant life expectancy and YPLL-75 or PAAM values. Correlations tested associations of life expectancy with key health measures (eg, smoking, child poverty, uninsured). Results Among 3073 US counties, life expectancy ranged from 62.4 to 98.0 years, with a mean of 77.4 years. Life expectancy was strongly and negatively correlated with YPLL-75 ( r = −0.91) and PAAM ( r = −0.95) at the county level. Life expectancy was also associated with other key health metrics, such as smoking, employment, and education rates, where an improvement in the health factor indicated improvement in the respective length-of-life measure. Counties with discordant life expectancy and YPLL-75 or PAAM values had differing age structures. Practice Implications Commonly used length-of-life metrics in population health settings are differentiated by methodological matters, such as computation complexity, data availability, and differential risk among age groups, especially among the very old or very young. The choice of metric should consider these factors, in addition to practical concerns, such as the communication needs of the audience.

An improved two-color method, which originates from an approximate emissivity ratio model based on the empirical emissivity formula by Hottel and Broughton, was developed to measure the temperature...

Contains fulltext : 228493.pdf (Publisher’s version ) (Closed access) Background: The present study examined the psychometric properties of the Anger Bodily Sensations Interview - intellectual disabilities (ABSI-id), an adapted instrument to measure anger-related interoceptive awareness (IA) in individuals with mild intellectual disabilities or borderline intellectual functioning (MID-BIF). Method: The ABSI-id was individually administered to 208 clients (51% male) with MID-BIF in residential facilities. Results: An EFA and CFA showed a two-factor structure of the ABSI-id, including nine items. The ABSI-id had moderate to good reliability, with an internal consistency ranging from acceptable to good, a test-retest reliability ranging from moderate to good and an adequate convergent validity. There was no significant difference in ABSI-id scores between individuals with MID and BIF. Conclusion: The ABSI-id is a promising instrument for measuring anger-related IA, additional research is needed on validity and sensitivity of change. 10 p.

Abstract. Alexithymia can be defined as difficulties in describing one’s emotions and is of interest within clinical and developmental psychology as a potential mediating and exacerbating factor across multiple forms of psychopathology. Measuring alexithymia via self-reports can be challenging, as those with heightened alexithymia may have difficulties in recognizing their alexithymia traits due to impaired metacognitive skills. Thus, there would be considerable benefits to the availability of a psychometrically validated parent-reported alexithymia measure that may circumvent the issue of self-reports. We, therefore, examined the psychometric properties of a new parent-reported alexithymia measure, the Alexithymia Questionnaire for Children – Parent (AQC-P) in a community sample of 257 child-parent dyads. Furthermore, we examined the level of agreement between the parent-rated AQC-P and its self-rated counterpart, the Alexithymia Questionnaire for Children (AQC). Confirmatory factor analysis found that an oblique three-factor structure provided the best model for both AQC-P and AQC, with this structure showing measurement invariance across child gender. All subscales had omega internal consistency values > .70, supporting their reliability. Cross-informant consistency was supported by significant correlations between AQC and AQC-P scores. Results support the use of the AQC-P as a measure of parent-reported alexithymia in children.

This interrupted time-series analysis examined whether activating a quality measure, supported by education and a population management tool, was associated with higher postdischarge engagement (PDE) in outpatient care after inpatient and residential stays for mental or substance use disorder care.Discharges from October 2016 to May 2019 were identified from national Veterans Health Administration (VHA) records representing all 140 VHA health care systems. Engagement was defined as multiple mental or substance use disorder outpatient visits in the 30 days postdischarge. The number of such visits required to meet the engagement definition depended on a patient's suicide risk and acuity level of inpatient or residential treatment. Health care system-level performance was calculated as the percentage of qualifying discharges with 30-day PDE. A segmented mixed-effects linear regression model tested whether monthly health care system performance changed significantly after activation of the PDE measure (activation rollout period, October-December 2017).A total of 322,344 discharges qualified for the measure. In the regression model, average health care system performance was 65.6% at the beginning of the preactivation period (October 2016) and did not change significantly in the following 12 months. Average health care system performance increased by 5.7% (SE=0.8%, p0.001) after PDE measure activation and did not change significantly thereafter-a difference representing 11,464 more patients engaging in care than would have without activation of the measure.Results support use of this measure, along with education, technical assistance, and population management tools, to improve engagement after discharge from residential and inpatient mental and substance use disorder treatment.

Background The “Primary Immunodeficiencies (PIDs) principles of care” were published in 2014 as the gold standard for care of patients with PIDs, setting a common goal for stakeholders to ensure that patients with PID have access to appropriate care and good quality of life. Since then, IPOPI (the International Patient Organisation for Primary Immunodeficiencies), has been working with national PID patient organisations as well as collaborating with scientific and medical institutions and experts to bring these principles closer to the day-to-day life of individuals with PIDs. Method The six PID Principles of Care were revised to consider advances in the field, as well as political developments that had occurred after their initial publication in 2014. Based on this revision the list was updated, and a new principle was added. The six established principles were: diagnosis, treatment, universal health coverage, specialised centres, national patient organisations and registries. Each principle was structured and measured through a series of criteria, and was given the same weight, as they have been considered to all be equally important. Specific weights were attributed to the criteria depending on their relevance and importance to quantify the principle. The index was translated into a survey for data collection: initially involving data from selected countries for a pilot, followed by integration of data from IPOPI’s national member organisations and key countries. Results The PID Life Index was developed in 2020 to assess the status of the PID environment and the implementation of the 6 principles worldwide. The Index allows for benchmarking countries either according to a set of principles and criteria or based on the user’s preferences. This can be displayed in an interactive map or through a data visualisation system. Conclusion The PID Life Index has been developed successfully and has potential to become an important source of information for PID stakeholders, to increase awareness and information as well as support advocacy initiatives on PIDs nationally, regionally or globally.

Cells regulate their cell volume, but cell volumes may change in response to metabolic and other perturbations. Many metabolomics experiments use cultured cells to measure changes in metabolites in response to physiological and other experimental perturbations, but the metabolomics workflow by mass spectrometry only determines total metabolite amounts in cell culture extracts. To convert metabolite amount to metabolite concentration requires knowledge of the number and volume of the cells. Measuring only metabolite amount can lead to incorrect or skewed results in cell culture experiments because cell size may change due to experimental conditions independent of change in metabolite concentration. We have developed a novel method to determine cell volume in cell culture experiments using a pair of stable isotopically labeled phenylalanine internal standards incorporated within the normal liquid chromatography-tandem mass spectrometry (LC-MS/MS) metabolomics workflow. This method relies on the flooding-dose technique where the intracellular concentration of a particular compound (in this case phenylalanine) is forced to equal its extracellular concentration. We illustrate the LC-MS/MS technique for two different mammalian cell lines. Although the method is applicable in general for determining cell volume, the major advantage of the method is its seamless incorporation within the normal metabolomics workflow.

Objective: This study examines the psychometric properties of the Brief Symptom Inventory 18 (BSI-18), a measure of psychological distress, across European Americans, African Americans, and...

Background: Perceived self-efficacy in advance care planning (ACP) is frequently used to measure the impact of ACP programs for professionals responsible for advanced chronic patients. A validated ...

Introduction Comprehensive and interdisciplinary measurement of rehabilitation outcome is an essential part of the assessment and prognosis of a patient. Thus, this requires substantial contributions from the patient, their family and the rehabilitation professional working with them. Moreover, the measurement tool should be comprehensive and must consider the cultural compatibility, cost efficiency and contextual factors of the region. Methods The Comprehensive Rehabilitation Outcome Measurement Scale (CROMS) was developed through consensus and followed the Delphi process incorporating inputs from various rehabilitation professionals. The domains and items were finalized using Principal Component Analysis (PCA). The tool was validated in two native languages and back-translated considering the semantic equivalence of the scale. Intra-class correlation coefficient was performed to determine the agreement between the therapist and patient-reported scales. Results The final CROMS carries 32 comprehensive items that can be completed by the person with disability and the professional team. CROMS compares well to similar items on FIM (l ICC of 0.93) and has good internal consistency with a Cronbach's Alpha of 0.92 for both patient and therapist reported measures. Conclusions The 32 item CROMS is a tool that can potentially be used to evaluate the functional independence of various patient populations, predominantly patients with neurological disabilities.

Objectives: This study aimed to measure the performance of physical therapy students in the pharmacology course by using pre-and post-lecture online quizzes.Methods: A total of 119 graduate student...

In accordance with modern understandings of criminal law science and solutions present in the comparative criminal legislation, the Criminal Code of the Republic of Serbia pays special attention to security measures as special and above all specific criminal sanctions. They are one of the four types of criminal sanctions provided for in this legal text. Among the eleven security measures, four are of a medical nature and they differ in a number of features, not only in relation to other criminal sanctions, but also other security measures. One of the medical safety measures is the obligatory treatment of alcoholics. There are a number of specifics of this security measure, and one of them is its manner of execution. Given this, the subject of analysis in the paper are two aspects of the safety measure of compulsory treatment of alcoholics. These are: normative and practical. The justification of this approach in the analysis of the subject matter is contained in the fact that only adequately performed and this security measure is in the function of its standardization - the function of eliminating conditions or conditions that may affect the perpetrator in the future does not commit crimes due to alcohol dependence. to the expression of criminal acts of violence that are increasingly present in the total mass of crime.

Individuals vary in their ability to perceive, as conscious sensations, signals like the beating of the heart. Tests of such interoceptive ability are, however, constrained in nature and reliability. Performance of the heartbeat tracking task, a widely used test of cardiac interoception, often corresponds well with individual differences in emotion and cognition, yet is susceptible to reporting bias and influenced by higher-order knowledge, e.g., of expected heart rate. The present study introduces a new way of assessing cardiac interoceptive ability, focusing on sensitivity to short-term, naturalistic changes in frequency of heartbeats. At rest, such heart rate variability typically reflects the dominant influence of respiration on vagus parasympathetic control of the sinoatrial pacemaker. We observed an overall tendency of healthy participants to report feeling fewer heartbeats during increases in heart rate, which we speculate reflects a reduction in heartbeat strength and salience during inspiratory periods when heart rate typically increases to maintain a stable cardiac output. Within-participant performance was more variable on this measure of cardiac interoceptive sensitivity relative to the "classic" heartbeat tracking task. Our findings indicate that cardiac interoceptive ability, rather than reflecting the veridical monitoring of subtle variations in physiology, appears to involve more interpolation wherein interoceptive decisions are informed by dynamic working estimates derived from the integration of afferent signaling and higher-order predictions.

Background The aim of this study was to evaluate the use of patient reported experience measures (PREMs) in humeral shaft fractures managed with or without surgery against patient reported outcome measures (PROMs). Methods Adult patients treated for a humeral shaft fracture between June 2015 and August 2017 were included in non-surgery and surgery (early and late surgery) groups. The PREM questionnaire was based on patient and clinician feedback obtained during focus groups and was posted to patients. PROMs included the short form-12 (SF-12) and visual analogue scale (VAS) for pain, stiffness, function and satisfaction. Results Eighty-one patients responded, 54 patients were treated in a brace and 27 with surgery (13 early, 14 late). There was moderate positive correlation between PREM and VAS satisfaction and function and moderate negative correlation with VAS pain and stiffness. There was also moderate positive correlation between PREM and SF-12 mental and weak positive correlation with SF-12 physical. The late surgery group had poorer PREMs (expectations, p = 0.002 and friends & family test, p = 0.0001) and PROMs (VAS satisfaction, p = 0.005) compared to the early surgery group. Conclusions PREMs can be used in conjunction with PROMs to improve the patient's quality of care and as a means of identifying, at an early stage, those patients not doing well and to offer surgery.

Aims: Community rehabilitation is a key component of health services within stroke care. Ongoing challenges exist as to how to best capture outcomes for these services, especially considering the multi-faceted service delivery and flexible focus on individual need. A goal setting tool, such as the multidisciplinary goal attainment measurement (MGAM), may be useful to objectively measure client outcomes that are meaningful and relevant to individuals within this complex environment. This study aims to review MGAM client outcomes within a stroke population in a community rehabilitation context. Methods: Pre and post goal outcome data was collected by multidisciplinary team members with stroke survivors, across the domains of impairment, activity/participation, and knowledge/information. These pre and post scores were compared with each other, as well as a measure of everyday functioning. Results: Clinically significant average change scores and statistically significant changes pre and post intervention were found across all domains on the MGAM. There were no correlations noted between MGAM and length of stay, quality of life and everyday functioning outcomes. Conclusion: As evidenced in the stroke population of this study, MGAM offers a unique outcome measure different to other clinical measures as it captures client outcomes that are relevant and meaningful to individual need across a range of domains within a multi-disciplinary setting. These formalized goal setting practices and outcomes, such as the MGAM, may assist in providing standardized outcome processes across various community rehabilitation settings.

Our concept of causability is a measure of whether and to what extent humans can understand a given machine explanation. We motivate causability with a clinical case from cancer research. We argue for using causability in medical artificial intelligence (AI) to develop and evaluate future human-AI interfaces.

Ultrasound is a quick, noninvasive, inexpensive tool that can provide an accurate airway assessment. Tongue thickness, oral cavity height, and their relationship were measured using submandibular ultrasonography with and without oral airway interventions during intubation in 26 patients. The mean tongue thickness to oral cavity height ratio was 0.83 ± 0.03. The percent change of tongue thickness to oral cavity height decreased significantly by 36.47% with an oral airway and by 43.49% with laryngoscope interventions (P

To evaluate the effect of demographic disparities on language outcomes in a diverse group of children who are deaf or hard of hearing.Retrospective cohort study.UCSF Benioff Children's Hospital (a tertiary care center).Forty-four patients aged18 years were identified with sensorineural hearing loss managed with a behind-the-ear hearing aid or cochlear implant. Demographic and clinical data were extracted from the medical record. The primary outcome measure was the Preschool Language Scales-5 at least 6 months after intervention. Predictors of language outcome were assessed: hearing level at the time of hearing intervention, cochlear implant status, age of identification and intervention, travel time to site of hearing care, home language, race/ethnicity, insurance type, and Access Challenge Index-a novel measure of educational environment and family support based on the Child Cochlear Implant Profile. Multivariate and univariate analysis assessed predictors for association with intervention and receptive, expressive, and total language scores.Overall 82% of patients had cochlear implants. The median age at hearing intervention was 12 months. The sample was 59% female, 52% non-White, and 61% publicly insured, and 20% had a non-English primary home language. Accounting for multiple demographic and clinical predictors, a high Access Challenge Index score was independently associated with longer time to intervention (Access Challenge Index-a novel comprehensive measure of educational and family environment-is a strong independent predictor of language outcomes in children who are deaf or hard of hearing.

Background/aims Ankle instability is one of the most common injuries that can occur during everyday life, sports and exercise. Recently, smartphone accelerometers have been used to measure single leg balance associated with ankle instability, because they are easy to use, inexpensive and can be used in small spaces. Thus, the purpose of this study was to introduce and investigate the intra- and inter-rater reliability of the smartphone accelerometer when assessing ankle instability. Methods A total of 26 individuals who had ankle instability were recruited. The single leg stance balance was measured using a smartphone accelerometer (Accelerometer application) and a force platform (I-Balance) for 5 seconds with their eyes open or their eyes closed. Results In the eyes open position, intra-rater reliability of the smartphone accelerometer was excellent for both raters (intraclass correlation coefficient: 0.87–0.90); and the inter-rater reliability was moderate (intraclass correlation coefficient: 0.71). In the eyes closed position, the intra-rater reliability of the smartphone accelerometer was excellent for both raters (intraclass correlation coefficient: 0.90–0.93); the inter-rater reliability was good (intraclass correlation coefficient: 0.82). Additionally, there were fair positive correlations between the smartphone accelerometer and the Cumberland Ankle Instability Tool, and between the smartphone accelerometer and I-Balance (r=0.33, 0.30 respectively). Conclusions The present study demonstrated excellent intra-rater reliabilities of two raters and moderate to good inter-rater reliabilities. The smartphone accelerometer offers several important advantages as a potential portable medical device to assess ankle instability accurately. Although there was a positive correlation, the relationships between the smartphone accelerometer and Cumberland Ankle Instability Tool and that between the smartphone accelerometer and I-Balance were fair. Future studies should investigate the validity of the smartphone accelerometer as a portable medical device for determining ankle instability.

Artificial lipid bilayer single-channel recording technique has been employed to determine the biophysical and pharmacological properties of various ion channels. However, its measurement efficiency is very low, as it requires two time-consuming processes: preparation of lipid bilayer membranes and incorporation of ion channels into the membranes. In order to address these problems, we previously developed a technique based on hydrophilically modified gold probes on which are immobilized ion channels that can be promptly incorporated into the bilayer membrane at the same time as the membrane is formed on the probes’ hydrophilic area. Here, we improved further this technique by optimizing the gold probe and developed an automated channel current measurement system. We found that use of probes with rounded tips enhanced the efficiency of channel current measurements, and introducing a hydrophobic area on the probe surface, beside the hydrophilic one, further increased measurement efficiency by boosting membrane stability. Moreover, we developed an automated measurement system using the optimized probes; it enabled us to automatically measure channel currents and analyze the effects of a blocker on channel activity. Our study will contribute to the development of high-throughput devices to identify drug candidates affecting ion channel activity.

In recent decades, mechanobiology has emerged as a novel perspective in the context of basic biomedical research. It is now widely recognized that living cells respond not only to chemical stimuli (for example drugs), but they are also able to decipher mechanical cues, such as the rigidity of the underlying matrix or the presence of shear forces. Probing the viscoelastic properties of cells and their local microenvironment with sub-micrometer resolution is required to study this complex interplay and dig deeper into the mechanobiology of single cells. Current approaches to measure mechanical properties of adherent cells mainly rely on the exploitation of miniaturized indenters, to poke single cells while measuring the corresponding deformation. This method provides a neat implementation of the everyday approach to measure mechanical properties of a material, but it typically results in a very low throughput and invasive experimental protocol, poorly translatable towards three-dimensional living tissues and biological constructs. To overcome the main limitations of nanoindentation experiments, a radical paradigm change is foreseen, adopting next generation contact-less methods to measure mechanical properties of biological samples with sub-cell resolution. Here we briefly introduce the field of single cell mechanical characterization, and we concentrate on a promising high resolution optical elastography technique, Brillouin spectroscopy. This non-contact technique is rapidly emerging as a potential breakthrough innovation in biomechanics, but the application to single cells is still in its infancy.

The present study investigated evidence of the construct validity of scores from the Behavioral and Emotional Rating Scale (BERS-3), which is a multi-informant assessment designed to measure the behavioral and emotional strengths of school-aged youth. The purpose of this research was to evaluate the degree to which BERS-3 scores differed between students with school-identified emotional disturbance and students without disabilities. Two nationally representative samples were used in this study: (a) 1,575 students rated by teachers and (b) 793 youth who provided self-ratings. The results of multivariate multiple regression analyses supported the primary hypothesis that students with emotional disturbance would have lower scores on each of the five BERS-3 subscale scores compared to peers without disabilities. This finding held for both samples; however, differences between students with emotional disturbance and the peers without disabilities were substantially smaller for the youth self-ratings compared to teacher ratings. Implications for practice and directions for future research are also discussed.

Actigraphy has been used to measure older adults’ sleep, but few studies have evaluated the factor structure among actigraphy-measured sleep parameters. Additionally, previous studies have reported the association between actigraphy-measured and self-reported sleep parameters in older adults but have not controlled for covariates of gender, insomnia, cognitive impairment, depression, and health conditions. We therefore investigated the factor structure of actigraphy-measured sleep parameters and, controlling for covariates, the association between actigraphy-measured and self-reported sleep parameters in 62 older adults (female: 75.8%; mean age: 69.9). The factor analysis gave a three-factor solution: length of wakefulness during sleep, sleep disruption, and total sleep time. Self-reported sleep parameters and covariates explained actigraphy-measured total sleep time (explained variance: 61%) substantially more than length of wakefulness during sleep (explained variance: 14%) and sleep disruption (explained variance: 11%). Studies need to select sleep measures based on their focus to best understand sleep characteristics in healthy older adults.

Background: We previously invented a new technique to measure the cross-sectional area of soft tissue of a limb (ΔCSA) with lymphedema using ultrasonography. The measurement correlated strongly wit...

Purpose: Interest in measuring the therapeutic alliance has grown in recent years in both the clinical field and the literature. Several instruments can be used to measure the therapeutic alliance in physiotherapy, and choosing the most appropriate one is challenging. The purpose of this systematic review was to (1) identify the instruments that have been used to evaluate the therapeutic alliance in physiotherapy and (2) appraise the methodological quality of studies of the psychometric properties of these instruments. Method: The researchers carried out a systematic search in MEDLINE, SciELO, PsycINFO, Theseus, Cochrane Library, and Open Grey. Only articles published in English and Spanish were included. The articles were evaluated by two independent reviewers in accordance with the COnsensus- based Standards for the selection of health Measurement Instruments (COSMIN) and Preferred Reporting items for Systematic Review and Meta-Analysis standards, using the four-point COSMIN checklist. Results: Four studies were included in this review, and four instruments evaluated the therapeutic alliance in physiotherapy. The methodological quality of the studies was fair for most of the psychometric characteristics analyzed. Conclusions: The Working Alliance Inventory is the best instrument to measure therapeutic alliance and the measure that had the greatest number of psychometric properties evaluated against the COSMIN standard. More studies of high methodological quality are required to evaluate the psychometric properties of the instruments used to assess the therapeutic alliance in physiotherapy.

Quantifying prolonged low-frequency force depression (PLFFD) with the gold-standard 1-s trains presents challenges, so paired pulses have been used. Owing to greater impairment of high-frequency doublet than tetanic torque, paired pulses underestimate PLFFD. This study aimed to approximate the minimum number of high-frequency pulses needed to avoid such underestimation and assess the feasibility of modeling PLFFD from a limited number of experimental pulses. In 13 participants, a 1-s 10-Hz train and 100-Hz trains with 2, 4, 7, 12, 15, 25, 50, or 100 pulses were evoked before and after (15 min, 2, 4, and 7 days) eccentric exercise of the dorsiflexors. With ≤12 pulses, impairment of 100-Hz torque was greater than the 1-s train (

Introduction: Patient safety culture is described as employees’ shared values, attitudes, and behaviours in a healthcare organization. Its main goal is to improve patient safety. Assessment of patient safety culture in the hospital environment is most often carried out using self-assessment tools. Although several of these tools have been developed, their comprehensive overview is lacking in literature. Aim: To provide an overview of instruments measuring patient safety culture in a hospital setting. Methods: The study has a character of a narrative literature review. The search was performed in the scientific databases Scopus, ProQuest, and PubMed in January 2021. The search produced a total of 1,767 studies and was limited to language (English). The search and the retrieval process reflected PRISMA’s recommendations. The content analysis method was used in the data synthesis. Results: We identified 24 tools for assessing the patient safety culture in a hospital setting, of which seven were developed for specific workplaces; others are considered general. Eighteen tools might be utilized by all healthcare professionals within the hospital setting and only three were designated explicitly for nurses. The most commonly used instruments were the Hospital Survey on Patient Culture and the Safety Attitudes Questionnaire. Conclusion: Assessing a patient safety culture is considered one of the strategies for improving patient safety while increasing care quality. An appropriate tool’s choice depends on the target population, the instrument’s validity and reliability, and other aspects. Awareness of the various assessment tools can help hospitals choose the one that best suits their circumstances.

This study aims to validate a measure of well-being, the PERMA-Profiler, among a sample of young adult survivors of pediatric central nervous system (CNS) tumor. Measurement structure of the PERMA-Profiler was evaluated using exploratory factor analysis and confirmatory factor analysis using pretest–posttest data. Reliability and concurrent validity of the PERMA-Profiler were examined. This study included 127 young adult survivors of pediatric CNS tumor between the ages of 18 and 30 ( M = 23.83, SD = 3.00) years. The results of factor analyses yielded a single-factor solution for well-being. Significant relationships between well-being and happiness, life satisfaction, perceived stress, and physical health were observed, providing support for the concurrent validity of the PERMA-Profiler. The PERMA-Profiler displayed good internal consistency and test–retest reliability. The PERMA-Profiler can help rehabilitation researchers and counselors better evaluate well-being in young adult survivors of pediatric CNS tumor, which provides opportunity for more targeted psychosocial interventions.

The Digit Span test is a widely used working memory measure. However, when using standardized scoring procedures, previous studies have demonstrated inconsistent relationships between Digit Span subtests and working memory measures frequently used in cognitive psychology experiments. Partial scoring involves awarding credit for all digits recalled in the correct serial location, whereas traditional scoring involves only awarding credit for a trial if all digits are recalled in the correct serial location. The current study compared the traditional all-or-nothing scoring method and the partial scoring method on Digit Span with other working memory measures and with measures of general fluid intelligence. The results showed that when differences were found, partial scoring was associated with stronger relationships with Digit Span Backwards but weaker relationships with Digit Span Forward and Sequencing compared with traditional scoring. These results support previous findings identifying differences between the Digit Span subtests and the utility of examining traditional scoring procedures.

The collapse of long-term lending relationships amplified the Great Depression. We demonstrate this by developing a new measure of lending relationships that can be calculated from widely available data at any level of aggregation. Our approach exploits differences in the responsiveness of loan rates to bank funding costs and is supported by historical evidence and theoretical arguments. The new measure reveals that the marginal impact of bank suspensions on economic activity was higher in more relationship-intensive areas, providing the first formal evidence that relationship lending propagated the real effects of banking sector distress in the early 1930s.

The aim of the paper was to improve development of a basic pattern block with modelling a curve of a side seam across the hips of the skirt or trousers. The area between waist and maximum hip line is completely overlooked since none of the pattern construction systems give exact instructions. Data from anthropometric measurement of the 162 young Slovenian females between 18 and 27 years of age were used to support the idea. The shape of the curve on the side seam of the skirt was quantified with a hip curve distance (HCD) based on a new measure: additional girth measurement 11 cm below the waist girth. HCD range of 4,77 cm pointed to significant differences in shape of the curve on the side seam of the skirt which could not be neglected.

We introduce in this paper a reliable method for automatic extraction of lungs nodules from CT chest images and shed the light on the details of using the Weighted Euclidean Distance (WED) for classifying lungs connected components into nodule and not-nodule. We explain also using Connected Component Labeling (CCL) in an effective and flexible method for extraction of lungs area from chest CT images with a wide variety of shapes and sizes. This lungs extraction method makes use of, as well as CCL, some morphological operations. Our tests have shown that the performance of the introduce method is high. Finally, in order to check whether the method works correctly or not for healthy and patient CT images, we tested the method by some images of healthy persons and demonstrated that the overall performance of the method is satisfactory.

Computer-adaptive tests use respondents' answers to previous questions to select the subsequent questions. They are gaining popularity for their increased measurement precision and decreased administration time compared to static questionnaires. The purpose of this study was to estimate the test-retest reliability and construct validity of the computer-adaptive test version of a participation measure, the Late Life Disability Instrument (LLDI-CAT) for people with COPD and to compare scores and administration time with those of the static LLDI. Among 76 older adults with COPD, scores on the LLDI-CAT were compared to scores on measures of related constructs, between groups based on symptom severity, prognosis and frailty phenotype, and to scores on the static LLDI. A subsample of 28 people completed the LLDI-CAT a second time within one week of the initial administration for test-retest reliability. The LLDI-CAT had very good test-retest reliability (ICC

Aim. Identification of opportunities to influence the development of the epidemic process of HIV infection.Materials and methods. Mathematical modeling and statistical analysis methods were used to assess the epidemiological situation forecast. In addition, the work uses methods of epidemiological research: analytical, descriptive and evaluative, statistical observation method with the calculation of intensive and extensive indicators, a continuous observational retrospective epidemiological study in the volume of the General population over a long period.Results. A retrospective analysis of the development of the epidemic process of HIV infection in a region with a high level of HIV infection over a 26-year period since the first case was registered in 1993 showed that a concentrated stage of the epidemic has formed in the region at the present stage with an average annual rate of HIV growth of +259,9% against the national rate of +31,4%. By the end of 2018 a characteristic trend in the age structure of HIV is to reduce the proportion of persons aged up to 24 years, the prevalence of persons 35–44 years of age, a notable increase of the age group 55–64 years with a predominance of women infected by heterosexual sex (55,8 per cent). Predicting the epidemiological situation in relation to the age structure of HIV-infected people until 2023 showed a steady trend towards an increase in the HIV-positive age group up to 14 years, 40– 49 years, 50 years and older. There is a fairly high rate of HIV transmission among women.Conclusions. At the present stage of development of the epidemic process of HIV infection, the main share of HIV-infected people is 35–44 years old (72,4%). The results obtained during the study of predicting the development of the epidemic situation with regard to HIV infection until 2023 allow us to focus the anti-epidemic work of epidemiologically significant age groups.

Although research traction is increasing, intangible social impacts are still difficult to measure and relatively under-researched compared to their tangible economic counterparts. Thus, the curren...

Grid weakness measurement is an extremely important process in the modern-day VLSI design flow. In designs that contain power gating switches, there are additional challenges. It is desirable to find the PG grid weakness of only the gated domain. The tools used in the industry typically measure the total voltage drops from the bump location to the transistor pin. This voltage drop is the summation of the voltage drops in the external domain, switch pin network, and internal domain. This paper explores the ways to measure the internal pin domain voltage exclusively. Ansys Totem tool is used for simulation. Finally, the simulation results are presented to propose the effectiveness and accuracy of the given solution.

Impairments in theory of mind (ToM)—long considered common among individuals with autism spectrum disorder (ASD)—are in fact highly heterogeneous across this population. Although such heterogeneity should be reflected in differential recruitment of neural mechanisms during ToM reasoning, no research has yet uncovered a mechanism that explains these individual differences. In this study, 78 (48 with ASD) adolescents viewed ToM vignettes and made mental-state inferences about characters’ behavior while participant electrophysiology was concurrently recorded. Two candidate event-related-potentials (ERPs)—the late positive complex (LPC) and the late slow wave (LSW)—were successfully elicited. LPC scores correlated positively with ToM accuracy and negatively with ASD symptom severity. Note that the LPC partially mediated the relationship between ASD symptoms and ToM accuracy, which suggests that this ERP component, thought to represent cognitive metarepresentation, may help explain differences in ToM performance in some individuals with ASD.

There is growing interest in not only intensive care unit (ICU) outcomes but also the resources required to deliver this care and itscost-effectiveness. The most available metric of resource utilisation is ICU length of stay, which is influenced by casemix, illness severity, and institutional characteristics, including delays in discharge. For instance, ICU length of stay is generally longer for more severely ill patients. Comparison of length of stay between units must therefore account for differences in baseline patient characteristics.

Predictive power of many behavioral measures relies on high test-retest reliability, whereby a measure yields similar data when repeated measure administration occurs at spaced-out intervals. Howev...

It is well established that cardiorespiratory fitness (CRF) is inversely associated with numerous morbidities independent of age, biological sex, race or ethnicity, and commonly obtained risk factors. More recent evidence also demonstrates that the addition of CRF to multivariable risk prediction algorithms used to estimate cardiovascular disease risk improves risk stratification. However, it is neither feasible nor appropriate to perform an exercise test to quantify CRF during most routine clinical encounters. A growing number of studies have suggested that CRF can be assessed pragmatically and reasonably accurately without performing a maximal exercise test. The concept that CRF can be substantially improved in response to regular exercise consistent with consensus recommendations underscores the recommendation that CRF should be a routine measure—a vital sign—across health care settings. Herein, we provide a brief, narrative overview of the evidence in support of this recommendation.

Bacnground: Accurate measurement of the femoral neck-shaft angle (NSA) is of great significance for diagnosing hip joint diseases and preoperative planning of total hip arthroplasty. However, the fitting lines of the femoral neck and femoral shaft did not always intersect in 3D space. Thus, it is unclear whether there is a difference between 2D and 3D methods for measuring NSA. Methods: The femoral point cloud datasets from 310 subjects were segmented into three regions, including the femoral head, femoral neck, and femoral shaft using PointNet++. We created a projection plane to simulate the hip anteroposterior radiograph and fitted the femoral neck axis and femoral shaft axis to complete the 2D measurement, while we directly fitted the two axes in space to complete the 3D measurement. Also, we conducted the manual measurement of the NSA. We verified the accuracy of the segmentation and compared the results of the two automatic and manual methods. Results: The Dice coefficient of femoral segmentation reached 0.9746, and MIoU of that was 0.9165. No significant difference was found between any two of the three methods. While comparing the 2D and 3D methods, the average accuracy was 98.00%, and the average error was 2.58°. Conclusion: This paper proposed two accurate and automatic methods to measure the NSA based on a 2D plane and a 3D model respectively. Although the femoral neck and femoral shaft axes did not intersect in 3D space, the NSAs obtained by 2D and 3D methods were basically consistent.

Background: Dexamethasone showed mortality benefits in COVID-19 patients. However, the optimal timing for dexamethasone initiation to prevent COVID-19 consequences such as respiratory failure requiring MV is debatable. As a result, the purpose of this study is to assess the impact of early dexamethasone initiation in non-MV critically ill patients with COVID19.Methods: A multicenter cohort study including adult patients with COVID-19 admitted to intensive care units (ICUs) and received systemic dexamethasone between March 2020 and March 2021. Patients were categorized into two groups based on the timing for dexamethasone initiation (early vs. late). The primary endpoint is developing respiratory failure that required MV; other outcomes were considered secondary. Propensity score matching was used based on the patient’s SOFA score, mechanical ventilation (MV) status, prone status, and early use of tocilizumab within 24 hours of ICU admission.Results: Among 208 patients matched using propensity score, 104 had received dexamethasone after 24 hours of ICU admission (1:1 ratio). Among the non-mechanically ventilated patients, late use of dexamethasone was associated with higher odds of developing respiratory failure that required MV (OR [95%CI]: 2.75 [1.12, 6.76], P=0.02). Additionally, late use was associated with longer hospital LOS (Est. [95%CI]: 0.55 [0.22, 0.88], P=0.001).The 30-day and in-hospital mortality were higher in the late group; however, were not statistically significant.Conclusion: Early use of dexamethasone within 24 hours of ICU admission in critically ill patients with COVID-19 might be considered a proactive protective measure in non-mechanically ventilated patients.

Signal functions are a representative shortlist of key interventions and activities that address major causes of morbidity or mortality and that are indicative of a certain type and level of care in a health facility. For example, signal functions indicative of "basic emergency obstetric care (EmOC)" could be provided by midwives at a lower level health centre, whereas "comprehensive EmOC" signal functions indicate a higher level of care, usually at a hospital or . Thus, signal function test is very vital in measuring Obstetric and Newborn Functionality of Health Facilities. On the other hand, third delays are the delays in receiving adequate and appropriate treatment at the healthcare facility by mothers during and after pregnancy.