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„Hier wie da wird geliebt“: Liebe als universales Phänomen in Verhandlungen zum Familienrecht
(2016)
Obwohl Liebe eines der zentralen Begründungsmotive dauerhafter Paarbeziehungen darstellt, wird der Begriff im deutschen Familienrecht mit Bezug auf die Ehe oder die eingetragene Lebenspartnerschaft nicht genannt. Davon ausgehend, dass in politischen Verhandlungen über Gesetzesänderungen eine Übersetzung gesellschaftlicher Realität in juristische Normen stattfindet, geht der Beitrag der folgenden Frage nach: Wie und wann sprechen Bundestagsabgeordnete von Liebe, wenn im Rahmen familienrechtlicher Reformen über Beziehungen zwischen hetero- und homosexuellen Paaren verhandelt wird? Das Material zeigt eine Spaltung zwischen einer Zuschreibung der Berechtigung von Liebe, die entweder mit sakralen Motiven in Verbindung gebracht wird, oder, wenn sie als unberechtigt gilt, als sexualisiertes Begehren abgewertet wird. Es ist außerdem darstellbar, dass eine universale Zuschreibung von Liebe bei hetero- und homosexuellen Paaren stattfindet, was allerdings wesentlich mit der Bereitschaft zur lebenslangen Unterhaltsverpflichtung zusammenhängt.
Selective retrieval of some studied items can both impair and improve recall of the other items. This study examined the role of working memory capacity (WMC) for the two effects of memory retrieval. Participants studied an item list consisting of predefined target and nontarget items. After study of the list, half of the participants performed an imagination task supposed to induce a change in mental context, whereas the other half performed a counting task which does not induce such context change. Following presentation of a second list, memory for the original list's target items was tested, either with or without preceding retrieval of the list's nontarget items. Consistent with previous work, preceding nontarget retrieval impaired target recall in the absence of the context change, but improved target recall in its presence. In particular, there was a positive relationship between WMC and the beneficial, but not the detrimental effect of memory retrieval. On the basis of the view that the beneficial effect of memory retrieval reflects context-reactivation processes, the results indicate that individuals with higher WMC are better able to capitalise on retrieval-induced context reactivation than individuals with lower WMC.
In listwise directed forgetting, participants are cued to forget previously studied material and to learn new material instead. Such cueing typically leads to forgetting of the first set of material and to memory enhancement of the second. The present study examined the role of working memory capacity in adults' and children's listwise directed forgetting. Working memory capacity was assessed with complex span tasks. In Experiment 1 working memory capacity predicted young adults' directed-forgetting performance, demonstrating a positive relationship between working memory capacity and each of the two directed-forgetting effects. In Experiment 2 we replicated the finding with a sample of first and a sample of fourth-grade children, and additionally showed that working memory capacity can account for age-related increases in directed-forgetting efficiency between the two age groups. Following the view that directed forgetting is mediated by inhibition of the first encoded list, the results support the proposal of a close link between working memory capacity and inhibitory function.
Objectives: A historical review of the editorial board and the founding editor of WORK: A Journal of Prevention, Assessment and Rehabilitation was conducted to examine the understanding of the editorship and contributions of this team to the knowledge in WORK.
Participants: The team of four authors worked together to identify an approach to evaluate the contributions and impact of WORK's editorial board (EB) on the journal's scholarship. The editor-in-chief (EIC) and editorial board members were participants in this evaluation.
Methods: Informative and formative evaluations were used to investigate how knowledge was shaped through the development of an epistemic community of scholars in the field of work. Metrics of the EB composition and participation in the journal as well as surveys and interviews with the board and the editor-in-chief were analyzed.
Results: The EB represents an international community of scholars with a common interest in work and who contribute academically both within WORK and beyond. The epistemic community that has evolved through the editorial board represents a pluralistic perspective on work that is needed to inform practice, and knowledge.
Conclusion: Future directions to continue to advance knowledge through WORK's editorial board and EIC are elaborated.
This paper presents a systematic literature review on both the risks affecting wood supply security and risk mitigation strategies by quantitative and qualitative data analysis. It describes wood-specific supply chain risks, thereupon resulting impacts and counteracting strategies to ensure supply. Risks, impacts, and strategies are documented as basis for a comparative analysis, discussion of results, challenges and research gaps. Finally, the suitability and the limitations of the chosen methodology and the achieved results are discussed. Scanning wood supply chain risks and supply strategies, most of the reviewed papers focus on wood supply for bioenergy generation and only a few studies investigate wood supply chain risk issues for the sawing, wood panel, pulp and paper industries, or biorefineries.
This review differs significantly from other reviews in this field as it considers the entire wood value chain including recent studies on new chemical wood-based products and thus provides a more complete picture of the wood-based bioeconomy. Consequently, it contributes to the literature by providing an overarching investigation of the risks affecting wood supply security and possible side effects of a growing wood-based bioeconomy. It was found that comprehensive value chain analyses considering established wood products, large-volume bioenergy products, as well as established and new chemical wood-based products in the context of wood supply security are missing. Studies that map the entire wood value chain with its multilevel interdependences and integrating cascading use of wood are lacking.
Die Pflegewissenschaft in Deutschland steht vor der Herausforderung, wissenschaftliche Strukturen und Karrierewege auszubilden. Erschwert wird dies durch einen Mangel an wissenschaftlichem Nachwuchs, der das Potential hat, pflegewissenschaftliche Professuren mit wissenschaftlicher Exzellenz und praktischer Erfahrung zu füllen.
Ziel dieses Beitrags ist es, darzustellen, was auslösende Momente für wissenschaftliche Karrieren sind, die in Professuren pflegebezogener Studiengänge münden, und welche Kontextbedingungen diese Karrieren beeinflussen. Es soll auch aufgezeigt werden, wie wissenschaftliche Nachwuchskräfte vorgehen, um ihre Ziele zu erreichen und welche Konsequenzen sich daraus für sie und für die Pflegewissenschaft ergeben. Auf dieser Grundlage sollen Empfehlungen für die Nachwuchsförderung entwickelt werden, um mehr geeignete Personen für Professuren in pflegebezogenen Studiengängen zu gewinnen.
Vorhandene Daten teilnarrativer Interviews mit ProfessorInnen (n=11) und Masterstudierenden (n=11) sowie Promovierenden (n=10) pflegebezogener Studiengänge wurden im Rahmen einer retrospektiven Datenanalyse mit dem dreistufigen Codierverfahren der Grounded Theory Methodologie ausgewertet.
Die Ergebnisse zeigen, dass in der Pflegepraxis gewonnene Erfahrungen auslösende Momente wissenschaftlicher Karrieren sind. Diese lösen den Drang aus, die dort herrschende Situation zu verändern, wobei sich vier Karrieretypen unterscheiden lassen: Typ A forscht, weil er erlebt hat, dass es für pflegerische Phänomene keine geeigneten Pflegeinterventionen gab. Typ B lehrt, um dazu beizutragen, dass Pflegende zukünftig besser ausgebildet werden. Typ C ist als Pflegeperson von ÄrztInnen nicht ausreichend anerkannt worden und absolviert eine wissenschaftliche Qualifikation, um mit ihnen auf Augenhöhe zu gelangen. Typ D wollte in der Praxis bleiben, ist aber bei Weiterentwicklungsprozessen blockiert worden und nimmt als Kompromiss eine Professur an.
Identifizierte Kontextfaktoren sind u.a. mangelnde Wertschätzung für wissenschaftliches Handeln in der Pflege und das Fehlen von Stellen für hochschulisch qualifizierte Pflegepersonen in der Praxis. Angesichts der bestehenden Bedingungen können hochschulisch qualifizierte Pflegende in der Praxis nicht Fuß fassen. Als Konsequenz für die Pflegewissenschaft als Disziplin zeigt sich, dass in der Pflegepraxis Vorbilder fehlen, die zukünftige Generationen Pflegender dazu anregen könnten, selbst eine wissenschaftliche Karriere in der Pflege einzuschlagen. Dadurch besteht die Gefahr einer Verkümmerung der Pflegewissenschaft.
Auf Grundlage der Ergebnisse wird die durchgängige Implementierung geeigneter Stellen für hochschulisch qualifizierte Pflegepersonen in der Pflegepraxis als Ausgangsbasis wissenschaftlicher Nachwuchsförderung betrachtet. Als Konzept werden Hochschul-Praxis-Partnerschaften skizziert, die beginnend auf Bachelorniveau bis zur Post-doc-Phase Strukturen zu einem systematischen praxisbezogenen wissenschaftlichen Kompetenzauf- und -ausbau für akademisch qualifizierte Pflegende etablieren.
Die Pflegewissenschaft in Deutschland steht vor der Herausforderung, wissenschaftliche Strukturen und Karrierewege auszubilden. Erschwert wird dies durch einen Mangel an wissenschaftlichem Nachwuchs, der das Potential hat, pflegewissenschaftliche Professuren mit wissenschaftlicher Exzellenz und praktischer Erfahrung zu füllen.
Ziel dieses Beitrags ist es, darzustellen, was auslösende Momente für wissenschaftliche Karrieren sind, die in Professuren pflegebezogener Studiengänge münden, und welche Kontextbedingungen diese Karrieren beeinflussen. Es soll auch aufgezeigt werden, wie wissenschaftliche Nachwuchskräfte vorgehen, um ihre Ziele zu erreichen und welche Konsequenzen sich daraus für sie und für die Pflegewissenschaft ergeben. Auf dieser Grundlage sollen Empfehlungen für die Nachwuchsförderung entwickelt werden, um mehr geeignete Personen für Professuren in pflegebezogenen Studiengängen zu gewinnen.
Vorhandene Daten teilnarrativer Interviews mit ProfessorInnen (n=11) und Masterstudierenden (n=11) sowie Promovierenden (n=10) pflegebezogener Studiengänge wurden im Rahmen einer retrospektiven Datenanalyse mit dem dreistufigen Codierverfahren der Grounded Theory Methodologie ausgewertet.
Die Ergebnisse zeigen, dass in der Pflegepraxis gewonnene Erfahrungen auslösende Momente wissenschaftlicher Karrieren sind. Diese lösen den Drang aus, die dort herrschende Situation zu verändern, wobei sich vier Karrieretypen unterscheiden lassen: Typ A forscht, weil er erlebt hat, dass es für pflegerische Phänomene keine geeigneten Pflegeinterventionen gab. Typ B lehrt, um dazu beizutragen, dass Pflegende zukünftig besser ausgebildet werden. Typ C ist als Pflegeperson von ÄrztInnen nicht ausreichend anerkannt worden und absolviert eine wissenschaftliche Qualifikation, um mit ihnen auf Augenhöhe zu gelangen. Typ D wollte in der Praxis bleiben, ist aber bei Weiterentwicklungsprozessen blockiert worden und nimmt als Kompromiss eine Professur an.
Identifizierte Kontextfaktoren sind u.a. mangelnde Wertschätzung für wissenschaftliches Handeln in der Pflege und das Fehlen von Stellen für hochschulisch qualifizierte Pflegepersonen in der Praxis. Angesichts der bestehenden Bedingungen können hochschulisch qualifizierte Pflegende in der Praxis nicht Fuß fassen. Als Konsequenz für die Pflegewissenschaft als Disziplin zeigt sich, dass in der Pflegepraxis Vorbilder fehlen, die zukünftige Generationen Pflegender dazu anregen könnten, selbst eine wissenschaftliche Karriere in der Pflege einzuschlagen. Dadurch besteht die Gefahr einer Verkümmerung der Pflegewissenschaft.
Auf Grundlage der Ergebnisse wird die durchgängige Implementierung geeigneter Stellen für hochschulisch qualifizierte Pflegepersonen in der Pflegepraxis als Ausgangsbasis wissenschaftlicher Nachwuchsförderung betrachtet. Als Konzept werden Hochschul-Praxis-Partnerschaften skizziert, die beginnend auf Bachelorniveau bis zur Post-doc-Phase Strukturen zu einem systematischen praxisbezogenen wissenschaftlichen Kompetenzauf- und -ausbau für akademisch qualifizierte Pflegende etablieren.
Es ist ein Experiment! In diesem Beitrag wird untersucht, wie das KI-gestützte textbasierte Dialogprogramm „ChatGPT“ im Rechnungswesen und Berichtswesen eingesetzt werden kann, um Routineaufgaben zu automatisieren, die Effizienz zu steigern und Finanzdaten besser zu verstehen. Die Erstellung des gesamten Beitrags selbst erfolgte mithilfe von ChatGPT, d.h., nicht nur die von der KI generierten Passagen, die als Screenshots gezeigt werden, sondern wesentliche Teile des vorliegenden Textes, wurden von der KI erstellt und anschließend inhaltlich und sprachlich durch den Autor redigiert und ergänzt. Damit soll einerseits das Potenzial der Anwendung in der Praxis gezeigt und verdeutlicht werden, dass der Umgang mit den Werkzeugen der KI in Zukunft unerlässlich sein wird, andererseits sollen aber auch die Risiken und Bedenken thematisiert werden. Denn nur allzu leicht werden in Zukunft die Grenzen einer Urheberschaft verschwimmen.
Ten new efficient p‐dopants for conductivity doping of organic semiconductors for OLEDs are identified. The key advantage of the electrophilic tris(carboxylato) bismuth(III) compounds is the unique low absorption of the resulting doped layers which promotes the efficiency of OLED devices. The combination of these features with their low fabrication cost, volatility, and stability, make these materials very attractive as dopants in organic electronics.
When Remembering Causes Forgetting: Electrophysiological Correlates of Retrieval-Induced Forgetting
(2007)
People tend to forget information that is related to memories they are actively trying to retrieve. On the basis of results from behavioral studies, such retrieval-induced forgetting is held to result from inhibitory control processes that are recruited to attenuate interference caused by competing memory traces. Employing electrophysiological measures of brain activity, the present study examined the neural correlates of these inhibitory processes as they operate. The results demonstrate that sustained prefrontal event-related potentials were 1) related to whether or not selective memory retrieval was required during reprocessing of previously studied words and 2) predictive of individual differences in the amount of forgetting observed in an ensuing recall test. The present findings give support to an inhibitory control account of retrieval-induced forgetting and are in accord with the view that prefrontal regions play an important role in the selection and maintenance of relevant memory representations at the expense of those currently irrelevant.
Each year, the Virtual Business Professional (VBP) program brings together professors and students from across the globe to engage in client projects. The VBP program of 2020 occurred from the beginning of March through the middle of April. In this article, we share how the COVID-19 pandemic affected VBP participants and their teams. We present post-project survey results (completed by 440 of 530 participants for an 83 percent response rate), professor comments, and student comments to demonstrate how VBP participants overcame many of the pandemic disruptions to work effectively in virtual teams, develop compassion and empathy for one another, and foster more global mindsets.
Manufacturing-Execution-Systeme (MES) werden in der Fertigungsindustrie dazu eingesetzt, einen durchgehenden Informationsfluss zwischen den an der Fertigung beteiligten Systemen herzustellen. Von der Vernetzung aller an der Produktion beteiligten Systeme wird dabei eine gesteigerte Produktivität auf Shop-Floor-Ebene erwartet. Beim Durchlauf des beispielhaft gezeigten Fertigungsauftrages wurden durch den Einsatz von MR-CM©, einem von der Maschinen-fabrik Reinhausen entwickelten und implemen-tierten MES, bereits einige Produktivitätspotenziale im Vergleich mit der konventionellen Abwicklung ohne Einsatz des MES deutlich. Diese resultieren im Wesentlichen aus der Eliminierung von nicht wertschöpfenden Schnittstellenproblemen zwischen den an der Auftragsdurchführung beteiligten Maschinen. Die erzielten Produktivitätszuwächse bestehen im Kern aus einer Verkürzung der Maschinenrüstzeiten, was zu einer Reduktion der Produktionskosten und einer Zunahme der Produktionsflexibilität führt und zu einer Reduzierung der Werkzeugbestände sowie der damit verbundenen Kapitalbindungskosten.
In many lakes, the most conspicuous seasonal events are the phytoplankton spring bloom and the subsequent clear-water phase, a period of low-phytoplankton biomass that is frequently caused by mesozooplankton (Daphnia) grazing. In Central European lakes, the timing of the clear-water phase is linked to large-scale climatic forcing, with warmer winters being followed by an earlier onset of the clear-water phase. Mild winters may favour an early build-up of Daphnia populations, both directly through increased surface temperatures and indirectly by reducing light limitation and enhancing algal production, all being a consequence of earlier thermal stratification. We conducted a field experiment to disentangle the separate impacts of stratification depth (affecting light supply) and temperature on the magnitude and timing of successional events in the plankton. We followed the dynamics of the phytoplankton spring bloom, the clear-water phase and the spring peak in Daphnia abundance in response to our experimental manipulations. Deeper mixing delayed the timing of all spring seasonal events and reduced the magnitudes of the phytoplankton bloom and the subsequent Daphnia peak. Colder temperatures retarded the timing of the clear-water phase and the subsequent Daphnia peak, whereas the timing of the phytoplankton peak was unrelated to temperature. Most effects of mixing depth (light) and temperature manipulations were independent, effects of mixing depth being more prevalent than effects of temperature. Because mixing depth governs both the light climate and the temperature regime in the mixed surface layer, we propose that climate-driven changes in the timing and depth of water column stratification may have far-reaching consequences for plankton dynamics and should receive increased attention.
BACKGROUND: Active performance is crucial for motor learning, and, together with motivation, is believed to be associated with a better rehabilitation outcome. Virtual reality (VR) is an innovative approach to engage and motivate patients during training. There is promising evidence for its efficiency in retraining upper limb function. However, there is insufficient proof for its effectiveness in gait training.
AIM: To evaluate the acceptability of robot-assisted gait training (RAGT) with and without VR and the feasibility of potential outcome measures to guide the planning of a larger randomized controlled trial (RCT).
DESIGN: Single-blind randomized controlled pilot trial with two parallel arms.
SETTING: Rehabilitation hospital.
POPULATION: Twenty subacute stroke patients (64±9 years) with a Functional Ambulation Classification (FAC) ≤2.
METHODS: Twelve sessions (over 4 weeks) of either VR-augmented RAGT (intervention group) or standard RAGT (control group). Acceptability of the interventions (drop-out rate, questionnaire), patients’ motivation (Intrinsic Motivation Inventory [IMI], individual mean walking time), and feasibility of potential outcome measures (completion rate and response to interventions) were determined.
RESULTS: We found high acceptability of repetitive VR-augmented RAGT. The drop-out rate was 1/11 in the intervention and 4/14 in the control group. Patients of the intervention group spent significantly more time walking in the robot than the control group (per session and total walking time; P<0.03). In both groups, motivation measured with the IMI was high over the entire intervention period. The felt pressure and tension significantly decreased in the intervention group (P<0.01) and was significantly lower than in the control group at the last therapy session (r=-0.66, P=0.005). The FAC is suggested as a potential primary outcome measure for a definitive RCT, as it could be assessed in all patients and showed significant response to interventions (P<0.01). We estimated a sample size of 44 for a future RCT.
CONCLUSIONS: VR-augmented RAGT resulted in high acceptability and motivation, and in a reduced drop-out rate and an extended training time compared to standard RAGT. This pilot trial provides guidance for a prospective RCT on the effectiveness of VR-augmented RAGT.
CLINICAL REHABILITATION IMPACT: VR might be a promising approach to enrich and improve gait rehabilitation after stroke.
Ergänzend zum bisherigen Stand der Wissenschaft und Technik wurden in dieser Veröffentlichung Fichtefasern aus einem thermo-mechanischen Aufschlussprozess über einen Spritzgusscompounder mit Polypropylen und Haftvermittler direkt compoundiert. Bei der direkten einstufigen Verarbeitung wurde ein steigender Holzfaseranteil bis 30 Gew.-% untersucht. Die Charakterisierung der Materialkombinationen erfolgte durch Zugversuche, Melt-Flow-Rate Messungen, Dichtebestimmung, Mikroskopie und Kerbschlagbiegeversuche. Bei steigendem Holzfaseranteil wird eine Steigerung der Zugeigenschaften, der Viskosität und der Dichte festgestellt. Die Kerbschlagzähigkeit bleibt bei steigendem Holzfaseranteil im Rahmen der Standardabweichung konstant, ist jedoch im Vergleich zum unveränderten Grundpolymer geringer.
Objective: To examine the relevance and completeness of the comprehensive International Classification of Functioning, Disability and Health (ICF) Core Sets for patients with rehabilitation needs in acute hospital care.
Design: Multi-centre cohort study.
Patients: A total of 391 patients (50.1% female, mean age 63.4 years) from 4 university hospitals in Austria, Germany and Switzerland and one Austrian general hospital.
Methods: Data on functioning were collected using the respective comprehensive acute ICF Core Sets. Data were extracted from patients' medical record sheets and interviews with health professionals and patients.
Results: Most of the categories of the comprehensive ICF Core Sets describing impairments, limitations or restrictions occurred in a considerable proportion of the study population. The most outstanding limitations and restrictions of the patients were problems with sleep and blood vessel functions, walking and moving and self-care. Thirty-eight aspects of functioning not previously covered by the comprehensive ICF Core Sets were ranked as relevant.
Conclusion: Categories of the comprehensive ICF Core Sets for the acute hospital situation were confirmed. Some additional categories not covered by the Set in its present version emerged from the interviews, and should be considered for inclusion in a finalized version.
Background: Existing instruments measuring participation may vary with respect to various aspects. This study aimed to examine the comparability of existing instruments measuring participation based on the International Classification of Functioning, Disability and Health (ICF) by considering aspects of content, the perspective adopted and the categorization of response options.
Methods: A systematic literature review was conducted to identify instruments that have been commonly used to measure participation. Concepts of identified instruments were then linked to the ICF following the refined ICF Linking Rules. Aspects of content, perspective adopted and categorization of response options were documented.
Results: Out of 315 instruments identified in the full-text screening, 41 instruments were included. Concepts of six instruments were linked entirely to the ICF component Activities and Participation; of 10 instruments still 80% of their concepts. A descriptive perspective was adopted in most items across instruments (75%), mostly in combination with an intensity rating. An appraisal perspective was found in 18% and questions from a need or dependency perspective were least frequent (7%).
Conclusion: Accounting for aspects of content, perspective and categorization of responses in the linking of instruments to the ICF provides detailed information for the comparison of instruments and guidance on narrowing down the choices of suitable instruments from a content point of view.
Implications for Rehabilitation
For clinicians and researchers who need to identify a specific instrument for a given purpose, the findings of this review can serve as a screening tool for instruments measuring participation in terms of the following:
• Their content covered based on the ICF.
• The perspective adopted in the instrument (e.g., descriptive, need/dependency or appraisal).
• The categorization of their response options (e.g., intensity or frequency).
The paper demonstrates how institutional ethnography provides a way forward for occupational scientists to understand how social policies shape and infiltrate people's daily lives and work. Institutional ethnography is a method of inquiry that starts in individual's experiences and from there traces how their experiences are coordinated to and become shaped within particular organizational processes and social relations. In this paper, we are specifically interested in how social policies, as higher order texts, shape the organizational processes and service agents' work at Labor Market Offices, and enter into the organization of people's everyday activities. We want to make visible how particular policies enter into the organization of the daily lives of women with rheumatoid arthritis who apply for unemployment benefits and ‘regulate’ what they can or may have to do, even though higher order policy texts are not immediately visible or actively referred to in the setting. We learn from the experiences of two women, who are of employable age, have been diagnosed with rheumatoid arthritis, and live in a mid-sized city in Austria.
Symptom frequency and severity in vestibular disorders often do not correlate well with patients' restrictions of activities of daily living and limitations of participation.
Due to the lack of appropriate patient reported outcome measures (PRO), the extent of limitations and restrictions is mostly unknown. The International Classification of Functioning, Disability and Health (ICF) is a conceptual framework and classification to evaluate all aspects of health and disability. An ICF-based measure, the Vestibular and Participation Measure (VAP), was recently proposed.
Also, an ICF Core Set for vertigo, dizziness and balance disorders was developed to describe what aspects of functioning should be measured. This study protocol describes the development and cross-cultural validation of a new measure, the VAP-extended (VAP-e), based on VAP and ICF Core Set on three continents.
To determine objectivity and cross-cultural validity of the VAP and to find potentially redundant items, Rasch models will be used. The VAP-e will be created by modifying or adding items from the Activities and Participation and Environmental Factors component of the ICF Core Set. Reliability, objectivity and responsiveness of the VAP-e will be tested.
Symptom frequency and severity in vestibular disorders often do not correlate well with patients' restrictions of activities of daily living and limitations of participation. Due to the lack of appropriate patient reported outcome measures (PRO), the extent of limitations and restrictions is mostly unknown.
The International Classification of Functioning, Disability and Health (ICF) is a conceptual framework and classification to evaluate all aspects of health and disability. An ICF-based measure, the Vestibular and Participation Measure (VAP), was recently proposed. Also, an ICF Core Set for vertigo, dizziness and balance disorders was developed to describe what aspects of functioning should be measured.
This study protocol describes the development and cross-cultural validation of a new measure, the VAP-extended (VAP-e), based on VAP and ICF Core Set on three continents. To determine objectivity and cross-cultural validity of the VAP and to find potentially redundant items, Rasch models will be used. The VAP-e will be created by modifying or adding items from the Activities and Participation and Environmental Factors component of the ICF Core Set.
Reliability, objectivity and responsiveness of the VAP-e will be tested.
The International Classification of Functioning, Disability and Health (ICF) Generic- 30 Set (previously referred to as Rehabilitation Set) is a minimal set of ICF categories for reporting and assessing functioning and disability in clinical populations with different health conditions along the continuum of care. Recently, the Italian Society of Physical and Rehabilitation Medicine (SIMFER) developed an Italian modification of the simple and intuitive descriptions (SID) of these categories. This study was the first one to implement the use of the SID in practice.1)
To implement the use of the ICF in clinical practice and research among Italian Residents in PRM. 2) To verify if the SID made the application of ICF Generic 30 Set more user-friendly than the original descriptions. 3) To examine the prevalence of functioning problems of patients accessing Rehabilitation Services to serve as reference for the development of an ICF-based clinical data collection tool.Multicenter cross-sectional study.
Italian Physical Medicine and Rehabilitation (PRM) outpatient rehabilitation services. Patients referring to Italian PRM outpatient rehabilitation services and Italian Residents in PRM.Each School of Specialization involved, randomly, received the ICF Generic-30 Set with the original descriptions or with the SID.
Residents collected over a 4-month period (April-July 2016) patients data related to the ICF Generic-30 Set categories. Moreover, the residents self- assessed their difficulty in using the ICF Generic-30 Set with the original descriptions or with the SID, through a Numeric Rating Scale (NRS).Ninety-three residents collected functioning data of 864 patients (mean aged 57.7±19.3) with ICF Generic-30 Set: 304 with the original descriptions and 560 with SID. The difficulty in using the ICF Generic-30 Set with SID was rated as lower than using the original descriptions (NRS = 2.8±2.5 vs 3.5±3.1; p<0.001).
The most common disease was the back pain (9.6%) and the most common altered ICF categories were b280 (76.3%) and b710 (72.9%).This multicenter cross-sectional study shown that the ICF Generic-30 Set is a valuable instrument for reporting and assessing functioning and disability in clinical populations with different health conditions and along the continuum of care and that SID facilitate the understanding of the ICF categories and therefore their use in clinical practice.
This National survey, improving the knowledge of ICF among Italian PRM residents, represents an important step towards the system-wide implementation of ICF in the healthcare system.
Usability is considered a major success factor for current and future decision support systems. Such systems are increasingly used to assist human decision-makers in high-stakes tasks in complex domains such as health care, jurisdiction or finance. Yet, many if not most expert systems—especially in health care—fail to deliver the degree of quality in terms of usability that its expert users are used to from their personal digital consumer products. In this article, we focus on clinical decision support systems (CDSS) as an example for how important a human-centered design approach is when designing complex software in complex contexts. We provide an overview of CDSS classes, discuss the importance of systematically exploring mental models of users, and formulate challenges and opportunities of future design work on CDSS. We further provide a case study from a current research project to illustrate how we used codesign as a practical approach to produce usable software in a real-world context.
Practical Relevance: We make a point for usability to be considered a major success factor and non-negotiable characteristic of expert software. With software evolving into virtual coworkers in terms of supporting human decision-making in complex, high-risk domains, the necessity of and demand for systems that are unambiguously understandable and interpretable for their expert users have never been higher. We show that this is a real-world problem with high practical relevance by describing our work in the domain of clinical decision support systems (CDSS) as an example. We introduce the topic and a classification of CDSS. Thus, we highlight a conceptual framework of how to approach complex domains from a technology designer’s point of view. We continue by explaining why usability must be regarded as a major goal in software development. We derive challenges and opportunities that may well be transferred to other domains. Finally, be including a real-world example from our own professional work we propose a practical approach towards taking the challenges and exploiting the associated opportunities.
Distribution network design is about recommending long-term network structures in an environment where logistic variables like transportation costs or retailer order sizes dynamically change over time. The challenge for management is to recommend an optimal network configuration that will allow for longer term optimal results despite of environmental turbulences. This paper studies the robustness of cost-optimized FMCG (fast-moving consumer goods) distribution networks. It aims at observing the impact of changing variables/conditions on optimized logistic structures in terms of the optimal number and geographical locations of existing distribution centers. Five variables have been identified as relevant to the network structure. A case study approach is applied to study the robustness of an existing, typical, and optimized FMCG network. First, distribution network data of a German manufacturer of FMCG are recorded and analyzed. A quantitative model is set up to reflect the actual cost structure. Second, a cost optimal network configuration is determined as a benchmark for further analysis. Third, the variables investigated are altered to represent changes, both isolated (ceteris paribus) and in combination (scenario analysis). Each one of the variables investigated proves to be fundamentally able to suggest a change of the optimal network structure. However, the scenario analysis indicates that the expected changes will by and large compensate each other, leaving the network in near optimal condition over an extended period of time.
Clinical assessment schedule (CLAS) is a core part of the ICF-based implementation of functioning reporting across health conditions and along the continuum of care.
The Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists (UEMS PRM) workshop held in January 2016 aimed to develop and specify a CLAS within the context of rehabilitation services.
UEMS PRM Workshop in Nottwil, Switzerland, January 2016.PRM physicians representatives from 12 European countries, as well as Israel and Japan, mostly delegates of UEMS PRM Section and Board, and experts with other rehabilitation professional backgrounds.Participants were divided into 6 working groups and asked to specify what functioning aspects would be essential to document using the available ICF sets for the identified rehabilitation services contained in the newly developed service classification (ICSO-R): acute, post-acute and long-term rehabilitation services.
The 7 ICF Generic and 23 Rehabilitation Set categories were confirmed as well as specific health condition categories for acute rehabilitation services (mobile team), for postacute rehabilitation services (general outpatient rehabilitation, musculoskeletal and neurological rehabilitation, as well as specialized SCI rehabilitation), and for long-term rehabilitation services (day clinic and rehabilitation provided in the community). While general principles of the CLAS were defined, the need to align the CLAS for a specific service, as well as across services along the continuum of care was highlighted.
All groups deliberated on this topic; however, no conclusive statement was presented yet.The groups recognized a need for a systematic effort to identify data collection tools currently used.CLASs will serve in the future to ensure that functioning information is systematically and consistently collected across services, and thus respond also to various global reports and initiatives which stress the need for improving data collection on people's functioning.
Introduction: The aim of this review was to gain an understanding of the first 20 years of contributions to WORK within the assessment domain and to reflect on the perspectives underscoring this knowledge base.
Method: A narrative review of assessment articles using the WORK ARTicle database was conducted. Assessment articles were searched using issues from 1990 to 2009. Descriptive data was analyzed to examine historical trends of the specific types and dimensions of articles, the regional location of the contributions, and the methodological accordance. A reflective process was used by an editorial board member of WORK to inductively interpret perspectives and contextual issues that underpinned the evolution of the assessment domain in WORK.
Results: Over half of N= 108 of the articles on assessment in WORK focused on establishing or reporting reliability and validity of assessments used in clinical practice or evaluation research. The majority of the assessment articles were predominantly focused on the person. Contributions of articles were from 5 regions: North America, Europe, Australia, Asia and Africa.
Conclusions: Assessment articles in WORK have contributed to the development of evidence to support assessment of the worker. These articles represent a knowledge base that emphasizes evidence-based assessments to evaluate what a person can and cannot do to participate in work. Efforts are needed to expand knowledge generation in assessment to include more evaluations on the workplace and occupation dimensions, and that also considers the worker in context.
Ausgehend von der herkömmlichen Pin-on-Disc-Prüfmethodik wurde ein Tribologieprüfstand hinsichtlich seiner Leistungsfähigkeit zur Fasercharakterisierung optimiert und angepasst. Die Methodik wird erläutert und erste Anwendungen im Bereich der tribologischen Charakterisierung von Einzelfasern werden vorgestellt. Der Prüfungsablauf zur Untersuchung der Polymerfasern, deren Durchmesser nur einige 100 µm betragen, ist so generiert, dass eine Erfassung der Daten als Funktion der Zeit im Bereich von einigen 10 µm bis zu einigen 100 µm Faserverschleiß kontinuierlich während der Messung bereits in den ersten Minuten erfolgen kann. Der Prüfmodus startet hierbei mit Linienlast und entwickelt sich dynamisch zur Flächenlast durch Änderung der Auflagefläche der Faser während der Messung. Es wird gezeigt, dass Einzelfasern hinsichtlich ihrer Reibungs- und Verschleißeigenschaften in unterschiedlichen tribologischen Systemen charakterisiert werden können. Die Abhängigkeit der Verschleißraten von Fasermaterial, Oberflächenrauheit der Gegenkörper und Schmiermittelraten wird dargestellt.
Transient dynamics of pelagic producer-grazer systems in a gradient of nutrients and mixing depths
(2008)
Phytoplankton–grazer dynamics are often characterized by long transients relative to the length of the growing season. Using a phytoplankton–grazer model parameterized for Daphnia pulex with either flexible or fixed algal carbon : nutrient stoichiometry, we explored how nutrient and light supply (the latter by varying depth of the mixed water column) affect the transient dynamics of the system starting from low densities. The system goes through an initial oscillation across nearly the entire light–nutrient supply space. With flexible (but not with fixed) algal stoichiometry, duration of the initial algal peak, timing and duration of the subsequent grazer peak, and timing of the algal minimum are consistently accelerated by nutrient enrichment but decelerated by light enrichment (decreasing mixing depth) over the range of intermediate to shallow mixing depths. These contrasting effects of nutrient vs. light enrichment are consequences of their opposing influences on food quality (algal nutrient content): algal productivity and food quality are positively related along a nutrient gradient but inversely related along a light gradient. Light enrichment therefore slows down grazer growth relative to algal growth, decelerating oscillatory dynamics; nutrient enrichment has opposite effects. We manipulated nutrient supply and mixing depth in a field enclosure experiment. The experimental results were qualitatively much more consistent with the flexible than with the fixed stoichiometry model. Nutrient enrichment increased Daphnia peak biomass, decreased algal minimum biomass, decreased the seston C:P ratio, and accelerated transient oscillatory dynamics. Light enrichment (decreasing mixing depth) produced the opposite patterns, except that Daphnia peak biomass increased monotonously with light enrichment, too. Thus, while the model predicts the possibility of the “paradox of energy enrichment” (a decrease in grazer biomass with light enrichment) at high light and low nutrient supply, this phenomenon did not occur in our experiment.
Objective: A national, multi-phase, consensus process to develop simple, intuitive descriptions of International Classification of Functioning, Disability and Health (ICF) categories contained in the ICF Generic and Rehabilitation Sets, with the aim of enhancing the utility of the ICF in routine clinical practice, is presented in this study.
Methods: A multi-stage, national, consensus process was conducted. The consensus process involved 3 expert groups and consisted of a preparatory phase, a consensus conference with consecutive working groups and 3 voting rounds (votes A, B and C), followed by an implementation phase. In the consensus conference, participants first voted on whether they agreed that an initially developed proposal for simple, intuitive descriptions of an ICF category was in fact simple and intuitive.
Results: The consensus conference was held in August 2014 in mainland China. Twenty-one people with a background in physical medicine and rehabilitation participated in the consensus process. Four ICF categories achieved consensus in vote A, 16 in vote B, and 8 in vote C.
Discussion: This process can be seen as part of a larger effort towards the system-wide implementation of the ICF in routine clinical and rehabilitation practice to allow for the regular and comprehensive evaluation of health outcomes most relevant for the monitoring of quality of care.
Road network performance (RNP) is a key element for urban sustainability as it has a significant impact on economy, environment, and society. Poor RNP can lead to traffic congestion, which can lead to higher transportation costs, more pollution and health issues regarding the urban population. To evaluate the effects of the RNP, the involved stakeholders need a real-world data base to work with. This paper develops a data collection approach to enable location-based RNP analysis using publicly available traffic information. Therefore, we use reachable range requests implemented by navigation service providers to retrieve travel times, travel speeds, and traffic conditions. To demonstrate the practicability of the proposed methodology, a comparison of four German cities is made, considering the network characteristics with respect to detours, infrastructure, and traffic congestion. The results are combined with cost rates to compare the economical dimension of sustainability of the chosen cities. Our results show that digitization eases the assessment of traffic data and that a combination of several indicators must be considered depending on the relevant sustainability dimension decisions are made from.
In 2011 the Chinese leadership in rehabilitation, in collaboration with the International Classification of Functioning, Disability and Health (ICF) Research Branch, embarked on an effort towards the system-wide implementation of the ICF in the healthcare system in China. We report here on the lessons learned from the pilot phase of testing the ICF Generic Set, a parsimonious set of 7 ICF categories, which have been shown to best describe functioning across the general population and people with various health conditions, for use in routine clinical practice in China. The paper discusses whether classification and measurement are compatible, what number of ICF categories should be included in data collection in routine practice, and the usefulness of a functioning profile and functioning score in clinical practice and health research planning. In addition, the paper reflects on the use of ICF qualifiers in a rating scale and the particularities of certain ICF categories contained in the ICF Generic Set when used as items in the context of Chinese rehabilitation and healthcare. Finally, the steps required to enhance the utility of system-wide implementation of the ICF in rehabilitation and healthcare services are set out.
Objective: The aims of this study were to evaluate the feasibility of using the International Classification of Functioning, Disability and Health (ICF) Generic Set in routine clinical practice, and of creating a functioning score based on it, and, subsequently, to examine its sensitivity to change.
Methods: In this prospective cohort study, data from 761 adult inpatients from 21 Chinese hospitals were analysed. Each patient was assessed at admission and discharge. Feasibility was evaluated by analysing mean assessment time. The Rasch model was used to create a metric of functioning. Sensitivity to change was analysed with mixed-effects regression and by calculating standardized effect size based on Cohen's f2.
Results: Mean duration of assessment was 5.3 min, with a significant decrease between admission and discharge. After removal of the item remunerative employment, the remaining ICF Generic Set categories fitted the Rasch model well. With a mean improvement in functioning of 12.1 (95% confidence interval (95% CI): 11.5–12.6), this metric proved sensitive to change, both in terms of statistical significance (p < 0.001) and standardized effect size (Cohen's f2 = 2.35).
Discussion: The ICF Generic Set is feasible for use in routine clinical practice and is promising to serve as the basis for the development of a functioning score that is sensitive to change.
Objective: Functioning is an important outcome to measure in cohort studies. Clear and operational outcomes are needed to judge the quality of a cohort study. This paper outlines guiding principles for reporting functioning in cohort studies and addresses some outstanding issues.
Design: Principles of how to standardize reporting of data from a cohort study on functioning, by deriving scores that are most useful for further statistical analysis and reporting, are outlined. The Swiss Spinal Cord Injury Cohort Study Community Survey serves as a case in point to provide a practical application of these principles.
Methods and Results: Development of reporting scores must be conceptually coherent and metrically sound. The International Classification of Functioning, Disability and Health (ICF) can serve as the frame of reference for this, with its categories serving as reference units for reporting. To derive a score for further statistical analysis and reporting, items measuring a single latent trait must be invariant across groups. The Rasch measurement model is well suited to test these assumptions.
Conclusion: Our approach is a valuable guide for researchers and clinicians, as it fosters comparability of data, strengthens the comprehensiveness of scope, and provides invariant, interval-scaled data for further statistical analyses of functioning.
As part of international efforts to develop and implement national models including the specification of ICF-based clinical data collection tools, the Italian rehabilitation community initiated a project to develop simple, intuitive descriptions of the ICF Rehabilitation Set, highlighting the core concept of each category in user-friendly language.
This paper outlines the Italian experience in developing simple, intuitive descriptions of the ICF Rehabilitation Set as an ICF-based clinical data collection tool for Italy.Consensus process.Expert conference.
Multidisciplinary group of rehabilitation professionals.The first of a two-stage consensus process involved developing an initial proposal for simple, intuitive descriptions of each ICF Rehabilitation Set category based on descriptions generated in a similar process in China.
Stage two involved a consensus conference. Divided into three working groups, participants discussed and voted (vote A) whether the initially proposed descriptions of each ICF Rehabilitation Set category was simple and intuitive enough for use in daily practice.
Afterwards the categories with descriptions considered ambiguous i.e. not simple and intuitive enough, were divided among the working groups, who were asked to propose a new description for the allocated categories. These proposals were then voted (vote B) on in a plenary session.
The last step of the consensus conference required each working group to develop a new proposal for each and the same categories with descriptions still considered ambiguous.
Participants then voted (final vote) for which of the three proposed descriptions they preferred.Nineteen clinicians from diverse rehabilitation disciplines from various regions of Italy participated in the consensus process. Three ICF categories already achieved consensus in vote A, while 20 ICF categories were accepted in vote B.
The remaining 7 categories were decided in the final vote.The findings were discussed in light of current efforts toward developing strategies for ICF implementation, specifically for the application of an ICF-based clinical data collection tool, not only for Italy but also for the rest of Europe.
Promising as minimal standards for monitoring the impact of interventions and for standardized reporting of functioning as a relevant outcome in rehabilitation.
Objective
Functioning is an important outcome in hand osteoarthritis (OA). The heterogeneity of patient‐reported outcome measures (PROMs) available challenges the direct comparability of information collected by these instruments. This study aimed to examine whether it is possible to achieve metric equivalence of PROMs commonly used to measure functioning in people with hand OA.
Methods
A secondary analysis of data from 253 persons who participated in the Vienna Hand Osteoarthritis Cohort Study was conducted applying the Rasch measurement model. Participants completed the Health Assessment Questionnaire, the Australian/Canadian Index for Hand Osteoarthritis, the Functional Index for Hand Osteoarthritis (FIHOA), and the Cochin Scale. The assumptions of stochastic ordering, local independence, unidimensionality, and invariance were tested for each scale independently before the scales were co‐calibrated onto a common metric.
Results
Except for the FIHOA, all measures indicated issues of local dependency in the initial analyses. After accommodating those with testlets, all scales satisfied the assumptions of the Rasch model (χ2 > 0.05). Marginal misfit in 2 items was found in the FIHOA, but this did not disturb person estimates. As the 4 scales form a common metric that satisfies the assumptions of the Rasch model, the scores can be equated.
Conclusion
The scores of the 4 hand function measures can be transformed to a common 0–100 metric, such that scores can be interchanged. A user‐friendly transformation table enables clinicians and researchers to have access to the common metric by simply adding up the total score for each instrument and identifying the corresponding transformed score on the common metric.
Study design
Case study.
Objective
To present a framework for developing an International Classification of Functioning, Disability and Health (ICF)-based documentation system in spinal cord injury (SCI)-specific rehabilitation.
Setting
Data collection took place at Maharaj Hospital, Thailand. The preparatory studies and analysis were performed at Swiss Paraplegic Research, Switzerland.
Methods
Data collected from interviews and health records of four SCI cases across the continuum of care (acute, post-acute, early and late long term) were linked to ICF categories using established ICF linking rules. The resulting categories were compared with selected ICF sets (ICF Generic-30, ICF core sets for SCI and multiple sclerosis) to determine the extent of coverage. Furthermore, the context of applicable services was described systematically.
Results
Less than half of the ICF categories in the defined ICF sets were covered by clinical assessment tools. Low correspondence was found predominantly in acute and late long-term phase. Least well covered were categories of activities and participations and environmental factors. The correspondence of categories increased when considering the additional ICF categories identified from patient interviews. The description of rehabilitation services provided in each case classified according to the dimensions of service provider, funding, and service delivery.
Conclusions
There is a need to promote the systematic and standardized assessment of functioning among health professionals working in the field of SCI in developing countries. This study describes basic steps toward developing a standardized ICF-based system for assessing and reporting functioning outcomes in SCI rehabilitation and across the continuum of care.
Time series are series of values ordered by time. This kind of data can be found in many real world settings. Classifying time series is a difficult task and an active area of research. This paper investigates the use of transfer learning in Deep Neural Networks and a 2D representation of time series known as Recurrence Plots. In order to utilize the research done in the area of image classification, where Deep Neural Networks have achieved very good results, we use a Residual Neural Networks architecture known as ResNet. As preprocessing of time series is a major part of every time series classification pipeline, the method proposed simplifies this step and requires only few parameters. For the first time we propose a method for multi time series classification: Training a single network to classify all datasets in the archive with one network. We are among the first to evaluate the method on the latest 2018 release of the UCR archive, a well established time series classification benchmarking dataset.
Retrieving a target item from episodic memory typically enhances later memory for the retrieved item but causes forgetting of competing irrelevant memories. This finding is termed retrieval-induced forgetting (RIF) and is assumed to be the consequence of an inhibitory mechanism resolving retrieval competition. In the present study, we examined brain oscillatory processes related to RIF, as induced by competitive memory retrieval. Contrasting a competitive with a noncompetitive retrieval condition, we found a stronger increase in early evoked theta (4–7 Hz) activity, which specifically predicted RIF, but not retrieval-induced enhancement. Within the cognitive framework of RIF, these findings suggest that theta oscillations reflect arising interference and its resolution during competitive retrieval in episodic memory.
Due to their lightweight potential and good eco-balance, thermoplastic hybrid composites with natural fiber reinforcement have long been used in the automotive industry. A good alternative to natural fibers is wood fibers, which have similar properties but are also a single-material solution using domestic raw materials. However, there has been hardly any research into wood fibers in thermoplastic back-injected hybrid composites. This article compares the bond strength of an injection molded rib from polypropylene (PP) and wood fibers to different non-wovens. The non-wovens consisted of wood fibers (spruce) or alternatively natural fibers (kenaf, hemp), both with a polypropylene matrix. Pull-off and instrumented puncture impact tests show that, given similar parameters, the natural and wood-fiber-hybrid composites exhibit very similar trends in bond strength. Further tests using viscosity measurements, microscopy, and computed tomography confirm the results. Wood-fiber-reinforced thermoplastic hybrid composites can thus compete with the natural fiber composites in terms of their mechanical behavior and therefore present a good alternative in technical semi-structural applications.
Recent work with young adults has shown that, depending on study context access, selective memory retrieval can both impair and improve recall of other memories (Bäuml & Samenieh, 2010). Here, we investigated the 2 opposing effects of selective retrieval in older age. In Experiment 1, we examined 64 younger (20–35 years) and 64 older participants (above 60 years), and manipulated study context access using list-method directed forgetting. Whereas both age groups showed a detrimental effect of selective retrieval on to-be-remembered items, only younger but not older adults showed a beneficial effect on to-be-forgotten items. In Experiment 2, we examined 112 participants from a relatively wide age range (40–85 years), and manipulated study context access by varying the retention interval between study and test. Overall, a detrimental effect of selective retrieval arose when the retention interval was relatively short, but a beneficial effect when the retention interval was prolonged. Critically, the size of the beneficial but not the detrimental effect of retrieval decreased with age and this age-related decline was mediated by individuals’ working memory capacity, as measured by the complex operation span task. Together, the results suggest an age-related dissociation in retrieval dynamics, indicating an earlier decline of the beneficial than the detrimental effect of selective retrieval with older age. (APA PsycInfo Database Record (c) 2016 APA, all rights reserved)
We examine the interaction in the market for physician services when the total budget for reimbursement is fixed. Physicians obtain points for the services they render. At the end of the period the budget is divided by the sum of all points submitted, which determines the price per point. We show that this retrospective payment system involves – compared to a fee-for-service remuneration system – a severe coordination problem, which potentially leads to the “treadmill effect”. We argue that when market entry is possible, a budget can be efficiency enhancing, if in addition a price floor is used.
The presentation of a subset of studied items as retrieval cues can have detrimental effects on recall of the remaining (target) items. In three experiments we examined whether such part-list cueing impairment depends on the similarity between cue and target items. Item similarity was manipulated by making use of pre-experimental semantic similarities between cue and target items (Experiments 1 and 2), or was episodically induced through a similarity-encoding task, in which participants were asked to interrelate cue and target items in a meaningful way (Experiment 3). In all three experiments reliable part-list cueing impairment arose when the similarity between cues and targets was low, but no impairment was found when the similarity between cues and targets was high. Inhibitory as well as non-inhibitory explanations of the findings are discussed.
Purpose
The purpose of this paper is to explore the impact of information technology (IT) on supply chain performance in the automotive industry. Prior studies that analyzed the impact of IT on supply chain performance report results representing the situation of the “average industry.” This research focuses on the automotive industry because of its major importance in many national economies and due to the fact that automotive supply chains do not represent the supply chain of the average industry.
Design/methodology/approach
A research model is proposed to examine the relationships between IT capabilities, supply chain capabilities, and supplier performance. The model divides IT capabilities into functional and data capabilities, and supply chain capabilities into internal process excellence and information sharing. Data have been collected from 343 automotive first-tier suppliers. Structural equation modeling with partial least squares is used to analyze the data.
Findings
The results suggest that functional capabilities have the greatest impact on internal process excellence, which in turn enhances supplier performance. However, frequent and adequate information sharing also contributes significantly to supplier performance. Data capabilities enable supply chain capabilities through their positive impact on functional capabilities.
Practical implications
The findings will help managers to understand the effect of IT implementation on company performance and to decide whether to invest in the expansion of IT capacities.
Originality/value
This research reports the impact of IT on supply chain performance in one of the most important industries in many industrialized countries, and it provides a new perspective on evaluating the contribution of IT on firm performance.
Providing a subset of studied items as retrieval cues can have detrimental effects on recall of the remaining items. In 2 experiments, the authors examined such part-list cuing impairment in a repeated testing situation. Participants studied exemplars from several semantic categories and were given 2 successive cued-recall tests separated by a distractor task of several minutes. Part-list cues were provided in the 1st test but not the 2nd. Noncue item recall was tested with the studied category cues (same probes) in the 1st test, but novel, unstudied retrieval cues (independent probes) in the 2nd test. The authors found detrimental effects of part-list cues in both the 1st (same-probe) test and the 2nd (independent-probe) test. These results show that part-list cuing impairment can be lasting and is not eliminated with independent probes. The findings support the view that the impairment was caused by retrieval inhibition.
Objective: The study aimed to explore existing prediction models of functioning in spinal cord injury (SCI).
Study design and setting: The databases PubMed, EBSCOhost CINAHL Complete, and IEEE Xplore were searched for relevant literature. The search strategy included published search filters for prediction model and impact studies, index terms and keywords for SCI, and relevant outcome measures able to assess functioning as reflected in the International Classification of Functioning, Disability and Health (ICF). The search was completed in October 2020.
Results: We identified seven prediction model studies reporting twelve prediction models of functioning. The identified prediction models were mainly envisioned to be used for rehabilitation planning, however, also other possible applications were stated. The method predominantly used was regression analysis and the investigated predictors covered mainly the ICF components of body functions and activities and participation, next to characteristics of the health condition and health interventions.
Conclusion: Findings suggest that the development of prediction models of functioning for use in clinical practice remains to be fully exploited. By providing a comprehensive overview of what has been done, this review informs future research on prediction models of functioning in SCI and contributes to an efficient use of research evidence.
In any dimension d≥2, there is no known example of a low-discrepancy sequence which possesses Poisssonian pair correlations. This is in some sense rather surprising, because low-discrepancy sequences always have β-Poissonian pair correlations for all 0<β<1/d and are therefore arbitrarily close to having Poissonian pair correlations (which corresponds to the case β=1/d). In this paper, we further elaborate on the closeness of the two notions. We show that d-dimensional Kronecker sequences for badly approximable vectors α→ with an arbitrary small uniformly distributed stochastic error term generically have β=1/d-Poissonian pair correlations.
Background
Joint contractures are frequent conditions in individuals in geriatric care settings and are associated with activity limitations and participation restrictions. As such, relevant intervention programs should address these aspects, and the effectiveness of such programs should be determined by assessing improvement in activities and participation. However, no patient-centred and psychometrically sound outcome measures for this purpose are available so far.
Objectives
The objectives of this study were to develop and to validate a new outcome measure, the PaArticular Scales, to quantify activities and participation in older individuals with joint contractures. Specific aims were (A) to operationalize the content of an International Classification of Functioning, Disability and Health-based standard set towards meaningful questions and to combine them to a questionnaire and (B) to assess the psychometric properties of the developed questionnaire, in detail to evaluate test–retest reliability, objectivity, internal consistency reliability and criterion validity.
Design
Operationalization was reached by an expert consensus conference and a subsequent expert Delphi survey. Psychometric properties were assessed in a cross-sectional study.
Settings
Nursing homes, geriatric rehabilitation facilities.
Participants
23 experts (nurses, physicians, physical and occupational therapists) participated in the consensus conference and the Delphi survey. A total of 191 individuals with joint contractures (as confirmed by physician, nurse or physical therapist) between 65 and 102 years, living in nursing homes or as patients in geriatric rehabilitation were enrolled in the cross-sectional study.
Methods
Rasch Partial Credit Modelling.
Results
The consensus conference and Delphi survey resulted in a questionnaire with 86 items of the International Classification of Functioning, Disability and Health. Test–retest-reliability among those was acceptable (Cohen's weighted kappa: 0.779). The Rasch analysis revealed two independent interval-scaled scales with 24 items for the Activities scale and 11 items for the Participation scale with high internal consistency reliability. Cronbach's alpha was 0.96 for the Activities scale and 0.92 for the Participation scale. Criterion validity was −0.40 and −0.30 for the Activities scale and for the Participation scale, respectively.
Conclusions
The PaArticular Scales, a new patient-centred and psychometric sound outcome measures to comprehensively assess the impact of joint contractures in geriatric care, are available now. These developed scales will serve as primary outcomes in a scheduled evaluation of a complex intervention to improve participation and quality of life in nursing home residents with joint contractures.
Background: The International Classification of Functioning, Disability and Health is the international standard for describing and monitoring functioning. While the categories, the units of the classification, were not designed with measurement in mind, the hierarchical structure of the classification lends itself to the possibility of summating categories into some higher order domain. Focusing on the chapters of d4 Mobility, d5 Self-Care and d6 Domestic Life, this study seeks to ascertain if qualifiers rating of categories (0-No problem to 4-Complete problem) within those chapters can be summated, and whether such derived measurement is consistent with estimates obtained from well-known instruments which purport to measure the same constructs.
Methods: The current study applies secondary analysis to data previously collected in the context of validating Core Sets for stroke, rheumatoid arthritis, and osteoarthritis. Data included qualifier-based ratings of the categories in the Core Sets, and the physical functioning sub-scale of the Short-Form 36, and the World Health Organization Disability Assessment Schedule 2.0. To examine qualifier-comparator scale item agreement Kappa statistics were used. To identify whether appropriate gradients of the comparator scales were observed across qualifier levels, an Independent Sample Median Test of the ordinal scores was deployed. To investigate the internal validity of the summated ICF categories, the Rasch model was applied.
Results: Data from 2,927 subjects from Europe, Australasia, Middle East and South America were available for analysis; 36.3% had experienced a stroke, 35.8% osteoarthritis, and 27.9% had rheumatoid arthritis. The items from the Short-Form 36 could not match directly the qualifier categories as the former had only 3 response options. The Kappa between World Health Organization Disability Assessment Schedule 2.0 items and categories was low. For all qualifiers, a significant (<0.001) overall gradient was observed across the comparator scales. Only in few of the World Health Organization Disability Assessment Schedule 2.0 items could no discrete level be detected. The aggregation of the qualifiers at the Chapter and higher order levels mostly revealed fit to the Rasch model. Almost all ICF qualifiers showed ordered thresholds suggesting that the current structure and response options of the qualifiers worked as intended.
Conclusions: The findings of this study provide supporting evidence for the use of the professionally rated categories and associated qualifiers to measure functioning.
Implication for Rehabilitation
- This study provides evidence that functioning data can be collected directly with the International Classification of Functioning, Disability and Health (ICF) by using the ICF categories as items and the ICF qualifiers as rating scale.
- The findings of this study show the aggregated ratings of ICF categories from the chapters d4 Mobility, d5 Self-care, and d6 Domestic life capture a broader spectrum of the construct than the corresponding summated items from the SF36-Physical Function sub-scale and the corresponding items of the World Health Organization Disability Assessment Schedule 2.0.
- This study illustrates the potential of building quantitative measurement by aggregating ICF categories and their qualifier ratings into meaningful domains.
The occupational therapy community has been receptive to the World Health Organisation's International Classification of Functioning, Disability and Health (ICF) published in 2001. Building upon results of a survey (2008–2009) and subsequent workshop (2010) conducted by the World Federation of Occupational Therapists on the use and utility of the ICF for occupational therapists, this paper addresses some of the opportunities and challenges to strengthening the use of the ICF in occupational therapy practice. Attaining further clarity on the relationship of occupational therapy concepts and the ICF and developing crosswalk tables to exemplify linkages between occupational therapy terminology and the ICF will strengthen utility of the ICF for occupational therapy. Enhanced clarity about the concepts within occupational therapy that correspond to the ICF will ultimately assist other professions and disciplines in their understanding about occupational therapy and occupational therapists’ roles in health and related systems.
Objective
To demonstrate the influence and added value of a Standardized Assessment and Reporting System (StARS) upon the reporting of functioning outcomes for national rehabilitation quality reports. A StARS builds upon an ICF-based (International Classification of Functioning, Disability and Health) and interval-scaled common metric.
Design
Comparison of current ordinal-scaled Swiss national rehabilitation outcome reports including an expert-consensus-based transformation scale with StARS-based reports through descriptive statistical methods and content exploration of further development areas of the reports with relevant ICF Core Sets.
Setting
Swiss national public rehabilitation outcome quality reports on the clinic level.
Participants
A total of 29 Swiss rehabilitation clinics provided their quality report datasets including 18 047 patients.
Interventions
Neurological or musculoskeletal rehabilitation.
Main outcome measures
Functional Independence Measure™ or Extended Barthel Index.
Results
Outcomes reported with a StARS tended to be smaller but more precise than in the current ordinal-scaled reports, indicating an overestimation of achieved outcomes in the latter. The comparison of the common metric’s content with ICF Core Sets suggests to include ‘energy and drive functions’ or ‘maintaining a basic body position’ to enhance the content of functioning as an indicator.
Conclusions
A StARS supports the comparison of outcomes assessed with different measures on the same interval-scaled ICF-based common metric. Careful consideration is needed whether an ordinal-scaled or interval-scaled reporting system is applied as the magnitude and precision of reported outcomes is influenced. The StARS’ ICF basis brings an added value by informing further development of functioning as a relevant indicator for national outcome quality reports in rehabilitation.
Background: The International Classification of Functioning, Disability and Health (ICF) is the World Health Organization’s standard for describing health and health-related states. Examples of how the ICF has been used in Electronic Health Records (EHRs) have not been systematically summarized and described yet.
Objectives: To provide a systematic review of peer-reviewed literature about the ICF’s use in EHRs, including related challenges and benefits.
Methods: Peer-reviewed literature, published between January 2001 and July 2015 was retrieved from Medline®, CINAHL®, Scopus®, and ProQuest® Social Sciences using search terms related to ICF and EHR concepts. Publications were categorized according to three groups: Requirement specification, development and implementation. Information extraction was conducted according to a qualitative content analysis method, deductively informed by the evaluation framework for Health Information Systems: Human, Organization and Technology-fit (HOT-fit).
Results: Of 325 retrieved articles, 17 publications were included; 4 were categorized as requirement specification, 7 as development, and 6 as implementation publications. Information regarding the HOT-fit evaluation framework was summarized. Main benefits of using the ICF in EHRs were its unique comprehensive perspective on health and its interdisciplinary focus.
Main challenges included the fact that the ICF is not structured as a formal terminology as well as the need for a reduced number of ICF codes for more feasible and practical use.
Conclusion: Different approaches and technical solutions exist for integrating the ICF in EHRs, such as combining the ICF with other existing standards for EHR or selecting ICF codes with natural language processing.
Though the use of the ICF in EHRs is beneficial as this review revealed, the ICF could profit from further improvements such as formalizing the knowledge representation in the ICF to support and enhance interoperability.
This study examines the impact of perceived foreign language proficiency on hybrid culture building in multicultural teams. Hybrid culture includes a mutually shared set of norms, communication patterns, problem-solving approaches, and synergistic task coordination that result from the diverse cultural backgrounds of the team members. Language is the main vehicle for communication and plays a major role in social interaction and therefore hybrid culture building. We argue that the level of perceived language proficiency of multicultural team members influences hybrid culture building; consequently, adequate language skills lead not only to an efficient task solution but are also an important factor in creating interpersonal relationships and building a shared culture. Our empirical analysis supports the positive influence of language proficiency in hybrid teams; however, foreign language proficiency is more influential on cognitively oriented areas of multicultural teamwork than on affective ones.
The Impact of Missing Values and Single Imputation upon Rasch Analysis Outcomes: A Simulation Study
(2018)
Imputation becomes common practice through availability of easy-to-use algorithms and software. This study aims to determine if different imputation strategies are robust to the extent and type of missingness, local item dependencies (LID), differential item functioning (DIF), and misfit when doing a Rasch analysis. Four samples were simulated and represented a sample with good metric properties, a sample with LID, a sample with DIF, and a sample with LID and DIF. Missing values were generated with increasing proportion and were either missing at random or completely at random. Four imputation techniques were applied before Rasch analysis and deviation of the results and the quality of fit compared. Imputation strategies showed good performance with less than 15% of missingness. The analysis with missing values performed best in recovering statistical estimates. The best strategy, when doing a Rasch analysis, is the analysis with missing values. If for some reason imputation is necessary, we recommend using the expectation-maximization algorithm.
Abstract
Objective: Since the 1990s the Functional Independence Measure (FIM™) was believed to measure 2 different constructs, represented by its motor and cognitive subscales. The practice of reporting FIM™ total scores, together with recent developments in the understanding of the influence of locally dependent items on fit to the Rasch model, raises the question of whether the FIM™ 18-item version can be reported as a unidimensional interval-scaled metric.
Design: Rasch analysis of the FIM™ using testlet approaches to accommodate local response dependency.
Patients: A calibration sample containing 946 cases of data from 11,103 patients undergoing neurological or musculoskeletal rehabilitation in Switzerland in 2016.
Results: Baseline analysis and the traditional testlet approach showed no fit with the Rasch model. When items were grouped into 2 testlets, fit to the Rasch model was achieved, indicating unidimensionality across all 18 items. A transformation table to convert FIM™ raw ordinal scores to the corresponding Rasch interval scaled values was created.
Conclusion: This study provides evidence that FIM™ total scores represent a unidimensional set of items, supporting their use in clinical practice and outcome reporting when applying the respective transformation table. This provides a basis for standardized reporting of functioning.
Lay Abstract
The aim of this study was to look in detail at the FIM™, an assessment tool often used for patients undergoing rehabilitation. Some users report the FIM™ as 2 scores: one related to motor tasks, the other to cognitive tasks; others recommend reporting it as a single score including both motor and cognitive tasks. This study explored whether it is statistically meaningful to sum all the points into a single FIM™ total score. The results support the current practice of summing the points into a single total score for patients undergoing musculo-skeletal and neurological rehabilitation. The results also allowed an interval scale to be derived from the FIM™, enabling a broad range of calculations to be made using the FIM™ score, such as calculating the change in FIM™ outcomes from the time a patient is admitted to a rehabilitation clinic until their discharge.
Background: The Extended Barthel Index (EBI), consisting of the original Barthel Index plus 6 cognitive items, provides a tool to monitor patients’ outcomes in rehabilitation. Whether the EBI provides a unidimensional metric, thus can be reported as a valid sum-score, remains to be examined.
Objective: To examine whether the EBI can be reported as unidimensional interval-scaled metric for neurological and musculoskeletal rehabilitation.
Methods: Rasch analysis of a calibration sample of 800 cases from neurological or musculoskeletal rehabilitation in 2016 in Switzerland.
Results: In the baseline analysis no fit to the Rasch Model was achieved. When accommodating local dependencies with a testlet approach satisfactory fit to the Rasch Model was achieved, and an interval scale transformation table was created.
Conclusion: The results support the reporting of adapted EBI total scores for both rehabilitation groups by applying the interval scaled transformation table presented in this study.
Objective:
Patient reported outcomes (PROs) are relevant in rheumatology. Variable accessibility and validity of commonly used PROs are obstacles to homogeneity in evidence synthesis. The objective of this project was to provide a comprehensive library of “validated PROs”.
Methods:
A launch meeting with rheumatologists, PROs methodological experts, and patients, was held to define the library’s aims and scope, and basic requirements. To feed the library we performed systematic reviews on selected diseases and domains. Relevant information on PROs was collected using standardised data collection forms based on the COSMIN checklist.
Results:
The EULAR Outcomes Measures Library (OML), whose aims are to provide and to advise on PROs on a user-friendly manner albeit based on scientific grounds, has been launched and made accessible to all. PROs currently included cover any domain and, are generic or specifically target to the following diseases: rheumatoid arthritis, osteoarthritis, spondyloarthritis, low back pain, systemic lupus erythematosus, gout, osteoporosis, juvenile idiopathic arthritis, and fibromyalgia. Up to 236 instruments (106 generic and 130 specific) have been identified, evaluated, and included. The systematic review for SLE, which yielded 10 specific instruments, is presented here as an example.
The OML website includes, for each PRO, information on the construct being measured and the extent of validation, recommendations for use, and available versions; it also contains a glossary on common validation terms.
Conclusion:
The OML is an in progress library led by rheumatologists, related professionals and patients, that will help to better understand and apply PROs in rheumatic and musculoskeletal diseases.
Occupational science has been discussed in terms of its relation to occupational therapy, its philosophical and theoretical foundations, and its international and interdisciplinary character over the past years. The disciplinary identity of occupational science in non-English speaking countries has not yet been debated in the literature. The aim of this article is to discuss occupational science as an emergent discipline in Austria, a German-speaking country. The discussion is divided into two parts. In the first part we engage in critical reflexivity to explicate the current development of occupational science in Austria by reviewing the disciplinary and historical context of occupational science and the related profession of occupational therapy, the educational and institutional influences as well as the influence of language. In the second part, we illustrate that occupational science is an emerging discipline in Austria by drawing on an ongoing research project: the Gender, Occupational Balance, and Immunology Study. By making explicit how occupational science has emerged, from our insider perspective, we aim to contribute to the further development of the disciplinary identity of occupational science nationally and internationally.
This article investigates multimodal elements—images, links, gifs, videos, and galleries—of crowdfunding campaigns on the platform Kickstarter to develop an understanding of characteristics of successful campaigns. The authors scraped 327,586 campaign pages, analyzing the multimodal elements of successful and unsuccessful campaigns. They found that successful campaigns featured more images, links, and gifs and more frequently included a project video than did unsuccessful campaigns. Images, links, and the presence of a project video had a positive impact on success while gifs and project galleries did not. These findings give business communicators practical guidance, develop theoretical aspects of Kickstarter research, and validate previous findings with a larger data set.
Previous developmental work has indicated that animacy is a foundational ontogenetic category that is given priority already early in life. Here, we investigated whether such priority is also present in children’s episodic memory, examining whether young children show enhanced retention of animacy-related information. Kindergartners and younger and older elementary school children were presented with fictitious (non)words (e.g., BULA, LAFE) paired with properties characteristic of humans (e.g., “likes music”), (nonhuman) animals (e.g., “builds nests”), and inanimate things (e.g., “has four edges”) and were asked to rate the animacy status of each nonword. After a retention interval, a surprise recognition test for the nonwords was administered. We found enhanced recognition of nonwords paired with human and animal properties compared with (the same) nonwords paired with inanimate properties. The size of this animacy advantage was comparable across age groups, suggesting developmental invariance of the advantage over the age range examined (i.e., 4–11 years). The results support a functional–evolutionary view on memory, suggesting that already young children’s memory is “tuned” to process and retain animacy.
In March 2019, German-speaking scientists and scholars calling themselves Scientists for Future, published a statement in support of the youth protesters in Germany, Austria, and Switzerland (Fridays for Future, Klimastreik/Climate Strike), verifying the scientific evidence that the youth protestors refer to. In this article, they provide the full text of the statement, including the list of supporting facts (in both English and German) as well as an analysis of the results and impacts of the statement. Furthermore, they reflect on the challenges for scientists and scholars who feel a dual responsibility: on the one hand, to remain independent and politically neutral, and, on the other hand, to inform and warn societies of the dangers that lie ahead.
The Challenges and Opportunities of AI-Assisted Writing: Developing AI Literacy for the AI Age
(2023)
Generative AI may significantly disrupt the teaching and practice of business communication. This study of 343 communication instructors revealed a collective view that AI-assisted writing will be widely adopted in the workplace and will require significant changes to instruction. Key perceived challenges include less critical thinking and authenticity in writing. Key perceived benefits include more efficiency and better idea generation in writing. Students will need to develop AI literacy—composed of application, authenticity, accountability, and agency—to succeed in the workplace. Recommendations are provided for instructors and administrators to ensure the benefits of AI-assisted writing can outweigh the challenges.
The classical results of the binomial and negative binomial probability distribution are generalized by means of homogeneous Discrete Time Markov Chains to series of stochastically independent random trials. These have not only two possible outcomes but two groups of them -- different kinds of successes and failures with occurrence probabilities depending on the outcome of the previous trial. This generalization allows a uniform view of occupation time, first passage time and recurrence time. Our results are consequently derived and presented in matrix form, the probabilities as well as the moments. They can be applied to all Discrete Time Markov Chains, especially in computer capacity planning, performability and economics.
In adults, testing can enhance subsequent learning by reducing interference from the tested information. Here, we examined this forward effect of testing in children. Younger and older elementary school children and adult controls studied four lists of items in anticipation of a final cumulative recall test. Following presentation of each of the first three lists, participants were immediately tested on the respective list, or the list was re-presented for additional study. Results revealed that, compared to additional study, immediate testing of Lists 1–3 enhanced memory for the subsequently studied List 4 in adults and older elementary school children, but not in younger elementary school children. The findings indicate that the forward effect of testing is a relatively late-maturing phenomenon that develops over middle childhood and is still inefficient in the early elementary school years. Together with the results of other recent studies, these findings point to a more general problem in young children in combating interference.
This paper presents a method which allows to assess the wettability of thermomechanical pulp (TMP) with thermoplastic. The method is based on the usage of laboratory sheets made of TMP and plastic granules which form drops under heat. The contact angle of the drops after re-solidification on the surface of the laboratory sheets serves as the wetting characteristic. This method enables a direct and evaluable testing of wood fiber thermoplastic combinations. The exemplary results indicate that wood species, pulping temperature and mercerization influence the wettability of TMP with thermoplastic.
Background
As clinical practice guidelines represent the most important evidence-based decision support tool, several strategies have been applied to improve their implementation into the primary health care system. This study aimed to evaluate the effect of intervention methods on the guideline adherence of primary care providers (PCPs).
Methods
The studies selected through a systematic search in Medline and Embase were categorised according to intervention schemes and outcome indicator categories. Harvest plots and forest plots were applied to integrate results.
Results
The 36 studies covered six intervention schemes, with single interventions being the most effective and distribution of materials the least. The harvest plot displayed 27 groups having no effect, 14 a moderate and 21 a strong effect on the outcome indicators in the categories of knowledge transfer, diagnostic behaviour, prescription, counselling and patient-level results. The forest plot revealed a moderate overall effect size of 0.22 [0.15, 0.29] where single interventions were more effective (0.27 [0.17, 0.38]) than multifaceted interventions (0.13 [0.06, 0.19]).
Discussion
Guideline implementation strategies are heterogeneous. Reducing the complexity of strategies and tailoring to the local conditions and PCPs’ needs may improve implementation and clinical practice.
Objective
To validate the International Classification of Functioning, Disability and Health (ICF) Generic-6 in daily routine clinical practice in Mainland China. Specific objectives were to analyze (1) interrater reliability, (2) convergent validity, (3) known group validity, and (4) predictive validity of the ICF Generic-6.
Design
Multicenter prospective cohort study.
Setting
Fifty hospitals from 20 provinces of Mainland China.
Participants
A total of 4510 patients from departments of rehabilitation, orthopedics, neurology, cardiology, pneumology, and cerebral surgery of the participating hospitals with different health conditions were included in this study.
Intervention
Not applicable.
Main Outcome Measures
The assessment was undertaken by nurses with ICF Generic-6 in combination with a numeric rating scale. Interrater reliability was evaluated with intraclass correlation coefficients (ICC). Convergent validity was evaluated with Spearman correlation coefficients between ICF Generic-6 and Medical Outcomes Short Form (SF)-12 items. Known group validity was examined by comparing discharge scores between different discharge destinations. Predictive validity was determined by using ICF Generic-6 baseline scores for estimating length of hospital stay with a loglogistic survival model with gamma shared frailty and cost of in-hospital treatment with a mixed effects generalized linear regression model of the gamma family.
Results
The interrater reliability of items and score of ICF Generic-6 was good with ICCs ranging from 0.67-0.87. ICF Generic-6 items were further correlated with respective SF-12 items. Discharge scores of patients differed significantly by discharge destination. The ICF Generic-6 admission score was a significant predictor of length of stay and treatment cost.
Conclusions
The ICF Generic-6 administered in combination with a 0-10 numeric rating scale is a reliable and valid tool for the collection of minimal information on functioning across various clinical settings.
Generating a more detailed understanding of domestic electricity demand is a major topic for energy suppliers and householders in times of climate change.
Over the years there have been many studies on consumption feedback systems to inform householders, disaggregation algorithms for Non-Intrusive-Load-Monitoring (NILM), Real-Time-Pricing (RTP) to promote supply aware behavior through monetary incentives and appliance usage prediction algorithms. While these studies are vital steps towards energy awareness, one of the most fundamental challenges has not yet been tackled: Automated detection of start and stop of usage cycles of household appliances. We argue that most research efforts in this area will benefit from a reliable segmentation method to provide accurate usage information.
We propose a SVM-based segmentation method for home appliances such as dishwashers and washing machines. The method is evaluated using manually annotated electricity measurements of five different appliances recorded over two years in multiple households.
This article introduces the Database for Estimation of Road Network Performance (DERNP) to enable wide-scale estimation of relevant Road Network Performance (RNP) factors for major German cities. The methodology behind DERNP is based on a randomized route sampling procedure that utilizes the Worldwide Harmonized Light Vehicles Test Procedure (WLTP) in combination with the tile-based HERE Maps Traffic API v7 and a digital elevation model provided by the European Union’s Earth Observation Programme Copernicus to generate a large set of independent and realistic routes throughout OpenStreetMap road networks. By evaluating these routes using the PHEMLight5 framework, a comprehensive list of RNP parameters is estimated and translated into polynomial regression models for general usage. The applicability of these estimations is demonstrated based on a case study of four major German cities. This case study considers network characteristics in terms of detours, infrastructure, traffic congestion, fuel consumption, and CO2 emissions. Our results show that DERNP and its underlying randomized route sampling methodology overcomes major limitations of previous wide-scale RNP approaches, enabling efficient, easy-to-use, and region-specific RNP comparisons.
This research presents a decision support methodology for the multi-criteria supplier selection and order allocation problem. The proposed approach supports purchasing managers in assembling mid-term supplier portfolios while making them aware of the trade-offs between the supplier sustainability, the purchasing costs, and the overall supply risk. First, we propose a multi-objective optimization model with three objectives: to maximize the supplier sustainability, to select the supplier portfolio with the lowest purchasing costs, and to minimize the supply risk. Our model extends existing mathematical approaches that follow the portfolio theory fathered by H. Markowitz by integrating the aspect ‘risk’ into the supplier selection problem. Secondly, since we allow for integer variables in our model—in contrast to the classical Markowitz portfolio theory—we use the ε-constraint method to visualize the efficient surface. The possibility of considering the non-dominated set of supplier portfolios is advantageous for purchasing managers as they gain a picture of the different optimal supplier portfolios and are able to analyze the trade-offs between the different purchasing goals before making a decision. Finally, we illustrate the applicability of the proposed methodology in a real-world supplier selection and order allocation case from the automotive industry. In the example case, we identify 1754 optimal supplier portfolios that may be assembled based on the eight available suppliers. Our analyses show that each optimal portfolio consists of two suppliers, with one specific supplier being included in each portfolio. Furthermore, four suppliers are not part of any optimal solution.
Background
The World Health Organization developed the International Classification of Functioning, Disability, and Health (ICF) in 2001 and has been in the process of implementing it in clinics since then. Current international efforts to implement ICF in rehabilitation clinics include the implementation of ICF Core Sets and the development of simple, intuitive descriptions for the ICF Generic-30 Set (also called Rehabilitation Set). The present study was designed to operationalize these ICF tools for clinical practice in Japan. This work included 1) the development of the Japanese version of the simple, intuitive descriptions for the ICF Generic-30 Set, 2) the development of a rating reference guide for Activity and Participation categories, and 3) the examination of the interrater reliability of rating Activity and Participation categories.
Methods
The Japanese version of the simple, intuitive descriptions for the ICF Generic-30 Set was developed following the process employed to develop the Chinese and Italian versions.
For further operationalization of this ICF Set in practice, a rating reference guide was developed. The development of the rating reference guide involved the following steps: 1) a trial of rating patients by several raters, 2) cognitive interviewing of the raters to analyse the thinking process involved in rating, 3) drafting of the rating reference guide, and 4) review by ICF specialists to confirm consistency with the original ICF concepts.
After the rating reference guide was developed, interrater reliability of the rating with the reference guide was determined. Interrater reliability was examined using weighted kappa statistics with linear weight.
Results
Through the pre-defined process, the Japanese version of the simple, intuitive descriptions for 30 categories of the ICF Generic-30 Set and the rating reference guides for 21 Activity and Participation categories were successfully developed. The weighted kappa statistics ranged from 0.61 to 0.85, showing substantial to excellent agreement of the ratings between raters.
Conclusions
The present study demonstrates that ICF categories can be translated into clinical practice. Collaboration between clinicians and researchers would further enhance the implementation of the ICF in Japan.
Objectives
The objective of this study was to assess the objectivity, cross-cultural validity, and convergent validity of the Vestibular Activities and Participation (VAP) questionnaire among four countries, Germany, United States, Jordan, and Saudi Arabia.
Study Design and Setting
This was a cross-sectional study conducted in four specialized outpatient dizziness clinics in Germany, United States, Jordan, and Saudi Arabia.
Results
A total of 453 participants were included in the study. The Rasch analysis revealed two separate subscales. Subscale 1 items included focusing attention, lying down, standing, bending, lifting and carrying objects, and sports. Subscale 2 items included walking long distances, climbing, running, moving around within buildings other than home, using transportation, and driving. The Pearson product–moment correlation between the Dizziness Handicap Inventory and the summary score of the VAP subscale 1 was 0.66 and was 0.64 for subscale 2.
Conclusion
Owing to its shortness and intercultural adaptability, the new two-scale version of the VAP questionnaire lends itself to clinical practice and research across countries to estimate the effect of vertigo and dizziness on activity limitation and participation restrictions. Psychometrically sound summary scores can be calculated. More extended versions of the VAP can be used for comprehensive clinical assessment where summary scores are not needed or a more detailed documentation is warranted.
Objective: To test subgroups of a community-based sample of individuals with spinal cord injury, categorized by the application of current recommendations by the International Spinal Cord Society.
Design: Community survey.
Participants: Individuals with traumatic and non-traumatic spinal cord injury residing in Switzerland.
Methods: Recommended subgroups of age, gender, years since injury, severity of injury and aetiology were tested against the following criteria: (i) distribution of participants across categories; (ii) within- and between-group variability with regard to selected outcomes of functioning and quality of life.
Results: Data-sets for 1,549 participants (28.5% women; mean age 52 ± 15 years) were available for analyses. There was a number of participants in every subgroup, yet numbers were relatively small in the group with the shortest time since injury (< 1 year; n = 23) and in the oldest age group (≥76; n = 94). A high variability in some outcomes was detected between categories. All variables were predictive for most of the endpoints investigated.
Conclusion: Recommended categorization could well fit the present sample. A minor concern was the low numbers of participants in some subgroups.
We report on an investigation of student thinking about steady-state pipe flow of an incompressible fluid. About 250 undergraduate engineering students were given a test consisting of two hydrodynamics questions, combining multiple-choice format with subsequent open-ended explanations. There is substantial evidence that students have difficulty applying and prioritizing the two basic principles of mass conservation (expressed in the continuity equation) and energy conservation (i.e., Bernoulli’s equation). When faced with questions that involve gravity, dissipative effects (“friction”), or a visible pressure drop, a considerable number of students did not invoke the continuity equation in situations where applying it is a necessary step for arriving at the correct answer. Instead, even after lecture instruction on this topic, many of the first-year students based their answers on ill-supported assumptions about local pressures. Some of them used formal arguments from a simplified Bernoulli equation (“lower pressure means higher velocity”), while others based their answer on intuitive arguments (“higher pressure leads to higher velocity”). We also found reasoning based on analogies to single-particle motion (“flow velocity decreases when flowing upwards or friction is present”). Contrary to other researchers, we did not see any evidence for the hypothesis that students think of water as a compressible fluid. Instead, students’ answers often indicate a lack of understanding of the conservation of mass or its implications for incompressible fluids or of the role that this principle plays in the context of fluid flow. In addition, our data indicate that some students have more general difficulties in describing and reasoning about technical situations, such as applying equations containing multiple variables, distinguishing spatial differences in a quantity from its changes with respect to time, or realizing the meaning of idealizations. We also present some evidence that different levels of activation of students during instruction influence the prevalence of these difficulties and discuss some implications for instruction.
This paper concerns the development and validation of Finite Element Methods (FEM) to simulate the dynamic response of a dowelled-joist timber floor. This is a solid floor comprised of timber joists connected using timber dowels with individual assemblies connected using inclined metal screws. The focus is on the structural dynamics in the low-frequency range up to 200 Hz which is the relevant range for impact sound insulation and vibration serviceability. Dowel connections between the joists that formed each assembly were modelled using either rigid or spring connectors in the FEM models. The validation against experimental modal analysis showed that both approaches were valid in terms of the eigenfrequencies, Modal Assurance Criterion (MAC) and the spatial-average velocity with point excitation. Whilst the FEM model with spring connectors had a higher number of correlated modes in the MAC analysis, this required removal of many spurious modes before predicting the response. The validated models were used to demonstrate the potential in predicting assessment parameters for vibration serviceability that are contained in EN 1995-1-1 (Eurocode 5). This predictive approach to the evaluation of vibration serviceability has the advantage in that it can be used for non-standard timber floors with non-standard boundary conditions or floor plans.
Quality issue
Responding to person's health and related needs requires the availability of health information that reflects relevant aspects of a health condition and how this health condition impacts on a person's daily life.
Initial assessment
Health information is routinely collected at different time points by diverse professionals, in different settings for various purposes with varying methods. Consequently, health information is not always comparable, posing a challenge to the regular monitoring of quality.
Choice of solution
The World Health Organization's (WHO) International Classification of Diseases (ICD), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI; under development) are complementary and serve as meaningful reference classifications for comparing data on persons’ health and related interventions across health systems.
Implementation
We developed a systematic approach of translating routinely collected information into a standardized report based on the three WHO reference classifications and the Rehab-Cycle®. Subsequently, we have demonstrated its application using five random case records of individuals attending a rehabilitation program.
Evaluation
All identified concepts were able to be linked to WHO's reference classifications. The ICF served as a tool to standardize information on rehabilitation goals and their achievement. The ICHI served as the basis for reporting the interventions that were documented in the case records, including the intervention targets that were derived from the ICF codes.
Lessons learned
Our experience shows that, it is possible to translate routinely collected information into standardized reports by linking existing narrative records with WHO's reference classifications.
The annual instructional virtual team Project X brings together professors and students from across the globe to engage in client projects. The 2020 project was challenged by the global disruption of the COVID-19 pandemic. This paper draws on a quantitative dataset from a post-project survey among 500 participating students and a qualitative narrative inquiry of personal experiences of the faculty members. The findings reveal how innovative use of a variety of collaboration and communication technologies helped students and their professors in building emotional connection and compassion to support each other in the midst of the crisis, and to accomplish the project despite connectivity disruptions. The results suggest that the role of an instructor changed to a coach and mentor, and technology was used to create a greater sense of inclusion and co-presence in student-faculty interactions. Ultimately, the paper highlights the role of technology to help the participants navigate sudden crisis affecting a global online instructional team project. The adaptive instructional teaching strategies and technologies depicted in this study offer transformative potential for future developments in higher education.
BACKGROUND: In clinical practice and research a variety of clinical data collection tools are used to collect information on people’s functioning for clinical practice and research and national health information systems. Reporting on ICF-based common metrics enables standardized documentation of functioning information in national health information systems. The objective of this methodological note on applying the ICF in rehabilitation is to demonstrate how to report functioning information collected with a data collection tool on ICF-based common metrics. We first specify the requirements for the standardized reporting of functioning information. Secondly, we introduce the methods needed for transforming functioning data to ICF-based common metrics. Finally, we provide an example.
METHODS: The requirements for standardized reporting are as follows: 1) having a common conceptual framework to enable content comparability between any health information; and 2) a measurement framework so that scores between two or more clinical data collection tools can be directly compared. The methods needed to achieve these requirements are the ICF Linking Rules and the Rasch measurement model. Using data collected incorporating the 36-item Short Form Health Survey (SF-36), the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), and the Stroke Impact Scale 3.0 (SIS 3.0), the application of the standardized reporting based on common metrics is demonstrated.
RESULTS: A subset of items from the three tools linked to common chapters of the ICF (d4 Mobility, d5 Self-care and d6 Domestic life), were entered as “super items” into the Rasch model. Good fit was achieved with no residual local dependency and a unidimensional metric. A transformation table allows for comparison between scales, and between a scale and the reporting common metric.
CONCLUSIONS: Being able to report functioning information collected with commonly used clinical data collection tools with ICF-based common metrics enables clinicians and researchers to continue using their tools while still being able to compare and aggregate the information within and across tools.
Die Reinraumtechnik zielt darauf ab, mit gerichteten partikelfreien Luftströmungen die im Reinraum stattfindenden Prozesse vor Fremdeinflüssen zu schützen. Die Spritzgussproduktion stellt die Reinraumtechnik dabei vor besondere Herausforderungen. Im Bereich des Spritzgusswerkzeugs können aufgrund des relativ hohen Temperaturunterschieds zur Reinraumluft Kamineffekte auftreten, die der Reinraumströmung entgegen wirken. Im Folgenden wird deshalb der thermische Einfluss eines Spritzgusswerkzeugs exemplarisch bei unterschiedlichen Temperaturen untersucht. Dazu werden Strömungsvisualisierungen mittels Nebel und Schlierenfotografie sowie Strömungssimulationen genutzt. Bereits relativ
niedrige Werkzeugtemperaturen von 40 °C reichten aus, um einen Kamineffekt im
Werkzeugbereich entstehen zu lassen, der die Reinraumströmung ungünstig beeinflusst. Erst durch den Einsatz einer Filter-Fan-Unit über dem kritischen Werkzeugbereich konnte die Luftströmung auch bei höheren Werkzeugtemperaturen kontrolliert werden.
We describe physically based analytical models for n‐channel amorphous silicon thin film transistors and for n‐ and p‐channel polysilicon thin film transistors. The models cover all regimes of transistor operation: leakage, subthreshold, above‐threshold conduction, and the kink regime in polysilicon thin film transistors. The models contain a minimum number of parameters which are easily extracted and can be readily related to the structural and material properties of the thin film transistors. The models have been verified for a large number of devices to scale properly with device geometry.
Considering climate change, recent political debates often focus on measures to reduce CO2 emissions. One key component is the reduction of emissions produced by motorized vehicles. Since the amount of emission directly correlates to the velocity of a vehicle via energy consumption factors, a general speed limit is often proposed. This article presents a methodology to combine openly available topology data of road networks from OpenStreetMap (OSM) with pay-per-use API traffic data from TomTom to evaluate such measures transparently by analyzing historical real-world circumstances. From our exemplary case study of the German motorway network, we derive that most parts of the motorway network on average do not reach their maximum allowed speed throughout the day due to traffic, construction sites and general road utilization by network participants. Nonetheless our findings prove that the introduction of a speed limit of 120 km per hour on the German autobahn would restrict 50.74% of network flow kilometers for a CO2 reduction of 7.43% compared to the unrestricted state.
Recently, the SQL standardization Committee published a specification for support of the concept called Row Pattern Recognition in SQL. That way, the focus for the members of the Committee turned back to a kernel issue of the language, after standardizing the storage and manipulation of data formats, such as XML and JSON. In this paper we discuss the specified features using several examples and show to what extent different relational database systems as well as Data Analytics tools have integrated them. At the end of the paper, we describe the main inaccuracies of the proposal and the ways how to solve them. From our point of view, the following should be modified in one of the future proposals of the standard in relation to this concept: (a) Naming of several pattern navigation operations is inappropriate and should be changed; (b) The concept of implicit definition for row pattern variables in DEFINE should be changed to explicit; (c) The set of existing functions should be extended.
We employed the well-established Horton-Strahler, hierarchical, stream-order (ω) scheme to investigate scaling of nutrient loads (P and N) from ~845 wastewater treatment plants (WWTPs) distributed along the river network in urbanized Weser River, the largest national basin in Germany (~46K km2; ~8.4 million population). We estimated hydrologic and water quality impacts at the reach- and basin-scales, at two steady river discharge conditions (median flow, QR50; low-flow, QR90). Of the five WWTPs class-sizes (1 ≤ k ≤ 5), ~68% discharge to small low-order streams (ω < 3). We found large variations in capacity to dilute WWTP nutrient loads because of variability in (1) treated wastewater discharge (QU) within and among different class-sizes, and (2) river discharge (QR) within low-order streams (ω < 3) resulting from differences in drainage areas. For QR50, reach-scale water quality impairment assessed by nutrient concentration was likely at 136 (~16%) locations for P and 15 locations (~2%) for N. About 90% of these locations were lower-order streams (ω < 3). At QR50 and only with dilution, basin-scale cumulative nutrient loads from multiple upstream WWTPs increase impaired locations to 266 (~32% of total) for P. Considering in-stream uptake decreased P-impaired streams to 225 (~27%), suggesting the dominant role of dilution in the Weser River basin. Role of in-stream uptake diminished along the flow paths, while dilution in larger streams (4 ≤ ω ≤ 7) minimizes the impact of WWTP loads. Under QR90 conditions [(QR50/QR90) ~ 2.5], water quality impaired locations will likely double for the basin-scale analyses. Long-term water quality data suggested that diffuse sources are the primary contributors for water quality impairments in large streams. Our data-modeling synthesis approach is transferable to other urbanized river basins and extends understanding of point source impacts on water quality across spatial scales.
Single equivalent approximation for multiple contact structure-borne sound sources in buildings
(2012)
The work reported in the paper addresses structure-borne sound transmission between multiple contact sources and non homogeneous plate receiver structures. This study concentrates on a practical method of predicting the installed structure-borne sound power from mechanical installations in lightweight buildings. The structure-borne sound power is a function of source activity, source mobility and receiver mobility, and all three quantities must be known to some degree. It is rarely practical to consider all transmission paths individually and in detail, and therefore, reduced data sets and less computationally demanding procedures are proposed. The paper examines how source data can be used to assemble single equivalent values, using spatial averages and magnitudes. Single equivalent values of receiver mobility also are proposed for lightweight, point-connected ribbed plate constructions. In case studies, the single equivalent values are used for predicting the structure-borne power in the installed condition.
Objective: Cohort studies are an appropriate method for the collection of population-based longitudinal data to track people's health and functioning over time. However, describing and understanding functioning in its complexity with all its determinants is one of the biggest challenges faced by clinicians and researchers.
Design: This paper focuses on the development of a cohort study on functioning, outlining the relevant steps and related methods, and illustrating these with reference to the Swiss Spinal Cord Injury Cohort Study (SwiSCI).
Methods and results: In setting up a cohort study the initial step is to specify which variables are to be included, i.e. what to assess. The International Classification of Functioning, Disability and Health (ICF) is valuable in this process. The second step is to identify how to assess the specified ICF categories. Existing instruments and assessments can then be linked to the ICF.
Conclusion: The methods outlined here enable the development of a cohort study to be based on a comprehensive perspective of health, operationalized through functioning as conceptualized and classified in the ICF, yet to remain efficient and feasible to administer.
The aim of this secondary analysis is to explicate taken-for-granted practices in the health care system in which the life stories of six women with rheumatoid arthritis (RA) are embedded. A secondary analysis of life stories of six women with RA, which were assigned to a typology named "rheumatoid arthritis as a source for new challenges" (STAMM et al., 2008) in the primary narrative study, was conducted. The theoretical framework applied for the analysis was informed by feminist standpoint theory and feminist philosophy. In the present analysis, each of the women challenged established health care practices and the cognitive authority of medicine at a certain point in their life story reflections. Becoming more conscious about health care practices enabled the women to acknowledge their own knowledge and to make choices about their health. The findings challenge health care providers to engage in critical reflexivity to become conscious about and to transform taken-for-granted practices as embedded in larger systems and to create health care environments that enable dialogue between clients and health care providers.
We describe a new physics based, analytical DC model accounting for short channel effects for hydrogenated amorphous silicon (a-Si:H) thin film transistors (TFT's). This model is based on the long channel device model. Two important short-channel phenomena, self-heating and kink effects, are analyzed in detail. For the self-heating effect, a thermal kinetic analysis is carried out and a physical model and an equivalent circuit are used to estimate the thermal resistance of the device. In deriving the analytical model for self-heating effect, a first order approximation and self-consistency are used to give an iteration-free model accurate for a temperature rise of up to 100/spl deg/C. In the modeling of the kink effects, a semi-empirical approach is used based on the physics involved. The combined model accurately reproduces the DC characteristics of a-Si:H TFT's with a gate length of the 4 /spl mu/m. Predictions for a-Si:H TFT's scaled down to 1 /spl mu/m are also provided. The model is suitable for use in device and circuit simulators.
1. Understanding and explaining the structure of communities in response to environmental gradients is a central goal in ecology. Trait‐based approaches are promising but yet rarely applied to understand community dynamics in response to changing environmental conditions.
2. Here, we investigate seasonal succession patterns of functional traits in phytoplankton communities and how nutrient reductions (oligotrophication) alter these patterns. We used phytoplankton data from 40 years of observation from the Rappbode Reservoir (Germany), which underwent a strong shift in trophic conditions, and translated taxonomic composition into functional traits by assigning trait values compiled from the literature.
3. All studied traits (morphological, behavioural and physiological traits) responded to changing environmental conditions and showed consistent, reoccurring seasonal developments. The seasonal succession of phytoplankton communities was shaped by a trade‐off between small‐celled, fast‐growing species that are able to rapidly incorporate existing resources (r ‐strategists) and large‐celled species with more complex and efficient mechanisms to exploit scarce mineral nutrients or acquire previously unexploited nutrient pools (k ‐strategists). In summer, when nutrients were scarce, the k ‐strategy was prevailing (important traits: phosphate affinity, nitrogen fixation, motility and mixotrophy). During the rest of the year, nutrients and turbulence were high and r ‐strategists dominated (important traits: maximum growth rate and light affinity).
4. A comparison between eutrophic and oligotrophic years revealed that the main features of functional trait succession were largely preserved, but intra‐annual fluctuations from spring to summer were stronger during eutrophic years. Nutrient reductions mainly affected functional traits and biomass in spring, while in summer the functional community composition changed little.
5. Synthesis. This study provides for the first time a quantitatively supported functional template for trait‐based succession patterns in lakes under different nutrient conditions. By translating taxonomic composition into trait information, we demonstrate that the quantification of functional characteristics enables ecological interpretation of observed community dynamics and provides not only a testable template but also a powerful tool towards a more mechanistic understanding. The quantification of functional traits further improves the predictability of community shifts in response to changing environmental conditions and thus opens new perspectives for predictive limnology using lake ecosystem models.
Objective: Functioning is an important outcome for rheumatoid arthritis (RA) management. Heterogeneity of respective patient-reported outcome measures (PROMs) challenges direct comparisons between their results. This study aimed to standardize reporting of such PROMs measuring functioning in RA to facilitate comparability.
Methods: Common Item Non-Equivalent Groups Design (NEAT) with the Health Assessment Questionnaire (HAQ) as a common scale across data sets from various countries (incl. UK, Turkey and Germany) to establish a common metric. Other PROMs included are the Physical Function items of the Multidimensional Health Assessment Questionnaire (MDHAQ), Disabilities of Arm, Shoulder and Hand (DASH), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), World Health Organization Disability Assessment Schedule Version 2.0 (WHODAS 2.0), and four short forms (20, 10, 6, and 4 physical function items) from the Patient-Reported Outcomes Measurement Information System (PROMIS). As the HAQ includes mobility, self-care and domestic life items, this study focuses on these three domains. PROMs were described using Standard Error of Measurement (SEM) and Smallest Detectable Difference (SDD). Rasch Measurement model was used to create the common metric.
Results: Range of SEM is 0.2 (MDHAQ) to 7.4 (SF36-PF). SDD revealed a range from 9.7 % (WOMAC-RAT) to 33.5 % (WHODAS-PF). PROMs co-calibration revealed fit to the Rasch measurement model. A transformation table was developed to allow exchange between PROMs scores.
Discussion: Scores between the Daily Activity PROMs commonly used in RA can now be compared. Factors such as SEM and SDD help determine choice of PROM in clinical practice and research.
Keywords: Common metric; DASH; Disability and Health; HAQ; International Classification of Functioning; Multidimensional HAQ; PROMIS-SF; Rasch measurement model; Scale banking; WHODAS 2.0; WOMAC.
Objective: Functioning is an important outcome for rheumatoid arthritis (RA) management. Heterogeneity of respective patient-reported outcome measures (PROMs) challenges direct comparisons between their results. This study aimed to standardize reporting of such PROMs measuring functioning in RA to facilitate comparability.
Methods: Common Item Non-Equivalent Groups Design (NEAT) with the Health Assessment Questionnaire (HAQ) as a common scale across data sets from various countries (incl. UK, Turkey and Germany) to establish a common metric. Other PROMs included are the Physical Function items of the Multidimensional Health Assessment Questionnaire (MDHAQ), Disabilities of Arm, Shoulder and Hand (DASH), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), World Health Organization Disability Assessment Schedule Version 2.0 (WHODAS 2.0), and four short forms (20, 10, 6, and 4 physical function items) from the Patient-Reported Outcomes Measurement Information System (PROMIS). As the HAQ includes mobility, self-care and domestic life items, this study focuses on these three domains. PROMs were described using Standard Error of Measurement (SEM) and Smallest Detectable Difference (SDD). Rasch Measurement model was used to create the common metric.
Results: Range of SEM is 0.2 (MDHAQ) to 7.4 (SF36-PF). SDD revealed a range from 9.7 % (WOMAC-RAT) to 33.5 % (WHODAS-PF). PROMs co-calibration revealed fit to the Rasch measurement model. A transformation table was developed to allow exchange between PROMs scores.
Discussion: Scores between the Daily Activity PROMs commonly used in RA can now be compared. Factors such as SEM and SDD help determine choice of PROM in clinical practice and research.
Objective
Functioning is an important outcome for the management of rheumatoid arthritis (RA). Heterogeneity of respective patient-reported outcome measures (PROMs) challenges direct comparisons between their results. This study aimed to standardize reporting of such PROMs measuring functioning in RA to facilitate comparability.
Methods
Common-item nonequivalent group design with the Health Assessment Questionnaire (HAQ) as a common scale across data sets from various countries (including the UK, Turkey, and Germany) to establish a common metric was used. Other PROMs included are the physical function items of the Multidimensional HAQ (MDHAQ), the Disabilities of the Arm, Shoulder, and Hand questionnaire, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the World Health Organization Disability Assessment Schedule II (WHODAS II), the Medical Outcomes Study Short Form 36 (SF-36) health survey, and 4 short forms (20, 10, 6, and 4 physical function items) from the Patient-Reported Outcomes Measurement Information System. As the HAQ includes mobility, self-care, and domestic life items, this study focuses on these 3 domains. PROMs were described using standard error of measurement (SEM) and smallest detectable difference (SDD). A Rasch measurement model was used to create the common metric.
Results
The range of the SEM was 0.2 (MDHAQ) to 7.4 (SF-36 health survey physical functioning domain). The SDD revealed a range from 9.7% (WOMAC rating scale) to 33.5% (WHODAS physical functioning domain). PROMs co-calibration revealed fit to the Rasch measurement model. A transformation table was developed to allow exchange between PROM scores.
Conclusion
Scores between the daily activity PROMs commonly used in RA can now be compared. Factors such as SEM and SDD help to determine the choice of a PROM in clinical practice and research.
Oncologic patients are regarded as the population most at risk of developing a severe course of COVID-19 due to the fact that malignant diseases and chemotherapy often weaken the immune system. In the face of the ongoing SARS-CoV-2 pandemic, how particular patients deal with this infection remains an important question. In the period between the 15 and 26 April 2020, a total of 1227 patients were tested in one of seven oncologic outpatient clinics for SARS-CoV-2, regardless of symptoms, employing RT-qPCR. Of 1227 patients, 78 (6.4%) were tested positive of SARS-CoV-2. Only one of the patients who tested positive developed a severe form of COVID-19 with pneumonia (CURB-65 score of 2), and two patients showed mild symptoms. Fourteen of 75 asymptomatic but positively tested patients received chemotherapy or chemo-immunotherapy according to their regular therapy algorithm (±4 weeks of SARS-CoV-2 test), and 48 of 78 (61.5%) positive-tested patients received glucocorticoids as co-medication. None of the asymptomatic infected patients showed unexpected complications due to the SARS-CoV-2 infection during the cancer treatment. These data clearly contrast the view that patients with an oncologic disease are particularly vulnerable to SARS-CoV-2 and suggest that compromising therapies could be continued or started despite the ongoing pandemic. Moreover the relatively low appearance of symptoms due to COVID-19 among patients on chemotherapy and other immunosuppressive co-medication like glucocorticoids indicate that suppressing the response capacity of the immune system reduces disease severity.