The inter-rater reliability and validity of self-report of risk factors for cumulative trauma disorders within the hand therapist population - a pilot study

OBJECTIVES: This study examined the validity of hand therapists' self-report of cumulative trauma disorder (CTD) risk factors by comparing the self-report to observations performed by the raters. Inter-rater reliability was also analyzed between the raters who observed the hand therapists. STUDY DESIGN: Two raters simultaneously observed each hand therapist during a splinting task at a therapy facility. Following this task, the raters and the hand therapist independently completed an identical assessment tool. Thirteen therapists were observed and a total of six raters observed the therapists. Responses from two categories of the self-assessment, "posture" and "mechanical stress", were compared. Percentage of agreement was calculated by dividing the number of like responses by the total number of possible responses for each category. RESULTS: Overall inter-rater reliability was 72%, significantly above the accepted minimum standard of 60-70%, and validity was 39%, significantly below the accepted minimum. CONCLUSION: The high percentage of inter-rater reliability established consistency and accuracy among the raters in their observations. However, the low percentage of validity should prompt hand therapists to investigate the accuracy of a patient's self-report before relying on it for treatment.     

Social Support: An Important Factor for Treatment Adherence and Health-related Quality of Life of Patients with End-stage Renal Disease

ABSTRACT

End-stage Renal Disease (ESRD) or chronic kidney disease constitutes a serious public health problem in the United States. The purpose of this study is to examine the causal relationship of perceived social support with treatment adherence and health-related quality of life (HRQOL) of ESRD patients. The study utilized a non-experimental research design and Structural Equation Modeling (SEM) to analyze the data collected from a sample of 413 ESRD patients. The findings of the study supported a statistically significant relationship between perceived social support and HRQOL as well as between perceived social support and treatment adherence. Formulating appropriately targeted interventions to improve social support may help in enhancing the HRQOL and treatment adherence, where both those factors were empirically supported to be related to mortality and hospitalizations in ESRD patients. This study helps to enhance the body of knowledge relating to HRQOL of ESRD patients, and provided foundation for interventions in improving treatment adherence and the HRQOL. Future research may focus on the complexities associated with the HRQOL and treatment adherence in ESRD patients, with emphasis on demographic characteristics and its relationship with social support.     

Isolation as a Form of Marital Violence: The South Asian Immigrant Experience

Isolation is an important factor in marital abuse among South Asian immigrant families. It lends itself to the invisibility immigrant women experience based on their ethno-gender status in the United States. Drawn from unstructured interviews with abused South Asian immigrant women, three different levels of isolation are explained. The first level involves the quality of a woman's relationship with her spouse; the second is related to the frequency and quality of social interaction with friends, relatives, and coworkers; and the third is explained in terms of the level of access to and participation in the ethnic community and other formal institutions.     

The Challenges Facing Children Reunified With Their Families From an Orphanage in Ghana

This qualitative case study explores the challenges facing children reunified with their families from an orphanage in Ghana. Eight children, their biological families, and two social workers participated in semi‐structured interviews and shared their experiences and views. The study found that challenges facing the children include educational issues, poor living conditions and social isolation within their communities. The factors causing the challenges included the financial difficulties facing caregivers due to the lack of support, limited preparation for the children and their families for the reunification and the children's limited participation in the decisions concerning such reunification.     

Bee community response to local and landscape factors along an urban-rural gradient

Urban Ecosystems - Over a third of the world’s crops require insect pollination, and reliance on pollination services for food continues to rise as human populations increase. Furthermore, as...     

Chance Constrained Programming Approach to Empirical Analyses of Mutual Fund Investment Strategies*

Chance constrained programming concepts are used to formalize risk and return relations which are then modeled for use in an empirical study of mutual fund behavior during the period 1984 through 1988. The publicly announced strategies of individual funds are used to form ex ante risk classifications which are employed in examining ex post performance. Negative relations between risk and return held in every year of the period studied. The bearing of these negative risk-return findings for the Bowman paradox, as studied in the strategic management literature, are thus extended from the industrial firms studied by Bowman (and others) and shown to be present even in these investment oriented mutual funds in each of the years of the great bull market from 1984 through 1988. Finally, our use of chance constrained programming enables us to separate risk from return behavior and evaluate their relative strengths as sources of these negative relations, which are found to be more in the returns than the risks.     

Voting power: an information theory approach

In recent years, there has been increasing awareness of the importance of formal measures of voting power and of the relevance of such measures to real life political issues. Nevertheless, existing measures have been criticized, especially because of their dependence on the unrealistic assumption that different coalitions have equal probabilities. In this paper we show that the classical problem of measuring voting power can be naturally embedded in information theory. This perspective on voting power allows us to extend measures of voting power to cases in which there are dependencies among voters. In doing so, we distinguish between two different notions of a given voter’s power—‘control’ and ‘informativeness’—corresponding, respectively, to the average uncertainty regarding the outcome of a vote that remains when all others have voted and the average uncertainty that is eliminated when only the given voter has voted. This distinction settles a number of well-known paradoxes and enables the study of voting power on the basis of actual political behavior at all levels.     

Subgroup analyses in cost‐effectiveness analyses to support health technology assessments

‘Success’ in drug development is bringing to patients a new medicine that has an acceptable benefit–risk profile and that is also cost‐effective. Cost‐effectiveness means that the incremental clinical benefit is deemed worth paying for by a healthcare system, and it has an important role in enabling manufacturers to obtain new medicines to patients as soon as possible following regulatory approval. Subgroup analyses are increasingly being utilised by decision‐makers in the determination of the cost‐effectiveness of new medicines when making recommendations. This paper highlights the statistical considerations when using subgroup analyses to support cost‐effectiveness for a health technology assessment. The key principles recommended for subgroup analyses supporting clinical effectiveness published by Paget et al. are evaluated with respect to subgroup analyses supporting cost‐effectiveness. A health technology assessment case study is included to highlight the importance of subgroup analyses when incorporated into cost‐effectiveness analyses. In summary, we recommend planning subgroup analyses for cost‐effectiveness analyses early in the drug development process and adhering to good statistical principles when using subgroup analyses in this context. In particular, we consider it important to provide transparency in how subgroups are defined, be able to demonstrate the robustness of the subgroup results and be able to quantify the uncertainty in the subgroup analyses of cost‐effectiveness. Copyright © 2014 John Wiley & Sons, Ltd.     

"消经"日记《正大光明》与普洱马阿洪

普洱马阿洪,名寿清,中国伊斯兰教陕西学派云南籍著名阿洪。在清朝同治年间参加陕西回民起义期间,用“消经”撰写了一本“随军日记”———《正大光明》,简要记录和回忆了那时回民起义的起因、经过、“受抚”谈判的情况、“善后”的安置、义军的活动、开支账目、作者的感想、回民被左宗棠大肆屠杀以及义军悲壮逃难的历史等。本文以普洱马阿洪一生的历史和陕甘回民起义为轴线,以历史事实为基础,根据民间调查、口头传述和文本资料,对普洱马阿洪的生平、著述略作介绍,以期引起更多读者和研究者的关注。